Doctors have begun seeing a sharp rise in the number of premature births in some areas of Ukraine, as the conflict enters its second month.
Prenatal clinics in both Kharkiv and Lviv have told the BBC that the rate of preterm births has doubled or tripled in the past few weeks, as a result of stress and medical issues linked to the war.
Polina was born in Kharkiv’s regional perinatal clinic weighing just 630g (1.4lbs). The average weight for a full-term baby girl is five times that.
Viktoria, 800g (1.7lbs), was born in Lviv’s perinatal hospital in early March along with her twin sister Veronika, after her mother fled from Kyiv. She’s just passed her first kilogram.
These two little girls, one a refugee, the other struggling for life in a city bombarded by Russian forces, reveal the gruelling choices facing mothers and doctors here.
Iryna Kondratova, the medical director in charge of Polina’s care, told me premature births had jumped to three times their normal rate at her Kharkiv clinic, and now account for 50% of all deliveries.
“Infections, lack of medical help, bad nutrition: war creates a risk of premature birth,” Dr Kondratova says. “Our premature birth rate was already high, because we had a lot of patients from Donetsk and Luhansk.
“In conflict zones, women spend a lot of time in crowded basements, where infections are active. And it’s also harder for women to reach medical help if they need it.”
While the percentage of premature births in her clinic has risen, Iryna says the total number of her patients has shrunk, as women flee the fighting in Kharkiv.
Across the country in Lviv, away from the front lines, they’ve seen an influx.
Viktoria’s mother, Iryna Zelena, fled to Lviv from Kyiv just before she gave birth. “We left because of mass shelling,” she says. “We’d been in a shelter all that time.”
She believes the stress of spending the first days of the war in a bunker contributed to her delivering Viktoria – and her twin sister Veronika – more than seven weeks early.
Down the corridor, in the pre-natal unit, Olga Bogadiza is six months pregnant and also expecting twins. She fled from Kyiv too, desperate to find somewhere safe to have her babies, away from the shelling and curfews.
It took three days to reach Lviv, she says, and during all that time she couldn’t eat or drink from fear.
“Have you heard of the saying, ‘animal fear’?” she asks me. “It’s not like the fear of pain, or giving birth – it’s fear that makes your skin hurt. You’re so scared you can’t eat or think. When I arrived in Lviv, the doctor said I had lost 3.5kg (7.7lbs), and that my babies’ lives were in danger because their development had stopped.”