Ukraine Symposium – Russia’s Reproductive Violence in Ukraine: Hidden Atrocities of War

Russia’s full-scale invasion of Ukraine has inflicted enormous harm on the civilian population, exposing many women, children, and in some cases men, to abuses including sexual and reproductive violence. Although global media often highlight missile strikes and large-scale troop actions, violations targeting personal autonomy and maternal health are equally devastating. Maternity hospitals have been bombed, and survivor accounts detail reproductive abuse like Russian soldiers torturing detainees’ reproductive organs and forcing women in occupied territories to accept Russian documents to access critical medical care.

These reproductive crimes must be recognized as severe breaches of the law of armed conflict. This post examines how such acts fit into a broader pattern of atrocities, and what measures are necessary to ensure justice and accountability.

Defining Reproductive Violence

Reproductive violence involves more than direct assaults on sexual autonomy. It also includes deliberate acts intended to impede or harm the capacity to conceive, carry a pregnancy, or safely give birth. The Rome Statute of the International Criminal Court (ICC) enumerates two acts of reproductive violence: forced pregnancy and enforced sterilization, which may amount to war crimes and crimes against humanity when committed as part of a widespread or systematic attack on the civilian population. Such acts can also intersect with torture or the destruction of health services in violation of customary international humanitarian law (IHL) and treaty-based obligations to protect civilians and medical personnel.

Recent guidance from the ICC Office of the Prosecutor’s 2023 Policy on Gender Persecution and Gender-Based Crimes underscores the broader harms of reproductive violence. Besides physical and psychological harm, these violations may erode social stability and threaten the survival of communities. In Ukraine, evidence suggests that targeting reproductive health facilities is part of a deeper strategy to damage the country’s demographic future, undermining foundational IHL principles that women and children should receive special protection in armed conflict.

Acts of Reproductive Violence in Ukraine Since 2022

Three years since Russia’s February 2022 full-scale invasion, deliberate attacks on healthcare infrastructure have become distressingly common. One of the most notable early events was the strike on a Mariupol maternity and children’s hospital in March 2022, which left pregnant women and infants in the rubble. In July 2024, a wave of missile attacks struck healthcare and civilian infrastructure such as Okhmatdyt children’s hospital, killing 27 civilians, four of which were children. The World Health Organization (WHO) has verified 1,878 attacks affecting healthcare services since February 2022. Ukrainian prosecutors have condemned such strikes as potential war crimes under the Geneva Conventions and Additional Protocol I, arguing that Russia deliberately targeted healthcare sites rather than accidentally damaged them collaterally. By targeting civilian objects rather than legitimate military objectives, these attacks flout the principle of distinction, a core tenet of IHL.

Additional reports from the WHO and other monitors describe large-scale attacks on hospitals and clinics, including shelling that damaged or leveled entire facilities. The repeated bombing of healthcare infrastructure in areas like Odesa and Kharkiv has driven pregnant women to underground shelters or forced them to flee to less affected regions of Ukraine. That displacement can lead to inadequate prenatal care as overworked local health providers struggle with medicine shortages and a lack of specialized obstetric equipment. Officials in western Ukrainian cities like Lviv acknowledge that while they have tried to accommodate patients arriving from occupied or embattled zones, they cannot always handle the surge in births amid inadequate power, staff shortages, and frequent electricity cuts.

The scope of reproductive violence also includes acts of torture targeting fertility and sexual function. Certain detainees, particularly prisoners of war, have described being subjected to electric shocks on their genitals, attempted rape, castration, and forced nudity well beyond any purported security check. Some women who reported acts of rape say they were injected with chemicals or had objects inserted into their bodies to inflict permanent harm on their reproductive organs, forcibly sterilizing them. Multiple survivors recounted that Russian troops or prison personnel told them these abuses were meant to prevent the birth of more “Nazi[s],” exposing a possible genocidal intent by interfering with the capacity of Ukrainians to have children.

A parallel concern centers on the forced transfer of children from occupied regions to Russia. Numerous reports document systematic Russian networks to engineer the forcible removal Ukrainian children from their families and communities. According to Ukrainian officials, Russian has forcefully deported over 20,000 Ukrainian children who are then labeled orphans, despite having living parents, and relocated into Russia for adoption. This practice may run afoul of Article 6 of the Rome Statute, which includes in the definition of genocide forcibly transferring children of one national group to another group. In sum, these acts have far-reaching implications for Ukraine’s demographic future, indicating that harm to reproductive autonomy is more than a by-product of the war: it is part of a strategy.

Why These Violations Matter

Reproductive violence inflicts harm that extends well beyond individual victims. Grave violations of obstetric care can lead to chronic physical injuries and psychological trauma. Women subjected to sexual violence in war zones may confront unwanted pregnancies and a shortage of prenatal services, compounded by stigma. Prolonged conflict often undermines traditional family and community support structures, leaving survivors isolated. If these abuses are not properly investigated or acknowledged, entire generations may carry the burden of unresolved trauma.

Under IHL, pregnant women and newborns merit additional safeguards. Article 14 of the Third Geneva Convention and Article 76 of Additional Protocol I mandate humane treatment and specialized medical care for pregnant detainees and new mothers. Systematic attacks on maternity clinics and the denial of healthcare to pregnant civilians violate these norms, reflecting a willingness to sideline fundamental humanitarian principles.

Several aspects of Russia’s military conduct in Ukraine could meet the legal thresholds for atrocity crimes under international law. Bombing hospitals, especially maternity wards, constitutes a grave breach of the Fourth Geneva Convention (art. 147) and may be prosecuted as a war crime under Article 8 of the Rome Statute if shown to be intentional rather than accidental.

The forced deportation or adoption of Ukrainian children inside Russia could amount to genocide under Article 6(e) of the Rome Statute if the intent is to erase the national identity of these minors. Reports that detainees have been told they “should not be able to father children” after Russian forces beat and tasered their genitals support the genocidal intent to destroy, at least in part, the Ukrainian national group.

Undermining Maternal Health on a National Scale

Ukraine’s already grim pre-war demographic outlook has worsened dramatically. Data shows a sustained drop in monthly births from around 23,000 to roughly 16,000. Medical professionals in frontline towns report higher rates of complicated deliveries, miscarriages, premature births, and maternal mortality, attributing them to chronic stress, inadequate prenatal monitoring, and malnutrition. Women remaining near active fighting experience frequent power cuts, making it difficult to store blood and medicine; local teams may rely on mobile incubators or limited telemedicine, which are precarious solutions when critical energy facilities are repeatedly hit.

The forced displacement of healthcare professionals compounds these problems. In heavily shelled cities, specialists often flee for safety, leaving overwhelmed colleagues behind. In Odesa, for example, doctors note a rise in pregnancy complications, partly tied to missile attacks on local power and water grids. Such instability undermines obstetric and pediatric care.

Even after childbirth, challenges abound. New mothers must care for infants in areas where utilities are sporadic and quality pediatric care is limited. Occupied territories face shortages of baby formula, antibiotics, and safe drinking water. Distribution of humanitarian aid is fraught in contested regions, transforming an already fragile healthcare system into a crisis zone for maternal and infant care.

Foreign Aid Freezes: Exacerbating the Crisis

Experts worry that foreign aid cuts could erode efforts to collect evidence of Russian atrocities since February 2022. More than 140,000 war crimes cases have been opened by Ukraine’s Prosecutor General’s Office, which insists that thorough documentation is critical for future accountability, particularly since Russia denies wrongdoing. Several legal experts have already stopped working. The Ukrainian Helsinki Human Rights Union lost nearly three-quarters of its annual budget, forcing it to seek alternate funds to continue war-crime monitoring. The Atrocity Crimes Advisory Group for Ukraine, co-led by the United States, the European Union, and the United Kingdom, has also been impacted, as its U.S.-funded component helped deploy experts to support Ukrainian prosecutors.

These freezes threaten Ukraine’s long-term judicial capacity and broader legal reforms. Projects modernizing case-management systems, which are vital for Ukraine’s bid to join the EU, are stalled. Leonid Sapelnikov, Deputy Head of Ukraine’s State Judicial Administration, warns that such delays undermine broader legal reforms reliant on international technical and financial support. While some officials express confidence in Ukraine’s newly strengthened legal framework, most experts stress the need for continued assistance to handle the volume of war-crime allegations.

The Path Toward Accountability

Ensuring justice for reproductive violence demands a coordinated approach that includes domestic courts, international tribunals, and humanitarian organizations. Ukraine’s Prosecutor General’s Office has prioritized gender-based violence, backed by various partners that provide training and forensic expertise. In 2022, the ICC launched an investigation into alleged war crimes in Ukraine, yet building a case for crimes like forced pregnancy, enforced sterilization, or genocide requires extensive evidence. Reliable witness testimonies, medical documentation, and robust chain-of-custody protocols for digital evidence are all crucial.

Investigators must handle survivors’ accounts with sensitivity. Sexual and reproductive violence survivors often face societal stigma. Without access to mental health support and safe reporting channels, they may hesitate to testify or share medical records. Non-governmental organizations and civil society groups are working to create trauma-informed interview techniques and survivor-centered safe spaces, although funding constraints threaten these initiatives.

At the national level, legal reforms could further solidify the framework for prosecuting reproductive violence. Draft legislation now under consideration in Ukraine’s parliament proposes a clearer definition of conflict-related sexual violence and more consistent victim assistance. Greater participation of women at all levels of the justice system, including investigators, prosecutors, and judges, may also bring a deeper understanding of victims’ needs and encourage more survivors to come forward.

Conclusion

Russia’s war in Ukraine is characterized not only by devastated cities and large-scale displacement but also by a systematic assault on reproductive autonomy. Bombed maternity wards, castration threats in detention, and forced transfers of children reveal an intent to fracture Ukrainian communities at their roots. Such acts likely meet the criteria for war crimes or crimes against humanity, with some evidence pointing toward genocidal intent.

Delivering accountability demands sustained cooperation from civil society, Ukrainian authorities, and international partners. Yet this effort has become more precarious as certain foreign-funded programs essential to documenting atrocities and strengthening Ukrainian legal institutions face sudden financial freezes. If ongoing investigations stall, perpetrators may go unpunished, and survivors may lose hope in a just resolution.

Ultimately, holding individuals to account for reproductive violence signifies more than punitive justice, it reaffirms that the law of armed conflict extends robust protection to women and children. For Ukraine, making this principle a reality is essential to rebuilding a society that respects human dignity and ensures that families can plan for the future free from terror and obstruction. When resources are adequately sustained and legal frameworks fully enforced, reproductive violence can be recognized, prosecuted, and prevented, offering a measure of redress and a blueprint for postwar reconciliation.

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Winona Xu is a Research Fellow at the University of California, Los Angeles (UCLA).

The views expressed are those of the author, and do not necessarily reflect the official position of the United States Military Academy, Department of the Army, or Department of Defense. 

Articles of War is a forum for professionals to share opinions and cultivate ideas. Articles of War does not screen articles to fit a particular editorial agenda, nor endorse or advocate material that is published. Authorship does not indicate affiliation with Articles of War, the Lieber Institute, or the United States Military Academy West Point.

Photo credit: State Emergency Service of Ukraine