“The doctors were pessimistic. They were convinced that my child would not survive,” said 28-year-old single mother Marta Asryan. “I was weak, bleeding – but I insisted that my son was going to be born no matter what.”

Ms. Asryan had feared for her pregnancy even before she was forced to flee her home in Karabakh, the region at the heart of a decades-long territorial conflict between Armenia and Azerbaijan.

But her anxiety escalated at the border crossing into Armenia, where the stress of displacement triggered labor pangs. She only hoped she would not have to give birth on the road.

More than 100,000 people have crossed into Armenia since hostilities reignited on September 19. Among the refugees, more than 2,000 are estimated to be pregnant and hundreds are expected to give birth in the coming months.

Displacement makes pregnant women more vulnerable to violence and health issues. To combat these risks, UNFPA, the United Nations sexual and reproductive health agency, is on the ground in Armenia distributing essential medicine and supplies and training health workers on the provision of sexual and reproductive health care and support for survivors.

“We are making sure pregnant women have everything they need in the health facilities when they arrive,” UNFPA humanitarian coordinator Emmanuel Roussier told UN news in October.

Struggling with health, then forced from home

Ms. Asryan became pregnant several months after a blockade went up against Karabakh in December 2022, restricting access to essentials like food, fuel and medicine. In its aftermath, UN experts warned pregnant women faced “significant risk”, and in August 2023 a majority of local residents reported rationing meals.

“There was no proper food,” Ms. Asryan said. “I frequently sought medical care; they would have me hospitalized for a couple of days and treat me, and then the same thing all over again.”

The only corridor out of Karabakh into Armenia at the time was closed under the blockade. It reopened, running one-way, after the current crisis to facilitate transport out of Karabakh.

It was on this road that Ms. Asryan feared she would go into labor; instead, the passage led her to Goris, Armenia, where she was able to access health care and take an ambulance to a UNFPA-supported maternity hospital in Vardenis.

She gave birth in Vardenis on October 10, 2023, becoming one of 88 women refugees to have delivered in Armenia as of the end of October.

Her baby was born about one month early, mirroring a trend that Mr. Roussier said affected many pregnant refugees that went into labour in Armenia after fleeing the flare-up in conflict in Karabakh.

“Fifty per cent of the women were delivering much earlier than they should have been because of stress, malnutrition – because of everything they went through,” he told UN News.

New beginnings

As pregnant refugees bring new life into the world, families are also finding ways to begin life anew across the border.

According to UNICEF, two thirds of refugee children are in Armenian schools; among them are Ms. Asryan’s eldest. Her younger children will soon head to kindergarten.

While the Armenian government has created pathways for displaced people to access medical care, housing, financial assistance and jobs, challenges remain for families dealing with the loss of their lives back home as well as of loved ones. Ms. Asryan’s father died in a devastating explosion at a fuel depot shortly before she came to Armenia.

While trying to envision an uncertain future, she stays rooted in the present, a strong pillar for her family. She told UNFPA: “I will stand tall and work diligently to provide for my children.”