MARIUPOL, Ukraine — A Russian airstrike devastated a maternity hospital Wednesday in the besieged port city of Mariupol amid growing warnings from the West that Moscow’s invasion is about to take a more brutal and indiscriminate turn. Ukrainian officials said the attack wounded at least 17 people.

The ground shook more than a mile away when the Mariupol complex was hit by a series of blasts that blew out windows and ripped away much of the front of one building. Police and soldiers rushed to the scene to evacuate victims, carrying out a heavily pregnant and bleeding woman on a stretcher as light snow drifted down on burning and mangled cars and trees shattered by the blast.

Another woman wailed as she clutched her child. In the courtyard, a blast crater extended at least two stories deep.

“Today Russia committed a huge crime,” said Volodymir Nikulin, a top regional police official, standing in the ruins. “It is a war crime without any justification.”

Ukrainian emergency employees and volunteers carry an injured pregnant woman from the damaged maternity hospital that was hit by a Russian airstrike in Mariupol, Ukraine, on Wednesday. Evgeniy Maloletka/Associated Press

In Zhytomyr, a city of 260,000 to the west of Kyiv, bombs fell on two hospitals, one of them a children’s hospital, Mayor Serhii Sukhomlyn said on Facebook. No one was wounded, he said.

President Volodymyr Zelensky said the Mariupol strike trapped children and others under the rubble.

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“A children’s hospital. A maternity hospital. How did they threaten the Russian Federation?” Zelenskyy asked in his nightly video address, switching to Russian to express his horror at the airstrike. “What kind of country is this, the Russian Federation, which is afraid of hospitals, afraid of maternity hospitals, and destroys them?”

He urged the West to impose even tougher sanctions, so Russia “no longer has any possibility to continue this genocide.”

Video shared by Zelenskyy showed cheerfully painted hallways strewn with twisted metal.

Bodies of the dead are placed into a mass grave on the outskirts of Mariupol, Ukraine, on Wednesday. Families cannot bury their dead because of the heavy shelling by Russian forces. Evgeniy Maloletka/Associated Press

“There are few things more depraved than targeting the vulnerable and defenseless,” British Prime Minister Boris Johnson tweeted, adding that Russian President Vladimir Putin will be held “to account for his terrible crimes.”

The World Health Organization said it has confirmed 18 attacks on health facilities and ambulances since the fighting began, killing 10 people. It was not clear if that number included the assault on the maternity hospital.

U.S. Secretary of State Antony J. Blinken condemned Russia’s “unconscionable attacks” in a call with his Ukrainian counterpart, Dmytro Kuleba, that also covered diplomatic attempts to roll back the invasion, the State Department said.

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Two weeks into Russia’s assault on Ukraine, its military is struggling more than expected, but Putin’s invading force of more than 150,000 troops retains possibly insurmountable advantages in firepower as it bears down on key cities.

Despite often heavy shelling on populated areas, American military officials reported little change on the ground over the past 24 hours, other than Russian progress on the cities of Kharkiv and Mykolaiv. The officials spoke on condition of anonymity to assess the larger military situation.

Authorities announced new cease-fires Wednesday to allow thousands of civilians to escape bombarded towns around Kyiv as well as the cities of Mariupol, Enerhodar and Volnovakha in the south, Izyum in the east and Sumy in the northeast.

A car burns at outside a damaged maternity hospital that was hit by a Russian airstrike in Mariupol, Ukraine, on Wednesday. Evgeniy Maloletka/Associated Press

It was not immediately clear whether anyone was able to leave other cities, but people streamed out of Kyiv’s suburbs, many headed for the city center, as explosions were heard in the capital and air raid sirens sounded repeatedly.

From there, the evacuees planned to board trains bound for western Ukrainian regions not under attack.

Civilians leaving the Kyiv suburb of Irpin were forced to make their way across the slippery wooden planks of a makeshift bridge, because the Ukrainians blew up the concrete span leading to Kyiv days ago to slow the Russian advance.

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With sporadic gunfire echoing behind them, firefighters dragged an elderly man to safety in a wheelbarrow, a child gripped the hand of a helping soldier, and a woman inched her way along, cradling a fluffy cat inside her winter coat. They trudged past a crashed van with the words “Our Ukraine” written in the dust coating its windows.

“We have a short window of time at the moment,’’ said Yevhen Nyshchuk, a member of Ukraine’s territorial defense forces. “Even if there is a cease-fire right now, there is a high risk of shells falling at any moment.”

Previous attempts to establish safe evacuation corridors over the past few days largely failed because of what the Ukrainians said were Russian attacks. But Putin, in a telephone call with Germany’s chancellor, accused militant Ukrainian nationalists of hampering the evacuations.

In Mariupol, a strategic city of 430,000 people on the Sea of Azov, local authorities hurried to bury the dead from the past two weeks of fighting in a mass grave. City workers dug a trench some 25 yards long at one of the city’s old cemeteries and made the sign of the cross as they pushed bodies wrapped in carpets or bags over the edge.

About 1,200 people have died in the nine-day siege of the city, Zelensky’s office said.

Nationwide, thousands are thought to have been killed, both civilians and soldiers, since Putin’s forces invaded. The U.N. estimates more than 2 million people have fled the country, the biggest exodus of refugees in Europe since the end of World War II.

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The fighting knocked out power to the decommissioned Chernobyl nuclear plant, raising fears about the spent radioactive fuel that is stored at the site and must be kept cool. But the U.N. nuclear watchdog agency said it saw “no critical impact on safety” from the loss of power.

The crisis is likely to get worse as Moscow’s forces step up their bombardment of cities in response to what appear to be stronger Ukrainian resistance and heavier Russian losses than anticipated.

Echoing remarks from the director of the CIA a day earlier, British Defense Secretary Ben Wallace said Russia’s assault will get “more brutal and more indiscriminate” as Putin tries to regain momentum.

Britain’s Defense Ministry said fighting continued northwest of Kyiv. Kharkiv, Chernihiv, Sumy and Mariupol were being heavily shelled and remained encircled by Russian forces.

Russian forces are placing military equipment on farms and amid residential buildings in the northern city of Chernihiv, Ukraine’s military said. In the south, Russians in civilian clothes are advancing on the city of Mykolaiv, a Black Sea shipbuilding center of a half-million people, it said.

The Ukrainian military, meanwhile, is building up defenses in cities in the north, south and east, and forces around Kyiv are “holding the line” against the Russian offensive, authorities said.

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On Wednesday, some of Ukraine’s volunteer fighters trained in a Kyiv park with rocket-propelled grenade launchers.

“I have only one son,” said Mykola Matulevskiy, a 64-year-old retired martial arts coach, who was with his son, Kostyantin. “Everything is my son.”

But now they will fight together: “It’s not possible to have it in another way because it’s our motherland. We must defend our motherland first of all.”

In Irpin, a town of 60,000, police officers and soldiers helped elderly residents from their homes. One man was hoisted out of a damaged structure on a makeshift stretcher, while another was pushed toward Kyiv in a shopping cart. Fleeing residents said they had been without power and water for the past four days.

Regional administration head Oleksiy Kuleba said the crisis for civilians is deepening in and around Kyiv, with the situation particularly dire in the suburbs.

“Russia is artificially creating a humanitarian crisis in the Kyiv region, frustrating the evacuation of people and continuing shelling and bombing small communities,” he said.

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The situation is even worse in Mariupol, where efforts to evacuate residents and deliver badly needed food, water and medicine failed Tuesday because of what the Ukrainians said were continued Russian attacks.

The city took advantage of a lull in the shelling Wednesday to hurriedly bury 70 people. Some were soldiers, but most were civilians.

The work was conducted efficiently and without ceremony. No mourners were present, no families to say their goodbyes.

One woman stood at the gates of the cemetery to ask whether her mother was among those being buried. She was.

Associated Press journalists Yuras Karmanau in Lviv, Ukraine, and Felipe Dana and Andrew Drake in Kyiv contributed along with other reporters around the world.

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