Since January 2012 newborn babies in Russia have had to be registered according to the international criteria of the World Health Organization.


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Up to 2012 a child with a weight of less than 1000 grams was only registered if he or she remained alive more than 7 days after the birth. Since January 2012 newborn babies in Russia have had to be registered according to the international criteria of the World Health Organization. Since then, doctors around the country were obliged to treat patients who had reached 22 weeks of gestation, a birth weight 500 grams, and a height of 25 centimeters.

This law is the next step to increase the national birth rate, decrease infant mortality, and improve infant health.

The survival of low-birth-weight infants depends on a number of external factors. They require ideal conditions and care of optimal quality to reduce their mortality rate and ensure their future development.

 

“Are our maternity hospitals ready to save the lives of such children?”

The chief neonatologist of Russia, Doctor of Medicine, Professor Elena Baybarina answered this question. The interview was conducted by a Russian newspaper journalist.

Russian Newspaper: “In recent years our country has had a decrease in infant mortality thanks to the efforts of the National Health Service and the finance the government has provided for improving obstetrics in Russia. It goes without saying that the mortality rate of infants with extremely low birth weights will always be higher than other infants. Due to the aforementioned changed in legislation, future infant mortality rates will now include many infants with extremely low birth weights who were formally uncounted. Therefore the new mortality rates will be higher.”

Elena Baybarina: “Yes, the statistics will worsen. However, only the virtual numbers will worsen, because the system of calculating the rates has changed. The real numbers of the deceased infants will not have changed. Moreover, the amount of saved lives will have increased. Thus, the new law will contribute to the saving of the lives of more infants.

In 1993 I advised doctors to treat children with birth weights of less than 1000 grams, and to make all the efforts to save their lives, because they are also human beings. Furthermore, I asked doctors to accord these infants the care they deserve as fellow humans, and to begin writing medical records from the time of birth. However, no law was passed to enforce this.

This means the law did not place any obligation upon doctors to protect the lives of these infants. Why didn’t we try to change this situation back in 1993? I figure we were right, in that even if the law had been changed, back then the situation would not have changed. This is because financial aids, modern equipment, and the special training of doctors are the essential in order to nurse such children, were not readily available at that time. Aside from this, the government lacked funds to pay the mothers of babies with extremely low birth weights full maternity leave. Nowadays the government has sufficient funds for all of the aforementioned”.

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Russian Newspaper: “Certainly, demography has to be preserved. We have to fight with infant mortality and stimulate a birth rate. However, in society we often listen to different opinions. Should the country increase a birth rate saving lives of such children? Who will grow from them? Would they be fully functioning citizens or handicapped persons?”

Elena Baybarina: “I don’t have any doubts. Nowadays 80% of similar children survive. In the Scientific Center of Obstetrics, Gynecology and Perinatology 81% of prematurely born children with the extremely low mass of a body not only survive, but don’t have any gross defects. With each year the percentage of child disability decreases. Five years ago we nursed 60%of prematurely born children with weights from 500 to 1000 grams without any gross pathology (the pathology which can be seen by the naked eye) and we are proud of this. Thus, medical technology becomes more sophisticated and the situation changes.

Not only do many people in our country think badly of handicapped persons, many also think it is better if these die in childhood. Do you know that health is a philosophical conception? For example, a person has defective vision, he or she wears glasses. Such a person is related to a group of unhealthy people, though he or she is normal in general. I always tell the opponents of nursing of children with extremely low birth weights: “Let’s put on scales two handicapped person on one side and eight healthy children who had extremely low birth weights on the other side. Given that eight out of ten infants born with extremely low birth weights are not handicapped, are you ready to deprive these eight children of their rights to live because the other two? Do you not agree that a handicapped person is also a human being?

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Do you know Stevie Wonder? He is a world famous and talented singer who has been blind from birth. People around the world love his music. He was a prematurely born baby. Nowadays we fight the same kind of blindness successfully. Should the doctors left Stevie Wonder without any medical assistance? Do you know there is one more argument? It is medical. When we learn to save children with weights of 500 grams, we will be able to save lives of children with weight 1-1,5 kilograms with confidence. This will result in a higher quality of life for all. In our center we have already experienced this.”

Russian Newspaper: “Do you know any other famous people who had been premature babies?”

Elena Baybarina: “Napoleon was such a child. I know one wonderful poem about handicapped persons.

Gomer was blind,

Beethoven was deaf,

Demosthenes was inarticulate,

But who has risen on the same level?

Who talks to muses without any problems?

 

Recently I have met my former patient. She is 26 years old now. She had a birth weight about one kilogram. I remember that our team of doctors went to great lengths to save her life. She has grown into an exceptionally beautiful and intelligent woman. She recently graduated from University and has become a psychologist. She goes to camps and works with problem teenagers, who adore her. She has only one defect-poor vision. Would you subscribe to the doctor’s decision not to save her life if you were a doctor 26 years ago, when that girl was born? I didn’t.

Translated from Russian into English by Irina Zykova

Edited by Clinton Rabjohns

 


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