In Irkutsk in the first quarter of 2009, the birth rate rose compared with last year, and for two years in a row births have exceeded deaths, something not seen since 1985. The city perinatal center, where all premature births are handled and very premature babies are cared for, uses modern technology, many borrowed from French colleagues. The article also tells how the birth certificate program helped solve staffing problems, and about plans to build a new center building for Irkutsk's 350th anniversary.

The birth rate in Irkutsk in the first quarter of 2009 increased compared with the first quarter of 2008. This was reported by the chief physician of the city perinatal center and deputy of the Irkutsk City Duma, Irina Yezhova, at a meeting with representatives of the General Council of the Department of Haute-Savoie (France). According to her, the birth rate in Irkutsk has exceeded the death rate for 2 years already; the last time such figures were seen in Irkutsk was in 1985. And the city’s maternity institutions are fully feeling the “baby boom”: for example, last year the city perinatal center handled about 7,000 births.
The city perinatal center was one of the first facilities visited by the French delegation from the Department of Haute-Savoie as part of the official visit. Vice President of the General Council of the Department of Haute-Savoie Raymond Bardet was getting acquainted with the sister city for the first time, while the head of international cooperation of the General Council of the Department of Haute-Savoie, Aline Fabresse, had visited the city perinatal center in September 2004 and appreciated the changes that had taken place there thanks to cooperation between the two territories.
After a visit to medical institutions in the Department of Haute-Savoie, doctors from the city perinatal center brought to Irkutsk technologies for caring for low-birth-weight newborns. In particular, on the recommendation of French pediatricians, artificial formulas were almost completely removed from the diet of premature babies and replaced with breast milk. This made it possible to reduce the number of gastrointestinal diseases in newborns. In France, they also “borrowed” the protective regime for neonatal intensive care units, which made it possible to reduce the incidence of IVH syndrome in newborns (brain hemorrhages) several times.
The need to open the city perinatal center arose 15 years ago in order to create conditions in one building for women whose pregnancies are complicated. All premature births in the city of Irkutsk take place in this specialized institution. Women in labor are referred on a planned basis to the city perinatal center by all women’s clinics in Irkutsk; in emergency cases, they are brought in by an ambulance team. The center specializes in caring for deeply premature babies (after 22 weeks). Over the past 2 years, new technologies have made it possible to achieve positive changes in this area.
Despite the fact that the building of the city perinatal center is only adapted for providing medical care, modern perinatal technologies are used there. In parallel with the world’s leading obstetric clinics, Irkutsk doctors are mastering technologies for caring for premature babies with “cardiac immaturity.” “Non-transportable” infants are operated on in the perinatal center building by mobile surgical teams from the city’s Ivano-Matreninskaya Clinical Children’s Hospital. Over 2 years, mobile teams consisting of a surgeon, anesthesiologist, and nurse have performed more than 30 operations. During a trip to a hospital in the city of Eugene, Irina Yezhova was convinced that American colleagues use the same methods of medical care for premature babies.
Aline Fabresse became interested in the practice of birth certificates, which has been used for three years now in all maternity institutions in Russia. The Department of Haute-Savoie is trying to solve the problem of staff turnover among mid-level medical personnel in cities located on the border with Switzerland. Swiss clinics pay very high salaries to maternity workers, and French medical staff prefer to work abroad, especially since the clinic is 7-10 kilometers from their hometown.
Irina Yezhova said that as a result of work under the birth certificate program, the city perinatal center was able to solve the problem of staff turnover among mid-level medical personnel. After salaries increased by almost 50%, employees began to value their jobs, and staff turnover disappeared. Birth certificates, which are handed to women in labor, make maternity hospital funding targeted and allow institutions to receive federal off-budget funds. The transparent certificate system creates healthy competition among maternity hospitals, from which both the institution and the patient benefit.
For the guests from France, Irina Yezhova presented a model of the renovated perinatal center and spoke about the large-scale construction that will begin this year. By the 350th anniversary of Irkutsk, the city’s mayor Vladimir Yakubovsky decided to build a new wing of the city perinatal center for 150 beds with 20 individual delivery rooms. The construction site has already been prepared, the dilapidated housing that stood there has been demolished, and the residents have been relocated to new well-appointed apartments. After the reconstruction, women in labor will be moved to the new wing, and a fourth floor will be added to the existing building. The reconstruction of the main building will make it possible to change the conditions for premature babies in the neonatal intensive care unit, and mothers will be able to take a more active part in caring for their children. For now, however, the city perinatal center, designed for 150 beds, has 9 individual delivery rooms. Women whose deliveries went well stay in the institution for about 3 days, while premature babies are cared for in the neonatal intensive care unit, where mothers come to visit them.
Aline Fabresse noted that representatives of the sister territory will have two reasons to visit Irkutsk in 2011: the 350th anniversary of the capital of Eastern Siberia and the opening of the new wing of the city perinatal center, equipped with the latest technology. On May 7, a final meeting will take place between representatives of the General Council of the Department of Haute-Savoie and the mayor of Irkutsk, Vladimir Yakubovsky. It will discuss the prospects for international cooperation between the sister territories.