They worked in shelters for almost a year: how Zhytomyr doctors are saving the future of Ukraine

In the midst of war, when rockets rip through the sky and air raid sirens become an eerie lullaby, life does not stand still. It continues in the most unexpected places, even in basements converted into delivery rooms. The Zhytomyr perinatal center is a vivid example of how Ukrainian doctors continue to fulfill their mission, even under the threat of shelling.

The basement, which was previously used as a warehouse, turned into a shelter, and then into a full-fledged maternity ward. Doctors and nurses worked around the clock, delivering to the sounds of explosions and sirens.

IA “FACT” journalist Yuliya Khomenko spoke with the head of the maternity ward with individual and family delivery rooms and the operating theater Maryna Tyshchenko and the head of the neonatal care department Maya Smolyar about how their work changed with the start of a full-scale war.

Maryna Yuriivna, let’s start from the very beginning. February 24, 2022. How did you meet this day? Was the maternity hospital ready for such a turn of events?

February 24… The day that turned our lives upside down. To be honest, it is impossible to prepare for this. The mind refused to accept what was happening. Already in the first days of the war, we realized that we had to act, so we immediately created a shelter in a reserve basement. At first there were only seats and a few beds for lying patients, but already on the second day it became clear that the air alarms could be long, the basement was converted into a full-fledged department with delivery rooms, postpartum wards, resuscitation and an operating room. We also brought oxygen there, moved some of the equipment, made a reception area… In fact, we created a mini maternity hospital underground.

As far as I know, the maternity hospital was hit by an airstrike on March 1. How did you deal with the consequences and continue working?

Yes, it was a scary day. We were all in the shelter when the explosion happened. The house itself seemed to jump up and down. When the alarm ended, we went upstairs and saw a terrible picture: broken windows, damaged equipment… The next day, the whole city came to help us. Volunteers, residents of Zhytomyr, local authorities – we all cleaned up debris and closed windows together. We could not stop and not work, because medical care for pregnant women must be provided constantly, so we continued to work in the shelter for about a year, until we restored the damaged premises. There were births and operations there, even a children’s intensive care unit worked there.

It turns out, was the birth right in the shelter?

Of course! And not only childbirth, but also operations. Women came to us even from the Kyiv region, because it was relatively calm here. Can you imagine giving birth to the sounds of sirens… But nothing, we managed! Our mothers are real heroes. Blackouts? But this is already our everyday life! But we are always ready. We have two large generators, rechargeable lamps, all necessary equipment. We often operated and gave birth during blackouts.

Let’s talk about patients. At what age do women most often give birth in your center? And did the war affect the age characteristics of women giving birth?

Most often, we are approached by women aged 20 to 35. This is such a gold standard, one might say. But, of course, there are exceptions. We have very young mothers, 15-17 years old, and women who give birth after 40. Each story is unique, each woman has her own reasons and circumstances. Since the beginning of the war, we have seen an increase in the number of premature births. Stress, worries, instability – all this, unfortunately, affects the health of women and their babies. It is especially difficult for women whose men are fighting and cannot support them. There were cases when a woman, staying with us, learned about the death of her husband in the war. It’s scary to look at! Pregnant women cry and are in a difficult psychological state. There were also cases when women asked to give birth sooner in order to attend the funeral of their husband.

You mentioned that women with complicated pregnancies turn to you. Tell us more about it.

Yes, our perinatal center specializes in helping women with complicated pregnancies and various associated diseases. These can be threats of miscarriage, high blood pressure, placental abruption, problems with the development of the fetus, impaired carbohydrate metabolism… Unfortunately, the war and the stress associated with it only worsen the situation, but we do everything possible to help our patients and their to children Of course, stress makes itself felt. Many women are going through difficult times, so the number of premature births has increased. However, in general, our babies are born as strong and healthy as they were before the war. The Ukrainian spirit is indomitable, even in the smallest.

How did the war affect the birth rate in the perinatal center, and what trends are observed in 2022 and 2023?

In 2022, we had 1,510 children, in 2023 – 1,800. Although the number of children born in 2023 is up from 2022, it is still below the pre-war level of 2021, when 2,250 children were born. This shows that the number of female patients has decreased compared to the pre-war period, but there is a positive trend towards an increase in the birth rate.

Maya Myronivna, now it’s your department’s turn. Tell us about the work of the neonatal care unit. Are there cases when women give up children because of war?

Fortunately, such cases are rare. In the last three years, we have recorded only three refusals. War is a terrible ordeal that brings a lot of grief and suffering. But even in such conditions, maternal instinct is an incredible force. Our patients are real heroines who protect their babies even in the most difficult times. They understand that children are our future, our hope. Currently, there is a child in our department whose mother gave him up. We surrounded her with care and love, and we hope that soon she will find a new mother. The reasons for refusal of children are different. This is due to difficult life circumstances caused by war or personal problems. But we have no right to judge these women, we can only give them the necessary support and help.

Zhytomyr region is one of the regions where the project “Extended screening of newborns” has started. Tell us more about it.

From October 2022, extended neonatal screening of newborns is being conducted in Zhytomyr Region, which allows detection of 21 hereditary and congenital diseases. Advanced neonatal screening is a real breakthrough in medicine, especially in wartime, when every life saved has even greater value. I understand that parents may have questions or concerns about screening. But I want to assure you that this is a safe and painless procedure, which is carried out with the help of a few drops of blood taken from the baby’s heel.

The results of the examination will help doctors identify possible health problems and take the necessary measures in time. More than 6,500 children have already been examined during the year, which indicates the active participation of parents in the program. Through screening, children with rare diseases such as phenylketonuria, congenital hypothyroidism, galactosemia Duarte, cystic fibrosis, nonketotic hyperglycinemia and MCCC1 have been identified and treated. All patients receive the necessary medical care. If deviations from normal indicators are detected, the parents will be informed about the threat to the child’s health for further research or the appointment of treatment by the experts of the medical and genetic center.

The entire process of neonatal screening is monitored and recorded in the electronic health care system: from the registration of the newborn and the taking of blood samples by the doctor to the processing of the referral by the laboratory technician and the recording of the diagnostic report based on the research results.
To conduct the research, we need to obtain written consent from the parents, after which the doctor will form a package of documents to send to the laboratory.