Russian doctors often push mothers to abandon disabled newborns to the state. The result is growing numbers of orphans, two years after Russia imposed a ban on American adoptions.
MOSCOW — Russia's orphanage system is growing by about 6,000 newborns every year because of the rising number of parents who "refuse" their children in the maternity ward, typically because of disabilities.
"When my baby was born, I heard, "Look what you gave birth to,"" recalled one mother, Svetlana Doronina. "Those were the first words the doctor said. The doctor said I had given birth to a vegetable, that he would never walk or talk and that spending money on him was useless. We were not sent to Moscow for evaluation. And in order to get the free medicine I was entitled to, I had to write two articles in the local newspaper."
Doronina, from Volgograd Oblast in western Russia, was recorded on video and shown recently in a meeting of the Guardianship Council, overseen by Vice Premier Olga Golodets. And this isn't an experience she had in the 1990s: Her son was born in 2013. He suffers from hydrocephalus — a condition in which fluid accumulates in the brain — as well as other related diseases, but the child has a chance because his mother didn't abandon him.
Refusals and mistakes
According to Russia's Ministry of Health statistics, the situation in Volgograd Oblast is worse than the national average. The region has a high rate of both child disability and death. The Ministry of Health has sent experts to root out the reasons behind both of those statistics, but Doronina's story explains a lot.
There are around 10 regions in the country with statistics that mirror those in Volgograd Oblast. But children are abandoned in maternity wards throughout Russia, with the exception of some North Caucasian republics. In 2013, 5,757 newborns were refused by their parents and in 2012, the number was 6,230.
The concerns about child abandonment in Russia come two years after a Moscow-Washington diplomatic row led to an ongoing Russian ban on adoptions by Americans, who are often more willing to adopt children with disabilities.
Specialists in preventing newborn abandonment all say that maternity wards don't give women the necessary psychological and educational support they need. On the contrary, they often hear horrible prognoses related to newborns who have some sort of health problem.
Doctors in the maternity ward are often the ones who introduce the idea of abandonment — even when a mother hasn't asked about it. In general, these doctors are not familiar with modern rehabilitation methods and the outcomes for disabled children who receive proper treatment, nor do they have any inkling of how the disabled can integrate into society.
These doctors think that disabled children are impossible to teach and that they don't have a future, despite the fact that experiences in many European countries have proven otherwise.
"In the medical world, there is still an idea that refusing a problematic baby gives the mother a chance to return to a full life," explains Elena Klochko, a Guardianship Council member. "But that's incorrect. Research has shown that in 80% of cases the mothers who abandon their newborns have a series of physical and psychological problems, especially anxiety and depression."
In 2013, 1.9 million children were born in Russia, and 623,000 had some kind of health problem. Specialists say that many diagnoses given to newborns are subsequently withdrawn in the baby's first year of life, although there are no exact data on the topic. That means that a maternity doctor telling a mother that her baby will never walk or talk could very well be mistaken.
Ksenia Alferova, co-founder of a non-profit that deals with issues related to disabled children, says doctors are frequently wrong. "We have our own statistics, and we know of cases where the screening didn't show anything but the child was born with a handicap, and other cases where the screening showed a high probability of Down's syndrome, and the child was born normal," she says. "In 2013, the number of abortions in Russia increased by 130% compared with 2012 — because of prenatal screenings. Parents trust doctors absolutely."
You can always say "No"
In most cases, women make the decision to abandon their child without having seen the baby, because doctors say that seeing the baby isn't necessary. Experts who are working to prevent newborn abandonment say that specialists in the maternity ward should be required to provide contact between mothers and newborns.
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Archive picture of a maternity ward in Yakutsk — Photo: RIA Novosti/V. Yakovlev
Alferova says that new standards for maternity ward doctors could largely solve the problem of infant abandonment. "It's too late to teach the current doctors," she says. "They think that they are "saving" the mother from a disabled baby. But we need to teach new specialists that that's not right, so that they work under different assumptions. A lot depends on how the doctor tells the woman that her child has, for example, Down's syndrome. Why does the doctor give her the news like it's a tragedy? Children with Down’s syndrome can walk, talk, go to school. Why is that bad news? Is it just that they are different from others? We are all different from each other. If we were all identical, life would be pointless."
Along with unethical behavior among doctors, the absence of professional psychological and social support for new moms has been cited as a reason for abandonment. There is also a common misconception that only poor, marginal parents have children with physical or psychological disabilities.
"That's absolutely not the case, but stereotypes are hard to break," Klochko explains. "A disabled child in a well-off family would be seen as a threat to the family's status and reputation. That's why society doesn't judge harshly those who abandon disabled children. To a certain extend, society supports the decision. Correspondingly, it's an easy procedure legally — much easier than adopting a child." Klochko says that families raising a disabled child risk becoming isolated, and the divorce rate for couples with a disabled child is much higher than average.
More than half of the people with Down's syndrome in Russia grow up in orphanages. They represent one of the largest categories of orphans because they are often abandoned in maternity wards and are rarely adopted. The orphanages don't give them the pedagogical and social help that they need, and when they become adults they are often committed to mental institutions, where they often die as a result of the aggressive pressure from a new environment. At the same time, most people with Down’s syndrome are capable of attending regular schools, learning a job and living in society.
Around 2,500 babies are born with Down's syndrome in Russia annually. Fifteen years ago, 95% of babies with Down's syndrome were abandoned at the hospital, whereas today the figures are between 20% and 80%, depending on the region and city.
Although the presence of a disability — coupled with pressure from doctors — can be the reasons parents abandon children, a careful review of the statistics show that it's only a part of the problem. Lack of housing and employment is still the most commonly cited reason for abandoning a child.
Nonetheless, Aleksandra Marova says that while solving the problem of abandoned children is complex, it's possible. The non-profit she runs is dedicated to reducing the number of children abandoned in the hospital, and in the past two years, it has worked with 1,700 mothers who had already signed the paperwork to abandon their children. In half of the cases, the child was returned to its family of origin.
"That confirms that with the right support for women after they give birth, the number of orphans in this country could go down," she says.