Early Social Orphanhood as a Relevant Problem of Russian Health Care (On the Example of the Chelyabinsk Region, Russia)

BACKGROUND: The second decade of this century is characterised by the fact that the number of pregnant women who intend to give up their children has considerably decreased. However, despite this, the proportion between the number of abandoned children and all newborns increased from 2009 to 2014. AIM: The goal of this work is to scientifically substantiate changes in Russian legislation based on a comprehensive analysis of the main trends in the development of early social orphanhood and changes in the medical and social characteristics of mothers who give up their children. MATERIAL AND METHODS: The general aggregate of mothers who gave up their children in the Chelyabinsk Region has been studied. In total, 1,438 mothers were observed in 2009-2017. The information has been copied from the reports and records for 2009-2017 found in 51 maternity homes of the Chelyabinsk Region: reporting form No. 32 “Information on Medical Care for Pregnant Women, New Mothers and Women in Labor” and registered form No. 96 “Labor and Delivery Medical Record”. RESULTS: During the period under study, on average, 158 newborns per year were abandoned in maternity homes of the region: 51 children were abandoned by residents of the regional centre, 74 and 33 were abandoned by the women who lived in urban districts and rural municipalities, respectively. Today, mothers who give up their children tend to be marginalised. Two-thirds of them give birth to children out of marriage. Seven out of ten do not have a regular income, and six out of ten have socially significant diseases caused by their lifestyle. CONCLUSIONS: The decline in attention to the prevention of early social orphanhood is caused by the inevitable increase in the number of newborns left without parental care. Every year, the number of well adapted in society women who give up their children when they find themselves in a difficult life situation is decreasing. The number of marginalised pregnant women is growing. Reducing the rate of abandonment of newborns among the marginalised contingent of pregnant women requires changes in the medical legislation of the Russian Federation.