is the director of the republican scientific and practical center mother and child sergey vasilyev sergey alekseevichomen with pathologies receive help, in principle, no. we help women who, for example, are healthy. but there are problems with the babies in utero, some peculiarities or malformations, which then either require or do not require the provision of surgical care. in general, when it is understood that there may be some moments of complications, the mother herself she is healthy, but she must give birth in our institution, because assistance in children's resuscitation of the pediatric service. it should be generally close to patients. just like that, if you want, i want to give birth in the rspc. mother and child such should not be some direction of rendering. yes, a small most often it is still evidence, but a small percentage. we are in general. eh, they even did it in their center. you are a family type of an apartment type, where, in general, and a mother can give birth there with her husband, a spouse with her mother, there and uh, family, maybe her visit and everything else. we talk

sergey vasilyev sergey alekseevich and in your center only women with pathologies receive help, in principle, no. we help women who, for example, are healthy. but there are problems with the babies in utero, some peculiarities or malformations, which then either require or do not require the provision of surgical care. in general, so when it is understood that there may be some moments of complications, the mother herself is healthy, but she must give birth in our institution, because the assistance, children's resuscitation of the pediatric service. it should be generally close to patients. just like that, if you want, i want to give birth in the rspc. such a mother and child should not be some direction of kazan, but a small one , most often it is still evidence, but a small percentage. we are in general. uh, even in their center they made family chambers, like an apartment on this, type, where, in general, a mother can give birth there with her husband, spouse with her mother, there is a family, can visit her and everything else we talked about criticism of the president, and it basically sounded, what is it, that in the area, for example, there is a long wait, but some then the help of the same mri than in the capital. it seems to me that the most important thing here is how quickly they get to you from the region . mom, if there are such indications, does not happen, as i said in order for a woman to receive it as soon as possible. the entire list of medical care surveys is sufficient to be a pregnant woman uh-huh well, decipher it probably so that there is a correct understanding, if a pregnant woman really has some kind of problem , yes, starting from telemedicine counseling, that is, roughly speaking, in any central district and hospital, there are many local network television consultations, where there is an opportunity to consult in our specialists and not when necessary. we have a visiting obstetrician, rather an animation team that is ready to leave. take this patient to any point in our country according to the principle on yourself and bring her either to your center, if there are the main, prevailing obstetric problems of the totality with others, or she is pregnant , but with some kind of neurological cardiological issues, respectively, to the profile republican scientific and practical center, therefore, with this , just the same in terms of pregnancy we have built a multi-level. here is a multilevel system. yes, and there everything is absolutely clear first, second third. well, the fourth level is our institution and doctors who observe patients. yes, they predict where to give birth to her practically, it becomes clear as far as. so to speak. here is the collection, there is anamnesis-recovery of the diagnosis and all these other things, so this system is one of the best in the world. it works quite clearly throughout our region , the problem was more concerned. in general, there was probably a different therapeutic profile there, but i was interested to know how you are, that is, how soon a woman in labor can come from some farm, but it’s absolutely very pleasant to get to you instantly from this point of view . in obstetrics gynecology door all medical institutions. married couples are always open for our women. recently, with certain indications, they again can do ivf for free, but in your opinion, this is a popular procedure, in general, how did this program start working, did it show its effectiveness, which is definitely we have been working with this program for the third year already, when , by decree of the president , a married guy is provided free of charge and citizens of the republic of belarus are free of charge for ivf attempts with e, the presence of indications, that is, infertility itself and in the absence of evidence against, the most important points. this means that a commission has been created in each region, which determines if a person who really needs this kind of assistance comes to this commission and receives a referral, and he, in principle, can choose one of the three state centers, starting from our republican one. the mother and child center, and the second city clinical maternity hospital in minsk and gomel also have a third center, which means that the patient chooses and comes to us for help in demand. why because the main problem is that the procedure is expensive. not every couple, in general , can afford it, and here the state offers such an opportunity? yes, because sometimes for a woman, after all , the only way left is to make ivf clear that, from the point of view of demography, this is not such a big contribution. yes, but separately for the individual. e family. this is certainly the only way to get this child and make the family happy. therefore , help is certainly important and the second point is needed. we are, in principle, guided about 2.000. here's for last year. we had an attempt at eco on the basis of our center, for example, the efficiency was the third order of 39%. this is good and the result is even according to the general world trends in everything else, so help is needed. she's in demand. uh, i’ll say right away that there are no queues. we work at all three centers almost with a wheel of medicines in the product, in principle, there is enough of everything. well, 2000. uh, i say, we are working with wheels, queues. no, in general, yes, prices become actual. here he is now becomes. well, according to the phases of the cycle, it is clear that there is a small binding there, therefore from next month. he may actually be inferior in protocols. i counted this 700 pregnancy moms, because there are also pregnancy outcomes. the percentage of loss there is ectopic miscarriages fortunately he heeded, but nonetheless. he is, so we keep statistics. in general, we have a lot of questions because we have. uh, such a standard theme, yes, restrictions are up to 40 years. why because further it becomes practically ineffective or there is such concept of anti-mullerian hormone fertility? yes, below 0.5 this suggests that in a real reserve, that is, the ability of the ovaries to produce an egg and, accordingly , get pregnant, it is low and ineffective, that is, there is less than one percent, therefore, naturally, these limitations, as it were, also have us hmm a number of patients to ours who are there, for example, 50 years old. even now there is a unique case of 54 years due to different circumstances. i decided i want to become a mother and comes to our republican commission. she has a bouquet the disease begins with arterial hypertension, ending there with certain issues and everything else, so of course here already, of course, well, here is the legislation. and if the board can also refuse reproductive technologies there, in principle, everything is regulated. well, if let's say it doesn't work out, and even with the help of eco, to become a mother, women resort to surrogate motherhood. and what do you think about this way to become parents, well, for certain couples, of course. this is the only way. here already. eh, rests a little more on a psychological moment and why, because, well, from my point of view, women who give them a lift. uh, let's say someone else's embryo. she bears it must be morally stable enough. why because it's psychological? it's all hard, of course. she bears the whole pregnancy giving birth and suddenly, yes at all. it is these natural instincts that must be taken and given to the biological parents in my understanding. right here. there is always such a psychological moment, but then again, if there are people, who are sometimes ready, by the way, are absolutely free of charge, that is, relatives there are a cousin. there are others out there who want to help. here's a guy, yes, a good couple, everything is there. you know, children are not possible even relatives sometimes from this point of view. yes, everything is clear. this. in general. well, there are people who probably want to earn money, including helping, well , first of all, of course, i still sincerely think to help this married couple, but in addition to everything, to receive some kind of reward, of course. here without it nowhere legal. all the unique way of surrogate motherhood is those cases that we have in the republic, they certainly consist of notarial income. and everything is clearly spelled out there. somehow i don't get along. the problem that you are talking about is very often sung about in western cinema. yes, that mother does not want to give up her time, but she is with us. somehow i don’t hear cases, more and more often women become mothers for the first time at the age of 30 plus, so let’s call it as before. these mothers are considered age primiparous. well to fortunately, such a term has already remained in the distant past, like many certain points. well, it means age, if we take it earlier. yes, there in the 18th century, the average life expectancy was about forty-fifty years, now many, uh, are suitable for giving birth at that age, therefore, at an age. this is already thank god there is a moment left to go. everything is in the past, but certainly. here, the component is very simple, the younger the woman, the less she has. well, roughly speaking, the accumulated chronic sores, the more she can withstand, that you yourself remember. yes when, for example, i didn’t have 20-30 years of age, thieves raise with age, of course, the reserves of organisms decrease and everything else is therefore definitely the most optimal from 20 to 30 years. here is the birth age. here we have the same tendency, as in principle , in all european countries and in russia, uh, the average age of the order is slightly more than the first birth of twenty-eight, and the age of repeated births approaches thirty years with us, because every time, uh, getting i heard a question from the experts. oh, if you are planning to give birth, then this one is this they don't exclude anything at all. you can plan there even at the age of 50 absolutely. well, anyone. you see how e in mine will manage the point of view of understanding. the first question of birth must be decided by the married couple themselves, until they decide for themselves how many children they want there, one or two or three, and until the decision itself takes place. everything else. you can persuade them there to tell the dough, do other things. that's until they themselves decide, nothing will happen, but nonetheless. you said you wouldn't sign. the mission is, well, somehow there is objective data. well, i think that this also needs to be understood, er, material. well, definitely those who suffer with it. yes, that's the first second and fifth tenth, they can stop. there is already a psychological problem. you see, it seems to me that the problem here is complex. well, again, from memory. yes, i probably had such a case, a unique woman from the seventeenth attempt at an ecodile with nadia was 43 there, with a penny, her age is already a little. that's doing a caesarean section, but she achieved her goal unconditionally. there are certain moments. from one point of view. eco seems to have just taken the egg as well. i took the sperm. fertilized, received an embryo , implanted the uterine cavity, and that's it, unfortunately, there are many components here and that's it. the rest depends on the woman. as far as her body is ready, because most often such chronic sores begin there from certain, let's say. so the profile ending with profiles, when a woman cannot bear the body, for some moments sometimes happens and for some unknown reason she rejects this pregnancy. but you see, the seventeenth attempt. yes, he was fine. it was just necessary to see her, there are already tears. it is not clear something of joy, or already a long way of waiting - this is most likely, but this is a purposeful woman , of course, it’s worth applauding her, it’s clear that a psychologist should work with her and even a psychotherapist, because this all imposes certain imprints, but nonetheless less, probably, the joy of motherhood, struggling, active things completely. and when there are cases when such difficult births take place, and the child is born, let's say not quite healthy. yes, but how to tell mom from the point of view of a doctor that he is a problem, than to say so as not to injure her once again. mm, you know, over the years, probably, every doctor, in general, accumulates a certain one. eh, experience, let's say, why because women have different historical ones, they need to directly say to others , it is necessary to somehow bring this topic to this topic in a florid way. therefore, doctors already, as a rule , see with whom they work, that is , the psychological nature of the portrait of a woman, therefore, in general, they try to convey it in such a way that so that it would be, and not be so painful, er, truthfully and the third. e moment. e, let's say, the most important one, probably inspired the woman's hope that everything will be fine. these are the three criteria that make up, probably, the most important thing depends on the experience of absolutely psychology, medicine is nowhere, because each person should have an approach in the mfc mother and child, which provides support to the materials there. we work in the center. there are even three psychologists, a psychotherapist and a psychiatrist. everything that you tell sergeyly a wonderful country for mothers, and for future mothers for mothers who are at risk, and for their children, the entire base has also been created, but the birth rate, at the same time, is somehow not growing in our country. what would you say is the main reason. if there was such a simple answer to this question there would be a simple key to solving this problem, unfortunately the problem. it is multifaceted here, as i already started the conversation, yes, both psychologically and some social aspects, and in terms of health care. so here your piece of input from health care. yes, i am ready to answer that, in principle, everything is done as much as possible, starting from the stage of antenatal consultation, even the slightest , let's say. so the woman has some questions. so i want to get pregnant. she will be examined , prepared for pregnancy, recommendations given and ending with the most important question. she will be sent to a specialized center in time, which will deal wit

sergey vasilyev is our guest today good afternoon. good afternoon. hello sergey alekseevich is very glad to see you in our studio. uh, you are an obstetrician-gynecologist by profession and, uh, now you are the head of the rspc. mother and child. continue to practice taking birth and operating unconditionally the profession of an obstetrician-gynecologist. it generally implies a surgical specialty associated with surgical interventions, including with all the others, therefore , to remain a profession, you can only actively participate in it, therefore, of course, this part of my life is part of the profession, therefore, i go to the operating room with pleasure adoption of the gender, that is, continuing. the main functions of your specialty, but you probably counted up to some thousand operations there, and then asked, well, that's right. maybe there are not up to a thousand, maybe up to 500, but approximately so, because only then they lose all meaning when they have already exceeded several thousand. it is already in essence not fundamental, which operation scrolls. every year there is the most difficult thing in my head. well, of course, all the most, probably, the most difficult most difficult cases. uh, especially critical. i remember all my life. i'm not even alone such an operation. and in principle, probably, all of their such are the most difficult operations. they are remembered for a lifetime, you can’t get anywhere. yes, everything is going well, and then once and well, something like this, because there are different ceilings, including complex ones that require certain, how shall we say, moments of surgical technique. eh, skills and knowledge and everything else the efficiency of adoption. so to speak. to the decision, therefore, certainly here such a symbiotic is not one kind. childbirth is probably the most unpredictable process that exists, well, in nature provided so, yes, they most often end well and safely, but any obstetrician-gynecologist cannot say that yes. i am 100% sure that everything from start to finish will be without a hitch without a fuss. eh, our specialty is such a little bit on the verge of extreme. she why because at any moment? everything can go wrong and will require the doctor to take decisive action. why here, in general , is probably understandable. doctors kusher-gynecologist is responsible to heal, yes, in two lives, the life of a mother the life of a child, therefore, such moments are at stake, therefore endurance is unconditional. yes quickly, yes make a decision. and, of course, knowledge and skill in surgical technique and everything else. or you can remember your feelings when you took any childbirth in your arms for the first time. any childbirth, even here we do not start from the student bench. yes, it’s like everything is in the piggy bank this time, uh, of course, uh. and the first childbirth that we saw, let it be students, when there is a mother, tired once the child is approved the first cry, and such tears of joy, and in the delivery room to create so well, such an atmosphere reigns. you can’t imagine such a thing, well, it’s an inexpressible feeling, so it’s absolutely a miracle of birth. here is such a joy. well, this is something that cannot be conveyed from such a feeling, so this is what our profession is, probably this positive charge. he , uh, in general, people who came into the profession and endure in it, because our main purpose, of course, is to give mom a healthy child, so that everyone is happy, and everything is fine. well , there are not so many men among obstetrician-gynecologists. and what influenced your choice. it is this specialty, you know, many times asked questions. i many times. well, as if trying to give myself an answer, but i, probably, like and most in life. yes, when, when something is yours, you understand it right away, this is what happened to me, right? this is the specialty that i like. this is a job that will bring me the satisfaction of everything else. and then you start, probably, stringing. why is that happened and explain to yourself. yes, probably, maybe the teachers who showed them discovered the essence of this specialty, probably, these are the very first births that i spoke about, yes, with this atmosphere, probably, of course, there this difficult operation that ended. successfully it was all strung like this one another third, but it was already then it was like love at first sight. yes, when a person falls in love, he cannot explain himself. yes , what did the girl like there, eyes, hair , lips, oval, faces, something else you see person. you understand, this is your person. this is love. it's yours so, probably, my gynecology specialty happened. well, the fact that you are now going to the operating room with pleasure so far says, of course, that you made the right choice. yes, you are a happy person. absolutely. when i go to the operating room, i always joke, i rest. i rest mentally. get satisfaction with your soul. well, the pleasure of the operation, so this is part of my profession, when you have a difficult choice, who to save the child or the mother were the same, for sure cases fortunately, they happen, as if quite rare recently, i don’t even remember the last year, because our technologies allow us to nurse hmm very premature babies, and associated with some specific, let’s say, developmental problems and everything else, therefore last year, fortunately, such a choice is not worth it, but when i was when i started, i probably worked. yes, the question has always been that a woman has a more severe preeclampsia, for example, yes, uh, the pressure goes off scale and there is a question in life and death mothers and short-term pregnancy, which, unfortunately, sometimes. well, i had to interrupt in order for my mother to stay alive, because, and she has children. ben, she can still give birth in this choice, well, fortunately, i say, i repeat, that it practically does not happen at the present time. but at a recent meeting, the president criticized the work of the health care system to remind viewers of a fragment, so the meeting had door steps, roof ceilings, painting and other governors with chairmen, so that it was like this presidential hospital, where they were. that's what it was like, treatment of the protocol, regulatory or some kind of legal base you have there, put everything in order. it's not a problem. this is not a problem to do in a few one and a half to two months, but that's not the point. start feeling people in every district, see that they prolong their lives. well, sergeys mother and child say that doesn’t let go of your rpc, but nonetheless. if now, uh , they come to check on you, you will pass. i hope that yes the question is different, that criticism is always perceived. well, as if with a human point of view is not very good. but i consider this to be, probably, a healthy criticism, therefore, of course, the president is right and, as i say, e orders must be executed, they are discussed, therefore, there is no discussion here. uh, medical specialty. i say it implies a certain responsibility, so it is clear that the demand is gearing up. yes, somewhere in agriculture there are some other moments. if there are roughness. in general, let's say, they were somehow reparable from the point of view of health care, of course. this is life, health, holy things. and here allegory, interpretation and should not be, therefore, of course, criticism is healthy and we will fulfill orders to fulfill the passion to work with even better, because the specialty of a