BABY BOOM IN SARAJEVO

Birth-rate and War in B&H

AIM Sarajevo, June 29, 1996

Is Sarajevo experiencing a baby boom? "It is true that that the number of childbirths is increasing almost every day. In 1993, for instance, we had only 1,500 chidbirths. A year later, there were 2,000, and last year, in 1995 we registered 2,500 childbirths. This year we expect that the figure of three thousand will be exceeded", answers assistant professor Dr Idriz Bukvic, director of the Gynaecological & Obstetrical Clinical Hospital (GAK) of the Clinical Centre of the University in Sarajevo, whose one of the latest shifts was very "fruitful": in a single day 19 babies were brought to life.

At the same time in the State Hospital (former military) five to ten babies are born. However, "We cannot accept the allegations about a baby boom simply because a detailed analysis should be made with all relevant obstetrical indicators, then comparisons should be made and then conclusions could be drawn", Dr Bukvic says.

And the study of the data on consequences of the war, which the world public has already been informed about, has been done in the clinical hospital. This study was made by a team headed by Professor Dr Srecko Simic, long-time executive and expert of the World Health Organization in gynaecology and obstetrics. The conclusion is that war operations in the more than thousand-day long siege of Sarajevo have completely changed the prewar processes of birthrate, perinatal and general death rate, as well as the population growth. (Each woman awaiting childbirth had given 360 different information, answers, both in anamnesis, or through objectively determined status). The data show that in the first months of the war, April, May and June 1992, number of childbirths was significantly reduced. In "convoys of salvation", young women of fertile age with children in their arms or yet unborn were leaving Sarajevo at the time (it is going to be a very difficult task to determine the number of mothers and pregnant women who had left Sarajevo at the time).

In the months which followed, reduction of the number of chidbirths was affected also by a large number of abortions. There were three times more deliberate interruptions of pregnancy than there were childbirths. Only at the Gynaecological-Obstetrical Clinical Hospital there were 15-20 abortions a day! In February 1993, nine lunar months after the beginning of the war in Sarajevo, the smallest number of childbirths was registered in the past forty years. Only 77 babies were born! And during that whole year, there were 1,500 new babies. As a comparison, annual prewar average was 9,000 babies.

The physicians were not worried only by the small number of childbirths, but by other indicators as well. Children who were born weighed less than normal. A baby was born and survived although it weighed only 750 grams, which is a unique phenomenon in the world. There were many babies who weighed only 2,000 grams at birth. Average weight of newly-born infants at the GAK in Sarajevo before the war used to be about 3,600 grams. In the war period, there were also a lot of prematurely born children. The number of still-born babies also increased. Physicians explain this as a direct consequence of the war. Psycho-social stress situations initiate an entire neuro-hormonal process which leads to intra-uterine death of the foetus. Percentage of perinatal death-rate raised from 15.8 to 39.6 per thousand. This is how even unborn children became victims of the war.

Apart from the main study, some physicians of the mentioned clinic made their own notes. One of them, an expert in application of supersonic vibrations in gynaecology, Dr Senad Mehmedbasic, at a recent congress of surgeons of B&H, reported on war injuries of pregnant women. He presented data unknown to the world. For example, an unborn baby saved its mother's life. A shell fragment which wounded the mother passed through the abdomen wall, penetrated into the uterus, killed the unborn eight-month foetus, but saved the life of the mother. This woman, however, will never be a mother.

During the war, physicians encountered three times more malformations in newly-born infants than before. It was possible to cure only a part of them by surgeries. Unfortunately, children were born with severe malformations such as Down's syndrome, hydrocephalia and similar, and they are still quite frequent in the postwar period in some other parts of Bosnia & Herzegovina as well. According to the words of Dr Ibrahim Mehic, gynaecologist from Tesanj who also practices in surrounding villages and settlements, malformations with babies are encountered quite often in the postwar period. This physician gave birth to three such babies not long ago in two villages in the vicinity of this town in Central Bosnia with a severe malformation - they had no skin!

Nowadays, the Sarajevo baby boom reveals cases of giving birth to the third, fourth and even seventh child in the family, late childbirth (even women of 52 had babies). Not long ago, a fifty-year old woman gave birth to her eighth child, which is quite unusual even in this space. The average was mostly two children per family. There are cases of women making up their minds to have a baby after they had lost one or more children in the war. Even women who already have grown-up children decide to babies. They say that they have simply wished to give birth again, that they are happy they could.

Unfortunately, babies in Sarajevo come to this world in quite difficult conditions, although the maternity hospital along with the Gynaecological Clinical Hospital it is a part of, was moved to the former eye hospital. The building with modern equipment of the prewar hospital was demolished in the very beginning of the war, so the physicians were forced to work in very cramped premises of the Diagnostic Policlinic Centre. In the former eye clinic, there are up to 15 women waiting to deliver babies in a single room. Babies are also in inadequate premises. Sometimes there is not enough space for all the tiny patients.

The Gynaecological Department is even more crowded by very severe cases. Possibility of intra-hospital infections is high, so that women with their newly-born infants are discharged from the hospital sometimes only several hours after childbirth, if their health permits it. The situation is especially difficult at the department for prematurely born babies. The clinic has a sufficient number of incubators received from donations, but not all the other conditions for providing for these babies.

AMINA AHMETASEVIC