‘I appeal to our beloved women’ Russia says it wants more babies. So why is it closing maternity wards?
Across Russia, maternity wards are shutting down — even as officials urge women to have more children. A mix of falling birth rates, cost-cutting policies, and chronic staffing shortages has made access to childbirth care increasingly precarious. In many towns, expectant mothers must now travel hours to give birth, while doctors say they’re overwhelmed and underpaid. The independent outlet 7×7 examined the growing crisis facing maternity wards across Russia’s regions. Meduza shares an abridged English-language version of the outlet’s reporting.
In 2024, the only maternity ward in the remote town of Bodaybo, in Russia’s Irkutsk region, was shut down. Just 9,000 people live in Bodaybo, which can only be reached by plane or by car along a rough road that takes at least two days to traverse.
The town’s birth rate has been steadily declining. In 2020, 80 women gave birth there; in 2021, 56; in 2022, 47; and in 2023, just 29. Women with complicated pregnancies are sent to Irkutsk for delivery — at their own expense. There are about eight to 12 such cases a year.
The closure was ordered by Russia’s Health Ministry, which has been shutting down maternity wards that handle fewer than 100 births annually. In their place, hospitals are being equipped with “emergency delivery rooms” meant to provide urgent care for women in labor. After Bodaybo’s maternity ward closed, only a bare-bones clinic remained. But, as the town’s mayor, Yevgeny Yumashev, noted, that hardly solves the problem — half of such clinics in the region have no medical staff at all.
Indeed, staffing shortages are severe. Across the Irkutsk region, medical assistant positions in these rural clinics are filled to just 64 percent capacity, nursing positions to 54 percent, and midwife positions to 60 percent.
Our only hope is you. Support Meduza before it’s too late.
Governor Igor Kobzev has called reversing demographic decline one of his top priorities. In 2025, he proposed making the region’s maternity capital program permanent.
Galina Terentyeva, who heads the Irkutsk branch of the Union of Women of Russia, said she believes the purpose of life lies in building “a healthy, prosperous, and successful family” and raising children. “We support our president on this issue, who says that having many children should become part of our society’s philosophy,” she said.
But the closures extend far beyond Irkutsk. In January 2025, Nina Ostanina, who chairs the State Duma’s Family Protection Committee, noted that more than 150 state-run medical facilities have stopped offering maternity care in the past five years.
Overworked and underpaid
According to the outlet Glasnaya, the number of obstetricians and gynecologists fell across 66 Russian regions between 2016 and 2023. By August 2024, state hospitals were short 3,663 specialists, said Gennady Sukhikh, vice president of the Russian Society of Obstetricians and Gynecologists.
Heavy workloads and low pay are driving many to quit. Glasnaya found that in half the country, employers offer midwives less than 38,000 rubles (about $450) per month. Staff at a perinatal center in Bratsk, in the Irkutsk region, have also complained of low wages. The hospital’s chief physician, Marina Kostyushko, responded by blaming women themselves — saying that fewer births mean smaller salaries for medical staff.
Doctors who speak publicly about poor pay sometimes face threats of retaliation. In June 2024, staff at a maternity hospital in Buynaksk, Dagestan, wrote on a local online forum that they were working longer hours because of staff shortages but their pay hadn’t increased. Soon after, hospital administrators threatened to fire anyone who complained.
The senior midwife wrote to colleagues that the head of her department had ordered her to warn staff that he would “go after” whoever spoke out. “He was furious,” she said. “He said he would hunt down the person who wrote or said this — and punish them harshly, up to firing them.”
The situation in Buynaksk is far from unique. Across Dagestan, doctors and midwives say they face low pay and pressure from management, while the region itself is rapidly losing hospitals. Over the past year alone, Dagestan has lost four central district hospitals, four smaller branch hospitals, and two rural clinics. Some villagers must now travel 20 to 30 kilometers (some 12 to 19 miles) to reach medical care.
A crumbling system
“We’re stuck standing in these sterile gowns. We can’t go anywhere. That’s why doctors faint, nurses faint — everyone feels awful!” said a nurse from the maternity ward in Zelenodolsk, Tatarstan, in an interview with the local TV station Zeleny Dol.
Inside the hospital, temperatures reportedly climbed as high as 40 degrees Celsius (104 Fahrenheit). There was no air conditioning and no working ventilation. Operating room nurse Elnara Illarionova said she repeatedly fainted from the heat and struggled to concentrate.
Anesthesiologist and critical care specialist Vladimir Afanasyev told Zeleny Dol that both doctors and nurses had collapsed at the operating table. “It gets up to 40 degrees in here,” he said. “And when those surgical lamps are on, it’s even hotter.” He added that the hospital’s ventilation system hadn’t worked for 12 years and that administrators had been promising air conditioners for a decade. After local media reported on the issue, the hospital finally installed them.
Tatarstan’s head, Rustam Minnikhanov, has long urged women to have more children. In 2021, he publicly lamented the region’s low birth rate: “I appeal to our beloved women — please reconsider your plans and support the republic!” he said. By 2024, he was suggesting that religion might help fix the problem. “I think religion should help us,” he said. “Religious people are different. Families grounded in faith raise children differently. I’m not interfering — if someone is an atheist, fine. But this is something we should work on.”
The poor conditions aren’t limited to Tatarstan — nor are the complaints exclusive to medical workers. In Rostov, pregnant women have also reported unbearable heat and stifling air in hospitals. Elsewhere, the problem is the opposite: one patient in Nizhnevartovsk, in the Khanty-Mansi Autonomous Okrug, said she had to sleep in wool socks and a hood because cold air leaked through the hospital’s broken windows.
