The Horror of Childbirth in Neo-Soviet Russia

Journalist Natalia Antonova, writing on Foreign Policy’s website:

“Russia needs babies” may as well be the unofficial slogan of Prime Minister Vladimir Putin’s ruling United Russia Party. The country is in a demographic crisis, shedding 2.2 million people (or 1.6 percent of the population) since 2002, and the government is trying to encourage more women to bring Russian citizens into the world. This year, when I unexpectedly got pregnant soon after receiving my visa to work in Moscow, I became a test case.

Since the Soviet days, having a baby in Russia has been commonly understood as a nightmare of understaffed state hospitals and forbidding bureaucratic mazes. Feminist author MariaArbatova‘s My Name is Woman, an alternatively harrowing and hilarious account of childbirth in the 1970s, was the grim reality for many. Arbatova described being left completely unattended during the final stages of labor, which nearly resulted in her death and the death of her twin sons.

The fall of the Soviet Union did not improve matters. A 1996 Los Angeles Times article, titled appropriately “Childbirth in Russia is Miserable,” attested to Russia’s “scruffy, ill equipped, and harried” maternity wards. The article described a health system caught in a straitjacket of leftover communist-era regulations, which even dictated the posture mothers must lie in to nurse their newborns.

These days, thankfully, maternal mortality is decreasing in Russia, according to the WorldHealthOrganization, but this doesn’t mean that most women have renewed faith in the medical establishment — horror stories still pop up in the press and the blogosphere.

It’s only natural for the truly scary cases to make their way into the press, while the stories of regular birthing experiences remain generally untold. However, there are enough Russian bloggers out there recounting tales of being bullied and mistreated by medical staff to give a pregnant woman cause for concern.

Shortly before I gave birth, I was struck by a blogpost by a recent mother, detailing a personal experience at Moscow hospital not far from where I live — yelling midwives, a doctor who was mostly busy somewhere else, and, for dessert, getting stitched up with no anesthetic by a staff member who threatened to walk away should she continue to squirm. According to the midwives, “it was my fault that I overshot my due date and was now screaming (and here I thought I was only moaning softly),” the author wrote.

That’s not exactly good press if you’re trying to get more women to give birth. This is why Putin is seen on the television news these days touring newfangled perinatal centers and holding high-profile meetings on maternal care — to assure the childbearing public that the government is now watching out for them. The prime minister has also pledged to spend 1.5 trillion rubles (about $54 billion) over the next four years on demographics-related projects such as raising life expectancy and increasing the birth rate by 30 percent.

I hadn’t planned on serving as a canary for Russia’s new advances in state maternal care, but after my husband and I ran out of money, throwing ourselves on the mercy of free health care was our only choice. Last November, when I made my first appointment with an OB/GYN at the Norovkov Clinic, a private establishment in Moscow that came highly recommended by friends, my new doctor, Natalia Bovina, explained my options to me.

“You can pay for a special ‘birthing contract’ at a hospital that provides commercial services — or you can call an ambulance once labor kicks in, but then it will all depend on luck,” Bovina said. “Unless a nearby hospital is full, they won’t legally be able to refuse to admit a woman in labor, but who knows what kind of doctors you will end up with?”

I sat across from her, still recovering from the shock of discovering I was pregnant a mere six months after coming to Moscow to work as a journalist, and said that I’d “definitely” be paying for a contract.

But by the time I was at 36 weeks, the stage at which most commercial birth plans are set up, my husband and I were struggling just to keep our apartment. A standard birthing contract costs $2,500 to $3,500, but we could not spare even this relatively modest amount.

I spent a lot of time bemoaning my fate. Marooned in Moscow! Pregnant and broke! Russia was supposed to be an adventure, like it is for most expat journalists — not a dose of cold reality.

“It will work out,” Alexey, my Russian husband reassured me in, his typical, carefree manner. “The gods are on our side.”

Although I’m originally from Kiev, Ukraine, I spent most of my life living in the United States. My middle-class, private-school-educated American self demanded order, not a reliance upon nebulous “gods” — but I was too exhausted to argue. We decided to put our faith in the heavens, planning to forgo a birthing contract and give birth at City Hospital #70, which was directly across the street from our apartment.

We were hopeful: Not long before, Moscow Mayor Sergei Sobyanin had taken a wellpublicizedstroll through the hospital’s modernized perinatal center at the maternity ward, or “birth house,” as they are commonly known in Russia, handing out flowers to new mothers. I had been hospitalized there for a day and a half when my baby threatened to come early. The experience was decent — the ward was renovated and clean, and the doctors were curt but professional, and appeared genuinely concerned for my welfare and the welfare of the baby.

As the weeks passed, however, and our baby overstayed his due date, I grew antsy. Thankfully, I still had Natalia Bovina, my doctor from the private clinic. According to Russian health care tradition, she had shepherded me through the pregnancy process, but would not be there for the actual birth. Such practice is fairly common in Russia: One doctor guides you for nine months, another takes over once you are in labor, or close to it.

A week after my due date, I got in touch with Bovina, who arranged the paperwork so that I could check into the hospital before contractions actually began. This was supposed to be my ticket straight to Hospital #70.

But the hospital served up a surprise of its own. “I don’t care about your hospitalization papers, woman!” screamed the receptionist in the maternity ward there when I called to inquire about a place on the wards while waiting for my hospitalization papers to come through later in the day. “You need to be seen by your doctor — you can’t just show up here!” She proceeded to hang up.

Although turning down a pregnant woman without an explanation is against the law, admittance procedure can sometimes depend on the mood of whoever is on duty at the reception desk, and some hospital workers still bank on the fact that many pregnant women don’t know their rights. I could have argued with this charming receptionist, but my desire to give birth at Hospital #70 had quickly evaporated. I was emotional, scared and desperate for help.

Dr. Bovina quickly proceeded to Plan B: booking me a room in Hospital #15, famous for being one of the best in Moscow — modern, well-renovated, and the sort of place that promotes mother-and-child bonding and breastfeeding. Neither Dr. Bovina nor myself had originally thought I’d be able to give birth there, since the ward was closed near my due date. (Local rules demand that all maternity hospitals are closed for a month each year to be disinfected and spruced up — why it takes a month, however, is beyond me.) But the hospital had just reopened and was filling up quickly.

Natalia Akhsyamova, a friend of Dr. Bovina’s, was the anesthesiologist on duty at the prenatal ward in Hospital #15 when I showed up, a week late and feeling like my head was about to explode from terror and confusion. Friendly, polite, and more than a little amused by my terrified expression, she took me to see the head of the prenatal ward, Olga Glotova.

Glotova, a kindly blond clearly used to seeing all sorts of hysterical women, examined me in her office, highly amused by the whole situation. “You wanted to give birth at Hospital #70?” she laughed. “That’s ridiculous, their postnatal ward has four women to one room…. And oh, look, blood!”

“Blood! Where?”

“Here!” Glotova waved her bloodied glove at me. “You’re in labor! Go grab your husband and head to the reception area. I’ll get you admitted.”

After Glotova rushed me through admission, Akhsyamova was called in to give me an epidural so that I could rest. Epidurals on demand are also relatively new for Russia.

“We never had such options,” Glotova told me. “Nowadays, it’s standard practice in any decent hospital, of course.”

The labor was prolonged and difficult, even with the epidural. At one point, Glotova went away for a few minutes and came back brandishing a surprisingly pretty and colorful vacuum device. “A journalist writing an article about childbirth in Russia should know the latest in vacuum technology!” she said, beaming. “None of the old stuff! This is all shiny and brand new!”

I was immediately inspired to push properly.

Our son, Lev, was born not long after. Glotova placed him on my belly to share a few seconds of skin-on-skin contact — still a comparatively rare practice in Russia. Lev sneezed. My husband cried.

“See? The gods are on our side,” he said. This time, arguing with him didn’t cross my mind.

In our case, the gods had acted through sympathetic medical professionals — those who had the power to cut through the bureaucracy. However, other women who wind up in my situation are not always as lucky. While pumping money into maternal care is well and good, what these women most need is a change in the mainstream medical attitudes toward pregnancy and childbirth in Russia.

A hospital with modern technology is still only as good as the people who work there — a lesson I learned the hard way through my experience with Hospital #70. If the staff is not motivated to treat pregnant women like regular human beings, as opposed to mere prisoners to their condition, all the money in the world won’t improve Russia’s maternal care system.

For now, Lev — a positive statistic for the agencies that keep tabs on Russia’s population and determines official policy on demographics — has no idea as to the drama surrounding his coming into the world. He was born into a country that is both rapidly modernizing and, in some major ways, still clinging to the past. As I watch my Russian son sleep, I can only do what every new mother does — stock up on hope.

20 responses to “The Horror of Childbirth in Neo-Soviet Russia

  1. How awful the situation in Germany must be… Their birth rate is much lower than Russian, which is – surprisingly – growing every year…

    • But you see, dear illiterate Dmitri, the problem Russia has is not the BIRTH rate, it is the MORTALITY rate. Germany has safe streets and houses and a healthy population. Its people rank NUMBER 20 in the world for life expectancy. Russia ranks NUMBER 135.

      So it really doesn’t matter how many people are BORN in Russia, because Russia is far too good at KILLING ITS CITIZENS.

      And, by the way, how do you know Russia’s birth rate is growing? Do you have any source for that information other than the Kremlin? If not, do you really believe the Kremlin would not lie about it if Russia’s birthrate were falling?

      • Mortality is bad, but it is not evenly distributed. Infant mortality is near european level, women – too, men – high mortality in 35-70 age and very different in various stratas.
        Those who die are unlikely to affect childbirth and quantity of next generation, they are often heavily drinking and do not contribute to society and family. This may sound cruel, but their death is mostly irrelevant.
        And by the way, expected lifespan is growing since 2002, still low by european standards, but a lot better then ten years ago.

        • Ah, the good old Russian attitude “their death is mostly irrelevant”

          Yes, just like Russians said about the millions sent to the Gulags, about the ethnic minorities they slaughtered, and in recent years, about the women and children raped and murdered from Chechnya to Georgia and Moldova by Russian troops.

          BTW, your birth rate is still lower than your death rate Auriga, so I think those deaths are relevant.

      • Same old song about forged statistics:) Do you yourself, dear LR, have any source for that information other than the Kremlin?

        As to the life expectancy, see, LR, the main reason for higher male mortality is heart diseases, which are caused by stress. Stress is caused by the influence of 1) failing economy in the 90ies + 2) high cultural expectations from men.

        • You think men don’t experience stress in the United States and elsewhere? Like in Japan where 70-hour work weeks and 7 days a year vacations are pretty common.

        • I disagree. Higher then average rate of heart diseases is caused by bad habits (alcohol) and poor healthcare. It can (and should) be helped. But this is a long process.
          Still it doesn’t have any connection with childbirth. Infant mortality is greatly reduced and fertility is rising, this affects size of next generation. Death rate among men in 50+ age almost doesn’t affect this/

          • Actually the birth rate is dropping again according to statistics, and most Russian experts, including those working for the Russian state and the UN state that the (very small) rise in births was a temporary blip and unsustainable due to the demographics of Russia, ie the ageing of the female population.

            As for “Death rate among men in 50+ age almost doesn’t affect this”, well you ain’t too bright Auriga, take a look around Moscow, so many young trophy wives on the arms of 50 something Russian men, besides, unlike women, men can father children at any age once they become virile.

            • No. Drunkards can not create a good family. So whether they die or not, it doesn’t affect fertility. For men biological ability to father is 1000 times less important then ability to support family.
              Of course, there is an impact of female cohort born in the demographic peak of 80th in the current growth of birthrate (about 40% or 50% is thanks to it). So birthrate can descend a bit in the next years, but it is not going to fall to the level of 90th.
              Fertility is number of birth per number of women in the age of 15 – 45. So it already takes number of potential mothers into account.
              Good fertility is around 2.1 Russia has now 1.55, which is not enough, but still a lot better then 10 years ago.

              Important factors are number of kindergartens, schools, perinatal centers, temps of housing construction and general economy.

              • Junkies also “can not create a good family”. How many alcoholics and drug addicts are among the young Russians today, according to you? Few? Many?

                You also forgot the orphanages (and millions of Russian orphans, either living in the street or these hellish orphanages). If they survive until they’re adult, are they likely to “create a good family”?

                And how many of these newborn children are Russian/Slavic, and how many were born in the North Caucasian minorities, where Russia is often absolutely despised? How many young Russians even today are Muslim, as compared to non-Muslims? And how many ethnic Russians live in the Muslim-majority territories, as compared with 20, and 50 years ago?

                And getting back to the beginning, how many alcoholics and drug addicts, and the homeless children, are in the Russian-Muslim communites, as compared to the percantages of these among the non-Muslim Russians?

                You can get your own conclusions.

                • You are just using well known set of arguments.
                  All these ‘junkies, drug addicts, alcoholics’ are not creating normal families and so do not contribute to birthrate. The scary numbers have roots in the articles of other russophobes. I.e. one writes article with scary numbers based on his wild imagination, then 10 other russophobes may refer to that article as a well known fact proven by research.
                  It is immensely difficult to collect in the field some real data about number of orphans, alcoholics, drug addicts, AIDS infected et.c. So all numbers are estimates. Good approach is to compare projections made according to articles 10 years ago. Russophobes used to predict two digit percentage of AIDS infected, further acceleration of depopulation, alcoholism and takeover by muslims. These projections failed miserably and so initial estimates were falsified.
                  While you keep dreaming about extinction of russians, I see lots of babies every evening, when walking with my son. Some babies I see are not russian, but less then 20% for sure.

                  • Don’t you really see the connection between the number of alcoholics, and (yes) dysfunctional families (including deadly domestic violence, and various alcohol-related early deaths), and the very large number of orphans and abandoned / street children? That’s something to diregard for you?

                    Oh, the Russian AIDS epydemic is gone? Really? Some quotes from the 2010 UN report:

                    “Increases of up to 700 per cent in HIV infection rates have been found in some parts of the Russian Federation since 2006.”
                    The est. number of Russian inject drug addicts was 1.8 million last year and “In Moscow, Russian Federation, in 2005 the average age of injection start-up was 16 years old.”
                    “Combined international investments in HIV in the entire region do not come close to investments in a single country such as Ethiopia that has a similar number of new HIV infections annually as the Russian Federation”.

                    Who’s “miserable” in this, really? And how does it feel to be compared negatively with Ethiopia? As in: who needs more badly the international aid.

                    And don’t you know that eventually most conscripts will be Muslims? I mean, officially. (And even when they’re in minority, they still ten to band together, refuse to follow orders, and terrorise their unorganised Slavic “collegues”.) It’s not recent “some babies”. It’s the post-Soviet generation.

                  • Actually Auriga, you are either an outright liar or an idiot.

                    Junkies and alcoholics in Russia seem to have a lot of children given the country’s massive problems with FAS and drug damaged children.

                    Do you think that the births from these groups are not recorded in official figures or something?

                    You really are uneducated Auriga.

                    For example the horror of FAS (Fetal Alcohol Syndrome) rates in Russian orphanages.

                    Results Thirteen percent of children had facial phenotype scores highly compatible with prenatal alcohol exposure and 45% had intermediate facial phenotype scores. These scores correlated with maternal gravidity and age. At least 40% of mothers in whom history was available ingested alcohol during pregnancy; some also used illicit drugs and tobacco. Z scores for growth measurements corresponded to phenotypic score, as did the degree of developmental delay. Children with no or mild delay had significantly lower phenotypic scores than those with moderate or severe delay (p = 0.04); more than 70% of children with high phenotypic scores were moderately or severely delayed.

                    More than half of residents of the baby homes in Murmansk, Russia, have intermediate (45%) or high (13%) phenotypic expression scores suggesting prenatal exposure to alcohol. Despite good physical care, stable daily routine, availability of well-trained specialists, and access to medical care, these vulnerable children show significant growth and developmental delays compared with their institutionalized peers.


                    Considering the normal rate is 1.9 per 1000 children worldwide…….

                    • Andrew, stop it. You know nothing of demographics, you really should not show your ignorance every time you get an itch to make a stand.

                      There’s no “normal” rate of 1,9. Average TFR for europe is 1,5. 2,15 is enough for substitution of mortality. TFRs in most western european states are below 1,5. Russia does better than Germany, Spain, Georgia, every other european CIS state, Baltics, Greece, Italy, Poland, etc.

                      MUCH better than most of these states. Much better than Georgia, which has an TFR of 1,44 compared to Russia’s 1,54. Better, not worse.

                      So stop posting bullshit now.

                      Source – wikipedia, that you failed to check, as always.

  2. Robert, Andrew. You (generally Russophobes) have been saying this for ten years, or more. But your predictions just fail. So either you use faulty data or faulty logic.

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  5. Interesting article. Thanks for sharing your experience. I’ve often wondered what it was like for both my g’ma & my mom to have given birth in Russia (they refuse to indulge my curiosity on this subject), and I can understand why they are reluctant to talk about something that was probably pretty traumatic & frightening due to inexperience, lack of information & education as well as undoubtedly the standard, draconian policies of the so-called birthing centers.

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