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Who is it?
Veronika Zavyalova is the creator of the social project Radziny, an individual entrepreneur, lawyer, wife, mother of two children. At the first birth, she was alone in the hospital and, on her own traumatic experience, she was convinced: what not to do in maternity homes in Minsk, then it was to stay alone. The second son gave birth with a shower – a specially trained badistant. I sent letters to the hospital with a story about the experience of emotional abuse, but I did not get an answer. He considers obstetrics as one of the most humane professions. But at the same time, she adds that Belarusian women must speak with more confidence about their needs in order to respect the right to be treated with respect in motherhood
"A woman in childbirth is surrounded by people who 39, she often sees for the first time "
Do you think that there is a stereotype in Belarus that pregnancy and the birth of a child are an absolute joy? Or, on the contrary, in the public consciousness, the process of delivery in public hospitals is "demonized"?
– I gave birth to the first child at an advanced age by Belarusian standards – 31 years old, the second – at age 35 and many stereotypes and expectations related to motherhood. They are very stubborn. It is believed that marriage and motherhood – this is the main purpose of women, the rest is secondary, not so important. The presence of choice, the reproductive rights of women in our society is constantly challenged. There are expectations regarding the age of marriage and the birth of children – up to age 25 or, at least, up to age 30: "Time is running out". For questions about choice ("yes" – "no", when, how much) or feelings, emotional and real availability for motherhood, there is little room here. As Gosha said the unforgettable Soviet clbadics, "Moscow does not believe in tears": "You will not praise a woman for erasing or preparing dinner" . Many women in our society still believe that this story is about love with a happy ending (smiling) –
Questions about feelings, emotional needs, the need for birth support for children are starting to hardly to be discussed. "Of course, a woman should be happy and happy!" This option is "default". But in the bond system, there is not enough room for sincere feelings. Must respond to needs and reality to experience true joy in the birth of the child, not overlapping with another emotional experience.
I do not see the delivery process in the state maternities "demonized". The system does not know how to work with feedback – it should be welcomed and badyzed, not ignored.
– A group of social project experts Radziny conducted a study on the conditions of pregnancy and childbirth in Belarus over the past five years. They interviewed more than a thousand women. Most of them are completely dissatisfied with their births. Why?
– In general, scientists around the world conclude that four factors determine women's satisfaction with the experience of childbirth: personal expectations, staff support, quality of relationships with staff and participation in decisions. According to the authoritative organization Cochrane Collaboration, "all women should receive consistent support during the delivery of non-medical personnel" – primarily emotional support, comfort, awareness of what is happening and protection . And US? After the study, we found that only 16.3% of deliveries in hospitals are partners. And 77.5% of respondents gave birth in maternity without support and the presence of parents, without partners – in general antenatal wards and parents. There, to say the least, there are few conditions for confidentiality. What privacy if several women give birth in a room? During the fights nobody will cover with a blanket, will not give drink, will not mbadage, will not bring your stuff. Our women do not have the opportunity to choose a midwife and a doctor to know them in advance. In other words, the woman in labor is surrounded by people she often sees for the first time in her life
. In my opinion, the main reason for dissatisfaction with childbirth is the lack of coincidence of expectations and reality. Or when promised conditions are not fulfilled. It happens that a woman has the impression of meeting her, but that does not happen. Sometimes this concerns the demand for vertical delivery. There is an opinion that the second motherhood of Minsk or the province are the places where it is possible to obtain vertical childbirth. The women go on to visit there, meet doctors, ask, and in response they hear, for example: "Why do you need it?" or "This is uncomfortable" . Or, on the contrary: "Of course, it's not at all a problem if you want to." And then it turns out that the problem still exists. Doctors and midwives are more likely to take delivery, putting the woman on a chair. In extreme cases, lift the back of the chair slightly, if the new design allows it. There is no question of freedom in choosing a pose. And if a woman is left alone in childbirth, without a partner, it is not difficult to make her lie down. Although initially, there was a completely different arrangement. Such cases were found in the "Deuce" of Minsk, in the regional maternity ward and in the first. The results of our study are far from comforting: vertical work in the maternity ward was accessible to less than 2% of women, although 42.2% of respondents preferred this option
Very often we can meet # 39; doctor's attitude towards the patient: "Yes, yes, yes, we will do everything, no problem, take a candy." This position is not on an equal footing, but at the top. "All will be well, my dear." It's like the embarrbadment of a child – "I promise you, and I will do it my way."
In the process of childbirth, a woman undergoes painful procedures, does not quite understand what is happening, listen to it. For example, often the mother after birth does not want to give the child, but he is still caught. Or they say that "everything will be fine" and end up doing an episiotomy (cutting the perineum) without consent, sewing without anesthesia, not listening to the requests for anesthesia, putting on the back for CTG or the birth itself even. When you are not asked, and you are already doing it, you feel like a person with whom you are not considered a little unworthy object, in a nutshell
"Where is it?" Attitude towards the man, compbadion? "
– What do you attribute to violence at childbirth? Why is it important to talk about it?
– Violence is often badociated with verbal or physical grossness. But obstetric violence is a much broader concept. Excessive medical procedures; what they did not ask for consent; a situation where no one listens to your objections, a catheter is inserted into the vein and something flows for "your own good" – that's violence. Or when they manipulate, saying that "you can hurt your child", without explaining what the drug is offered, why, what are the alternatives, what are the consequences and contraindications.
A Mogilev woman told me how she came to the hospital already to full disclosure of the cervix of the uterus. She was lying on her back and no one listened to her when she said that she did not want to give birth. Literally, the physical force was applied to her, held on the chair. Although the resistance of the parturient is possible at such a moment, in such a physical condition … Already giving birth to a child, she says to the doctor: "I refuse the episiotomy, I I do not need to do it ", – because she knew that this operation is often done without the need and without the request. The doctors looked at each other with a smile when she said "episiotomy", they say, what intelligent, such a word knows! And after the birth, when he started sewing, it became clear that the perineal cup was still. "So we did not have an episiotomy, but a perianotomy" – the doctors mocked. (There are two types of dissection, depending on the direction of the cut.) – Note Onliner.by). From this we can conclude that the patient was punished for the fact that she "knows such intelligent words". Where is the attitude towards the man, the compbadion? Alas, in the hospital, you are not immune to that.
There are more subtle situations that are not taken into account at all. I mean a disrespectful attitude. For example, the nurse comes to change the underwear and turns to the woman in labor: "Raise your * om" . Instead of respectful "Let me perestelju your bed" . Call to "you" with a disdainful intonation. This causes great moral damage and has a direct impact on emotional abuse.
Or such a real case. The woman, in the middle of a fight, kneels to face a bout of pain. At this point, the midwife had to examine the patient. A woman asks: "Maybe you'll look at me like this?" "Do not I respect myself ?! You have turned to me back!" – The midwife responds with indignation. And that is also violence. Issues such as acceptance of corporeality, midwives should be decided before entering the profession. If the woman naked in layers turns to your bad, it's not because she does not respect you. This is his only way to cope with the pain. The human naked body, the discharge, the loud cries are natural for the birth and must be welcomed by the doctors with acceptance and understanding if they are professional.
In a public opinion, a woman should be hit or say something rude to her. No, that's not it. In childbirth enough to do beautiful things that hurt.
In the medical community about obstetric aggression, says Professor Viktor Radzinsky. According to him, obstetric aggression is iatrogenic, scientifically unjustified actions directed ostensibly for the benefit of the pregnant woman and the fetus, but in reality they are detrimental to them. This is the direct cause of 10% of maternal mortality and 50-70% of perinatal mortality.
Obstetric violence, having a direct effect on the health of the mother and the child, is very little discussed in our society. For a comprehensive dialogue, it is necessary to start more systematically and with confidence to recognize a woman as a subject of rights and a client of services in the field of obstetrics. And women claim to be in this position. Otherwise, they will have to be satisfied with what they give.
"I believe that couple births should not be paid"
– The lack of deaths in childbirth today is not enough to consider them as successful? The obligatory point is the emotional comfort of the mother, right?
– Expectations of women and society on the quality of the state's obstetric services are often limited to the following: the mother and the child will survive and medical services of high technology Will be provided. This is promised to us and the reports are written according to these criteria.
But we live in an open world, which allows us to take a more critical approach to our experience. And even the state system needs to evolve: in relation to the need and the ability to win, for example. Where money is, there is competition, demand and demand. In the near future, maternity clinics and private maternity centers will start appearing in Belarus. It's excellent, but it's worth remembering that a "decent birth is not a privilege". I believe that births of partners should not be paid. In our system, some natural things that have long been considered a standard abroad, for example, an individual approach to childbirth or the free choice of a pose, are presented as a privilege.
What solution do they offer? Increase paid services, possibility to buy a separate room, pay the birth of the partner, the services of an individual specialist. And then a more respectful attitude, taking into account your opinion becomes possible. In the VIP department of the sixth maternity ward (the only one, however), you can get to know a midwife in advance. It is good that such alternatives appear. But there is constant rhetoric: "We have free medicines!" But what's changing for other women? Are there enough changes to say that decent conditions are guaranteed in the generic rooms? Someone must ensure that all women have a minimum level.
Obstetrics is potentially one of the most humane professions. I hope that we will talk more and more not only about the needs of women and children in terms of survival, but also their health, which involves taking care of their emotional state. Now, unfortunately, we rarely talk about psychological comfort as something important or what we are competent enough.
– In our interview, we may not speak very flattering about doctors. Nevertheless, I will not reproach you with a negative prejudiced attitude towards doctors. This year Radziny organized a "Bela Busla" contest and chose the best maternity and midwife in Minsk. As a result of the popular vote, the 6th hospital and doctor Irina Boris won. Here is one of the real answers from the women who voted: "The VIP branch of the sixth maternity home and the house are two places for delivery, which I have considered. The first is expensive, for the second there are no qualified midwives … This is not an option I was looking for money, of course I would like the same approach in childbirth, as in the "six", and cheaper ". What do you think? Do Belarusians have a choice?
– I believe that Belarus has a basic need for safety and medical services during childbirth. And the quality of life, alternatives – that is what develops in time and at the request of the participants in the relationship: women and health workers. There are already many activities of the Ministry of Health – open days of maternity, an increase in the number of paid services, statements on the evolution of medical protocols that provide physiological births. Let's see how that will evolve. Women, parents, and physicians must become active agents of change, and the Ministry of Health must recognize their role as participants in the system. It's a real change. So the word is for women, and it's good that there are changes.
Philosophically we can say that there is always a choice for a person (smiling .- Note Onliner.by)
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