Abstract
Preventive measures taken by the Russian maternity care system in response to the COVID-19 pandemic are very tough. Supporting persons (doulas and partners) are being completely excluded from the maternity hospitals. Pregnant women and newborns are distributed in different types of hospitals according to their epidemiological status (confirmed, suspected, contact, or “clear”). Severe infection control measures are introduced for women with confirmed or suspected COVID-19: separation from newborns and weeks of hospital quarantine. How do obstetricians and other perinatal specialists perceive these measures? What strategies do they choose and what new practices are being created? The study is based on interviews conducted between March and August 2020 with obstetricians-gynecologists, midwives, perinatal psychologistsdoulas, and women who gave birth during the pandemic and is focused on their subjective interpretations of COVID-related changes in maternal care. My data indicate that this pandemic with its high risks and uncertainties reveals multiple ethical and organizational conflicts among bureaucratic, managerial and professional logics in Russian health care in which mistrust has played an important role.
Highlights
Reviewed by: Hannah Dahlen, Western Sydney University, Australia Elena Zdravomyslova, European University at Saint Petersburg, Russia
Preventive measures taken by the Russian maternity care system in response to the COVID-19 pandemic are very tough
How do obstetricians and other perinatal specialists perceive these measures? What strategies do they choose and what new practices are being created? The study is based on interviews conducted between March and August 2020 with obstetricians-gynecologists, midwives, perinatal psychologistsdoulas, and women who gave birth during the pandemic and is focused on their subjective interpretations of COVID-related changes in maternal care
Summary
In recent works, Mühlfried calls for a revision of the existing social science approach to the phenomenon of mistrust “as the. The first maternity hospital, which, in accordance with the recommendations of the Ministry of Health, was designated "to receive pregnant women with ARVI, community-acquired pneumonia and patients who are quarantined due to contact with coronavirus infection" (Guidelines 2020) began working in Moscow on March 31 It is a large 170-bed maternity hospital with more than 7,000 births per year. My interlocutors from the older generation of doctors believe that this reaction is caused by "historical memory": in a situation of epidemic danger, health officials immediately reverted back to the old Soviet practice based on the principles of prohibition and separation, the dominance of bureaucratic logic, paternalism, and neglect of patient rights, when maternity hospitals were completely closed institutions with strict and prohibitive rules, separation of mothers and newborns, and severe sanitary and infection control measures. Doctors, with the help of women activists, could transform themselves into system changers rather than system “soldiers.”
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