What you need to know about maternity hospitals in Russia. Maternity hospital

Having gone through the first days of euphoria about the future of motherhood, having made all relatives and friends happy with the good news, women, as a rule, begin to plan: what to buy, how to make repairs. The most important thing - where the joyful event will take place - is the last thing they think. But it is very important to choose a maternity hospital in which your child will be born.

Before making a decision, it is worth figuring out what and at what moment happens to the woman in labor in the hospital.

Admission department
The first department that the expectant mother gets into is the foster room. Here you will be asked for documents: passport, exchange card, birth certificate and health insurance policy. In the third trimester of pregnancy, they should always be at your fingertips.
One of my friends, originally from Murmansk, lived in Moscow, and was going to give birth in Belgorod, where the father of the unborn child was registered. At the eighth month of pregnancy, the guys finally decided that it was time to go, packed their bags and bought tickets to Belgorod, where they were to undergo the last examination before giving birth. But on the eve of departure, the expectant mother woke up because the waters broke. While the couple were arguing about what to do, the woman in labor began to have labor pains. The bag was not collected at the hospital, even the dressing gown was lost somewhere at the bottom of the suitcase, on the hands of 500 rubles, a passport and a medical insurance policy, no tests on hand. From the medical documents, only a certificate from a doctor stating that the girl needs a cesarean section due to poor eyesight. “No one has remained pregnant forever,” the doctors reassured the “ambulance” expectant mother, who is worried about the lack of an exchange card (a document containing information about your health and the condition of the child). The delivery was successful, the doctors made a caesarean without any questions. Moreover, the friend admits that the attitude of the medical staff to those who paid for childbirth and those who could not do this was absolutely equal.

This is a good example, but not always everything goes smoothly. For example, due to the lack of an exchange card, doctors who do not have information about the state of health of a pregnant woman are obliged to send it to the infectious diseases department. It's not so much dangerous as it is unpleasant. So keep the papers in a visible place.

By the way, when going to the hospital, you should take a bag with the necessary things with you. Collect it in advance! When it came time for my neighbor to give birth, she, pregnant with her first child, was ashamed to wake up her husband's family in the middle of the night. I told everyone that she was giving birth when the process was already in full swing. Her mother-in-law rushed to us - my mother is not a doctor, but she often gave injections and put IVs to neighbors. They called an ambulance, but then the baby's head appeared. The matter was complicated by the fact that the future grandmother fainted at the sight of blood. Grabbing a home first-aid kit, armed with alcohol and regular scissors, my mother went to deliver. Fortunately, everything went well, the doctors arrived at the moment when the umbilical cord was bandaged for the newborn. And then it turned out that the young mother was not at all ready for the trip to the hospital. Towels, panty liners, socks, a dressing gown were collected by the entire entrance. If you do not want such a birth, prepare everything you need in advance!

After examining your documents, the emergency room doctor will examine you, listen to the fetal heartbeat, and determine its presentation. If you do not have an exchange card in your hands, you will have to take the necessary tests. After the examination, you will be prepared for childbirth - they will change your clothes, give you an enema, and shave your crotch. If you do not want to undergo these procedures in the hospital, do everything at home yourself in advance, as soon as you feel the contractions.

Prenatal department
After examination, the woman in labor is transferred to the prenatal department. Here obstetricians will monitor her - to control blood pressure, dilatation of the cervix. If necessary, they call a doctor who makes his appointments: perhaps the expectant mother needs stimulation of labor or other medical assistance.

Lately, many parents-to-be are in the prenatal ward together - the husband supports his wife, gives her a massage or distracts her from contractions by talking. But now the time of the birth itself comes, the woman is transferred to the maternity ward. Whether a future dad should be present at childbirth is an important question. On the one hand, this can be a huge relief for a woman in labor. Nearby is a loved one who holds your hand, wipes sweat from his forehead, soothes and echoes the doctors "push!" On the other hand, not every man is ready to endure such a sight. One friend of mine confessed that he divorced his wife after being present at the birth - he fell out of love: “I understand intellectually that this is a natural phenomenon, that this is the appearance of a new life, that she was tormented for the sake of our child. I understand that I look like a scoundrel in the eyes of many, but I cannot overcome myself and overcome disgust. After all that I saw, I never touched her again. " Of course, everything depends on the man, but no one is safe from such surprises. And this guy went to childbirth, being sure that everything would be fine and he would even like the process. Another friend of mine told me that she and her husband decided to have their second child together. Their experience only strengthened the family, and most importantly, she admitted that the attitude towards women of doctors who give birth in the presence of a faithful is changing greatly. If she gave birth to her first child alone, and the doctors could even shout at her, here the obstetricians were more than courteous, even gentle, as if they were giving birth to their daughter. So think, decide with your husband, but do not overestimate his strength and stress resistance.

Maternity ward
When the cervix is \u200b\u200bfully dilated, the woman in labor is transferred to the rodblock. Here, after attempts, a miracle appears - your baby. The newborn is examined by a doctor, and if everything is in order with the baby, it is laid out on the mother's stomach. In some maternity hospitals, the child is allowed to be immediately attached to the breast. Then the newborn is waiting for a more detailed examination, treatment of the umbilical wound and medical supervision. For two to four hours, you still remain in the delivery room, where a doctor will monitor your condition. Only after that the mother and child are transferred to the ward.

Postpartum department
Now, most women prefer to have their child in the same room with them. But it happens that the baby is brought to you only for feeding, every two to three hours. If childbirth took place without complications, then discharge occurs on the third or fifth day. Keep in mind that your family and friends will probably come to check out with cameras and camcorders. So you should go out beautiful and happy to those who meet you. It's better to take care of your appearance in advance - ask loved ones to bring you suitable clothes and cosmetics. After all, now you are the wonderful mother of the best baby in the world!

Katya Fedorova

In the minds of the expectant mother, a maternity hospital is often associated with a hospital, which means it is associated with illness, the smell of drugs, terrible metal tools and other unpleasant images. This idea of \u200b\u200ba maternity hospital is completely wrong, but easy to explain. The fear of a maternity hospital is caused by a complete lack of understanding of how a modern obstetric institution works and how it works. In order to get rid of unnecessary fears and anxieties and get to know more closely the departments and staff of the maternity hospital, we have prepared a fascinating tour of the maternity hospital on the pages of our magazine.

Admission department

This is the first department we enter when we open the door of the maternity hospital. There is necessarily a hall or a large room in which expectant mothers, accompanied by loved ones, await a call to the doctor. The admission department itself usually consists of three rooms: an obstetric post, an examination room and a sanitary room. In the first room there is a table, a couch, a scale and a height meter. Sitting at the table is the emergency midwife. Her responsibilities include paperwork for admission to the hospital, measuring weight, height, blood pressure, pulse and body temperature of the expectant mother. Upon completion of these manipulations, the midwife escorts the pregnant woman to the next room - the examination room, where she is met by a doctor - obstetrician-gynecologist.

The doctor asks the expectant mother about her state of health, the peculiarities of the course of pregnancy, the reasons for treatment and well-being at the time of admission to the hospital. The doctor records the data obtained in the history of childbirth - this is the name of the woman's medical record in the maternity hospital. After the conversation, the expectant mother is offered to undress and lie down on the couch located here. The doctor measures the size of the abdomen and pelvis, determines the location of the baby in the uterine cavity, listens to his heartbeat with a special tube or ultrasound device. The woman is then asked to climb onto the gynecological chair and the doctor performs a vaginal examination. Immediately, we note that during an obstetric examination on a gynecological chair, mirrors or other "terrible" medical instruments are not used: in order to determine the degree of cervical dilatation, the doctor needs two fingers.

After the examination, the midwife invites the expectant mother to the sanitary room for sanitary and hygienic preparation for childbirth.This concept includes a cleansing enema, shaving of the perineum and a shower. In the sanitary room there is a couch on which the crotch and enema are processed, a toilet and a shower.

After the shower, the woman in labor is helped to change into clothes for childbirth - "official" or brought with her (depending on the requirements of a particular maternity ward). In a number of maternity hospitals, the expectant mother will be offered to change immediately as soon as she crosses the threshold of the hospital. In any case, the clothes must be given to the accompanying persons, if the woman arrived alone, then the things will be left at the reception for a short time (within a day).

Maternity unit

From the admission department, the woman in labor is sent to the maternity ward, or birth block. This is undoubtedly the most important department of the maternity hospital - this is where childbirth takes place! In modern maternity hospitals, the delivery unit can have two different layouts. Let's talk about each of them separately.

The so-called "box" layout assumes the division of the rod block into separate rooms-boxes, designed for one woman in labor. Boxing is a room with an ordinary bed, bedside table, table, chair. Next to the bed of the expectant mother is the CTG apparatus (cardiotocographs are devices that allow you to register the baby's heartbeats and the contractile activity of the uterus) and, of course, a special device for childbirth - Rakhmanov's bed. Also in the box there is a changing table and scales for crumbs. In some maternity wards, Rakhmanov's beds are being replaced by more modern obstetric chairs or comfortable transforming beds, which, at the right time, with the help of a remote control, are “converted” from an ordinary bed into a device for childbirth. The expectant mother is in boxing for all 3 periods of childbirth (I period - contractions, II period - attempts, III period - birth of the placenta) and 2 hours of postpartum follow-up. Examination of the birth canal and (if necessary) restoration of damaged tissues is also carried out in the box, where the initial examination and treatment of the newborn takes place.

Another, older version of the layout involves dividing the delivery unit into prenatal wards, delivery rooms and examination rooms (or small operating rooms), as well as children's rooms. In this case, the wards are designed for several women in labor. Women are in the prenatal ward during the entire I period, as well as approximately half of the II period of labor (before the start of productive attempts). In such a room there are several beds and bedside tables. The equipment necessary to monitor the condition of the woman in labor and the fetus (for example, CTG) is usually installed here. In the prenatal ward, the woman in labor can walk, lie on the bed, or take special positions.

When productive attempts appear, the expectant mother is transferred to the delivery room located nearby. There are several Rakhmanov beds in this room. On one of these beds, the woman in labor spends the end of the II period and the III period of labor. After birth, the child is taken to the children's ward, where he is examined, weighed, measured, the umbilical cord is processed and dressed.

After the completion of childbirth, the mother is moved on a gurney to a small operating room, or examination room. There is a gynecological chair in the examination room, on which the doctor examines the birth canal and, if necessary, repairs damaged tissues. The postpartum woman is then placed back on a gurney next to the midwife's post for observation.

If everything is in order, two hours after giving birth, the young mother with the baby is transferred to the postpartum department.

Postpartum department

The layout of the postpartum department depends on the mode of stay of the mother and baby practiced in the given maternity hospital.

When the mother and child are together in the postpartum ward, in addition to the mother's bed, table, chair and bedside table, there is a changing place for the baby, as well as his crib. Mom and newborn are together all the time. In this case, the nurse and the neonatologist examine the baby in the ward with the mother. On the first day, the children's sister teaches the mother to take care of the baby, wash and change his clothes. As a midwife in the postpartum department

this includes helping with breastfeeding. When staying together in many maternity hospitals, it is allowed to use "their" clothes for the baby.

Separate stay implies the presence in the maternity hospital of a children's department where the newborns are, In this case, the mother and the baby meet only during feeding - 7 times a day every three hours. The first feeding is usually at 6 am, the last at 00 hours. From 00 to 6 in the morning - a break for sleep. Examination and other manipulations with the baby are carried out in the children's department, and then the neonatologist bypasses mothers and tells them about the well-being of the children.

The postpartum department in this case is arranged as a normal therapeutic department, with the exception of the presence of an examination room, in which women are treated with stitches and examination before discharge.

In any case, family visits may be allowed in the postnatal ward. As a rule, this is provided if childbirth is carried out within the framework of voluntary medical insurance or the service ward of the postpartum department is additionally paid.It should be borne in mind that even at the same time, only 1-2 people can come to one woman in labor at the same time, it is strictly forbidden to enter the postpartum department of children up to 14 years old.

Department of pregnancy pathology

Women with complications of pregnancy that require constant monitoring are admitted to the Department of Pregnancy Pathology, or OPB. Such complications include, for example, gestosis (a complication of pregnancy, often manifested by an increase in blood pressure, edema, the appearance of protein in the urine1, the threat of termination of pregnancy, chronic fetal-placental insufficiency (a condition in which the fetus receives less oxygen and nutrients due to deterioration work of the placenta), In the department, expectant mothers are observed and receive the necessary therapy.It differs from the usual department of OPB by the presence of an examination room, as well as rooms for auxiliary diagnostics - ultrasound and CTG.

In addition to expectant mothers who have health problems, the OPB hospitalizes pregnant women before a planned caesarean section. With a tendency to prolong pregnancy, the expectant mother is also sent to the OPB.

Other departments of the maternity hospital

In addition to the listed departments, any maternity hospital has operating unit, which includes two operating and auxiliary rooms. Cesarean section operations are performed here. Next to the opera block is intensive care unit, where puerperas are observed during the first days after surgery. Caesarean section is usually performed by two obstetricians-gynecologists; they are assisted by an operating nurse and a midwife. At the operation, as well as at physiological childbirth, a neonatologist is present. Anesthesiologist is responsible for pain relief during the operation; he is assisted by an anesthetist - a nurse in the intensive care unit.

If after childbirth the mother or baby has complications, they are transferred to observational, or second obstetric department... In the same department, expectant mothers give birth, who, at the time of admission, have symptoms of acute respiratory infections or other infectious diseases or have no exchange card. This department has a delivery room, postnatal and children's wards.

Some maternity hospitals provide resuscitation and intensive care unit newborns. The staff of this department has all the necessary knowledge, skills and equipment for caring for children born in serious condition. Typically, such maternity hospitals specialize in preterm birth: premature babies often need intensive care.

With the development of medicine, the state sought to take control of such an important area as childbirth. How this happened in pre-revolutionary Russia, and will be discussed in this article by Irina Martynova. The text is taken from her book "To be born of your own free will".

---
At the end of the 16th century, under Ivan the Terrible, the first state body was created to manage the health care system, the so-called Pharmaceutical Order. The traditions and Domostroy that existed in Russia retained the idea that it was not appropriate for male doctors to engage in obstetrics, and the birth was usually attended by midwives.

Midwives were renowned for their skill, based on the experience of generations. They resorted to the help of midwives until the middle of the 20th century.

Under Peter I, many Western doctors came to Russia, whose opinion was not recommended to be criticized. This is how a scientifically grounded medical "male" approach to the process of childbirth began to form, displacing the natural intuitive "female" management of pregnancy and childbirth. Although until the beginning of the 19th century “doctors were not only not allowed to study obstetrics on the human body, but if a doctor examined a woman in labor without a midwife, then he was put on trial” (V.P. Lebedeva, 1934).

In 1754, Pavel Zakharovich Kondoidi, a physician-in-law under Empress Elizabeth Petrovna, submitted to the meeting of the Governing Senate "The idea of \u200b\u200bthe decent institution of the Babichi case in favor of society." All "Russian and foreign grandmothers" had to pass qualification certification in the Medical Chancellery, according to this "Submission". Those of them, "who are worthy according to their certificates," were sworn in - which is why such grandmothers were called jurors. The list of sworn attendants who had permission to practice independently was supposed to be submitted to the police "for the people's news."

In taking the Bible Oath, each midwife promised, among other things:

- "day and night, immediately go to the mothers of the rich and the poor, of whatever rank and dignity were";
- "if the homeland will be long, I will not bend or force to torment in vain, but I will wait with patience for the present time, with the same cursing words, oaths, drunkenness, obscene jokes, disrespectful speeches and other things, I will completely hold back";
- "I will not agree to throwing out a baby by giving preemptive and expulsive drugs, or in any other way, and I will never agree to use it, and I will not give myself to that for anything", etc.

On April 29, 1754, the Governing Senate approved the Representation of the Medical Chancellery, with all its annexes, by issuing a Decree "On the Decent Establishment of the Babich's Case in the Benefit of Society".

Johann Friedrich Erasmus, summoned by Kondoidi from the city of Pernova (now Pärnu), became the first professor and teacher of "women’s business" in Moscow and in Russia in general.

In 1757, the first schools for training qualified midwives were founded in Moscow and St. Petersburg. The training was conducted by midwives (foreign, mostly German), not doctors. Male doctors were still not allowed to touch a pregnant woman.

With the beginning of the development of capitalism, yesterday's peasants who entered the city lived in incomparably worse conditions than in the countryside. With the enlargement of cities, moral principles begin to change little by little, and the status of the family is eroding. It is in the cities that the number of illegitimate pregnancies is growing. The state was forced to organize maternity hospitals for the poorest urban women. Obstetrics were originally intended exclusively for women from the poorest segments of the population, as well as for unmarried women in childbirth as a secret refuge. It was a shame to give birth in a hospital, so many of those who wanted to use medical help invited midwives to their homes.

In 1764, by decree of Catherine II, an Orphanage was opened at the University in Moscow, and under it was an obstetric ward for unmarried women in childbirth, which included the first specialized institution in Moscow - the Maternity Hospital - for poor women in childbirth.

In 1771, by order of Catherine II, an orphanage was opened in St. Petersburg, and the first obstetric hospital was established under it - for unmarried and poor women in childbirth (nowadays - Maternity Hospital No. 6 named after Prof. VF Snegirev).

In tsarist Russia, it was customary to donate hefty sums to charity. Maternity hospitals were created like shelters and almshouses out of charitable motives, and not out of medical necessity.

The scientific development of obstetrics and the improvement of teaching "women’s business" in St. Petersburg was due to NM Maksimovich-Ambodik (1744-1812), who is rightly called "the father of Russian obstetrics." In 1782, he was the first Russian doctor to receive the title of professor of obstetric art. NM Maksimovich-Ambodik introduced classes on the phantom and at the bed of women in labor, used obstetric instruments. He wrote the first Russian manual on obstetrics, "The art of obstetrics, or the science of women’s business," which taught many generations of Russian obstetricians.

NM Maksimovich-Ambodik, a well-educated doctor, a talented scientist and teacher, who passionately loved his work, was the first to introduce the teaching of obstetrics in Russian, and fought against foreign domination in Russian medical institutions. He was an ardent patriot who showed concern for the growth of the population of Russia: as an epigraph to his "Art of twisting", he put the words in bold: "Common reason commands more talk about the multiplication of the people, the useful maintenance of newborn children than the population of uncultivated land by German foreign aliens."

On the other hand, it was from this time that male doctors began to be allowed to the pregnant woman and to childbirth - just 200 years ago they were allowed to "touch" the pregnant woman. These 200 years have been characterized by the continuous struggle of doctors to increase their influence on the woman in labor. At first, they passed on to midwives only the basics of scientific knowledge, later the process of ousting the midwife from her legal field, where she regularly worked for millennia, began actively.

During the reign of Catherine II, in 1789, the "Charter for midwives" was given, according to which only those who were tested in knowledge and who took a special Oath were allowed to the "woman's occupation". They also required good behavior, modesty, discretion and sobriety, "so that at all times they would be able to do their job." It is important to note that the jury grandmothers "underprivileged" had to "serve without money." In capitals, a sworn midwife was on the staff of every police unit, along with firefighters, lamplighters, etc.

In 1797 in St. Petersburg, on the initiative of Empress Maria Feodorovna, the third maternity hospital with 20 beds was opened. This was the first obstetric and at the same time educational institution in Russia - the Midwifery Institute (now the Ott Institute of Obstetrics and Gynecology of the Russian Academy of Medical Sciences). "Maternity" received pregnant women at any time of the day. Obstetrics and hospitalization were usually carried out free of charge, and were intended mainly for married poor women in labor. The midwifery art at the institute was read by N.M. Maksimovich-Ambodik.

After the death of Maria Feodorovna, Nicholas I, by decree of December 6, 1828, declared the Midwife Institute a state institution and, according to the wishes of his deceased mother, appointed Grand Duchess Elena Pavlovna as patroness. The institution was named "The Imperial Institute of Midwifery Art with a Maternity Hospital". Under him in 1845, the first in Russia school of rural midwives began to work.

In 1806, a new obstetric institute and a three-bed maternity hospital for poor women in labor (now the Moscow Medical School No. 1 "Pavlovskoye") was opened at Moscow University. In 1820, the number of beds increased to six.

After the abolition of serfdom in 1861, the midwife worked both in the newly formed zemstvo medicine and in the state health care system. For their work, midwives were given a salary and an increased pension, as well as "for long-term diligent performance of duties" they were awarded insignia and government awards.

In tsarist Russia, there were three professional groups of women involved in obstetrics: "midwife" (higher medical education), "village midwife" (secondary medical education) and "midwife" (correspondence education).

Midwives were trained by the Midwives' Institutes, of which there were no less than two dozen in Russia by the end of the 19th century. The diploma for the title of midwife was issued upon completion of training (usually six years) and the adoption of the "Oath of midwives on their position."

The midwife was entrusted with the "giving of benefits" and care for the normal course of pregnancy, childbirth and the postpartum state, as well as caring for the newborn. The obstetrician was called only if the course of all these conditions was incorrect.

Midwives submitted monthly reports to the medical boards on the work done, rural midwives - once a quarter.

Anyone wishing to become a midwife must be at least twenty and not older than forty-five years.

The rural midwife received a three-year medical education in specialized midwife schools in large county towns. There were at least fifty midwife schools across Russia.

In addition, there were the so-called central, local and zemstvo schools, in which were taught: the law of God, the Russian language, arithmetic and a course in theoretical and practical obstetric art.

The rural midwife worked in the countryside without the right to work in the city. She took delivery and trained midwives from neighboring villages.

The midwife received a certificate of correspondence education on the basis of a certificate from the midwife with whom she studied, signed by the city or county doctor.

Great importance was attached not only to experience, but also to moral and ethical qualities. The grandmother had to be of impeccable behavior, be honest and respected in society. She received a blessing from a priest, regularly confessed and received communion. As already noted, according to the Charter, “every midwife should be<...> well-behaved, good behavior, modest and, sober,<...> should at any time, day or night, from whoever she is called upon, regardless of the person, immediately go and upon arrival to the puerpera to act kindly and promptly. "In the textbook" Complete Guide to the Study of Midwifery Art "from 1886, Dr. I. Dobrynin, Associate Professor at the "St. Petersburg Obstetric Facility" states: "The trust of patients and respect from society are acquired by the exact and unswerving performance of their duties, and this should always be guided by religion, the prescription of the law, oath, the rules of taught science and feelings of honor and self-esteem. "

With the development of society, the number of trained midwives increased, and not just casual helpers - relatives and neighbors. In 1757, 4 midwives worked for registration in Moscow. In 1817 there were already 40 of them in Moscow, and in 1840 there were already 161 midwives. And in the 1899-1900 academic year, the Military Medical Academy in St. Petersburg alone trained about 500 midwives. In 1902, there were already 9,000 midwives, of whom 6,000 lived and worked in cities, and 3,000 in rural areas.

In the 18th century, maternity hospitals began to open (Strasbourg, 1728; Berlin, 1751; Moscow, 1761; Prague, 1770; Petersburg, 1771; Paris, 1797). Obstetrics and maternity hospitals were set up to accommodate pregnant women from disadvantaged classes of the population during childbirth and the postpartum period or to provide an opportunity for a fee to carry out childbirth in an environment that meets the scientific requirements of antiseptics and asepsis. But soon after their organization, doctors met with a serious, often fatal complication - "childbirth fever", that is, postpartum sepsis. Massive epidemics of this "fever" were the scourge of maternity hospitals in the first half of the nineteenth century. Mortality from postpartum sepsis fluctuated in certain periods of the 18th - first half of the 19th centuries from 10 to 40 - 80%.

In the 19th century, two major scientific discoveries - the introduction of ether and chloroform for the purpose of pain relief - as well as the study of the ways of spreading infection during and after childbirth and the first means of combating it, had a strong impact on the fate of obstetrics. The development of obstetrics has followed the path of more and more introduction into practice of medicinal and surgical principles and scientific methods. Among others, one can name the operation of a caesarean section, the destructive effect of which on the development of the physiology and psyche of the child was not yet known (see Notes of the midwife. Caesarean section.). The risk of sepsis has decreased, as a result of which this operation has become widespread in obstetric practice.

Operative obstetrics (through surgical intervention) in Russia also had national characteristics. The main distinguishing features of Russian obstetrics were concern for the interests of both the mother and her child and a high consciousness of responsibility in relation to the fate of both lives. It was possible to avoid the extremes of individual European obstetric schools (the ultra-conservative Viennese school and the overly active German school of Oziander) and develop an independent direction designed to maximize the use of the physiological efforts of the woman herself during the act of childbirth and to reasonably limit surgical interventions to the sizes that are really necessary in the interests of the mother and child. Individual operations (for example, dissection of the womb, or caesarean section) from the very beginning did not meet with sympathy from the majority of Russian obstetricians due to the crippling results of these operations.

And yet, the majority of the Russian population was skeptical about the practice of maternity hospitals. Until the beginning of the twentieth century, only women gave birth in maternity hospitals, who did not have the opportunity to give birth at home - because of poverty or because the child was illegitimate. So, in 1897, at the celebration of the 100th anniversary of the Imperial Clinical Midwife Institute, Vel. Book. Elena Pavlovna, its director, life obstetrician Dmitry Oskarovich Ott noted with sadness: “98 percent of women in labor in Russia are still without any obstetric care!”, Or, in other words, they preferred to give birth at home.

In 1913, throughout the vast country, there were nine children's clinics and only 6824 beds in maternity hospitals. In large cities, the coverage of inpatient obstetrics was only 0.6% [BME, volume 28, 1962]. Most women traditionally continued to give birth at home with the help of relatives and neighbors, or they invited a midwife, a midwife, and in difficult cases, an obstetrician.

After the revolution of 1917, the existing system of obstetrics was destroyed.

The state system of training midwives, which developed under the tsarist regime, continued to operate by inertia until 1920. At first, the Bolsheviks were simply not up to her. In 1920, a reorganization of health care broke out. Midwife institutes and schools were re-profiled - they stopped training specialists in normal physiology. A course was taken on the comprehensive coverage of women in labor with medical services.

At the IV All-Russian Congress of Health Departments in December 1922, the question of introducing criminal liability for illegal medicine was raised. From that time on, a departure from the practice of home childbirth began, and a course was first taken on collective farm maternity hospitals, and then on full inpatient medical obstetrics. Midwives who continued to practice normal childbirth were prosecuted and subsequently exiled.

Instead of maternity hospitals for poor and unmarried women in childbirth, a grandiose construction of maternity hospitals for all women, without exception, began in the country. So, by 1960, there were already more than 200 "000 maternity beds in the Soviet Union. Compared to tsarist Russia, there was a 30-fold increase in the number of beds with a simultaneous drop in the birth rate.

Midwife Charter

1. Every midwife must be tested in her title, honored and sworn in; moreover, she is well-behaved, of good behavior, modest and sober, so that at all times she is able to carry out her work.

2. The midwife should at any time, day or night, from whoever she is called upon, regardless of the person, immediately go and upon arrival to the mother, act kindly and promptly, always observing silence, especially in such cases, which do not tolerate disclosure ...

3. When Grandma is summoned to some poor or low condition, who is just about to give birth, or is already suffering, she should not, if at the same time it will be required to some rich, honorable, or acquaintance of hers, under no look, leaving the first, to leave, unless, with the consent of the mother, another juror and skillful Grandmother, instead of herself, leave

4. Likewise, the midwife should not leave the woman in labor before the birth is completely over, and the mother and child are brought into proper tranquility.

5. When the Grandmother notices that the birth is coming difficult, then either another skillful Grandmother, or the midwife science Professor, or the obstetrician subordinate to him, should be called to the council immediately, so that through a long-term vain waiting time is not wasted, and through that the danger does not increase.

6. The grandmother's duty is to explain to the Obstetrician or the Doctor everything that happened and the present state of the childbirth, and what he will order at his discretion, then the grandmother is guilty to fulfill in all accuracy.

7. When a strange and not an ordinary freak is born, the grandmother should immediately and thoroughly report on it according to the convenience of the place, or the Medical College, or the College of Kantor.

8. When the puerperant, not relieved of the burden, died not long before the grandmother's arrival, in this case, this should immediately inform the Obstetrician about it, either to a nearby Doctor or Doctor, so that through a skillful opening of the womb, removing the baby, save his life, if perhaps.

9. Midwives should have Assistants with them, but they should not be allowed to give birth without themselves until they receive evidence of their art.

10. In order for the Assistant to apply the care to the midwife, the grandmother, in the report submitted to the Professor of Midwifery Science, or Obstetrician, after each month, must show their names, behavior and diligence.

11.A grandmother in monthly reports is obliged by the sworn office to show whether she herself, or her assistant, had a colic number of births, how many and what gender were born, whether they were dead, and whether there were difficult births that required the help of an Obstetrician.

12. Every student of midwife art must know the Letter of Merit; not be under the age of twelve, not under thirty.

13. As soon as a student of her abominable ability in obstetric science will have enough time, and her knowledge in trials and in actual childbirth will show, then, in spite of the short duration of training, she will be awarded a midwife.

14. Grandmothers are allowed, in similar data to them in training, to prescribe the lightest medicines for the woman in labor and the newborn, such as rosemary, chamomile, almond oil, manna, rhubarb syrup, cinnamon water, also required for poultices and for washing.

15. In difficult childbirth, the grandmother should not dare to start the operation, but is guilty immediately from a certain obstetrician, or in his absence for legal reasons, from the Professor of Midwifery Science to demand help.

16. Grandmothers are strictly forbidden to enter into treatment for other diseases.

17. Each grandmother should not, at anybody's request, begin the advancement of premature permission from pregnancy, and is guilty of such illegal intentions to inform where it should be.

18. Every grandmother, diligently and faithfully performing her title, has to expect proper patronage from the State Medical College; with negligence, and the prescriptions depicted in this Statute, transgressed, will be acted according to the severity of the laws.

From the State Medical College to the City of St. Peter. September 9, 1789.

POWING OF THE BABOKES ON THE POSITION OF THEIR.

I am the one named below, I promise and swear by my Almighty God, before His Holy Gospel, in the fact that I am my office, in which I have been determined by the Decree of HIS IMPERIAL MAJESTY, with all zeal and serviceability against the prescribed order of the given Instruction; to rich and poor women in childbirth, of whatever rank and dignity, when I was in demand, day and night, immediately walk, all possible diligence and zeal to show them, and not to let them through in a malicious manner, neglect below, if the homelands will be long, to torment it is in vain not to persuade and not force, but with patience I will wait for the present time, with the same cursing words, oaths, drunkenness, obscene jokes, disrespectful speeches and so on, I will completely restrain myself; I will not agree to the discarding of the baby by giving carrying and expulsive medicines, or in any other way, I will never agree with anyone, and I will not let myself use myself for anything, if a nasty and dangerous case happens to any woman in labor, then not only in advance more city midwives, but at the request of the doctor and the obstetrician, I have to ask and to demand that. When, in equal cases and to other women in labor, I will be called upon, then I will faithfully and diligently advise for the best, and I will hide anything that is useful, successful and capable of being born, not from any anger, envy, hatred, below other reasons, for the sake of hiding I will not; when I will be used for such a woman in labor, about which, either in the place where she is, or for other circumstances, no one should know, and not disclose to me about such a woman in labor, and not tell anyone; if some strange and extraordinary freak happens, then at that hour I will inform the medical authorities about this, and if either woman in labor has any injury, or any other sorrow, I will not declare all this to anyone, but I will commit in complete secrecy unless using that person to a doctor or a doctor, and I will declare with caution; over and above this I will diligently watch over the disciples that I have been with, so that the behavior of a quiet, sober, honest and well-behaved life will be; moreover, I will firmly observe that these pupils should diligently go to study and teach them with all zeal and joy, and I will encourage them, but I should represent the truth about those who are not appropriate and obscene to the Medical Authority; after each month has passed to the Medical Board, I must invariably report in writing and without concealment the names and dignity of women in labor, whom I served in that month, and were released or died, and if I find out that an unverified and untested woman is in charge of the Medical Woman’s Office. Immediately, I will not fail to inform my Superiors about this with accurate proof. In the conclusion of this oath of mine, if I keep all of the above inviolably, may the Lord God help me in this and the future century with salvation and prosperity and in the cause of calling my success; If I will violate the willful one, may the opposite one follow, and in that whole words and the cross of my Savior. Amen."

(Handwritten signature).

Detailed information about the internal structure of the maternity hospital, which will help expectant mothers feel calmer and more confident when moving from department to department.
As you know: "He who is informed is armed!" The more the expectant mother knows about the place where she is going to give birth, the better she will be prepared for the upcoming birth and the more calm and confident she will be able to feel.

All maternity hospitals in our country are arranged differently depending on the time when they were built and their profile of work, but, nevertheless, there is a certain common arrangement for all such medical institutions. The maternity hospital usually has:

• admission department,
• physiological maternity ward,
• observational maternity ward,
• postpartum department,
• department of pregnancy pathology,
• department of anesthesiology and resuscitation,
• children's department,
• children's resuscitation.

Admission department

Any patient who crosses the threshold a gets here. Here, a woman is met at any time of the day or night by a midwife, who listens to complaints and calls a doctor. The doctor examines the pregnant woman, listens to the baby's heartbeat and decides which department she will go to.

If they started or left, then the patient will go immediately to the maternity ward.

If not yet real (so far these are only precursors of childbirth), the woman is hospitalized in the pregnancy pathology department, and if she wants to wait for the onset of labor at home, she can be released after a written refusal of hospitalization. But in case of any problems - a tendency to prolonged pregnancy, too large or, on the contrary, small sizes of the fetus, high or low water, pelvic or oblique, e, the doctor will insist that the patient stay in e, where treatment will be prescribed and for the condition mom and baby will be monitored.

The admission midwife will take the documents of the incoming patient. You must have an exchange card, compulsory medical insurance policy and a passport with you. The midwife examines the patient's skin (there should be no pustules, scratches), nails, measures body temperature, height and weight of the pregnant woman, as well as the circumference and the height of the uterine fundus. In the admission department, attention is paid to the presence of cough, as well as other signs of infection, and depending on this, they decide in which department the woman will give birth: physiological or observational. To resolve the same issue, the midwife carefully examines the exchange card, checking the availability of all tests and their results. Further sanitization is carried out: if a pregnant woman enters, she is given an enema and the suprapubic area is shaved (for obvious reasons, it is better to do this at home).

Maternity ward

This is probably the main place in the city, because babies are born here. It consists of a prenatal and delivery room. Prenatal can be designed for 2-6 women in labor. In the delivery room, as a rule, there are 2-3 delivery chairs. (In ah with a boxed system, there is no such separation: the pregnant woman is in a separate box during contractions and gives birth to a child there.)

In the maternity ward, the doctor talks with the patient and examines her. The midwife is constantly with the women in labor, and the doctor, if everything is going well, comes in periodically, since at the same time patients arrive in other departments, emergency operations are underway, etc. During the marriage, the woman in labor can walk, they explain to her how to breathe correctly, if very painful, anesthesia is performed. During childbirth, cardiotocography is performed - monitoring the baby's heartbeat, the strength and frequency of contractions, at this moment the woman in labor should lie down.

At the end of the first stage of labor, the patient will be guided to the delivery room. At this time, a doctor, a midwife and a neonatologist are with her. After the birth of the child, they show it to the mother, spread it on where it lies while the umbilical cord pulses. After that, it is crossed, and the child is examined by a neonatologist and assessed on the Apgar scale. While the child is being processed, the placenta is born and the birth canal is examined, the tears are sutured.

They put a heating pad with ice on the mother, cover her with a blanket, teach her to put the baby to her breast. Here she spends 2 hours with the baby under the supervision of medical personnel. After 2 hours, together with the baby, the mother is transported on a gurney to the postpartum ward.

If you give birth under a contract, then you will be provided with a separate prenatal room, in which you and your husband (optional) will spend everything and two hours after them. Usually, there is everything you need for a married couple: a bed, which is then transformed into a delivery chair, a chair for a husband, a large bathroom, a fitball, a table, cups, a kettle, a tape recorder, etc. The obstetrician-gynecologist with whom you have concluded contract.

Observational department

Patients with acute respiratory infections, various inflammatory diseases (for example, kidneys), colpitis (for example, thrush), fungal infections of the nails, as well as carriers of the hepatitis B and C virus, patients with "positive" RW, unexamined and under-examined (if not enough analysis results in the exchange card).

A woman can get here from the physiological postpartum department if there are infectious complications after childbirth, such as endometritis, mastitis, suture divergence, acute respiratory infections, etc.

The structure of this department is the same as that of a regular maternity ward. There are prenatal, maternity and postnatal rooms.

Postpartum department

Depending on the chosen one, it is possible to stay with the child together or separately (when he is brought on schedule only for feeding). When staying together in the “mother and child” ward, the newborn is constantly with the mother, which certainly helps to establish breastfeeding, the mother learns to take care of the baby (bath, dress, treat the umbilical wound).

Such wards are usually designed for 3-4 mothers with children, they have adult and children's beds, bedside tables and a changing table, there is a sink and everything you need to treat the baby's skin.

If you gave birth under a contract, then the postpartum ward is designed for 1-2 people, it is possible for the dad to stay in the family ward permanently. The paid wards additionally have a table, dishes, a microwave oven, as well as a shower and toilet. Food will be brought to the ward, the rest of the puerperas eat in a special buffet. In the postpartum department, doctors monitor the condition of the mother and baby, the obstetrician-gynecologist and neonatologist make rounds and examinations every day, take tests. The midwife fulfills the doctor's prescriptions, helps to establish breastfeeding, straighten the breasts. Before discharge, as a rule, a woman is given. After natural childbirth, they are discharged for 4-5 days, if there are no problems.

Department of Pathology

In the Department of Pregnancy Pathology, as the name suggests, there are patients with different stages of pregnancy who have problems that require hospital treatment: the threat of premature birth, placental insufficiency, exacerbation of a (inflammatory kidney disease) and many others. There are also patients here who are preparing for childbirth and elective cesarean section.

Department of Anesthesiology and Reanimation

In any e, there are several operating rooms and an intensive care unit (ICU), where patients are transferred after a caesarean section. Also, in the ICU, patients who are admitted in a serious condition, for example, with severe ohm (high blood pressure, protein in the urine), are monitored and prepared for delivery. An anesthesiologist joins the management of such patients. He also provides pain relief during childbirth and operations, monitors patients for the first day after surgery and, if all goes well, transfers them to the postpartum department.

Children's department

Presented by children's wards. Now, when many maternity hospitals are moving to a system of joint stay with a child, children stay in children's wards only on the first night after childbirth, if the mother is tired and cannot take care of the baby on her own. Children born by cesarean section are also monitored on the first day while the mother is in the ICU.

Children's resuscitation

There are many, but not all of them. This department is specially equipped for nursing premature babies, children after difficult childbirth or with various pathologies. Newborns from intensive care can be transferred to the regular children's unit after a few days, if all is well; if problems persist or the baby is deeply premature, then after stabilization of the condition, he is transferred to the children's hospital.

Background

Here you can get information about the condition of the mother, find out who was born, and donate the necessary things and products for mom and baby.

Discharge room

This is the last place that you will visit in St. Petersburg. They will help you to change your baby's clothes, wrap them in a beautiful "envelope", the mother will have the opportunity to change clothes and do makeup. A professional photographer often offers his services in the discharge.

An article from the magazine "Baby and I"

Maternity hospital I Maternity hospital

a medical and prophylactic institution designed to provide inpatient and outpatient care to women during pregnancy, childbirth and gynecological diseases, as well as medical care for newborns until they are discharged from the maternity hospital.

The main tasks of the maternity hospital are to provide women with inpatient obstetric care during pregnancy, childbirth and after childbirth; ensuring proper nursing of newborns and qualified medical and diagnostic assistance to sick and premature babies; providing medical and diagnostic assistance to gynecological patients; work on hygienic education, promotion of a healthy lifestyle; transfer of patients according to indications to other medical institutions; implementation of rehabilitation measures and the issuance of recommendations for their implementation after discharge from the obstetric hospital.

II Maternity hospital

a medical and prophylactic institution designed to provide medical care to women and their treatment during pregnancy, childbirth and in the postpartum period; R. is a part of the hospital and.

1. Small Medical Encyclopedia. - M .: Medical encyclopedia. 1991-96 2. First aid. - M .: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary of Medical Terms. - M .: Soviet encyclopedia. - 1982-1984.

Synonyms:

See what "Maternity Hospital" is in other dictionaries:

A medical institution providing assistance to pregnant women, women in labor and parturient women. Usually there are antenatal clinics at the maternity hospital, gynecological departments in large maternity hospitals ... Big Encyclopedic Dictionary

A medical institution providing assistance to pregnant women, women in labor and postpartum women. Usually maternity hospitals have antenatal clinics, in large maternity hospitals gynecological departments. * * * MATERNITY HOSE MATERNITY HOSPITAL, medical ... ... encyclopedic Dictionary

The very first maternity hospital in Severodvinsk, now the Severodvinsk City Museum of Local Lore Maternity hospitals provide qualified medical care to women during ... Wikipedia

A medical and prophylactic institution designed to provide medical care to women and their treatment during pregnancy, childbirth and the postpartum period; R. d. includes a hospital and a women's consultation ... Large Medical Dictionary

In the USSR, a medical and prophylactic institution providing qualified medical care to women during pregnancy (See Pregnancy), childbirth (See Childbirth), the postpartum period (See Postpartum period) and gynecological ... ... Great Soviet Encyclopedia

A medical and prophylactic institution providing medical care to pregnant women, women in labor and parturient women. (