“Soldiers of the System”: Maternity Care in Russia Between Bureaucratic Instructions and the Epidemiological Risks of COVID-19

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.

Emotional labour as a vehicle of organisational change in maternity care: The case of Russian doulas' institutional work

“…Preventive measures introduced by the Russian healthcare authorities were quite tough and supporting persons were officially excluded from the medical facilities. However, some maternity hospitals in Moscow and St. Petersburg have maintained the practice of doulas' unofficial participation in deliveries (Ozhiganova, 2021a).…”

Quality of perinatal care for women with high-risk pregnancies during the COVID-19 pandemic in Iran

“… 16 Various countries also took new precautions to protect pregnant women, including only allowing asymptomatic partners in the delivery process or excluding supporting persons (doulas and partners) from maternity hospitals, the distribution of pregnant women and infants based on the epidemiological situation in different types of hospitals, telephone or video conferencing appointments, mask-wearing, and handwashing. 17 , 18 However, emerging evidence indicates that services were impaired for many women, including suspended and/or canceled appointments, maternity-leave restrictions, continuous care, and ambiguities regarding partner attendance during childbirth. 19 According to Heaman et al., the quality of antenatal care is supported by constructs including information-sharing, preventive guidance, adequacy, accessibility, and availability, 20 which are likely to be disrupted during COVID-19 epidemics.…”