Protection of Women and Children in Soviet Russia
Prenatal attention is a revolutionary matter as far as the women of Russia are concerned and it is very carefully attended to wherever there are maternity clinics with the gratifying result that the infant and maternal mortality rates have been greatly reduced since 1917. At one time or another the women of Moscow visit a maternity clinic sometime in the early months of their pregnancy. Usually they go voluntarily because they are already informed of clinical work. Otherwise they are sent by their own or their husbands' trade unions or in case they have no such connections, the local clinic sends a home visitor on the advice of a friend or neighbor. As is always the case when a woman visits any department of a medical clinic for the first time she has an intimate talk with one of the doctors, whose business it is to put her at her ease and make her see the value of regular medical attention both to herself and to her society. Careful records are kept of each of her monthly visits; the doctor has complete information concerning her physical condition from the beginning and she is advised accordingly. In addition a home visitor calls on her and gives her hints on how to make her work easier, how to cook her food, and how to make the best use of whatever equipment she may possess in her home. The course of her pregnancy is well watched and she runs little risk of mishap because she can at any time get in touch with the proper medical authorities.
Her local Museum of Mother and Child where she is sent almost immediately gives her a graphic idea of what she should do for herself and her coming child, how to prepare for the child's arrival and how to make whatever clothing is necessary for herself and the new baby. The Museum also supplies her with a simple scientific account of her condition, the mechanics of giving birth and a description of the main ills which accompany pregnancy and how to deal with them. Her doctor also gives her prescriptions for any special foods and milk which she might need and a certificate of pregnancy so that she need not wait in queues or stay in crowds unnecessarily.
Both the maternity clinics and the Museums of Mother and Child hold regular meetings for pregnant women where they and their husbands are given general instruction in the biological processes of pregnancy and their practical applications to everyday life. In case the employment of a pregnant woman would endanger the life of her child she is released from it when she presents a disability card signed by her doctor. In any event she is not allowed to go to work for about two months preceding and two more months succeeding the giving of birth. Her release from work because of her pregnancy does not involve any financial hardship for she continues to receive her regular wages and is always allowed to go back to work as soon as her doctor gives her a bill of good health. In case of a miscarriage, the woman is given careful treatment and ample time to recuperate in order that such an accident may be avoided in the future.
Pregnant women are from their first appearance at a medical clinic closely watched for any signs of tuberculosis and venereal disease. Those suffering from tuberculosis are treated in special hospitals and clinics, but venereal disease clinics are usually connected with the general medical clinics. An abortion is advised for any pregnant woman who is a venereal patient if her pregnancy has not continued for more than two and a half months, otherwise the maternity hospital is notified and special precautions are taken. In either case the woman is given regular care and as a result congenital syphilis has decreased from 6% in 1923 to 1%o in 1930 in the Moscow area.
Sterile women are also treated and advised in the maternity clinics, and with some success, though there are no figures on that type of medical work.
In 1928 there were twenty-one Maternity Hospitals in Moscow and six Gynaecological Hospitals as well as thirty Points of Medical Consultation where pregnant women are treated. In the spring of 1931 there were, thirty Maternity Hospitals, ten Gynaecological Hospitals and thirty-five Points of Medical Consultation and these are to be doubled before the end of the Five Year Plan. As a result of the good work of these various institutions, 90% of the children born in Moscow are alive at the end of their first year as compared to 66.3% who survived their first year in 1922. Today in Moscow each clinic is equipped to care for between six to ten thousand pregnant women a year which at the present time adequately covers the number of births.
The doctor who attends to the prenatal care of any given woman usually delivers the child and is notified as soon as she goes to the hospital. Owing to the difficulty of procuring chemicals in the U. S. S. R. anaesthetics are seldom used in obstetrical cases and never in normal ones. Maternity hospitals in Russia are not unlike lying-in hospitals as we know them for they have about the same equipment and the usual well-trained staff of doctors and nurses. As a rule there are places for about six women in the delivery rooms though whenever an operation is necessary the patient is moved to a special operating room. Few Russian hospitals have private rooms and in maternity hospitals there are usually eight beds to each room. Babies sleep in special nurseries as long as they remain in the hospitals.
All mothers are encouraged to nurse their babies and most of them are able to do so. At the end of four days the mothers are required to sit up and on the fifth day they take a few steps. The following day they are removed to another ward for the remaining three days before they go home. During the last three days in the hospital they are given instruction in special exercises, usually the knee-chest, and are taught how to nurse their babies.
Considering the two-month holiday required of each woman after she has given birth it is surprising that they are encouraged to walk as soon as they are. However, it is difficult to keep them in bed for as long as five days and most Russian women consider such a long convalescence a waste of time. Rest periods in post-natal care are a matter of education and they will be lengthened as the Russian women are persuaded of their value. There is a high percentage of slightly premature births among the working women and in such cases it is frequently possible to insist on the women remaining in bed a little longer than when their births are normal.
As soon as a mother returns home with her new baby she is visited again by a nurse from the maternity clinic who instructs her in the care of herself and her child, and before the mother returns to work her child is a regular visitor to the pediatric department of her clinic.
All such care is free to workers and the wives of workers and peasants and no woman, no matter who she is, is turned away from a hospital or clinic when she needs care. At the moment the burden of this type of public hygiene falls on all too few doctors and nurses, for as fast as new ones are trained they are sent out into the smaller cities and to the collectives, but conditions are constantly improving and with the great interest in medicine there is a rapid growth in the numbers of medical experts.