How Belarusian helps American moms during pregnancy and childbirth - ForumDaily
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How Belarusian helps American mothers during pregnancy and childbirth

Mother of four children and professional dole Elizaveta Schaefer from Belarus, who has been helping women in labor for many years, told the project KYKY how they give birth in the States and Europe, how much it costs, why they put inflatable baths in American chambers and how doules accompany abortions. Now Elizabeth lives in Cyprus.

Фото: Depositphotos

Profession doula

— You worked as a doula in Belarus for seven years. How in demand is this profession?

Elizaveta Schaefer: there is no doula profession in Belarus, but the demand for her services is increasing. Affiliate childbirth involves one partner - a husband, mother, sister. But increasingly, women are looking for a doule for support. I often accompanied women to the hospital: I helped answer questions in the emergency room, and then they left to give birth with her husband. I practice several formats of work with women during the period of pregnancy and in the postpartum period: individual and group (doul circle and post circle) - therefore, it is difficult for me to say how many Belarusian women I was doula. Probably more than three hundred women across the country.

I have four children, so in the last ten years I have been doing quite long breaks in work. I decided that I did not go “to childbirth” when I have very little children in my arms. Now the youngest daughter is one and a half years old, so from September I begin to accompany women in childbirth again, already in Cyprus.

- In Europe and the United States, the doula profession exists at the legislative level? How much is it in demand there?

E.Sh .: Of course, it exists there at the official level. There is a lot of dole in the States, the boom in this profession began a couple of decades ago. Now, a novice doula in the States takes about 300-350 dollars for participation in childbirth, a professional doule with experience - from 1000 to 1500 dollars, these are absolutely reasonable, usual prices. By the way, in the US, some insurance covers the cost of a pregnant woman to give birth with doula.

- How does the clinic staff respond to your presence?

E.Sh .: In Belarus, I did not say that I came as a doula. Although some doctors, I probably amused and remembered. It was presented as a friend, acquaintance, sister, but there were cases when she was not allowed to come to the woman’s room anyway.

In America, please bring whomever you want, if only the woman is good. This summer I spent a few months in the state of Minnesota, visiting my parents. There I met a midwife who has been living in America for fifteen years, but she comes from Belarus herself. She told me how she once attended childbirth, where, in addition to the woman in the ward, there were still about fifteen people. The woman did not give birth to her first child, so she wanted all her relatives to be with her at that moment. No problems with this at the medical staff arose.

Of course, if one of the guests interfered with the process, he would be asked to leave, but everything was fine. In addition, there are clamshells for older children and husbands in American wards - relatives can not part with a woman after giving birth.

I gave birth to my first son in Germany. My mother had to come to me to help with the firstborn. Coincidentally, she flew in just that night when I was giving birth. It was winter, February ninth, she arrived at a German hospital by taxi directly from the airport, the midwife immediately began to call her to the ward, they say, go faster, she will give birth now. It is now my mother lives in America and looks at many things differently, but then she was a man of Soviet education, so she began to refuse and say that where she would go straight from the plane in winter boots, she even asked to wash her hands. The midwife convinced that there was nothing wrong with that, said something like: "You are kin, microbes are useful." So in the first minutes of my life my son visited his father, grandmother and my stepfather.

How much is childbirth in the West

- Tell us how the process of pregnancy in the States. I want to start by asking how much does it cost?

E.Sh .: I can tell you about the state of Minnesota, where I was, - in all states of America the circumstances are different. The same Russian-speaking midwife from Belarus gave me a tour of the hospital where she works, and told me everything, for which she thanks a lot. There is an insurance medical system in the States, so insurance covers all expenses for managing pregnancy, childbirth and the postpartum period. What do people who do not have this insurance, I do not know. For migrants, the cost of delivery at the hospital is estimated at an average of 10 to 12 thousand dollars, but these are very approximate amounts. It is not known in advance what medical interventions will be required for a woman: resuscitation for a child, and so on, the cost of all this is considered extra. Home births in Minnesota cost about four thousand dollars, but they are not covered by insurance.

How much is giving birth in Cyprus - I do not know. In general, here in 56% of cases, women are undergoing a caesarean section. For comparison, in America, about 30% of women who did caesarean, in Belarus, 20-25% of cases of childbirth.

- Do doctors insist on independent childbirth in the States?

E.Sh .: In America, everything is very dependent on the clinic and the state, for example, in the hospital where I was, the percentage of cesarean is quite small - only 16% of the total, this clinic is focused on natural childbirth. As for failures in this procedure - I can not say, I was not interested in this topic. In Cyprus, the medical staff himself offers caesarean on 38 week every second woman. And epidural anesthesia is offered to almost everyone.

- In the West, there is a practice like ours, when a pregnant woman gets registered?

E.Sh .: in the States there is no concept of "registering", but pregnancy is, of course. Doctors give recommendations to women, for example, see a doctor for the first time and go to the first screening in 10-12 weeks, but a woman can refuse it - that is her right. Doctors will visit, but they will not say anything. In the States, it is considered normal if a woman came to the first admission to the hospital even after the 11-12 week, then she visited the doctor once a month, and she was examined once a week after the 36 week. In general, it is very similar to the Belarusian system, but in America a pregnant woman takes fewer tests. If a woman does not like something - a midwife, a doctor or something else, she can easily move to another hospital or maternity center. To do this, you need to call your hospital and ask for its history to be transferred. This is done in just a couple of minutes.

The only thing is that in some delivery centers there is a condition: if a woman has never been observed anywhere until the 22 week of pregnancy, she has the right to refuse to accept childbirth. The fact is that there are no doctors in the maternity centers, only obstetric teams work there.

Photo: instagram.com/doula_lizzy

Most Russian-speaking women do not know that in America there is a choice of personnel who will take delivery, and on an influx they immediately go to the doctors. This is not about a specific person, but about a team: it happens in the States of medical and obstetric. If a woman chooses the second, midwives conduct her entire pregnancy, sometimes sending additional procedures and tests to doctors. Midwife and childbirth takes. At birth, there will be a person on duty, but who exactly is a doctor or midwife, a woman can determine in advance. When the obstetric team is selected, the doctor is not present at the birth, unless medical circumstances require it.

This spring I was at a training seminar by Michel Oden (the world famous obstetrician) in Amsterdam, after one lecture day we were taken on a tour of the local maternity center, where we were told about obstetrics of the Netherlands. Holland is the country with the highest percentage of home deliveries in Europe. So, as far as I understood their three-step system of medical care, a pregnant woman there, in principle, cannot go to the first visit to the doctor - only to the midwife, she has no choice. If the situation requires it, she goes to the doctor. And only then, in special cases - to university doctors, professors of a narrow profile.

- Do they practice pregnancy preservation at the clinic?

E.Sh .: I didn’t ask this question in the States, but I can tell you what kind of practice is in Germany - they don’t practice saving up to 12 weeks. They will not offer pregnant drugs before this time. People will not just lie in American and European hospitals simply because it is very expensive. No one wants to give that kind of money just to lie and eat under the supervision of doctors - insurance will not pay for such a case.

In Belarus, everything is different, because doctors are afraid to take responsibility. He also always, in the event of what, “from above” comes flying over the cap.

Photo: instagram.com/doula_lizzy

How are home births actually going on

- What does the maternity hospital look like in the States? What are the chambers equipped with?

E.Sh .: In America, there is no such thing as a maternity hospital, most often these are departments at a hospital in the 7-8 maternity wards. There are no cases when several women give birth in the same room. Pregnant lies in the ward, in which she and give birth. There she spends several hours after giving birth, no one drives her anywhere. Only after a while is transferred to the postpartum ward.

There are large baths in the wards - any midwife knows: water is very effective as an anesthetic. I myself in every birth lay in the bathroom. I gave birth to one child in the water, but not the other children, but I experienced worries in the water. If there is no bathroom, the woman will be dragged into the ward in an inflatable pool and filled it.

I noticed that in the wards of the hospital where I was in Minnesota there are a lot of different sources of light: there is a night light (or even several) and a mobile lamp, with the help of which you can not shine a woman’s face, but only in the crotch area. This is important because the bright light interferes with the process of childbirth, any doctor and obstetrician knows this. There is also a blackboard where they write with a washable marker a plan of childbirth, which was developed by a woman. For example, “I want the uterus to be opened not often,” or “I want to give birth in the bathroom,” “I want the umbilical cord not to be cut immediately,” and so on. This is done so that if during the birth the clan team changes, the “new” staff does not ask the woman any questions, but calmly continues his work.

Well, personally I am always surprised how a woman is fed in a foreign hospital after giving birth - very satisfying and diverse. They do not say that because of breastfeeding, you need to follow a diet - on the contrary, they encourage a varied diet: spaghetti, sauces, cabbage, desserts, coffee, tea.

- Is it true that in the United States under the windows of a woman giving birth at home is an ambulance car?

E.Sh .: No, this is absolutely not true. In no country in the world under the windows of a house where a woman gives birth does not cost an ambulance - it is very expensive. I often heard about these fairy tales from Belarusian women, I don’t know where they come from. Home births, for example, in Minnesota cost about 4000 dollars. This amount includes managing the pregnancy of a domestic midwife: pre- and post-natal visits and the birth itself. If you make a premium for reanimobile, it will be a huge amount. This is not necessary: ​​a midwife with a woman stipulates in advance the situation in which case they will go to the hospital. No one will give birth at home just to give birth at home. Theoretically, I can assume that a woman hires an ambulance when she lives away from civilization. In the States, it’s quite possible to have a farm house a hundred miles from the nearest medical care. It is possible that some domestic midwives right in the contract stipulate that there should be no more than 20-30 minutes from the place where home births take place to the clinic.

I asked my familiar midwife what would happen if a woman giving birth arrived at the center, and there would be no one there but nurses on duty. She explained that they have the notion of "doctor on duty, but at home." This is a doctor who may not be in the clinic itself, but must arrive within twenty minutes after the call.

Therefore, as Michel Oden says, if the clinic is twenty minutes away, you can safely give birth at home with a midwife. She will follow the process of childbirth, the physical condition of the woman, listen to the baby's heartbeat, watch the disclosure and so on. There is another kind - solo-roda, in which a woman gives birth independently, without any medical care. In such cases, she takes full responsibility for everything that happens. But you know, it happens, they give birth and before the ambulance arrives - anything can happen.

I want to clarify, in America there are two types of midwives: those who receive a special medical education, so they can work anywhere (in the hospital, maternity center, and at home). And another kind - midwives, who can have any basic education and special certification of a midwife. Such specialists can work only at home or in the maternity center.

- Another doula told us that she was not obliged to be able to provide medical assistance at birth. Do you render?

E.Sh .: A midwife is following the course of childbirth, and doula is over the emotional and physical condition of a woman; this is not a medical profession. She pursues the goal of providing comfort to a woman so that she will begin her path of motherhood with a positive experience, recalling it as an event that gives strength and joy. Many studies and statistics confirm that the professional presence of doula during childbirth affects a woman very well. But I do not provide medical care at birth. This is contrary to pre-ethics, and not my task in principle.

Photo: instagram.com/doula_lizzy

Laughing gas and rudeness in the hospital

- Who abroad goes to obstetricians and obstetricians-gynecologists? If people who can give out a phrase like “could get pregnant — give birth, suffer”? Or in the hallway after birth leave?

E.Sh .: In the States, no woman will lie in the hallway after childbirth, it is excluded. Not so long ago came out very good films made by journalists about birth in the States. One of them is called "Birth as a business." It tells why there is such a medical system in the country, why there are a lot of unnecessary medical interventions in the process of childbirth, and so on.

That is, in America there are many problems, but there is no disrespect for women.

Just a couple of months ago, I watched an interview with poetess Vera Polozkova, in which she told her why she gave birth a second time at home. Even in the super-clinic of Moscow, where her first childbirth took place, everything is not as cool as they say. Yes, there may be a husband during childbirth, even a few doles, but after the birth is completed, everyone is asked to leave. When a woman remains, there are nurses, nurses who come to the ward at six in the morning and say: "So, you got up, I take the tests for another ten minutes, and then everything." This is an example of the fact that in Belarus and Russia you can be a well-known person, and still you can’t avoid rudeness in the hospital. What to do with it? At a minimum, do not be silent about it, constantly writing about the problem. If every second, and then the first woman begins to come to the hospital with the request "I want it differently," perhaps something will start to change. In addition, the generation is changing. Previously, all my clients were older than me, now I'm older. Today's 25-year-olds, for example, want a different level of comfort. And now the new generation is studying for gynecologists and midwives. I really hope that soon the rudeness in maternity hospitals will end.

— Are there doctors in the States who can refuse to give a woman an abortion?

E.Sh .: I was not interested in this topic. I only know that in the States there are doules who accompany a woman during an abortion. I could hardly have done it, this is not really my topic.

- Have you ever had births when the baby was born dead?

E.Sh .: No, I did not have this in practice - this is a very rare case. But in my environment there are two women who survived this tragedy. Most often, a woman knows that she is giving birth to a dead child: she is told about heart failure on an ultrasound, for example. The death of a child in the process of childbirth - isolated cases. I do not know what to do in a similar situation. Probably, you just need to be near, talk less, more - listen. And after a while, redirecting the woman to organizations that deal with psychological support in such situations. I know these.

- What drugs are used for pain relief childbirth in America and Europe?

E.Sh .: No one can reliably say that the same “epidural” for the health of a woman and a child is absolutely safe, usually a pregnant woman should sign a bunch of pieces of paper confirming her consent to this type of anesthesia. But, for example, in the maternity center of Amsterdam I was told that often during childbirth they use “laughing gas” - nitrous oxide with oxygen. It is considered to be harmless, but doctors do not recommend using it too often: dependence may appear, although it is unlikely that you will be able to get hooked in labor during labor. In the maternity center of America, where I was, laughing gas is the only legal remedy that can be used as an anesthetic because there are no doctors there. If a woman wants an "epidural", she will have to go to the hospital.

What other drugs? I will try to answer, as Michel Oden: we need to go back to the origins, the physiology of childbirth, understand why women are afraid of pain and how to make this fear go away.

Фото: Depositphotos

In the process of childbirth, women produce hormones, the main of which are oxytocin and endorphin. If the concentration of the latter in the blood does not increase, the birth will be long and difficult. Oxytocin is a “shy” hormone, therefore, in order to produce it, conditions are necessary for the normal course of labor. First and foremost, a woman should feel safe. Endorphins help to cope with pain and are produced in response to the concentration of oxytocin. But there is also an oxytocin antagonist - adrenaline, which dominates in the blood of a person in “hit-and-run” situations. At birth, it is produced when, for example, a woman enters a maternity hospital from a house, where a bright light shines in her face and asks a bunch of questions. Of course, it is very difficult to disconnect in such a situation, so contractions can stop or slow down: adrenaline interferes with oxytocin, and medical interventions begin. In fact, this is a domino effect - if at least one part of the physiological process is removed, there will be no natural birth. “Right” pain is useful, it sends signals to the brain about what hormones need to be developed, so that the woman adapts to the intensity of sensations, and the process can accelerate further.

You know, many dole are often asked: "And what do you do in childbirth?" I sometimes get lost and I can not give a clear answer. Well, we hold it by the hand, we are silent next to it - nobody cares, because it does not give beautiful headlines, it does not attract the attention of the audience. But this is so, this is true!

Of course, doules can and can do anesthetic massage, a cool vibrating massage with the help of Mexican scarves, they use aroma oils, they know the breathing techniques, and they can sing with a woman - all that is, but this is not the main thing. I had cases when a woman during home birth between contractions said: "Sit down, please, so!". I really wanted to change seats, because the priest was numb in all places, I even began to think that I could not get into the car in order to get home. But then she calmed down: if a woman needs me to sit, I will sit like that. A woman during childbirth is important that someone was there, and often - not the husband. It is better if it is a woman who has experience and knowledge, so she is absolutely calm, does not shine and does not rattle.

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