Hospital Helps Spread Modern Birth Practices in Crimea
FrontLines - April 2010
| Crimea Is Focus of U.S. Aid
in Ukraine Since the Ukraine voted to leave the Soviet Union in 1991, USAID has
helped it to develop a market economy and—especially prior to the 2005
Orange Revolution—to develop a professional media, judicial system, and
civil society groups dedicated to the rule of law.
The second free election in an independent Ukraine took place in February.
To develop the Autonomous Republic of Crimea, a large but remote region in the southeast of
the country, Ukraine is working with USAID to improve health, education, agriculture, and other
areas. American aid programs aim to train Ukrainians to raise living and health standards. Some
of these programs are the topics of the accompanying articles. |
Dr. Oleh Tikholaz, head physician
of the Kerch Maternity Hospital,
had always strongly
believed in traditional Soviet
birthing practices and did not
favor the Ministry of Health’s
adoption of maternal and child
care procedures recommended by
the World Health Organization.
“I was convinced that traditional
maternity practices,
including Rakhmanov beds, a
husband-free environment in a
delivery room, and separate
nurseries for newborns were the
most correct practices to implement,
and I was positive that this
is the way it should be in every
Ukrainian maternity,” Tikholaz
said. Rakhmanov beds have
metal brackets for women to
place their feet, which limit
birthing positions.
His views quickly changed,
however, when Tikholaz
attended a USAID-supported
training course at Simferopol
Maternity Hospital #2.
“I was dumbfounded by what I
saw,” Tikholaz said. “Husbands
and relatives were in delivery
rooms while women were in labor,
infants and mothers were together
in the postpartum department, and
there were no Rakhmanov beds.
Instead, women were choosing
positions in which to deliver.”
USAID’s Maternal and Infant
Health Project has significantly
helped to improve maternal and
infant health in Ukraine since
2003. Simferopol Maternity Hospital
#2, the first in Crimea to
participate in the project, today
provides high quality care and
has trained 650 Crimean health
professionals in new clinical
guidelines since 2004.
During the training course,
Tikholaz realized that the ideas
that had seemed outrageous at first
started to make sense. He found
especially interesting the story of a
trainer who had experienced a
complete shift in attitude, evolving
from a non-believer to a strong
supporter of modern birthing technologies.
By the end of the course,
Tikholaz’s attitude had completely
changed, too.
|
A woman warms her baby on her chest after the delivery with her husband.
|
“Thanks to my colleagues in
Simferopol, I understand the
importance of these new practices.
Now I’m certain that upon
my return from training, I will do
my best to introduce these technologies
in my maternity, and I
will establish individual delivery
rooms and throw away
Rakhmanov beds,” Tikholaz said.
Over five years, the Simferopol
Maternity Hospital reduced
unnecessary medical interventions
during delivery such as
postpartum anesthesia. And
deliveries in which a husband or
other companion assists increased
from 17 percent in 2004 to 61
percent by the end of 2008.
The hospital also cut mother-to-
child HIV transmission to less
than 2 percent by offering Caesarean
section to HIV-positive
women. And warm chain technology,
which keeps babies
warm through either the mother’s
body heat or warm clothing,
has reduced hypothermia.
In Crimea, the project currently
works with eight maternities, 11
women’s clinics, and 15 pediatric
polyclinics. These facilities support
approximately 12,500 births,
or 44 percent of the estimated
27,000 deliveries that occur in the
Crimean Republic each year.
★
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