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Hard Labor : In the Commonwealth of Independent States, says Dr. Vera Matdeyenko, giving birth is a nightmare. The Moscow obstetrician is touring hospitals and birthing centers here as part of an effort to implement kinder and safer methods back home.


SANTA MONICA — Having a baby in Russia is like going to jail. At least that is how the experience is described by Dr. Vera Matdeyenko, an obstetrician and gynecologist from Moscow who toured Southern California hospitals and birthing centers last week.

Matdeyenko's visit was part of an international health group's efforts to help doctors and midwives implement better birthing methods in the Commonwealth of Independent States, the former Soviet Union.

"If I dreamed about something, I would dream I worked at St. John's Hospital," said Matdeyenko, who toured five hospitals, including St. John's in Santa Monica. "It was the most beautiful hospital I saw in the U.S. Pregnant women dancing with their arms around their bellies. It's a happy experience, and everybody laughs. Americans are prepared for childbirth.

"I cannot create a St. John's, but I want to create a little hospital so that women don't see the difference between home and the hospital. So that women are not prisoners."

Matdeyenko's nine-day trip was sponsored by the International Center For Better Health, or ICBH, a Los Angeles- and New York-based nonprofit organization dedicated to improving health care in the Commonwealth of Independent States through health education programs.

The 2-year-old group, funded by Soros Foundation, Merck Laboratory and private donors, has sent three teams of certified-nurse midwives to Moscow to teach Western birthing techniques such as labor massage, emotional support during labor, and general aseptic measures often neglected by physicians due to a lack of supplies and education. The organization will send AIDS educators to Moscow in a week to address what many say will be an imminent explosion there of acquired immune deficiency syndrome.

Playing hostess to Matdeyenko at her Santa Monica apartment was Judy Chapman, a certified-nurse midwife from St. John's Hospital who was part of the first group of ICBH nurse-midwives that traveled to Moscow last September. Two more teams followed in November and January.

"At birthing house No. 5, one of the best three birthing houses in Moscow, there were two midwives to 14 rooms with one woman in each room," Chapman said. "They were overworked; one usually cleaned while the other attended the women. They didn't believe it was necessary to support a woman in labor, like offering words of encouragement, getting her up to walk around and comforting her until they saw us doing it. By the end, we had some midwives massaging pregnant women's feet. So we made some inroads."

For Matdeyenko, 53, the humanitarian approach to childbirth in Southern California hospitals was nothing short of revolutionary. To women in her country, she explained through an interpreter, childbirth is a nightmare that begins with the onset of labor.

When the contractions begin, she said, the woman is rushed to an arbitrarily selected birthing center by ambulance. There she remains until she delivers, even if the labor pains are premature and the birth is yet three weeks away. The centers are cold, impersonal structures, and poorly heated. With no curtains on the windows, birth is not a private affair.

Worst of all, family members cannot visit, as infection in maternity wards is a grave problem, she said. During delivery, anesthesia is often unavailable. Once the infant is born, it is rushed away from the mother and isolated for two hours to prevent infections. The mother yells out the infant's sex to her family standing outside.

"She is a prisoner," Matdeyenko said. "Each time a woman is hospitalized, it scares her. The first time a woman has a baby, it is so traumatic that she doesn't want to have a second baby. Women are afraid to sit on a hospital bed. In Russia, she spends about five days in the hospital after a vaginal delivery (the norm in the United States is one or two nights), and 10 days after a Cesarean section; they spend 10 days. . . .

"Infection is a big problem. Nobody explains anything to them. There is no information, no education, no psychological preparation. Adult women don't know anything about their own health care, child care, prenatal care. Not a lot of women go to doctors. They only go in an emergency."

Now, despite the dire state of her country's economy, Matdeyenko's dream is to open a model birthing center that replicates the coziness of the labor and delivery rooms she observed at Southern California hospitals. She also hopes to implement Lamaze Childbirth Education classes.

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