The rights of women in childbirth and obstetric violence

"Childbirth is about the experience of a woman, not a staff"

Why conversations in the kitchen cease to be conversations in the kitchen and what the fight against obstetric violence gives

We may continue to pretend that we are all right, as in the pink picture from the walls of the women's consultation. For decades, Ukrainian women silently endured violence in the maternity ward and talked about it only in their kitchen, and then, with the advent of the Internet, wrote on moms forums under nicknames.

But times have changed and women starts to transform Ukrainian realities to their daughters get a chance for another experience. And this is no longer a conversation between friends, but a large initiative of like-minded people across the country - this was the online presentation "Human rights in childbirth and the problem of obstetric violence in Ukraine in reports and facts", which was organized by experts of documentary activism Arts&Rights and NGO "Natural Rights Ukraine". During the quarantine, the presentation gathered hundreds of women across the country on the other side of the monitors. This is the best evidence that this conversation has gone beyond personal.

Diapers for Youtube videos and "some kind of sectarian"

The life of the average Ukrainian woman is very rich. She lives, works, goes to her favorite job, after - yoga and with friends for coffee. There are joys and there are difficulties - everything is like it has everyone. And now she is preparing to become a mother. Nine months she walks, tries to lead a healthy lifestyle, and close watching for the cute children's things. Her whole life changes radically during pregnancy: other habits, lifestyle and thinking. While she has been stroking her tummy for 9 months and all her family was trying to fulfill her whims, the Ukrainian woman is fine. As soon as she gets to the maternity ward, here the horror begins. Here woman faces another reality – cynical staff, obstetric violence, and pain and fear only complicate the problems.

Olga Bardziy from Ivano-Frankivs`k gave birth at the age of 21. The first birth recalls with horror. The woman had caesarean and everything would be fine if it were not for the experience of communicating with junior medical staff.

"No one gave me a hand after a caesarean. I couldn't get off the couch on the couch. In response - only the echid smiles of nurses, the echid comments that the man had to be nearby. But I wasn't allowed to take him with me!", - emotionally remembers the woman.

Olya has congenital asthma, so she agreed on a private single ward so as not to risk with Covid. But at the last moment she was refused and put in a common ward with another woman.It was their first child, Oli had no experience caring for children and she asked about everything from nurses.

"I was asked: "What have you been doing for 9 months?" So I swapped a small diaper with a help of youtube video. The nurses were here just to stuff the baby with the baby nutrition, while I wanted to breastfeed," Olya goes on.

Operated a few hours ago, Olya lay politely. When she asked the nurse to give her yogurt from the bag, the nurse told her that she was not a feeder here. And on the 4th day after the caesarean, the woman was sent to do fluorography in the same office together with coronavirus patients...

"I don't know what should have happened to change my impression of the maternity ward," Olya concludes.

After the first birth, clothing designer Antonina Zamoroka decided that she would no longer return to the maternity ward. But she was looking for a reliable doctor, interviewing potential doctors. And so she found one that supported her views on how she wanted to give birth. He was not against douls, listened to the wishes of a woman, Tonya was impressed of his views on episiotomy and other dubiously needed things. But not everything is so cloudless - the nurse achieved her an enema contrary to her will.

"Every time a man went out to smoke, I was constantly trying to do something. The doctor pierced the prolific bladder, despite the fact that we agreed otherwise, did an episiotomy, I was pricked with oxytocin, although we did not agree so. I was deceived once again. Later, doctors shared their impressions of my childbirth: "Can you imagine? She gave birth, refused all injections! Some sectarian"! 

It is impossible to wash myself, because the water is rusty and cold. The child with the fight was given a nutrition, the neonatologist threatened with resuscitation. The man was offered to sign a receipt that he did not mind that our child would die in intensive care," the mother recalls twice with pain in his voice.

There are many such stories across the country. Women tell it so as men talks about their serving at army - endlessly, at least during the presentation.

There are rights, but still needed to fight for

Paradox: the woman is protected for all of the nine monts, but during childbirth she turns into a lawless creature, unable to dispose of her body. No one even listens to her, but even medical protocols are on her side. Anna Petrovska, breastfeeding consultant, head of the NGO "Natural Rights Ukraine", argues that everything necessary for the right to decent childbirth is exactly recorded in medical protocols.

"A woman is not the object of medical manipulations, but the main participant in the process. Anyone can support her in childbirth – husband, mother, girlfriend, professional assistant – doula. They must be up to 2 people. It is recorded in the order No. 234 of the Ministry of Healthcare. The only thing they should have with them is clean clothes and replaceable shoes, nothing more, whatever devised in the maternity wards. There is an informal practice in childbirth – to bring with you a certificate that the accompanying people do not have tuberculosis. Everyone is afraid, because the statistics of this disease are very high. But this is not necessary. Protocol No. 624 on normal childbirth ensures that even if pregnant women with high risk (with chronic diseases who fell ill during pregnancy) have normal childbirth, they should be conducted accordingly, and not regarded as complicated. This protocol also regulates the conditions for a woman and her baby. There should be an individual ward close to home conditions, psychological support of the partner, and all medical manipulations must be explained, and the woman must give them informed consent. The protocol records the support and respect for the wishes of the woman by the medical staff.The ward must be knocked and enter only after permission. No any unknown people anymore! If someone wants to invite interns to childbirth, then the woman must give consent to this. Throughout childbirth, a woman has the right to move, she can find a comfortable position for the birth of a child. Also, a woman can eat, drink during childbirth. Childbirth on the back is not recommended, and the Krystiller method (squeezing the child manually) is generally prohibited," says Anna Petrovska.

In 2019, we already had documents on women's rights in childbirth. Latinos were the first to talk about it. They had even worse situation than ours, says Anastasia Salnikova, researcher, co-founder of the NGO "Natural Rights Ukraine". According to her, women who have experienced obstetric violence are less likely to return to their previous lives and to work. Therefore, this is a social problem, not a problem of a single woman.

"Childbirth is about the experience of a woman, not of a staff. No one who works with women's rights fights doctors or harms them. Our activity is about finding dialogue. We stands for comfor for everyone in this process. Obstetric violence is not a problem of individuals, it is a characteristic of a system that does not prescribe responsibility for a violation that creates burnout of doctors and persecution for leadership in a city or region, a system that bears the imprint of objectifying attitude towards a woman, which is key," convinced Anastasia.

An interesting fact is given by Olga Gorbenko, co-founder of the NGO "Natural Rights Ukraine", doula, psychologist. According to her observations, the introduction of partner births in Ukraine gave stunning results: from 2002 to 2008, the number of complicated births decreased by 40%, and infant mortality decreased by 67%. That is, to break the traditional morality, when pregnancy and childbirth are medical manipulations, and not a natural process, is still worth it. The result of the implementation of partner births is the adoption of 51 protocol of evidence-based medicine in childbirth. It should be continued!

Make a movie and change the world

The language of the cinema is eloquent. Probably this art that can speak to very different people. That is why the Arts&Rights documentary activism project supports so many films and young filmmakers.

Young promising director Tatyana Dorodnitsyna decided to make a movie and change the world. Her interests in cinema are very difficult. All her conscious life, Tnya wanted to make a film about women's rights and was very happy that she could implement this idea in the plane of women's right to decent childbirth within Arts&Rights. She gained complete freedom for creative expression.

Tanya swung at the tape, which should give the Ukrainian women hope that everything is to change.  

"Not a Scary Movie" is a documentary based on the stories of 5 women. This is the experience of various Ukrainian women who gave birth in Ukrainian maternity hospitals. They are very different, but their story is that no one asks a woman what she wants. I'm trying to make movies through the hero's story. So it is easier for me to tell all the things that need to be told for a long time," says Tanya.

When her own mother talked about how difficult was to birth her, Tanya thought that her mother was just very emotional. But over time, she realized that childbirth is a very traumatic experience for Ukrainian women that she would prefer to avoid. Filming is a form of Tanya's fight against a system that injures women so much that they no longer want relationships and more children.

"I am interested in this topic more and more, I dive into it more and more. I understood this in the process of working on the film. Childbirth is not about torment, it may be in a different way. I understand that for sure today. I also understand that I have rights. I want to tell a story about women trying to change the situation in the country so that the situation changes for everyone," says the director.

In general, "Not a Scary Movie" should turn out to be life-affirming. "I could take some tragedy history when something in childbirth went wrong. But I thought it wasn't quite that, it's very narrow," says Tanya. - American women raised the topic of how they want to give birth as soon as they were in 1960s. And we see that everything has changed quickly. We're going to change that, too.'

Irina Berezovska