Midwifery in the Soviet Union (1917-1991)

000000000000000000000000000000000000000000000000000000000000000

Research and Translation by

Adrian Chan-Wyles PhD & Gee Cheuk Wyles (BSc)

The 1917 Russian Communist Revolution was an unfolding progressive force that swept away the old and corrupt feudalistic regime of the Czar, and as its Socialist principles advocated the rule of the workers for the well-being of the workers, it is only natural to assume that the world’s first Workers’ State would devise programmes of rapid empowerment and development for all women and girls. In all regards, the Soviet Union (founded in 1922), had to build a country-wide military, political, cultural, social and medical infrastructure the likes of which the world had not yet known, and do this whilst isolated from the capitalist international community (a community that had purposely withdrawn all its finances from Russia when it became clear that Lenin was about to triumph). This was a mammoth task of systemic and cultural reorganisation designed to empower the disparate peoples of Russia, and in so doing create an entirely ‘new’ Socialist society premised upon the use of science to make life better for ordinary people.  Prior to 1917, Russian language historical documents describe Russia as being a politically and culturally ‘backward’ country, whose over-whelmingly peasant population was very much left to its own devices with regards to conception, pregnancy, birth and post-natal care for the child and mother.

Of course, the concept of a ‘midwife’ is of British origin, and its usage as a discernible historical term, stems from at least the 13th century CE (but is probably far older in concept), and translates as ‘a woman standing opposite a mother’, or ‘a woman caring for a mother’.  A midwife in the UK, particularly during the anti-pagan Christian-derived pogroms of the Middle Ages (and after), came to be associated with witchcraft (due midwifery’s ancient and non-Christian roots), and a number of unfortunate women were executed for the crime of ‘vile midwifery’. Ancient midwives in the UK used a mixture of herbalism, superstition, and a rudimentary knowledge of biology, coupled with an innate experience of pregnancy and child-birth (gained over years of assisting pregnant women through the process). This self-reliance and advocacy of herbal medicine and practical care was deemed by the medieval Church as being non-reliant upon god, and therefore a blasphemy in league with the devil.  The misogyny in this analysis is palpable and highly disturbing, as women caring for one another during pregnancy and child-birth was decreed a ‘crime’ by the Christian Church, and yet the institution of the ‘midwife’ survived all these attacks, and is now a respected (and ‘crucial’) non-medical aspect of holistic child-birth in the UK and around the world.

Prior to the Russian Revolution, Russia had its equivalent of ‘midwives’ which were peasant women who took over the responsibility of assisting other peasant women to give birth (heal and breast-feed, etc), and who helped (usually ‘young’) women by providing crude terminations.  As there was no medical services provided to the peasantry by the Czarist Russian State, midwifery as a form of folk-lore prevailed throughout the rural parts of Russia (with ‘midwives’ of a higher social standing working in cities – including foreign experts – being used by the rich, aristocratic circles, and the royal court.  On the face of it, this appears to be a very similar situation in Russia as it was in the UK (and other parts of Europe), but I have not read of any pogroms carried-out by the medieval Russian Orthodox Church against these early Russian midwives, the main function of which was to provide emotional and psychological support to pregnant women, as well as physical care.  However, as with the UK midwifery tradition, this Russian approach was ‘non-medicalised’ and entirely ‘holistic’ in nature.  This was due to the fact that objective medical knowledge did not begin to appear in Europe until around the 11th and 12th centuries CE, but which developed in sophistication and efficiency over the subsequent centuries.  Two medical disciplines associated with (but which remain ‘distinct’ from) midwifery are Obstetrics and Gynaecology. Obstetrics is the branch of medicine (and surgery) concerned with pregnancy and childbirth, whilst Gynaecology is the branch of physiology (and medicine) which deals with the functions and diseases specific to women and girls, especially those affecting the reproductive system. Modern midwives must be conversant with these two vitally important medical disciplines (and be able to assist, where necessary, medically qualified staff in the care of women), but the function of the midwife remains exclusively focused upon the ‘holistic’ care of the pregnant woman at every stage of the pregnancy, birth and post-natal situation.  A midwife over-seas a ‘normal’ pregnancy from start to finish, but should medical complications arise, a midwife is expected to immediately understand the situation, and to consult an expert is Obstetrics.  In the UK, Obstetric medical staff are generally used when there are pregnancy-related medical emergencies, but when a pregnancy runs smoothly, it is entirely midwife-led (unlike in the US, where midwives are virtually unknown and most babies are delivered by an Obstetric expert). Whereas a midwife takes care of a woman’s holistic needs, Obstetric experts deal only with the physicality of the birthing process and are not concerned with holistic care.

The Latin term ‘Obstetric’ refers to the body of knowledge relating to child-birth and midwifery. In Russia, a ‘midwife’ is referred to as ‘Акуше́рка’ (pronounced: ‘Akushérka’), which is a word derived from the Russian for ‘Obstetrics’ (i.e. ‘акушерстве’), pronounced ‘akusherstve’.  However, more informal or parochial terms used in the Russian language for ‘midwife’ are ‘бабка-повитуха’ (pronounced ‘babka-povitukha’), and ‘бабушка-повитуха’ (pronounced ‘babushka-povitukha’), both referring to a ‘grandmother midwife’.  Whereas the rich in Russia preferred medically trained ‘foreign’ experts (from Europe) in Obstetrics and midwifery, the ordinary Russian people had to make do with their old traditions, lack of modern medical knowledge, and general state of poverty (which included a high infant mortality rate).  This all changed following the October Revolution of 1917, and the coming to power of Lenin and the Communist Party.  This historical event placed the well-being of the majority of the ordinary people as its primary objective.  Feudalism, and the capitalist exploitation and oppression it encouraged and supported was abolished, and a Workers’ State built in its place.  The great achievement of Obstetrics and midwifery-led care during the Soviet period, was the creation of a unified state of maternal and childcare health. On December 28th, 1917, just weeks after the October Revolution, the People’s Commissariat of Public Charity was formed as a department tasked with the protection of infants.  Later, this was upgraded to the Department for the Protection of Mothers and Children. Since 1920, this department was merged with the People’s Commissariat of Health. In the years of chaos and civil war, the department launched a broad propaganda offensive regarding the importance of maternal and child health among the general population. The early work of this department at the time, was the drawing-up of legal decrees, the development of (Socialist) guidelines and regulations, and the convening of various meetings and conferences, etc, throughout Soviet Russia.  After the Civil War, the People’s Commissariat of Health initiated a broad reorganization of obstetric care in the country. The main objective of this reform was to create a free network of public obstetrical facilities easily accessible to the entire female population. These institutions became midwifery stations, rural maternity hospitals and antenatal clinics. By 1939, the number of obstetric beds in rural hospitals and maternity homes in Soviet Russia was brought up to 26,795, and the number of beds in maternity homes serving collective farms – was brought-up to 16,800.  During the Great Patriotic War, Soviet midwives and obstetricians carried-on assisting pregnant women (and their babies) in difficult and often terrible conditions.  Prof. KK Skrobansky worked in besieged Leningrad (co-ordinating a team of midwives) during the Nazi German blockade of that city.  Armed Soviet midwives in Leningrad (and elsewhere throughout the Soviet Union) often fought to the last round to protect pregnant women under their care, in the ruins of the cities, towns and villages, as ruthless Nazi German troops (and their allies) advanced, committing untold atrocities. In the last resort, Soviet midwives would lie over the pregnant women they were trying to defend. In the post-war period, maternal and child health continued to evolve. A significant role in this development was played by the methodical work carried out by leading specialist institutes, in particular the Scientific Centre for Obstetrics, Gynaecology and Perinatology (Moscow), the Institute of Obstetrics and Gynaecology (Leningrad) and many others.

A major contribution to the development of obstetrics was made through the developed theory of the biomechanisms associated with delivery through a narrow pelvis, made by IF Jordania – the Head of the Department of Obstetrics of the 2nd Moscow Medical Institute. He is the author of the famous obstetrics textbook for students.  KN Zhmakin headed the Department of Obstetrics and Gynaecology at the 1st Medical Institute from 1948 to 1967 – together with VI Bodyazhinoy he wrote an important textbook about Obstetrics, which went through several editions. KN Zhmakin and his numerous students successfully studied such topical issues as operational obstetrics, narrow pelvis, and other subjects. A Great contribution to the development of domestic obstetrics was also made by NA Tsovyanov, BA Archangel (1890-1934), IE Quater, AE Mandelstam, II Yakovlev, IL Braude (1882- 1960), and others.  The Soviet genius LS Persianinova (and his students) undertook the successful development of such important Obstetric issues as regulation of uterine activity, the fight against obstetric injuries, and anaesthesia delivery. LS Persianinova is also credited with the development of a new trend in Obstetrics – Namely antenatal protection of the foetus, and the introduction in Obstetric Practice of modern methods of diagnostics, as well as pioneering Phonocardiography Electricity and fetal ultrasound, amniocentesis and other innovative methods.  LS Persianinova was the author of two volumes entitled ‘Midwifery Workshop’, which was repeatedly republished in 1973 and 1974.

Russian Language Reference Articles:

https://ru.wikipedia.org/wiki/Акушерство

http://www.historymed.ru/encyclopedia/categories/?ELEMENT_ID=9

 

Leave a comment

Leave a Reply

Please log in using one of these methods to post your comment:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: