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Alina

 

“Fathers are as important for newborns as mothers”

© UNICEF Ukraine/2010/M.Teshaiva
Marynych couple in labour waiting for a son – fourth child in a family

Despite discussions around the negative effects of Chernobyl on the population’s reproductive health, Rivne oblast, which is considered one of the most heavily affected regions, currently boasts one of the highest birth rates in Ukraine. That’s why this oblast was among three to be targeted for the implementation of the UNICEF-EU project “Health Needs of Children Affected by Chernobyl.”

The project aims to educate health workers and supply medical equipment to maternity departments. Another component is the establishment of the Papa-school network in Rivne and Chernihiv oblasts, which involves fathers in the labour and delivery experience, to the benefit of the whole family.

“Everything is about the Oak”

In the village of Berezove, 36-year-old Valya breastfeeds her newborn daughter Nastya, the fourth baby in the family. Her neighbours just gave birth to their third child – and they have every chance to outnumber Valya’s family, since they are only 24 years of age. On average, families in Berezove and in neighbouring communities have between four to 10 children.

Local folks joke that secret of such fertility is explained by the powers of Prince Ihor’s 1,000-year-old oak tree, which grows nearby. Any person who leans against it is said to have large family. This is why an excursion to the oak is a compulsory element of any visit to the village.

Traditions or New Practices?

The village of Berezove, which is located in Rivne oblast near the Byelorussian border, is well-known for its health clinic’s maternity department, which has 330 to 350 deliveries per year. As a comparison, in some rayons of Ukraine, which include up to 50 villages, they have only about 100 births annually.

About a year ago, the clinic started to practise partner-attended births; today every two of three birthing mothers deliver with their husbands at their side. Valya, the oldest among “new mothers,” had her partner beside her for the first time, with her fourth child. Eight years ago, when she gave birth to her previous child, labour was considered purely a “feminine” business. Men often saw their newborn children for the first time only when they came to bring them home after discharge.

I ask her, “So, how did you like it (partner-attended birth)?” “Well, it was easier and faster – I felt my husband’s support,” she answers gladly, adding, “I delivered sitting on the chair, rather than lying in the bed, as it was in the past.”

Across the corridor from the ward for new mothers is a delivery room: midwife Maria Marynych is helping a couple in labour. For them a partner-attended birth is also something new, even though the couple already has three children. The husband carefully but somewhat irresolutely examines the pictures of positions that a woman in labour can take – he is trying to understand what he is supposed to do. The midwife comes up to help him, and in a couple of hours he receives a gift – he finally has a son after three daughters!

However, not every woman would like to have her husband beside her during labour and delivery. When asked about this, 36-year-old Tanya, the mother of 11 children, refuses without hesitation, “No, I feel shy.”

Despite efforts and the commitment of local health-care workers to introduce up-to-date perinatal technologies, in practice not everything works as intended. For example, they heat the delivery room with a simple stove and bring water from a well. This seriously complicates the ability to follow necessary sanitary and hygienic conditions, and increases the risk of infection. A new site for the maternity department is ready, but still must be connected to the water supply system.

© UNICEF Ukraine/2010/M.Teshaiva
Dima, who supported his wife at their son’s delivery, attends to them in a Sarny hospital

Why do we need a father here?

In contrast to Berezove, partner-attended births have been practised in the neighbouring town of Sarny, the rayon centre, for four years already. Women in labour come here from the entire rayon. The head of the maternity department of the Sarny central rayon hospital, Dr. Tetiana Vyshnevska, notes, “We started with having four per cent of births that were partner-attended; today this number has increased to 75 per cent.” In addition, the hospital supports rooming-in; it has a family-style delivery room, where fathers may stay with their wives and newborn babies until discharge from the hospital. Sarny hospital operates based on the school of responsible parenthood – more than half of all pregnant women come to see doctors together with their husbands. This encourages fathers-to-be to provide greater support to their pregnant wives and later, to be actively involved in child-care and rearing.

According to Dr. Vyshnevska, the presence of a loved one during delivery creates a positive emotional and physical condition in a woman in labour; her husband not only can talk to her in a soothing way, but also helps her to move around, to take comfortable positions during contractions. “These positive efforts of future fathers help to reduce the need for pain medications and surgical interventions; they also reduce the duration of labour and traumatism in mothers and babies. Fathers’ participation strengthens family links and develops greater trust and harmony. Sure to say, this is the best start-up for the baby’s greatest adventure called “life.”

“Several years ago the presence of a husband or significant others in the delivery room, as well as free choice of the position during labour, were considered to be something exotic in Ukraine,” notes Olena Sherstyuk, Programme Officer of the UNICEF Ukraine’s Child Health and Development Programme. “Currently it is becoming normal, routine practice, however slow and gradual. It was preceded by several years of hard work under the leadership of the Ministry of Health of Ukraine, which aimed to develop national protocols on effective perinatal care, and intensive training of health workers, including theoretical knowledge and evidence, and clinical practice. But most importantly, significant changes were made in maternity departments – from the establishment of family or individual delivery rooms to the introduction of the “open door” policy,” she says.

“However, taking into account the lack of budget funds, many health-care facilities are unable to repair their facilities, to procure necessary equipment and to finance educational workshops,” Sherstyuk notes. “It especially concerns Chernobyl-affected regions, because investment programmes and business activities in these oblasts are generally more limited than in the regions that do not suffer from Chernobyl-related stigma. This is why UNICEF prioritizes the improvement of medical services for mothers and children in these regions. In addition, UNICEF supports the development of the Papa-school network in order to make men aware of the fact that their presence during labour is not the test of their toughness – it shows them that fathers are as important for newborn babies as mothers.”

* * *
Currently the UNICEF Country Office in Ukraine implements the EU-funded project “Health Needs of Children Affected by Chernobyl.” One of the goals of the project is to educate health workers in evidence-based medicine, effective prenatal, antenatal and paediatric care, as well as to supply basic medical equipment to maternity departments. Establishment of the Papa-school network in Rivne and Chernihiv oblasts is a specific component of the project.

 

 
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