Women's experiences of giving birth in Northwest Russia in 2000 and 2002 and in Northern Norway 2000

Since 1994, Norway has supported health care projects in the Russian part of the Barents Region, some specifically directed towards the wellbeing of mothers and babies 1-4. A WHO/UNICEF-initiated Baby Friendly Hospital Initiative (1994–1999) was followed by the project Family Friendly Maternity Care (1999–2003), focusing on evidence-based and family-centered birth practices, as advocated in the WHO-Euro program Promotion of Effective Perinatal Care. To compare birth practices in designated baby friendly (BF) institutions with traditional care institutions (NBF) in 2000 and 2002, in the Archangelsk and Murmansk regions, compared with maternity institutions (all BF) in Northern Norway. The ‘Women's Experience of Birth’ questionnaire 5 was used as the basis for two cross-sectional questionnaire studies. Five maternity institutions in Northwest Russia in 2000 and 2002 (n = 528), were compared with 7 maternity institutions in Northern Norway in 2000 (n = 382). Full anonymity and confidentiality were assured 4. The response rate in Russia was 91% in 2000, and 76% in 2002, the Norwegian rate was 61%. Around 80% of the Russian women were <30 years of age, compared to 50% of the Norwegians. Approximately two-thirds of the Russian women in both 2000 and 2002 were primiparae, compared to only one-third of the Norwegian women. Parity did not change the emerging pattern of interventions. Table I shows birth practices experienced during labor and delivery. Medical interventions, such as amniotomy, induction, augmentation of labor, etc., declined in Russia between 2000 and 2002. Desegregated into BF or NBF, the institutions showed differing trends. In 2000, the above mentioned interventions were more frequently used in both BF and NBF institutions in Russia than in Norwegian institutions. In 2002, the Russian BF institutions continued this practices, while the NBF reduced them, thus becoming more in line with practices in Northern Norway. The rate of cesarean section was twice as high in the Russian NBF, than in BF. In the sample from Northern Norway, the rate of caesarean section was 11%, equal to BF in Russia in 2002 (Table I). In 2000, 35% of women at the BF and 15% at the NBF institutions had a relative or someone close to them present at birth, compared to 95% of the Norwegian women (Table I). The possibility for fathers or any other close relative to be together with the mother and the baby in the first hours after birth decreased in the BF institutions from 33% in 2000, to 17% in 2002. In the NBF institutions, this possibility increased from 12 to 25% (Table I). In 2002, more than half of the women in the BF institutions and one-third of women in the NBF institutions answered that they did not want anyone to be around (data not shown). It seems important that, in the future, the BF Hospital Initiative pay attention not only to breastfeeding, but also to its context, ie, the whole childbearing process, ensuring both clinical safety and psychological comfort to the mother-baby dyad. This study was part of a collaborative project between Norway and Northwest Russia funded by the Barents Health Program 1999–2003, through the Norwegian Health Care Department. Special thanks go to the Norwegian Institute of Public Health in Oslo for hosting the Norwegian part of the project. In relation to this particular article, we thank Professor emeritus Per Bergsjø for valuable professional comments.

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