Rus Articles Journal

History of development of povivalny matter in Russia of

was traditional children in families much, and the childbirth repeating nearly an every year was perceived by all as the most natural event. Our ancestors thanked God for favor in case of safe birth of the child, but also with humility accepted its loss.

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at the end of the 16th century at Ivan the Terrible created the first government body operating health system, the so-called Pharmaceutical order. The traditions and the Domestic tyranny existing in Russia kept idea that to doctors - men to go in for obstetrics did not stick, and midwives usually delivered.

Midwives were famous for the ability, based on experience of the whole generations. Resorted to the help of midwives up to the middle of the 20th century.

At Peter I to Russia there arrived many western doctors whose opinion it was not recommended to criticize. So it began to be formed medical scientifically - reasonable “man`s“ approach to process of a rodorazresheniye, forcing out naturally - intuitive “female“ conducting pregnancy and childbirth. Though before the beginning of the 19th century “doctors not only were not allowed to study obstetrics on a human body, but if the doctor investigated the woman in labor without midwife, then it was prosecuted“ (V. P. Lebedeva, 1934).

B 1754 Pavel Zakharovich Kondoidi, Labe is a physician at the empress Elizabeth Petrovna, gave to meeting of the Ruling Senate “Idea of decent establishment of a babichyev put in favor of society“. Everything “grandmas Russian and foreign“ had to pass, according to this “Representation“, in Medical Office qualification certification. Those from them, “which according to certificates will be are worthy“, were sworn in - why such grandmas were called jurors. The list of the jury grandmas having permission to independent practice was supposed to be submitted to police “for national news“.

Taking the oath on the Bible, each midwife promised, among other things, that:

“day and night, immediately to go to women in labor rich and poor, whatever rank and advantage were“ “if the homeland prodolzhitelnyya will be, to flour it is vain not to decline and not to force, and with patience I will expect nastoyashchago time, at the same branlivy words, oaths, alcoholism, obscene shutok, discourteous speeches and prochago absolutely to be kept“ “to a vykidyvaniye of the baby by giving pronosny and izgonitelny drugs or otherwise with anybody and I never will agree, and to that myself I will not allow to use for anything“, etc.

on April 29, 1754 the Ruling Senate approved by

Representation to Medical Office, with all its appendices, having issued the Decree “About Decent Establishment of a Babichyev of Business in favor of Society“.

the First professor and the teacher of “babichy matter“ in Moscow and in general in Russia. In 1757 in Moscow and St. Petersburg the first schools for training of the qualified midwives are based. Training was conducted by midwifes (foreign, generally Germans), but not doctors. Men - to doctors were still forbidden to touch the pregnant woman.

From the beginning of development of capitalism the yesterday`s peasants getting to the city lived in incomparably nastier conditions, than in the village. With integration of the cities moral principles begin to change gradually, there is a washing out of the status of a family. The number of illegitimate pregnancies grows in the cities. The state was forced to organize maternity shelters for the poorest city dwellers.

Obstetrical institutions initially intended only for women from the poorest segments of the population, and also for unmarried women in labor as a secret shelter. To give birth in hospital it was as if shameful therefore many of those who wished to use medical care, invited midwives to the house.

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B under Catherine II`s decree in Moscow at University open 1764 the Educational house and at it Obstetrical office for unmarried women in labor as a part of which the Moscow`s first specialized institution - “Maternity hospital“ - for poor women in childbirth was organized.

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In 1771 according to Catherine II`s instruction in St. Petersburg open the educational house, and at it the first povivalny hospital - for unmarried and poor women in childbirth was founded (nowadays - № Maternity hospital; 6 of the prof. of V. F. Snegireva).

could be donated

In imperial Russia the fair sums for charity. Maternity shelters were created like doss houses and almshouses from philanthropic motives, but not from - for medical need.

Scientific formation of obstetrics and improvement of teaching “babichy matter“ in St. Petersburg happened thanks to N. M. Maksimovich - to Ambodik (1744 - 1812), who is fairly called “the father of the Russian obstetrics“. In 1782 he the first of the Russian doctors was entitled professor of povivalny art. N. M. Maksimovich - Ambodik entered occupations on the phantom and at a bed of women in labor, used obstetric tools. He wrote the first Russian leaders on obstetrics “Art of a povivaniye, or Science about babichy business“ on which many generations of the Russian obstetricians were trained.

H. M. Maksimovich - Ambodik, widely educated doctor, the talented scientist and the teacher who was hotly loving the business the first entered teaching obstetrics in Russian, fought against foreign domination in the Russian medical institutions. He was the hot patriot showing care of growth of the population of Russia: an epigraph to the “Art of a povivaniye“ it put the words output by bold print:“ The sensible mind rules be peeped about reproduction of the people, useful keeping of newborn children, than the population of the raw earth by the German foreign newcomers more“.

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on the other hand, exactly from now on men - doctors began to be allowed to the pregnant woman and on childbirth - allowed them “to touch“ the pregnant woman only 200 years ago. These are characterized 200 years by continuous fight of doctors for strengthening of the influence on the giving birth woman. At first they gave to midwives only elements of scientific knowledge, later process of replacement of the midwife actively began with her lawful field where she regularly worked in the millennia.

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At Catherine II`s reign, in 1789, gave “The charter to midwives“ on which were only allowed to “babyichy occupation“ tested in knowledge and taken the special oath. Also kind behavior, modesty, not garrulity and sobriety were required from them, “that were able to execute the business at any time“. It is important to note that jury grandmas had to “do a favor “insufficient women in childbirth“ impecuniously“. In the capitals the jury midwife was on the staff of each police part along with firefighters, lamplighters etc.

B 1797 in St. Petersburg at the initiative of the empress Maria Fiodorovna the third maternity hospital on 20 beds was open. It was the Russia`s first obstetrical and at the same time educational institution - Povivalny institute (nowadays Institute of obstetrics and gynecology of the Russian Academy of Medical Science of Ott).“ Rodilnya“ accepted pregnant women at any time. Obstetric aid and stay in a hospital was carried out usually gratuitously, and intended generally for married poor women in labor. Povivalny art at institute was read by N. M. Maksimovich - Ambodik.

After Maria Fiodorovna`s death Nicholas I the decree of December 6, 1828 declared Povivalny institute public institution and according to desire of deceased mother appointed him the patroness the grand duchess Elena Pavlovna. The institution received the name “Imperial Institute of Povivalny Art with Maternity Hospital“. At it in 1845 there began work the Russia`s first school of rural midwives.

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B at the Moscow university open 1806 new povivalny institute and maternity hospital on three beds for poor women in labor (nowadays Moscow medical school № 1 “Pavlovsk“). In 1820 the number of beds increased to six.

the midwife worked with

After cancellation of a serfdom in 1861 both in system of again formed territorial medicine, and in the state health system. For the work to midwives the salary and the raised pension was appointed, and also “for long-term zealous fulfillment of duties“ they were marked out by distinctions and government awards.

In imperial Russia:“ midwife“ (the higher medical education), “the rural midwife“ (secondary medical education) and “midwife“ (correspondence education).

Midwives prepared Povivalny institutes which by the end of the 19th century in Russia there were not less than two tens. The diploma the midwife was issued for a rank upon termination of training (as a rule, six-year-old) and adoptions of “The oath of midwives about their position“.

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To the midwife assigned “a giving of grants“ and leaving at the normal course of pregnancy, childbirth and a postnatal state, and is equal also care of the newborn. The doctor - the obstetrician was called only at the wrong current of all these states.

Midwives monthly provided to

in medical justices reports on the done work, rural midwives - quarterly.

Wishing to be entitled the midwife has to be not younger than twenty and is not more senior than forty five years.

the Rural midwife got three-year medical education at specialized povivalny schools in the large district cities. Across Russia of povivalny schools there were not less than fifty.

Besides, so-called central, local and territorial schools at which were taught were available: Scripture, Russian, arithmetics and course of theoretical and practical obstetrical art.

the Rural midwife worked as

at the village without the right of work in the city. She both delivered, and trained midwives from the neighboring villages.

the Midwife received the certificate on the correspondence education on the basis of the certificate from the midwife at whom she studied, signed by the policeman or the district doctor.

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attached great value not only to experience, but also morally - to moral qualities. The grandma had to be irreproachable conduct, to be honest and dear in society. She received blessing at the priest, regularly confessed and took communion.

As it was already noted by p, it agrees “To the charter to midwives“, “any midwife has to be <... > it is well-behaved, kind behavior, it is modest and, is sober, <... > has to at any time, in the afternoon or at night from whom it is called was to go, without respect of persons, immediately and on arrival to the woman in childbirth to arrive tenderly and promptly“.

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With development of society also the number of the trained midwives, but not just casual assistants - relatives and neigbours grew. In 1757 on registration in Moscow 4 midwives worked. In their 1817 was in Moscow already 40, and in 1840 - already 161 midwives. And in 1899 - 1900 academic year only one Voyenno - the medical academy in St. Petersburg trained about 500 midwives. In 1902 there were already 9000 midwives from whom 6000 lived and worked in the cities, and 3000 - in rural areas.

In the 18th century maternity hospitals begin to open. Obstetrical institutions, maternity hospitals and shelters were arranged for the placement on time of childbirth and the postnatal period of pregnant women from “insufficient classes of the population“ or for granting an opportunity for a payment to carry out childbirth in the situation conforming to scientific requirements of antiseptics and an asepsis. But soon after their organization doctors met heavy, often deadly complication - “a maternity fever“, i.e. postnatal sepsis. Mass epidemics of this “fever“ were a scourge of maternity hospitals and in the first half of the nineteenth century. The lethality from postnatal sepsis fluctuated during the separate periods of XVIII - the first half of the 19th centuries from 10 to of 40 - 80%.

In the 19th century two large discoveries - introduction of air and chloroform for anesthesia, and also studying of ways of distribution of an infection in time and after the delivery and the first means of fight against it - were reflected the strongest image in destiny of obstetric aid. Development of obstetrics went on the way of the increasing introduction to practice of the medicinal and surgical principles and scientific methods. Among other it is possible to call operation of Cesarean section which destructive action on development of physiology and mentality of the child was not known yet. Danger of sepsis decreased owing to what this operation found a wide circulation in obstetric practice.

I all - most of the population of Russia was skeptical about practice of maternity hospitals. Before the beginning of the 20th century in maternity hospitals only women who had no opportunity to give rise to houses - on poverty or because the child was illegitimate gave birth. So, in 1897 at celebration 100 - the anniversaries Imperial clinical povivalny institute of the grand duchess Elena Pavlovna his director Labe is obstetrician Dmitry Oskarovich Ott with grief noted: “98 percent of women in labor in Russia are still left without any obstetric care!“ or, in other words, preferred to give birth houses.

B 1913 in all territory of the huge country nine children`s consultations and only 6824 beds in maternity hospitals were. In the large cities coverage by stationary obstetric aid made only 0,6% [BME, volume 28, 1962]. Most of women continued to give birth traditionally houses by means of relatives and neigbours, or invited to themselves the midwife, the midwife, and in difficult cases - the doctor - the obstetrician.

After revolution of 1917 destruction of the developed system of obstetric aid happens.

the State system of training of midwives which developed at tsarism by inertia continues to work with

till 1920. To Bolsheviks first was simply not to them. In 1920 reorganization of health care burst. Povivalny institutes and schools were reorientated, there ceased to train experts in normal physiology. It was headed for every possible coverage of the giving birth women by medical services.

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At the IV All-Russian congress of zdravotdel in December, 1922 brought up a question of introduction of criminal liability for illegal doctoring. From now on withdrawal from practice of house childbirth began, and it was headed for collective-farm maternity hospitals in the beginning, and then for full stationary medical obstetric aid. The midwives continuing practice of conducting normal childbirth were exposed to prosecution and the subsequent exile.

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Instead of maternity shelters for poor and bezmuzhny women in labor in the country developed grandiose construction of maternity hospitals for all women without exception. So by 1960 across the Soviet Union of maternity beds there were already more than 200000. In comparison with imperial Russia occurred 30 - multiple increase in quantity of beds at simultaneous falling of birth rate.

To a bed of the giving birth woman instead of the midwife the doctor - the specialist in pathology got up. Introduction of “standardization“ of medical services began. Into 1935 - 1936 entered years mass labor pain relief. Are developed and from year to year techniques of medicamentous conducting childbirth - from the scientific point of view “for the benefit of the woman and a fruit“ are improved.

Nothing not constrained scientific “man`s“ obstetrics launched in maternity hospitals a full-scale aggression against female independence and intuitive accommodation of process of childbirth, and all this with assistance of government institutions of various level and mass media.

In parallel occurred destructions of institute of a family - full liberation of the woman, active attraction it to production work, public work, communistic construction. The child-bearing declareds social function of the woman...

From the book “Be Born at Own Will“