The isolation from the medicine: pregnant women in Moscow become the victims of the pandemic

By now in total, according to the transformation into the infectious hospitals, seven maternity hospitals were closed in Moscow.

Lyudmila Butuzova

Such measures were taken in connection with the current epidemiological situation. The tests for the examination can submit the relatives or the friends of a patient. Test results are discussed remotely by phone. Starting from 22 weeks, the future woman in labor should conduct daily self-monitoring of fetal movements. When contractions occur, you must call an ambulance. “And do not ask where you will be taken,” says Katerina Pershina, gynecologist at the Clinical Hospital of the Mother and Child Group of Companies. - In the corridor of the first hospital that came across, if the ambulance managed to arrive and you did not give birth at home? In Kommunarka, where is there a free spot after recovering from COVID-19? Why should a woman get into an incomprehensible ambulance to doctors who could take someone with snot and cough before her ?? Is it the safety? Are you totally crazy?!”

“I have no words to describe all my horror, anger and disappointment,” she writes. - At the moment, 7 maternity hospitals have been closed in Moscow, reprofiling them for the treatment of the infectious diseases, among them there were the maternity hospitals with a very strong pediatric resuscitation and neonatologists... There are no more hospitals obviously. Thanks to modernization and optimization.

I will not describe you the state and mood of the medical staff, who were obliged to remain and work with coronavirus patients on a voluntary-compulsory basis. Even the age-specific medical staff, as well as the nurse, for the most part refuse to transfer to other institutions: do not like it - quit. Children's resuscitation also does not transfer anywhere, just close it. How was they joking there two weeks ago? Stay home if you don't want a gynecologist to intubate you? Well, now this is no joke.

But now I have a separate question for Sergey Sobyanin and the Ministry of Health, as well as for everyone involved! The question is from a person on the 40th week of the pregnancy, who now sees the whole situation from the inside. Where can we give birth and with whom? At home? On the streets (by the way, is it still not a fact that the child will not immediately be smashed with batons for daring to get out without a QR code)? In the corridors of maternity hospitals? What are you doing???

1) The maternity hospital is crowded! Moreover, all the patrimonial and postpartum departments: both compulsory medical insurance and VHI. In generic just a conveyor. What does this lead to? In addition to the fact that there are not enough doctors and in critical situations, women in labor will still wait (and often by minutes and seconds), to the fact that everyone is trying to deliver as quickly as possible and make room. The consequences of stimulation of labor are also known to smart people. How many ruined children will we receive after such childbirth ?? But this is obviously unimportant. Fewer children, less mothercapital and benefits to pay, right?

2) Observation in antenatal clinics you canceled in essence. Although there are many situations in pregnant women, when a threat to the fetus may actually be asymptomatic. And by the time it is already revealed, it will be too late. Well, again, what little things! But we will treat those whom you drove like sheep in a queue at the entrance to the subway. The rest is all the same. Let them die!

3) The departments of the pathology of pregnancy The order of the Ministry of Health actually banned the laying of pregnant women for observation. No disputed moments can be observed in the LCD, nor in maternity hospitals! Just great! Perhaps, within the walls of the Ministry of Health they forgot how often CTG should be done according to the protocols in the last weeks of pregnancy, even taking into account that everything is apparently good? And if there is any doubt, then generally at least once a day! Now if they put it, then the task is also to quickly write out or quickly deliver. In maternity hospitals, almost all departments of pregnancy pathology are urgently now closed and converted into postpartum, leaving literally 20-30 beds for pathology (instead of 100-150). Girls with preeclampsia, edema, diabetes and other problems are sent home or, again, urgently delivered with stimulations and surgeries.

The doctors themselves are shocked, but they cannot do anything. Mothers are afraid (the last weeks before childbirth are often stressful, but in such circumstances everything is very sad): they are afraid for children, they are afraid to pick up SARS before childbirth (with any signs of SARS they will send an infectious child to give birth), they are afraid that someone will be in the hospital he will bring the coronavirus (there are no express tests, and most staff go to work every day by metro), they are afraid to get into such a stream when they have to give birth in the corridor without doctors. There is already a wave of messages on the Internet: I'll give birth at home! Should I again tell you the consequences of giving birth?

And this is all that is happening now, your merit! You brought the situation to the point of absurdity, and the health system was put under the line! Who will be responsible for this? Who will disentangle the consequences? Nobody! For several years now, in Moscow, the situation with maternity hospitals has been so-so (in principle, there have always been good ones on the fingers). Now you have also reduced their number and continue to do this weekly! Stop! Enough! You have already demonstrated everything to everyone over the past few weeks with your idiotic decisions.

Activist Lada Yurieva adds:

“Not only women in labor found themselves in this situation, but everyone. People with any disease, chronic or just emerging, were deprived of the opportunity to get help. Doctors also face this situation, they are forced to work 24 hours a day in unbearable conditions, what directly contradicts the Labor Code. These are the consequences of the criminal "optimization", or saying more simply, the collapse of the medicine by Sobyanin, Pechatnikov, Khripun..."

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Here’s what’s in the document on the special treatment for pregnant women:

“In the capital, the procedure for providing medical care to pregnant women has changed. Visits to antenatal clinics, day care centers and consultative and diagnostic departments are temporarily limited for them. Such measures were taken in connection with the current epidemiological situation. Expectant mothers must observe a special regime of self-isolation in order to protect themselves and the child from becoming infected with COVID-19 infection.

Muscovites should visit specialists only in the following cases:

• for pregnancy registration,
• for conducting screening ultrasound examinations in prenatal diagnostic rooms,
• for the introduction of anti-Rhesus immunoglobulin in order to prevent Rh sensitization during pregnancy and with complaints.

Planned visits will have to be postponed until further notice. Urine tests can be sent for the study to relatives or friends of the patient. She can discuss the results of the tests with her doctor remotely, by phone. Also by phone, without visiting a maternity welfare clinic, you can issue a sick leave for maternity.

Usually, doctors advise all expectant mothers, starting from week 22, to conduct daily self-monitoring of fetal movements using the simple “count to 10” test (a woman thinks how long it will take 10 movements; if, after 12 hours, ten movements have not been received, consult a doctor ), monitor the dynamics of body weight, the size of the abdominal circumference, and also keep a diary of blood pressure and water balance. During a period of unfavorable epidemiological situation, women should provide a weekly diary of the antenatal clinic doctor with a diary of blood pressure and water balance.

Moreover, in the case of the appearance of pulling or cramping pains in the lower abdomen, changes in the nature of fetal movements, increase in blood pressure up to 140/90 mm RT. Art. and more, the appearance of bloody or liquid discharge from the genital tract, you must call an ambulance by phone 103. You also need to immediately seek medical help if you feel unwell and the first signs of SARS appear.

The patient will be provided with all necessary medical care in full and, if necessary, promptly hospitalized in a 24-hour hospital (maternity hospital). When providing medical care in the capital's maternity hospitals, all necessary measures are taken to prevent the possibility of infection with infectious diseases, including COVID-19. Expectant mothers at high risk for coronavirus infection receive similar treatment, but in specialized hospitals, where all conditions are created to prevent the transmission and spread of infection.

The city’s maternity hospitals are open, all assistance in obstetric care is provided in full. The restrictions apply only to partner births and family visits. If a woman feels the birth is coming, an ambulance must be called. If a planned cesarean section is to be performed, the doctor of the antenatal clinic will determine the date of referral to hospital in the maternity hospital one day before the expected date of surgery for a complete clinical and laboratory examination.

Maternal care questions can be clarified by calling a single telephone number: 8 (499) 251-83-00. Future mothers must observe a special regime of self-isolation in order to protect themselves and the child from becoming infected with COVID-19 infection ..."