Why I chose the profession of a midwife. Interview about the profession: obstetrician. - What do they say about those who want to give birth with a partner

Every mom-to-be is looking forward to the birth of a baby. That is why she is so worried about how the birth will take place, whether the medical staff will make sure that the baby does not suffer and that any complications do not arise. The fair sex, who is about to become a mother for the first time, can only remotely imagine what a doctor does after the start of labor, and what a midwife does. Therefore, it is necessary to carefully study this issue and remember what the responsibilities of specialists are.

What does a gynecologist do during childbirth?

Of course, the doctor is the manager of the whole process. Only he can make the right decisions in a timely manner and give the necessary instructions to the rest of the staff. This person will do everything possible, and sometimes even impossible, so that the baby was born alive and healthy. Therefore, in no case should you underestimate the role of a doctor who, it would seem, is only observing the process.

First of all, the gynecologist examines the expectant mother and gets acquainted with the history of the entire pregnancy in order to draw up an approximate plan of action for obstetricians. Most often, already at this stage, the woman in labor will find out if a cesarean section, stimulation and other additional manipulations are required. When the long-awaited contractions finally begin, the doctor must examine the woman's vagina every hour to control the dilatation of the cervix. If the process of the appearance of the baby is successful, then in the future the gynecologist will appear in the ward only periodically.

Also, the specialist gives the necessary instructions to midwives and prescribes certain medications for the woman in labor, since there is often a need for the administration of painkillers. Moreover, the doctor carefully monitors the baby's condition, his heartbeat, in order to help him to be born in the event of complications. It is this person who dissects the perineum if the fetal head cannot come out in any way, as well as a puncture of the amniotic bladder with weak labor in a woman.

After the completion of the most important stage of the whole process, the specialist monitors the further exit of the placenta and, without fail, carefully examines it in order to draw final conclusions about the state of the body of the newly-made mom. If the integrity of the placenta has been compromised, then the woman is injected with drugs that accelerate uterine contractions and help the remnants of tissue to leave the womb.

Next, the doctor treats the external genital organs of the woman in labor with antiseptic agents and, if necessary, sutures the tears that were found in the vagina, uterus or the perineum itself. You should not worry about the painfulness of these manipulations, since they are performed under local anesthesia.

The final duties of a gynecologist are considered to be a detailed fixation of the course of labor and the execution of an extract. After that, he observes the state of mom and her baby until they finally go home.

What is the role of a midwife?

Many people greatly underestimate the role of midwives helping a baby to overcome all obstacles and be born. Of course, these people do not make any serious decisions, but they clearly follow all the instructions of the gynecologist, and it is they who bear a huge responsibility for the baby's health. After the expectant mother gets to the hospital, her blood pressure and pulse are repeatedly measured. The same person will help the woman with the correct execution of all important documents and certificates, and will also answer all the accumulated questions.

After the contractions begin, the midwife monitors the frequency and strength of contractions in order to provide timely assistance to the woman in labor. Moreover, after the order of the doctor, she will inject an anesthetic, make a relaxing massage. Very often, the staff teaches the expectant mother to breathe and push correctly, and morally supports her throughout the entire process.

When the baby finally shows the head, it is the midwife who helps him completely free himself from the womb and literally directs every movement of the woman in labor. Then the specialist observes the pulsation of the umbilical cord in order to cut it in time. Then the baby is thoroughly wiped and applied to the breast of the newly-made mom. After several hours, the baby is weighed, his height is measured and even dressed.

It can be understood that a huge responsibility falls on the entire medical staff, and therefore it is difficult to determine whose role is still more important. But the voice and face of the midwife, who for the first time showed the long-awaited baby and supported her during childbirth, will forever remain in the memory of a woman.

GOU SPO "Ryazan Medical and Social College"

Methodical development

open class hour

In the group "Obstetrics" 21

Curator: E. V. Potselueva

2009

The topic of the open class hour: "Me and my profession" in the group "Obstetrics" 21.

Purpose: Increasing the motivation of students in obtaining knowledge in their specialty, the formation of interest in the chosen profession.

The class hour is accompanied by a multimedia presentation with slideshows, photographs, diagrams, as well as O. Mityaev's song "Maternity hospitals".

Plan

Opening remarks by the curator.
Poem "You can't find a more beautiful profession"
A story about midwives.
Korablev G.I. - the famous Ryazan resident, one of the founders of Russian obstetrics and gynecology.
Characteristics of the profession of a midwife.
The poem "Someone is proud of the harvest."
Demonstration of the skills acquired by the students - changing the doll.
Demonstration of multimedia slides, listening to Oleg Mityaev's song "Maternity hospitals"
Functional duties of a midwife.
The poem "Monologue of the District Midwife".
The poem "Stop, let him see the sun."
Results of the survey.
The poem "The world is replenished daily."
Summing up, conclusion.

Obstetrics (from the French "accoucher" - to give birth) is one of the oldest branches of medicine. Pregnant women of Ancient Russia believed in the help of pagan spells, in sacrifices to the gods, in the power of herbs.

In the opinion of the ancients, the white water lily Odolen, a herb, was especially powerful. Before giving birth, the belly of the pregnant woman was smeared with an ointment made from hare bile, wheatgrass juice and goat fat, they gave water to drink in which two eggs were boiled, and two pieces of the rhizome of a white water lily were eaten.

Images of ancient Slavic deities Rozhanitsy

A song was even composed:

If a woman knew
What is Odolen - grass,
I would sew it into a belt
And I would wear it on myself ...

Traditionally, there were many children in families, and childbirth, which was repeated almost every year, was perceived by everyone as the most natural event. Our ancestors thanked the gods for their favor in case of a safe birth of a child and met his death with humility. In those days, the elders in the family of women provided assistance to the woman in labor. The chronicles have preserved the name of the physician Eupraxia, an unusually talented and selfless woman who lived in the XII century. From the period of early Christianity, the prayer of a woman in labor has come down to us:

I will become, blessed, I will cross myself,
from the hut by doors, from the courtyard by the gates,
into an open field, into the blue sea.
Is there Christ on the throne
the Most Holy Mother of God sits,
holds golden keys,
unlocks meat caskets,
releases the baby from the flesh, from the womb;
lets go of a baby of flesh, of hot blood,
so as not to smell any stinging or aches, amen.

But the Mongol-Tatar yoke, which reigned in Russia for more than two centuries (1237-1480), practically stopped the development of medicine. Only at the end of the 16th century, under Ivan the Terrible, was the first state body managing the health care system created - the so-called Pharmaceutical Order.

Midwives

Childbirth in Russia was usually taken by "midwives" ("twist" - to take a baby).

“... Village midwives are always elderly women, mostly widows. Sometimes married women also “babiat”, but only those who themselves have stopped giving birth. A girl, although an elderly woman, cannot be a midwife, and a childless woman is a bad midwife. What kind of grandmother is she, if she herself did not torture her? With her, it is difficult to give birth, and the children will not always be alive ... The midwife is invited to all difficult births, she always comes at the end of them to bandage the umbilical cord, wash and steam the woman in labor and the newborn, and take care of him for the first days ”. (G. Popov. Russian folk medicine. 1903)

Midwives did not have a special education, but were famous for their skill, based on the experience of entire generations. Not only in the village or in the city, but also in the capital, the tsar's and boyar's wives in most cases gave birth with the help of midwives.

The functions of midwives, in addition to the first care of the baby, were very diverse and consisted in the execution of customs, beliefs, conspiracies and various handicrafts. So that childbirth would be unleashed, the midwife would undo the braids of the woman in labor, untie all the knots on her clothes, walk with the woman in labor in the hut, hang her by the arms, shake her, and knead her belly. At the same time, the more the midwife knew such techniques, the more experienced and knowledgeable she was considered in the "woman's business".

Interestingly, the visit of the midwife to the pregnant woman was also surrounded by mystery. She always went through the backyards, through the vegetable gardens. Usually the midwife entered the house with the words: “God help to work! ”. She dressed the woman in labor in a clean shirt, gave the Epiphany water to drink and lit a candle in front of the icons. It was believed that the right means to speed up childbirth is to unbutton the collar of the shirt, remove rings, earrings, untie the knots, unweave the braids of the woman in labor. They unlocked all the locks in the house, opened the barriers of the stoves and gates: after all, if everything is open and untied, then the birth will be “untied” sooner. Throughout all childbirth, the midwife encouraged the woman in labor, saying that everything was going well, stroking her lower back. Almost until the moment the child erupts through the external genital organs, it was customary to lead the woman in labor by the arms of the hut. The umbilical cord of a newborn was tied with a thread twisted with the mother's hair, so that the connection between them, according to popular belief, would remain for life.

They resorted to the help of midwives until the middle of the 20th century.

Gerasim Ivanovich Korablev

Gerasim Ivanovich Korablev, an outstanding obstetrician of the first half of the 19th century, was born in Ryazan. After graduating from the Ryazan Seminary in 1809, Korablev entered the Moscow Medical-Surgical Academy, from which he graduated in 1813 with an award and was left with her as a dissector. Then he served as a regimental doctor in the Tarutino Infantry Regiment and in 1816 received the title of head physician.

In 1819, having successfully defended his thesis for the degree of Doctor of Medicine, Korablev was appointed professor of obstetric art at the Moscow Orphanage and Adjunct Professor of Pharmacy at the Medical-Surgical Academy. In 1826 he was approved as an extraordinary professor of obstetrics and forensic medicine, and from 1827 - an ordinary professor.

In the forties of the 19th century, the state of obstetric science and practical obstetric activity left much to be desired, despite a number of major studies.

Korablev was one of those who loved Russia, was rooting for her fate. "The goal of obstetric science," he said, "is to preserve and through that multiplication of citizens who constitute the main support and power of the state."

An educated and thoughtful doctor, Korablev was critical of the guidelines adopted in obstetrics. Those of them that he considered wrong, harmful to a woman's life, he disputed, despite the fact that they came from the leading figures of Western European science, and exhibited his own.

In 1840 Korablev wrote a three-volume manual with an atlas on obstetrics and women's diseases - "A course in obstetric science and women's diseases, or the doctrine of women's life regarding sexual functions, set out in physiological, dietary, pathological, therapeutic and operational relations."

Gerasim Ivanovich Korablev highly appreciated the art of obstetrics: "Obstetrics is one of the most important and predominant sciences, it differs from surgery in that surgery is one thing, and the obstetric science suddenly, and sometimes even more, saves two from death."

Korablev belongs to the priority of introducing into obstetric practice the concept of a "functionally narrow pelvis", usually incorrectly attributed to the German obstetrician Martin.

In the chapter on the hygiene of pregnancy, Korablev points out that it is necessary to pay great attention to the mental preparation of the pregnant woman, to maintain her good mood, to instill confidence in the successful outcome of childbirth. Realizing that in primiparous water discharge and other phenomena can cause fear and thoughts about an unfavorable course of childbirth, Korablev recommended that the pregnant woman be introduced to these moments in advance, explain how to behave during attempts. His advice forms the basis of modern psychoprophylactic preparation of pregnant women for childbirth.

Korablev presented the following requirements to obstetricians: "Anyone who wants to become an obstetrician must first know not only the obstetrician itself, but also other sciences: anatomy, physiology, mathematics and physics, pharmacology, pathology, therapy and surgery." At the same time, a good obstetrician must have some more special qualities, both bodily and mental and moral qualities.

Physical qualities include:

Reliable health. Hernias, consumption and wounds on the hands make the doctor incapable of obstetric practice.
A strong and well-formed body and especially agility and dexterity in hands, both of which should be equally capable. The arms should be strong, but not wide or thick in the hands, but narrow and flexible.
The obstetrician should not be very young and not very old.

The spiritual qualities include:

Lively imagination and good memory.
Sharp and resourceful mind and subtle considerations.
Determination and humane composure, caution without fear and cowardice.

On the moral side, it is necessary:

Decency, friendliness and gentleness, and sobriety.
Patience, compassion, indulgence, meekness, hard work and accuracy in business.
Conscience and unselfishness, modesty and respect for female bashfulness.

The name of academician G.I. Korableva occupies an undeservedly modest place in the history of our science. Meanwhile, it was a colorful figure of a teacher, a Russian scientist-writer, a famous practitioner and an ardent patriot.

Midwife functions

These are representatives of, one might say, the most ancient branch of medicine. Wherever obstetricians-gynecologists work, they are always assisted in their work by midwives. And there are many health care areas where the midwife provides assistance to women on their own, without the daily guidance and supervision of a doctor.
So, for example, working at a feldsher-obstetric station, she performs very important functions, which in other conditions are the responsibility of an obstetrician-gynecologist. Of course, patients do not remain completely without medical help, they are consulted by the doctors of the nearest hospitals and clinics, but these medical institutions are sometimes relatively far away, so that the follow-up observation and all the recommendations of the doctors are carried out by the midwife.
The midwife of the feldsher-obstetric station must be a very competent specialist, capable of providing the necessary assistance in any difficult situations. The life of a woman and her child often depends on how quickly the midwife makes a diagnosis and what tactics she chooses.
In the antenatal clinic, the midwife works directly with the doctor - she performs the procedures prescribed by him, keeps documentation. During the day, there are significantly more patients here than at the feldsher-obstetric station, and the midwife is required to be collected, quick and attentive, especially if she is entrusted with independent work in the examination room, where a preventive examination is carried out.

In addition to direct assistance to the doctor at the reception, the midwife of the antenatal clinic calls pregnant women and patients under dispensary registration for periodic examinations, takes care of the availability of the necessary medicines, instruments, sterile materials in the office, conducts classes at school for pregnant women, and conducts sanitary and educational work.
The responsibilities of a midwife in a maternity hospital are quite different. It would seem that here its functions are extremely narrowed, since its main task is, under the guidance of a doctor, to provide everything necessary for the normal course of childbirth. But how responsible this work is!
The midwife of the maternity ward, upon admission of a pregnant woman, directly monitors her condition, the child's life (heartbeat, movement), performs various procedures, makes injections, and distributes medications. With the onset of labor, the midwife is relentlessly close to the expectant mother, guiding her behavior. If necessary, he provides one or another assistance. She is the first to meet the appearance of a newborn, conduct an external examination and treatment of the baby, show it to the mother. In case of complicated childbirth, during surgical interventions, the midwife helps the doctor and prepares to receive the newborn.

MIDWIFE

1. General characteristics of the profession

Great importance in our country is attached to the protection of mothers and children. They begin to take care of the child's health from the earliest stage - from the period of pregnancy of the expectant mother. And a significant role in this belongs to the midwife, who observes the woman during the entire period of pregnancy, as well as the child of early childhood. The midwife works in obstetric and gynecological institutions and at the sites. What are its functions?

She establishes the fact of pregnancy, her terms and periods of maternity leave. Conducts consultations and measures for the prevention of pregnancy and sanitary and educational work in the field of women's hygiene, protection of mothers and children. Performs sanitary treatment of women in labor, isolation of patients, if necessary, provides initial assistance to a sick child. He makes surgical dressings, helps the doctor with operations and intravenous infusions. Makes subcutaneous injections, catheterization, applies cans, compresses, leeches, enemas.

2. Requirement for the individual characteristics of a specialist

I must love my job, be ready for empathy;

Emotional balance, tolerance for whims, observation, the ability to accurately determine the state of the woman in labor are required;

A large amount of short-term memory is required. you need to remember the doctor's prescription, the characteristics of the character of the woman in labor;

The ability to switch and distribute attention helps the midwife in the sequential change of various operations and while performing several actions at the same time to care for patients;

Developed empirical thinking makes it possible for the midwife to navigate what and in what sequence a particular patient needs.

3. Medical contraindications

Neuroses that cause inability to control oneself;

Mobility limiting diseases;

High degree of hearing loss and decreased vision.

May 5 is traditionally celebrated as International Midwife Day - a professional holiday for those who play an important role in ensuring safety during childbirth.

"The profession of a midwife is a profession that cannot be entered without a vocation." Still, the main quality of a midwife's work is professionalism.

"Wise woman"- this is what the word "midwife" means. This profession was and remains special, because it combines several specialties at once: in addition to the fact that midwives take part in childbirth, at the same time they perform the duties of a nursery, ward, operating room and anesthesiological nurse, and at the same time a psychologist. The approach to their education is more than serious.

Midwife one who loves children can become. Her work is not only noble, but also very responsible and difficult, since two lives depend on her. Therefore, in-depth knowledge, responsiveness, clinical thinking and good physical health are required of the midwife.

You have a special profession, because only midwives are given to experience an incomparable feeling of trepidation at the moment of the birth of a child, when you take your newly born life in your arms and say: “You have a daughter! ..”.

Monologue of the district midwife

Our work is complex and important.
It is necessary for everyone to realize the meaning
Our, albeit small, link
For prevention and treatment.

Before you were born
We are tender, we keep and cherish you,
We protect from future troubles,
We root for your happiness.

We take care and preserve your mother,
For nine months you are with an obstetrician.
After all, you are one, while only one
Separated by the placental barrier.

Watching closely: is the protein high?
How is the edema there? With weight? With the size?
And a significant time will come up -
Your first meeting is with an obstetrician.

Hello! Your birth -
This is a long-awaited exam for us,
The main result of our modest victories.
So, you are ours, and not just mother's!

Midwives' motto: "There is a way out of any situation."

The very first hands in the life of every person are not even maternal, they are the hands of a midwife who took delivery. Our path in this world begins with them. Probably, there is no need to once again talk about how significant and spiritual this one of the many medical specialties is. And what satisfaction she gives to those who have dedicated their lives to her.

But going into the profession of a midwife, you need to know that

1. low-paid profession. 2. Most likely you will have to work for days - women in labor like to give birth at night and in the morning.

3. Strong enough physical and nervous tension

The world replenishes daily
Everything is ahead of the baby.
From the hands of the midwife begin
And our destinies and paths.
Are we following the compass arrow
Or guide the path of the river,
Are we storming the vastness of space -
Everything is easy, everything is from her hand.
And there are no professions more human
On all six continents
When all of humanity lies
The midwife in her arms!

You can't find a more beautiful profession,
She is needed at any time of the century
Becoming a midwife is answering
For the appearance of a person in the world.

Someone is proud of the harvest, And someone will fly into space, and we give birth and give birth, and at night the hospital does not sleep.

We will apply our maximum skill - otherwise our conscience will not order. So that everything was without complications! Here… born… sighed… screams!

The choice of your future profession was influenced by:

Why did you choose this profession?

Thank you for your attention!

An obstetrician is a specialist who assists women during pregnancy and childbirth. There are two types of specialists in this profession: just an obstetrician and an obstetrician-gynecologist. These are not just different names, but the range of responsibilities and capabilities of the medic. A simple obstetrician provides moral support to patients and accepts newborns. The doctor, on the other hand, performs surgical interventions, controls the process of childbirth and applies stitches.

Story

The development of obstetrics is closely related to the development of medicine. In ancient writings, generic processes and actions are mentioned. But until the 13th century, this area of medical knowledge was often neglected, relegating it to the background. For the first time, Hippocrates studied and described in detail the process of birth and its components, devoting a whole section to this.

But over time, obstetrics has not advanced much. It reached a particular decline in the dark times of the Middle Ages. Everything was subordinate to the church, and any attempts at healing were equated with the machinations of the devil and were punishable by burning at the stake. At that time, midwives acted as helpers during childbirth, who often became the culprits of injuries and death of a newborn or mother. For a long time, only women were obstetricians, but in ancient Greece they also resorted to the help of men. This was done in later times, but only in the most extreme cases.

It was only in the 16th century that obstetrics began to be classified as a separate branch. At this time, the first manual on it with sketches is being created. This is the start of a new era and the beginning of the development of obstetrics as a separate component of medicine as a whole. In our time, generic activity has been studied almost completely. Modern technologies, combined with the constantly developing and supplemented knowledge of doctors, have made childbirth as safe as possible, and the profession of an obstetrician has made it prestigious and in demand. After all, it is these specialists who help to give birth to a new life and significantly facilitate the process of childbirth for a woman in labor.

Description

Obstetrics is a rather complex branch of medical knowledge. Despite the rather limited range of activities, this specialist is constantly faced with potentially dangerous processes. Obstetricians can work in two ways:

Obstetrician - paramedical. To obtain a diploma, it is enough to graduate from college. The main responsibilities of a specialist are psychological and physical preparation for childbirth. Also, if necessary, this specialist accepts the child, while the doctor performs other procedures necessary for a successful delivery.
An obstetrician-gynecologist is already a specialist with a higher medical education, a certified doctor. He knows everything not only about the process of childbirth, but about its pathologies and complications. This specialist guides the pregnant woman from the first visit to the doctor until discharge from the hospital. The range of his duties includes constant monitoring of the condition of the expectant mother, timely assistance in the event of toxicosis (especially in the last trimester), labor management, and all the necessary actions for the successful completion of the process. This includes surgery and suturing.

The obstetrician is one of the most important professions in medicine. After all, with the help of this specialist, each of us was born.

What specialties to study for an obstetrician

To become an obstetrician, you should choose one of the following specializations:

General medicine.
Obstetrics and gynecology.
Midwifery (for colleges).

All these specialties will allow you to get a job in a maternity hospital and take part in the emergence of a new life.

What you have to do at work and specialization

The work of an obstetrician is quite difficult and stressful. Choosing this specialty, you should remember that you will work around the clock, because childbirth does not know the time frame.

The range of daily duties of an obstetrician includes:

Examination of pregnant women and women in labor. Checking blood pressure, body temperature, weight, edema, measuring the circumference of the abdomen, the height of the fundus of the uterus and checking its tone by palpation. Also, the obstetrician listens to the fetal heartbeat.
Doppler sonography as prescribed by a doctor.
Collection of material for analyzes. Usually these are smears for flora.
Preparing for childbirth. This is a spectrum of examination procedures, to which psychological assistance is added.
Constant monitoring of the condition of the woman in labor and the fetus during the period of contractions, control of their intensity and frequency.
If it is impossible to give birth to a gynecologist, fetus reception.
Conducting an initial examination and measuring the weight and height of the newborn. The obstetrician attaches a clothespin to the umbilical cord and processes it.
Checking for the integrity of the placenta in the postpartum period.

Also, an obstetrician with a secondary education performs a number of equally important procedures every day.

In addition to the above, the following duties have been added to the range of activities of an obstetrician-gynecologist:

Surgical delivery by Caesarean section.
Carrying out other surgical interventions.
Performing specific procedures during childbirth, which require high qualifications. This is the rotation of the fetus, the establishment of a vacuum, forceps, or the use of an extrusion technique.
Pressing the uterus in order to contract it.
Gap suturing.
Prescribing the necessary medications.

In addition, an obstetrician-gynecologist can perform a number of prenatal procedures and operations. Only a highly qualified doctor can deal with the management of premature or pathological births.

Who is the obstetrician for?

The main criterion for a good obstetrician is stress resistance. Childbirth is a difficult process for both the mother and the child. The result is almost impossible to predict. The ability to quickly make the right decisions and a good memory - this golden combination will help save more than one life.

The obstetrician must have a certain physical strength and firmness of the hands. After all, you will hold a fragile newborn, which is so important to receive it correctly and not to drop it.

Self confidence. It is because of the obstetrician's uncertainty that accidents and negligence often occur.

Attention to details. Even the slightest deviation from the norm should attract attention.

Demand

This profession is in high demand. Both in maternity hospitals and in private clinics, new staff or already experienced specialists are always required.

How much do people working as an obstetrician get

Salary directly depends on the level of your qualifications: you are just an obstetrician or an obstetrician-gynecologist. On average, the salary ranges from 33-41 thousand rubles per month.

Is it easy to get a job as a midwife

It is easy to get a job. Obtaining a medical education requires compulsory practice. Already on it you can prove yourself, thereby providing a worthy workplace.

To get into a private clinic, you need experience and guidance. You will be judged according to various parameters. Only the best are taken to such structures.

How the career of an obstetrician is usually built

It is quite difficult for an obstetrician to get a promotion. After all, for this one should start with higher education and retrain as an obstetrician-gynecologist. Only then can we talk about career growth and managerial ambitions. You can grow to be the head of a maternity or gynecology department. As a result, this allows you to get closer to the position of the head physician.

Obstetrician Profession Perspectives

The obstetrician profession is quite promising. It opens up a lot of development opportunities for the owner. You can get a higher medical education, which will make you not a secondary employee, but a leading specialist. The diploma provides the opportunity to conduct private practice. After obtaining the qualification "obstetrician-gynecologist", you can apply for the chair of the head of the department. This is the prospect of becoming a head physician or getting a position in the Ministry of Health.

“I love my job and am still proud of my profession. What could be better when mothers go to the hospital with smiles on their faces? "

And also midwife of the highest qualification category Elena Kardashian loves to travel very much. In her family, all the girls are mother, sister and nieces. Most of them are from March. Mom was born on March 8, the eldest niece was born on the 7th, and two more grandchildren were born on March 4 and 5. By the way, the midwife Elena Vladimirovna received all her nieces with her own hand.

First man

In her work book - the only record of employment, made 23 years ago. The personnel officer laughs: “A copy of the labor? There is nothing to shoot! "

Even when I was at school, I worked in socially useful work as a nurse in the maternity hospital number 1, - says Elena Vladimirovna. - And I fell in love with the profession of a midwife from the age of 14! Therefore, I immediately entered a medical school. Did you know that the word "midwife" in translation from French means "standing at the bed"? This is probably why men are not hired for this specialty.

The practice took place with us on the basis of the second maternity hospital. The first time, when we, eight girls, came to the maternity ward, the midwife examined us carefully and for some reason chose me: "Come on, you will assist me!" I washed my hands and went, neither alive nor dead with excitement. It was scary, but very interesting! And I immediately realized that I was not mistaken with the profession.

Then the deputy chief physician for obstetrics and gynecology Vera Pavlovna Karpenko told me: "If you graduate from college - only here, to us!"

I was also lucky with the teachers: Alexandra Nikolaevna Novikova taught us obstetrics and instilled not only love for the profession, but also cleanliness, decency in relation to work, to a woman in labor. In general, starting with the appearance (to look neat, tidy, fit and benevolent, no frown!) And ending with high professionalism to the smallest detail. A midwife must have the highest qualifications: she is the first person whose hands take a new person into the world!

According to Kamchatstat, 2,430 babies were born in the regional center in 2015, which is 2 babies or 0.1% more than in the previous year. As of January 1, 2016, the population of the Kamchatka Territory was 316.5 thousand people, having decreased by 789 people over the year. The decrease in the population of the region is due to the migration outflow (1,314 people). The natural population growth was 525 people.

By the way, in our profession, physical strength is an important component. During a shift, you will bend over so many times, support, help the woman get up and lie down, take the childbirth - and all with your hands. You get so full that you don't feel the limbs. You spend days on your feet, practically without sitting down. Plus an emotional and mental load - after all, we have two lives in our hands, a mother and a child. But it happens that they give birth two or three times in a row. This was earlier, in the second half of the 90s, when the birth rate began to fall sharply, one or two women gave birth per day, and it happened that the watch took place without giving birth at all. And now, on average, there are 6-7 births, sometimes up to 10 per shift at normal times, and if the first maternity hospital is closed for prophylaxis, then it reaches 18. When to sit here?

I worked at all posts, I can, if necessary, replace any midwife, even the senior. But a leadership position is not for me. After all, she worked as a senior midwife for two years and wrote a statement - back to the post.

Absolute positive

- Did you have any critical situations during childbirth?

Sure, but most of them ended well. Rescued women with bleeding and other violations of labor. The specificity of our work is that you never know what will happen. It happens that a woman was seen by a gynecologist, the whole pregnancy proceeded normally, and everything ends in pathology. But we have a very close-knit team, a team of professionals, we understand each other from half a word and half a glance, in critical situations everyone knows what to do and acts quickly, everything is worked out to the smallest detail.

In physiological childbirth, our task is not to interfere! Childbirth goes by itself, nature has worked everything wisely. We only teach a woman to push, advise how to behave, how to breathe.

I believe that every midwife should be issued a psychology diploma. After all, women who come to us are afraid. For myself, for the child. Especially for the first time: they have never experienced such pain as during childbirth. Reassuring, attuning to a successful outcome is one of our most important tasks. It is no secret that some women come with a negative attitude - unfortunately, the attitude towards medicine in society has not been the most favorable lately.

The midwife should reassure the woman and tune in to a favorable outcome. Photo: Shutterstock.com

- Yes, there are enough critical arrows in your direction ...

You know, if satisfied women, of whom there are much more, would write in the media about their impressions, the attitude in society would be different! But the paradox is that happy people are not up to it. One woman came to me recently for her third child and said the invaluable phrase: “I gave birth to you for the first time in 2009, and only because of you I decided to give birth again. Thank you for your attentive and sincere attitude! " And many women, when they have already given birth, tell us: "You are real wizards!"

Obstetrics is one of the areas of medicine that carries an absolute positive. Because the agony ends with the appearance of a screaming toddler and the woman experiences happiness and joy. And we are happy with her!

Blue and pink

- How do the first minutes of life begin?

- I process the umbilical cord at the newborn, wipe it with a sterile napkin and carry it to the doctor: in the first minutes he is examined by a neonatologist. We measure the circumference of the chest and head, height, weight. Everything is fixed and recorded on tags that are fixed on the child's handle. Girls have pink tags, boys blue.

Two hours after giving birth, a woman lies in the delivery room - this period is considered the most responsible and dangerous, when complications may arise. And the baby is next to the mother: immediately after giving birth, we put it on her stomach, she puts the baby to the breast.

In general, now the tendency is to approach natural childbirth, only pain relief, a minimum of stimulation and medication. Each woman in labor has a heart monitor, we monitor the state of the baby and mother every minute. And before there was only a stethoscope. But all the same we have sleepless nights ...

- What time of day are babies born most often?

In a woman, the hormone oxytocin is produced in the pituitary gland. The peak of its production falls on 4 o'clock in the morning. Therefore, most often women "want" to give birth early in the morning. In general, at any time of the day, when the mother's body gives a command. And nobody knows this time.

With a smile for life

- For many years in your obstetric practice there have certainly been unexpected situations. Share?

The heaviest boy we have was born three years ago with a weight of five three hundred. What is surprising - the woman gave birth to the hero herself, without any complications. And there were babies and less than a kilogram, they were then nursed in the children's department, in the intensive care unit.

I remember once a woman from the coast gave birth to twins. At about one in the morning the first girl was born, six minutes later the second. Both - over two kilograms. I look at them - there are two absolutely identical girls. This is so unusual - double happiness and a miracle!

Double Happiness! Photo: Elena Akhremenko

And once in winter they brought a woman in an ambulance - they call, knock. The doctor and I went downstairs, and she is already giving birth, she could not stand it. They gave birth right in the car, on a stretcher: a large boy, about four kilograms. I took the child in my arms and carried it to the delivery room on the first floor, and my mother to the stretcher. Everything ended well!

Do you know what is amazing? Babies are all born beautiful! Little people are so cute!

- Do you have enough personnel?

Young people are not coming! They are afraid of difficulties, responsibility. Now young people are looking for where it is easier and more affordable. It seems to me that it makes sense to return to the distribution system after medical school, so that they work out at least three years! Otherwise, soon there will be no one to work at all.

- You are a very smiling woman. Is it natural or professional?

This is my credo. I smile and I will smile! No matter how hard it is ...

Elena Vladimirovna KARDASHYAN. She was born on December 11, 1973 in Petropavlovsk-Kamchatsky. She graduated from the Petropavlovsk medical school with a degree in midwife. Work experience in the specialty - 23 years.

A very useful post by midwife Olga Miroshnichenko about why individual midwives are needed during childbirth ("soft childbirth" programs in the hospital, etc.):

Now there are many posts in which somehow very differently describe the work of midwives. I wanted to tell you what individual midwives do maternity hospital under the programs "soft childbirth", "home birth", "in the hospital, like at home" ... There can be many variants of names, but the essence is the same: an individual approach to each birth.
Acquaintance with the midwife occurs much earlier than the birth begins: at courses, at "midwife get-togethers", at midwife appointments, individual lessons or just in a cafe. At such meetings, mutual understanding is established or, on the contrary, it becomes obvious that it does not arise. In addition, when communicating before childbirth, there is an opportunity to discuss everything that is important to you in this process, and sometimes adjust your expectations, bring them closer to reality. Courses are, in my opinion, the most reliable option, because During the lectures, you can understand in much more detail the professional position of the midwife, her temperament, the way of presenting information - to feel how close and accessible all this is for you, whether you want this particular specialist to be with you in childbirth.
Further, briefly, point by point.
How does an individual midwife help during childbirth?
1. It will help to determine whether it is really childbirth, or while the harbingers of labor.
2. Will be able, if there are no contraindications, to come home to the woman in labor, where, under her supervision, part of the initial period of childbirth can pass in a calm, familiar environment for the couple. Dads quite often, realizing that everything is under control, go to bed or go on business, depending on the time of day and their plans.
3. It will help you quickly go through the registration procedure in the maternity hospital, tk. in the admissions department will do some of the work of the local midwife. It will help to change clothes, bypassing the standard "completely undress, put on this shirt." For many, it is important to stay in their own shirt and underwear (especially important if the waters are flowing) - the presence of "their midwife" completely removes the acuteness of the problem.
4. Will become a "guide in the maternity hospital": it will help the mother and the future dad navigate if he takes part in childbirth. For dads, who are not involved in the process of helping the woman in labor, it is important to find a place where they would not interfere, but could quickly join their wife, when they call. The issue of nutrition and rest for dads is also successfully solved by the forces of a midwife.
5. Will create optimal conditions for the natural passage of childbirth: dim light, calm atmosphere, warmth, no unnecessary conversations. To do this, we often turn on quiet, calm music (background sound), light candles and / or an aroma lamp.
6. If necessary, with the help of massage, aromatherapy, bath, the midwife will help to cope with discomfort during labor. It happens that a bath and a massage are needed at the same time - then we combine this - we massage in water, while the oil allows you to massage both soft and effective
7. If there are difficulties, the midwife will tell you how to breathe better, what position to choose, so that in this particular case it would be easier to experience contractions and / or help the child move along the birth canal. These recommendations are based on the experience and knowledge gained from teaching midwifery.
8. If medical manipulations are necessary, the midwife will inform about the current situation, explain the sequence of the procedure, tell about possible alternative options so that the woman in labor can make her decision. Can a doctor do this? Certainly! But the doctor does not always have enough time to explain all the nuances and sort out the woman's doubts. And often a midwife is a much more familiar person for a woman in labor than a doctor (a contract for a dezh team, for example, or just one meeting with a doctor before childbirth).
9. The midwife can be in touch with relatives so that they do not worry, but also do not distract the woman in labor with their calls.
10. In the final stages of labor, the midwife will help the woman to get into the most comfortable position, receive the baby and ensure the reunion of mother and baby. Put it on your stomach or give it to your mom, take care of the comfort for the newborn and mom - warm, dark and quiet
After the birth of the baby, in the early postpartum period, the midwife:
- will closely monitor the condition of the newborn and mother;
- give him tasty and healthy postpartum tea, feed his mother. If you did not take food with you, then he will take care of delivery in advance.
- redeems the newborn, if necessary, then processes the umbilical cord;
- will help to attach the newborn to the breast, monitor the correct grip of the nipple, give the first recommendations for organizing breastfeeding;
- in 2-3 hours after giving birth, he will transfer the mother and the newborn to the postnatal department, help to settle down there.
I wrote this in almost official language - it turned out a little dry, but this is not about childbirth, but about the "functional" of the midwife.
In my opinion, all this is done by only one person, and not a whole team of assistants.
At one birth, a woman explained to me why her husband was waiting in the corridor and not helping her in the ward: "Each additional person present at the birth lengthens it by at least an hour." I don't know where she got such "statistics" from, but I agree that everyone brings their own energy into the space of childbirth, and while it integrates into the already formed space, time passes. It is very rare, but it happens that it is the midwife who has to integrate. The couple was already in the hospital at the time of her arrival, and they themselves formed the space in which childbirth is already taking place. Not so long ago I had such an experience - I came to them, literally, on tiptoe, fearing to disturb them.
About the doula. If the doula was preparing the couple for childbirth, then she herself becomes that "guide" for the couple, through which it is easier for them to perceive information, to orient themselves in what is happening. Doula is unable to deliver on her own, but finds a doctor and midwife whose "performance" she enjoys leading childbirth - and recommends them to her clients. Such cooperation is quite harmonious and effective. The option, when the midwife suggests to the doula "suddenly I will be tired", I do not like and causes rejection. If I (the midwife) are tired, then I will find a replacement - I will hand over the birth to another midwife who can do everything, no worse than me. Beforehand, I will tell her all the important details of obstetric care and the characteristics of the couple. In this case, the giving birth will not have to pay extra for one more team member for the delivery. Most medical centers cooperating with maternity hospitals provide for such a replacement, therefore, two midwives are included in the contract, and the woman gets acquainted with both in advance.

At the moment, an individual midwife can be at birth only if a contract is concluded at the hospital. In some maternity hospitals it is possible to conclude a contract for a team on duty (the birth will be carried out by the doctors on duty at this time), but more often the contract is concluded for a specific doctor. There are maternity hospitals that provide an “individual midwife for childbirth” service. You can get acquainted with the midwife in advance (usually, also more than one, because there may be a duty). I can't write about their work - I don't know the details.
This post describes the functionality and capabilities of individual midwives working in different centers in Moscow. I will not list, so as not to miss someone, and so that there is no advertising.