One aspect of Ukrainian culture and birth that I really like is the normalcy of un-pain-relieved birth. I mean birth without pain relief drugs (like epidurals, etc). Women here, while yes, they do consider birth painful generally, they don’t view it as impossibly so.
I say this based on my own culture in the U.S. I think that quite a few American women have the assumption that birth is impossibly painful, that there is no way for one to live through the experience of un-pain-relieved birth. I don’t say this in a judgmental way; just as observation. I think many American women sincerely think it’s impossible for herself to birth without pain relief. That is the cultural message passed along.
Ukrainian women generally start with the assumption that they can/will birth without pain relief, for various reasons (money, desire, etc). When I was pregnant with my first child, I was over at my friend’s house (we lived in a village at that time), and she had two kids. We were chatting about birth, and I mentioned the pain of labor, and she just smiled and said I would do just fine. … I like that women in a culture can pass that normalcy on to each other.
And I would like to insert a thought from Carla Hartley, the director of my midwifery school. Basically, if you’ve had a natural birth, “you’re nothing special.” In the sense that most of the world’s women birth without pain relief. It is the norm; it’s not heroic or a special achievement.
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Next, I would like to comment about finances and the economy of birth here.
Birth houses are government facilities. Opening a private birth house would be next to impossible without enormous sums of money and a lot of uncertainty about if, even then, the government would allow/approve it. It’s been done once so far.
So, being an ob/gyn is a government job, not a private one. Just like being a policeman or working in the local government buildings. And in Ukraine, probably in all post-Communist countries, the pay is laughable. In Kiev, this site says the average monthly cost of living is $1,728. That’s a really thrifty budget for Kiev, especially if you rent an apartment for $1000 or more.
Doctors in Kiev (like other govt workers) are paid a salary of $100/month. In order to actually live, they have to be “paid” by average citizens for their services.
I used to have a bad view of doctors and other govt workers who angled for personal money gifts. I don’t really anymore. The government is unjust. I dislike that treatment is based on this, and as a Christian, I hope I would be able to treat everyone well and without discrimination. But what means “well”?
When our daughter had her appendix out a few months back, the anesthesiologist took Vitaliy aside and said that it would be nice if Vitaliy would pay him $100 for doing the operation anesthesia, but it wasn’t necessary–just what we could afford would be OK. So Vitaliy paid him and also thanked the surgeon/doctor for $100. And we noticed that the entire stay, Vitaliy (who had to live in the hospital to take care of daughter) was given his own bed to sleep in, for example, when other parents had to sleep on the same bed as their child.
So, what is considered normal? What is a doable normal for the conditions in which these medical personnel work?
Personally, I see the advantages of this system. When people want to arrange ahead of time for their births and pay a particular doctor to attend them, they can bargain with one person who can be pretty flexible. They don’t have to bargain with an entire institution, for example, that pays the doctor. You have bargaining power because you are paying the doctor personally from your pocket to his.
So, economically, you can have a “free” birth, although you are expected to buy and bring with you a list of birthing supplies (kind of like home birthers do). Or you can opt to pay a pre-arranged sum to the doctor of your choice, or you can “thank” the doctors/medical personnel that are on shift when you arrive (or afterwards) to leverage some nicer treatment, etc.
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