- Статьи
- Society
- Childhood Time: The Ministry of Health has developed recommendations to support women in the situation of reproductive choice
Childhood Time: The Ministry of Health has developed recommendations to support women in the situation of reproductive choice
In Russia, new measures will be introduced to support pregnant women in situations of reproductive choice — when it is necessary to make a decision about carrying and having a child or terminating pregnancy. Patients will be able to talk with a psychologist and get legal advice. And those who are in a difficult life situation will be provided with a roof over their heads. These measures will be a support that will allow a woman to feel more secure, experts say. Izvestia learned the importance of such assistance.
The right choice
In order to increase the birth rate and reduce the number of abortions, the Ministry of Health has developed recommendations on the interaction of medical organizations, social services and employment agencies. They are intended for medical professionals, psychologists, social work professionals, and lawyers.
The document provides for conversations between women in a state of reproductive choice with a psychologist and legal consultations, the Parliamentary Newspaper writes. In addition, the Ministry of Health proposes to place pregnant women in special "crisis apartments." The manual also regulates work with those who wish to have a child.
Communication with women in situations of reproductive choice, including those in difficult situations, will be carried out in special rooms. To this end, a specialist in social work should appear in medical organizations.
The document also indicates the work schedule of a psychologist or other doctor who was contacted by a woman wishing to terminate a pregnancy. The specialist will have to find out what prompted the patient to make this decision.
If there is a conflict with relatives or a woman has no means of livelihood, she can be provided with a "crisis apartment". Such housing is planned to be created in a semi-stationary social service organization or on the basis of specialized non-profit organizations with the necessary material, technical and human resources. We are talking about NGOs included in the register of social service providers in the constituent entities of Russia.
In order to receive assistance from the state, a woman will need to apply for recognition as needing social services. After that, an individual service delivery program and a contract will be drafted.
If necessary, a "family supervisor" will be assigned to the woman. This person will introduce the pregnant woman to the performers and help her gain access to the services.
Legal advice will be provided on legal issues related to the patient's life situation. They will be provided by specially appointed lawyers.
Necessary help
From the point of view of statistics, the situation with abortions in Russia may seem encouraging — over the past 30 years there has been a rapid decline in this indicator, says psychiatrist Andrey Yefremov. But the 400-500 thousand cases recorded today per year are not an abstract figure, but hundreds of thousands of deep human dramas.
— Women come to my office whose decision is dictated by despair, fear of the future, pressure of circumstances and a complete lack of support. This is a state of acute stress disorder when a person does not see a way out," explains the specialist.
Despite the fact that there are fewer women applying in a state of uncertainty about motherhood, the problem is still relevant, confirms clinical psychologist Vadim Eliseitsev.
— A woman rarely has an abortion because of the "unwillingness of the child." More often, this decision grows out of fear of being left without support, without funds, without a future. The news of pregnancy radically changes the idea of the future, the familiar world is collapsing, and a woman needs support, both financially and psychologically," the expert points out.
The measures proposed by the Ministry of Health will become an additional filter on the way to abortions, acting psychologist Iya Kim is convinced.
"A woman is in a vulnerable position because of her new social status, so if the state supports her and creates conditions to save her new life and help with adaptation and integration, this will become another important factor in the reproductive choice of a future mother," the Izvestia interlocutor is sure.
The recommendations of the Ministry of Health offer the only correct path from a medical and human point of view, Efremov believes.
— Practice shows that the decision to terminate a pregnancy is rarely made in a calm and clear mind. It is often a consequence of the "tunnel consciousness" caused by stress, when all possible exits, except one, seem closed, — the doctor draws attention.
The psychologist acts as an "external support" at the time of reproductive choice, he emphasizes.
— It helps to structure thoughts, separate real threats from irrational fears, makes a woman feel that she is not alone, — says the specialist.
The help of qualified specialists is necessary for everyone, but it is especially important for those who find themselves in difficult life circumstances, Kim believes. Therefore, psychologists and lawyers, along with doctors, will become support that will allow a woman to feel more protected.
The ground beneath your feet
Specific legal or financial assistance is the second key factor influencing women's reproductive choice, Andrey Yefremov believes. Psychological support without a real solution to problems brings only temporary relief.
— When a woman realizes that she will not be fired from her job, that she will have a place to live, her psyche comes out of the "fight or flight" state. Only in this state is she able to make a balanced decision, not one imposed by panic," the doctor points out.
A lawyer will help eliminate an objective source of stress, he is convinced. Clarifying rights and providing protection directly affects a woman's mental health, giving her back a sense of control over her own life.
A woman left without help in a crisis pregnancy is a potential patient with post—abortion depression and anxiety disorder, or a mother who, due to instability, will not be able to provide the child with healthy conditions for development, which will create new social and medical problems in the future, the psychiatrist draws attention to.
— Therefore, a "crisis apartment" is not an expense, but an investment. Investing in the mental health of the mother, in the well-being of the child and ultimately in the health of the whole society. A mixed model, where the state cooperates with non—profit organizations, seems to me the most sensible and feasible," Efremov emphasizes.
At the same time, it is important to take into account that at different ages women will have different accents when deciding on the birth of a child, says Vadim Eliseitsev.
— For young mothers aged 18-24, the factor of housing availability and the feeling that they are not alone becomes crucial. In this case, the possibility of receiving support in the form of "crisis housing" can confidently tilt the decision towards future motherhood. And psychological help restores self—confidence at this crucial moment and helps to adapt to a new stage of life," the psychologist points out.
However, for women in their 20s and 40s, the opportunity to keep their jobs and legal protection is more important, he adds. And after 40 years, health and confidence in the future come to the fore.
Therefore, it is important to understand that a "crisis apartment" for the first few years is a serious help for a young mother, but not the only area where a woman needs support, emphasizes Iya Kim.
— It would be great if crisis centers cooperated with HR agencies and labor exchanges and helped young mothers find employment after or during maternity leave. To make mothers feel calm. The social package is not equal to subsidies and a roof over your head," the Izvestia interlocutor notes.
Overcoming the crisis
At the same time, it is not necessary to frighten women with abortions and ban them — this will not increase the birth rate, says Elena Mladova, a reproductive therapist and chief physician of the Remedi clinic. Discussions about banning abortions are a dangerous and cruel path leading to a dead end, Andrei Yefremov points out.
— From a medical point of view, the ban does not solve any problems, but creates many new ones: clandestine procedures, sepsis, infertility, maternal mortality and deep psychological trauma, — the doctor lists the dangers.
It is necessary to increase access to adequate counseling on pregnancy planning and abortion prevention, as well as access to quality medical care in the field of obstetrics, gynecology and pediatrics, believes Mladova.
There is another important issue — pre-abortion counseling. It allows you to make a choice in favor of childbirth and becomes relevant when a woman has already become pregnant. But a huge number of women refuse to plan pregnancy at all, says the reproductologist.
— As a rule, this happens due to socio-economic factors or personal beliefs. That is why it is so important to inform women that their reproductive capabilities are limited, and to encourage patients to contact reproduction clinics or a gynecologist to assess their reproductive status," the Izvestia interlocutor emphasizes.
A system of caring for women is needed at the state level, Yefremov believes. Doctors in this chain will help to preserve the patient's physical health, no matter what decision she makes.
— Psychologists and psychotherapists are needed to help her get through the crisis, find inner support and make an informed decision that she will not regret. Lawyers and social workers — to provide her with real protection and a material basis for the future," explains the psychiatrist.
And the complexity of the approach proposed by the Ministry of Health inspires great optimism, Vadim Eliseitsev believes.
— All this will give a woman a powerful sense of support in a truly crisis situation, which will allow her to make a decision about maintaining pregnancy. And every child's life saved is our future," the psychologist sums up.
The editorial board of Izvestia sent a request to the Ministry of Health of the Russian Federation. No response has been received at the time of publication.
Переведено сервисом «Яндекс Переводчик»
