It is proposed to implement the postpartum support program for Russian women within the framework of compulsory medical insurance

Deputy Yana Lantratova asks the Ministry of Health of the Russian Federation to include assistance to women in the postpartum period in the compulsory medical insurance system: consultations with specialized specialists, courses in therapeutic exercises and therapeutic massage, as well as psychological support. The deputy explained that the negative experience of the postpartum period affects the desire of Russian women to give birth in the future, which in general “negatively affects the demographic situation in the country.” The Ministry of Health promised to discuss the proposals with relevant specialists.

The first deputy chairman of the State Duma Committee on Education, Yana Lantratova (“A Just Russia – For Truth”), addressed the Minister of Health Mikhail Murashko with a proposal to include a postpartum rehabilitation program for women in the system of services provided under compulsory medical insurance. In particular, the program, according to the deputy, may include consultations with specialized medical specialists, courses in therapeutic exercises and therapeutic massage, as well as psychological support.

Mrs. Lantratova noted that, according to Rosstat, in 2022 the number of Russian women who want to have only one or two children has increased (71.6% instead of 65.3% in 2017), while the share of those who want to have an only child has increased by 6 % – from 17% in 2017 to 23% in 2022. At the same time, the number of women who would like to become mothers of many children has decreased: Russian women who want to have three children have decreased by almost 3%. In addition, the proportion of women who, in principle, do not want to have children has increased: by 0.4% to 2.4%, the deputy indicated.

In this regard, “a priority state task,” according to Yana Lantratova, is creating conditions for a comfortable and safe pregnancy and motherhood for Russian women. “One of the factors influencing a woman’s decision to have a child is the availability of postpartum recovery programs,” she emphasized in the address. According to her, now private clinics in the Russian Federation provide a wide range of services for postpartum recovery programs, which include individual consultations with medical specialists for women who have given birth, therapeutic exercises and therapeutic training, hydrokinesitherapy, therapeutic massage, individual nutritional recommendations, and also aesthetic procedures. The cost of such programs can reach 150 thousand rubles – not every family, the author of the initiative believes, can pay for them. “At the same time, the negative experience of the postpartum period can provoke a mother’s reluctance to experience pregnancy again, which, in turn, will negatively affect the demographic situation in the country,” Ms. Lantratova emphasized.

The postpartum period for a woman begins from the moment the child is born and lasts six to eight weeks. During this period, a woman in labor may experience postpartum depression. Almost a year ago, Master of the Higher School of Healthcare Management Anna Fedaka presented a study on the prevalence of postpartum depression in Russia at the OrgZdrav conference. From March 1 to March 15, 2023, an online survey was conducted in which 360 women over the age of 18 participated (18-23 years old – 3%, 24-29 years old – 32%, 30-35 years old – 43% , 36–41 years old – 19%, over 42 years old – 3%), having at least one child under the age of one year. According to the results of a study that used the Edinburgh Postnatal Depression Scale, 87% of women experienced the phenomenon under study. Of these, 45% scored more than 12 points, which corresponds to the threshold level for postpartum depression (PPD); 42% – more than 10 points, that is, they have an early stage of development of its symptoms. Moreover, most often PDD affects women aged 18–23 years (55%), unmarried or divorced (57%), with incomplete higher education or less, working part-time (51%) or unemployed (80%), those whose financial situation is below average (52%) or significantly below average (73%). The vast majority of respondents note that they were not offered to undergo a PDD diagnosis either during pregnancy (89%) or after childbirth (93%).

Psychologist of the Doctis telemedicine service Elena Burdelova says that a woman in the postpartum period needs psychological and physical support – this is a very important stage in the formation of motherhood and further attitude towards the birth of children. “If a woman finds herself without support and help, the likelihood that she will want to give birth again is lower,” comments Ms. Burdelova. “Help is needed in two directions: psychological support and opportunities for the mother to relax and take time for herself. For a woman who has given birth for the first time, the help of a psychologist is very important, since the birth of a child is both joy and stress, which changes the routine of life and the way of life in the family. If this is the second or third child, the whole family often needs help and adaptation.” According to the psychologist, the initiative will be more effective if it includes the opportunity for a woman to leave the child under supervision for a while and devote time to herself and relaxation: “Usually families resolve such issues themselves with the help of grandmothers or nannies, but not everyone has this opportunity. If help is free and accessible, this is a huge step.”

“I know from medical experience: when a woman is discharged from the maternity hospital, we wait for her at the antenatal clinic for a very long time, because she is immersed in the interests of the baby, especially if this is her first pregnancy, she learns everything on the go, adapts to his regime, and often “I still don’t have the opportunity to leave it to someone else,” says obstetrician-gynecologist, public health and health specialist, WHO expert Lyubov Erofeeva. “That’s why some women come to the antenatal clinic six months after giving birth, some only when they suspect a new pregnancy.” Ms. Erofeeva suggests first conducting a pilot project in any region to understand how much such an initiative will be in demand.

The Ministry of Health told Kommersant that the proposals were received on Monday and will be considered with the involvement of relevant experts.

Natalia Kostarnova