‘Childbirth is not a car rental’: mothers and obstetricians negotiating consumer service in Russian commercial maternity care

ABSTRACT

This article explores how commercialization of maternity care in Russia offers new opportunities and imposes new limitations on both mothers-to-be and doctors. The research is based on 35 in-depth interviews with patients and 24 with professionals in paid maternity car in St. Petersburg (2015–2017). It is a significant and illustrative case within the broader trends in the Russian health care system of the 2000s–2010s. This article’s contribution is an understanding of maternity care’s post-socialism market development from the perspective of women: mothers-to-be and mostly female doctors. The ongoing reforms and organization of paid maternity care in Russia are analyzed. I explore the position of mothers-to-be as consumers with growing demands, and of professional women as they respond to such demands. I depict how doctors, though improving their economic and working conditions, resist the symbolic decline of their status and seek to restore their power, and how mothers-to-be accept doctors’ authoritative role in highly medicalized maternity care.

KEYWORDS:

• Births
• consumption
• health

Acknowledgements

I am extremely grateful for comments to Michele Rivkin-Fish, Elena Zdravomyslova, Ekaterina Borozdina, Anastasiya Nokunskaya, Daria Litvina, and to midwife Viktoria Kuznetsova for the help in organization of this research. I am grateful to Alexei Stephenson for proofreading and to those mothers and professionals who were generous to participate in this research.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. According to the Federal Law, 21 November 2011, No. 323-FЗ ‘On Public Health Protection in the Russian Federation’; the Federal Law, 29 November 2010, No. 326-FЗ ‘On Mandatory Health Insurance in the Russian Federation’ and the Decree of the Ministry of Health, 1 November 2012, No. 572n ‘On Medical Health Provision in Obstetrics and Gynecology’.

2. Patient interviews listed with number and age, professional interviews listed with number.