A mother and her child’s wellbeing is our top priority: Interview with the Chief Doctor of Moscow’s best maternity hospital

Maternity Hospital No. 4, which is affiliated with the Vladimir Vinogradov City Hospital, was recognised as Moscow’s best obstetrics facility in 2018 based on the results of the Formula of Life Festival. Chief Doctor Olga Sharapova told mos.ru why the staff fully deserves the award, how modern maternity hospitals in Moscow operate and what aid new mothers and their newborn receive.

People are our priority

What changes has this maternity hospital undergone in the past several years and how does it operate today?

Olga Sharapova: First of all, we are fully transparent and open both to pregnant  mothers and their families. Second, we provide pre-labour assistance both to the woman and her family, including her husband, parents and elder children. As in other Moscow maternity hospitals, a patient is allowed to have a family member in the delivery room when she is giving birth – for example, her husband or her mother. Visitors are also allowed in the maternity ward after a birth has taken place provided that they comply with sanitary and medical regulations.

The wellbeing of new mothers and their babies is our top priority. We must do everything we can to ensure that a woman feels comfortable, safe and taken care of and is provided with high-level medical help. We try to apply an individual approach to every patient.  

Our maternity hospital was one of the first where upright childbirth became possible given that there are no medical reasons against it in a specific case. The position in which the woman delivers is agreed upon with her beforehand. We also discuss other specific circumstances. It has long been our standard to discuss with the woman her preliminary birth plan and anaesthesia options at every stage.

I would like to particularly point out that, in addition to complete transparency, our maternity hospital offers a very kind and home-like environment. There are individual en-suite wards, family wards where fathers can stay 24/7. It is very important both for the woman and her family.

Hospital employees, doctors, midwives, nurses and technical staff, love and value their jobs. They are all high-calibre professionals, which has been confirmed by the results of our work.

When a woman is released we ask her if she would return to our hospital. If she says yes, believe me, it is the best praise and award for us.

What does the main floor, the obstetric department, look like?

Olga Sharapova: The obstetric department is our ‘sancta sanctorum.’ Seventeen individual wards for delivering mothers are all equipped the same. There are wards with additional whirlpool tubs. We use warm water to relieve pain, help the woman relax and minimise pain during the second stage of labour. The woman does not give birth in water though – instead, she does it on a special delivery chair.

The approach to organising the process of labour has completely changed recently. The patient once in the delivery room can take any comfortable position she likes. She can get up, walk around, listen to music or use a birthing ball if necessary. There is a television and Wi-Fi for the woman to go online and communicate with their friends and family.

Ten years ago we introduced a medical information system. Each patient has an electronic account with personal access to her medical history. She can read through her medical documents in an interactive mode, including blood and other test results. It is very convenient for us because the woman has control over her treatment and can involve third party doctors for a second opinion. This is good for boosting discipline, including among our own doctors.

The City Government helps to increase the birth rate by implementing new measures and support programmes. For example, now new mothers receive a gift box full of necessary items for their babies.

Who is treated in the children’s intensive care ward? And what will be the function of the neonatal department which is now under construction?

Olga Sharapova: Only newborns in a severe condition such as pre-term babies and babies with life-threatening disorders are hospitalised in the intensive care ward. Overall in 2018, 12 babies were born here weighing less than1 kg; they were all incubated and survived. Our intensive care ward is considered one of the best in Moscow. We use cutting-edge technology for treating newborn babies.

Perhaps, this is exactly why it was decided to build a neonatal department. It is expected to be finished by the autumn of 2019. The maternity hospital and the new wing will be connected by a passageway. The first two floors will accommodate treatment wards for babies.  We also plan to have a catamnesis and rehabilitation department for children who were discharged from our hospital. All medical help will be provided free of charge and funded by a government guarantee programme.

The third floor will accommodate clinical departments for the second stage of pre-term baby incubation. According to the current regulations, newborns can be treated in our intensive care unit for up to seven days. After that, they should be transferred to specialised children’s hospitals. But when the neonatal department opens our newly born infants will be able to stay here. Most importantly, the babies will continue to be treated in the intensive care ward and will be there together with their mothers. It is very important not to break the bond between the mother and her child even in the intensive care ward.

Topnotch professionals and state-of-the-art equipment

What else has changed in the hospital over the past years?

Olga Sharapova: Several years ago, the city launched a modernisation programme. We were provided with new equipment such as heart monitors, infant incubators, heated changing tables, sonogram equipment, inhalation anaesthesia machines and new operating tables – everything necessary to give high-quality help to mothers and their newborns.

High technology is now used everywhere in Moscow, including at our hospital. But the equipment is not our only asset. More importantly, we have topnotch professionals who know how to handle this equipment. All this allowed us to significantly increase the quality and level of medical aid. There is no doubt about this.

Merging maternity hospitals with multidisciplinary hospitals was also an important stage of the modernisation process. For example, we are located on Novatorov Street but the hospital is affiliated with the Vladimir Vinogradov City Hospital on Vavilova Street. We are its branch. The hospital is only 15 minutes away. If we have a mother who is delivering with a heart or kidney condition, for example, we can involve respective specialists from the hospital. Another great innovation is that women’s health clinics were merged with maternity hospitals. Our merger comprises 13 women’s clinics. Therefore, we can ensure that pregnant women constantly get all the help they need from the time they register with one of the clinics and throughout the whole pregnancy. 

Can you compare your hospital with facilities abroad?

Olga Sharapova: I think when people go to another country to give birth, it is usually not for the quality of medical services. We have great specialists. They do internships at foreign clinics. We have been visited by doctors from Europe and the United States. I remember a visit by Richard Waldman, the then president of the American College of Obstetricians and Gynecologists (ACOG). He wanted to see a typical maternity hospital in Moscow. He was brought here. He looked at the facilities and said: “I’m home. You do everything exactly like we do.” Richard invited us to visit an obstetrics and gynecology clinic in Syracuse, NY. Several teams from our hospital did their internships there and it turned out that our maternity hospital is no different from a large private medical centre in the States.

Moreover, it turned out that we use many progressive methods which they did not have at the time. Their standards are different. We must conduct many tests – for example, functional diagnostics and ultrasound tests which are not compulsory there or cardiotocography which they only conduct if a woman is at risk. We do it for every patient.

Regardless of labour complexity, their patients are released from hospital 12 hours after giving birth. Our patients are discharged two days after giving birth.

My personal experience of studying in England, Italy, Germany and Finland demonstrated that our staff is more attentive and caring towards newborns and their mothers. We have always been taught (and we continue to teach this today) that a child does not stand apart from its family and from society. The approach is different in the West.

How many members of staff do you have?

Olga Sharapova: There are 450 people working in the hospital, including doctors, nurses and maintenance staff.

Obstetrics is the most difficult area of medicine. Some risks are just impossible to predict in advance. It is a very stressful job with many unpredictable situations. Therefore, our goal is not only to ensure professional development of our medical staff but also to create comfortable conditions for their work and leisure time.

In one of your interviews you explained that  hospital staff is holding training sessions very often. Can you tell us more about it?

Olga Sharapova:  During the three days that a mother is in hospital, nurses teach her how to take care of her baby.

Twice a month we have open days for future parents. They can tour all the facilities, see the wards and meet our staff.

Moreover, five times a week we have free classes for pregnant women and their family members. They learn about everything they need to know over a cup of tea. We give lectures, answer questions and show instructional videos.