Maria Mikhailovna was born on the first day of February with a weight of 4780. It was Monday, the head of the maternity hospital at the Khimki regional hospital, Semyon Martikovich Kazaryan, led him at a meeting at the Ministry of Health, so that he could see the newborn only during a round on Tuesday morning.
- Let me at least hold the child! - Semyon Martikovich quickly enters the room and bends over the transparent plastic cradle in which Maria Mikhailovna is sleeping. So her name here is midwives, nurses and the surgeon who helped her to be born.
- Just look, a three-month-old baby! - he carefully takes the girl in his arms, asks to take a picture with a slightly embarrassed mother Tatyana.
He asks her about her health after cesarean, at which time the girl wakes up and announces the ward with demanding and loud crying. The doctor hands the baby over to the mother, praises the chosen name:
- Maria is beautiful! Mother of Christ! My oldest daughter is also Masha.
After a round in the postpartum period, Kazaryan descends to the department of pathology of pregnant women - women are sent here with the threat of premature birth and with various complications. In the office of CTG - cardiotocography, which records the heartbeat and movements of the child in the womb, - talks with patients, asks questions to the doctor of the pathology department.
Notices on the go:
- Notice how beautiful the faces are! How the faces of women change in late pregnancy.
One of the patients comes up and asks if her mother can be with her during childbirth.
- Please, we will only do a test for coronavirus, - Semyon Martikovich answers.
Partnership childbirth in the Khimki maternity hospital is free: a husband, mother, sister, friend - any person with whom she wants to be at this moment can support a woman in labor.
- 95%, of course, come with their dads, this is understandable, you want to be with your loved one, to experience such an important event together, - says Kazaryan. - And for someone it is easier with mom, friend or sister. But as a rule, partner childbirth is easier and better than without support. So it is with contract. Not because my mother paid, she just meets the doctor in advance and trusts him, feels calm.
While we go to the maternity hospital, Semyon Martikovich says that calmness is generally a key thing in a successful pregnancy and childbirth, and laments that anxious mothers have significantly increased over the past decades.
- Of course, a pregnant woman worries about the child and worries about how everything will go. But many fuel this anxiety, do not crawl out of women's forums, especially women with difficult pregnancies. And then they come and tell the doctor how to manage their childbirth. I can say that before the advent of the Internet, women gave birth easier!
The maternity ward is located on the same floor as the "pathology", but separated from it by a staircase. Compared to the capital's perinatal centers, the department seems small, only five maternity wards.
“We have 15 births a day, so then it won't seem small to you, just have time to turn around,” notes Kazaryan.
But today is a calm morning - there are two patients in labor. Semyon Martikovich goes to the first - she is 38, gives birth to her second child, a boy. The woman is lying on her side, a midwife is standing next to her.
- This is who we need to shoot, - says the doctor, - our midwife Nina Vladimirovna. A person has been working in our hospital since 70! She came here unmarried as a girl, and now there are great-grandchildren!
Nina Vladimirovna explains to a woman in labor how to breathe during a fight, strokes her hand.
- We try to keep the midwife with the mother during childbirth all the time, so that the patients do not lie alone in the boxes.
He looks at the readings of the sensors, the woman asks how long it will take. Kazaryan quietly and calmly says that he is about to.
The woman in the next box groans loudly.
- We called the anesthesiologist, we are waiting for epidural anesthesia, - another midwife tells Semyon Martikovich. He talks to the woman in labor for a couple of minutes.
When we get out of the box, the doctor says that this woman has a third birth, but she does not endure them any easier than the first and second. Therefore, we decided to do anesthesia: the anesthetic is injected into the epidural space between the hard shell of the spinal cord and the periosteum of the vertebrae, so it relieves pain, but does not enter the baby's blood.
- There is still a long time, we will do anesthesia - a little rest.
I can’t resist and ask about whether doctors use the term "old-born" among themselves and how many late mothers are now.
- "Old-bearer" is a popular term, not a professional one. In obstetrics, even during my studies at the university, doctors used the term "age primiparous", it used to be applied to women who gave birth at the age of 25 and older. But now everything has shifted, a woman, as a rule, later creates a family, devotes a lot of time to study, work, and does not give birth, as before, having not yet graduated from college. She uses her entire childbearing age to become a mom. You see, two pregnant women of 35 years old can come to the doctor: but one got pregnant within six months of planning, quickly and without problems. This speaks of good health. And the other - married since 25, could not get pregnant for ten years, was treated for infertility, pregnancy came as a result of IVF. And the risks for these two women are completely different.
We leave the clan on the stairs. Between the first and second floors, on the landing, there is a white door: here is the office of the head of the maternity hospital. A tiny nook that only holds a desk with a computer and two chairs. From it you can go into the second room - here it is a little more spacious, in the corner there is a sofa with a pillow in a white hospital pillowcase, next to it is a glass table, an easy chair, a wardrobe, a coffee machine and a kettle on the nightstand by the window. Semyon Martikovich brews strong, thick black coffee for us, pours it into small coffee cups. He opens the cabinet and for a few seconds selects from a dozen boxes of chocolates, then asks:
- It says: Swiss chocolate. Do you like truffles?
Semyon Martikovich headed the Khimki maternity hospital 16 years ago. Prior to that, he worked for 17 years in Turkmenistan, where he was born and raised. After the medical institute in Ashgabat, he was assigned to work in the Tejen district, 220 km from the capital.
- It used to be called to take childbirth in some remote village, I served the ambulance. Once they summoned me to the aul, to the sands. "Come," they say, "the woman gave birth yesterday, and the afterbirth will not come out." This is a dangerous situation, if you do not provide assistance in time, bleeding may open, and sepsis may develop. Flew to the patient, she is lying. I examine her and understand that there is another fetal bladder with a baby in the uterus - she had twins, no one knew about it, just after the birth of the first baby, labor stopped. Two hours later, she gave birth to me. What was happening in the village! They had a holiday!
Kazaryan and his family decided to move to Russia when the youngest daughter was in seventh grade.
- We did not run away from a bad life, I was the head of the maternity hospital, my wife is also an obstetrician-gynecologist. The medical profession in Turkmenistan is highly respected. But we were not indigenous. Education in schools and institutes was transferred to Turkmen, it was unrealistic to place a child in a Russian school at the Russian embassy. And we decided.
It was not easy to get used to a new place - I had to look for a job in Moscow for eight months. After the warm Turkmen climate, the gray Moscow winters became a serious test: the doctor admits that he still misses the southern sun very much.
- The coldest day in Ashgabat in winter - 15 degrees Celsius, when we arrived here, we did not even have normal winter clothes, we did not foresee this, - Semyon Martikovich recalls.
But gradually life improved: the family settled in Khimki, Kazaryan got a job at the perinatal center in Balashikha. Every day two hours one way, two hours back. So two years passed, and then the doctor moved to the Khimki regional hospital as the head of the maternity hospital.
- It was possible to go to Moscow - there are more salaries, well-known maternity hospitals. But I like it here. We strive to maintain a homely atmosphere so that mothers and children feel comfortable.
Major repairs are planned in the maternity hospital next year. Semyon Martikovich says that the times when a woman went "to the doctor," and the conditions were not important to her, are leaving.
- If a patient has to stand in line on the floor to wash, what kind of quality of services can we talk about?
Here the doctor is somewhat disingenuous: many women go to him. One patient several times flew to Kazaryan to give birth from Armenia.
- Russian girl, married to an Armenian. A unique case in my practice: she gave birth to twins three times, and herself, without the help of IVF. Only the first birth was one child. It turns out that she has four births and seven children. Even reporters came to film her.
Semyon Martikovich jokes: he has been working for so long that he is already giving birth to those girls whom he once helped to be born.
- A pregnant woman came to me, she said: "And I was born in Ashgabat, and now I live in Khimki. Mom says that she gave birth to me with you, she always remembers you, now I also want to see you."
For 16 years, Kazaryan has become a recognizable person in Khimki: if he walks past the playground, his mother always comes up to him, says: "Oh, you were leading me, remember?"
- I don’t remember, the doctor often remembers the clinical case, not the patient.
The doctor considers his team to be the main achievement. Kazaryan has a small turnover, many doctors have been working for decades.
- We have a midwife in "pathology", Mirziya Saidakhmedova. Once our surgeon asked to take her to work, he is a Dagestan. I asked: what can she do? He joked: "You know, she cooks such delicious khinkal!" I say: "But this is clearly not enough in this work." Now I can say: if I had ten such midwives like her, I would probably have the best maternity hospital in Russia. She is like a mother to our pregnant women: she is caring, attentive, she will find a kind word for everyone, she will stroke and soothe.
Semyon Martikovich says that he does not tolerate indifference and indifference in his subordinates.
- I do not need an employee who can get nasty on a woman in labor and drink tea while she is alone in the box, suffering and screaming. I had to fire for such things. I myself know that working in obstetrics is hard. And many of us work at two rates, they get very tired, it is difficult to be friendly all the time. But if a woman, for example, came with contractions, and she was rude in the admission department, then no matter how hard the doctors tried later, it would be a bad maternity hospital for her, the most important event in her life would be overshadowed.
Kazaryan says that no one knows 100% obstetrics, but his knowledge is enough to immediately figure out what the mistake of his subordinates is.
- You cannot deceive me or hide something, my doctors know this. In obstetrics, there are often situations in which you need to react with lightning speed, at any moment something can go wrong. Therefore, the calmness of the doctor in childbirth is deceptive. It seems to me that I am an objective leader, sometimes, both a whip and a carrot are needed. You always need to understand the situation. Much depends on the experience of the doctor: if a person is only after graduation - there is only one demand, then you have to teach, become a mentor for him, educate a doctor "for yourself." I speak differently with experienced ones. Today I had to give a stick to the doctor, although she treated me when I was ill with covid.
Give birth to a pandemic
With the onset of the coronavirus pandemic, the Khimki maternity hospital began testing all women in labor upon admission, banned visits, and the discharge of newborns is now like in the Soviet film "Moscow Does Not Believe in Tears": a nurse takes the baby to relatives on the porch. They began to receive transmissions for women in labor through a window on the street. And yet, in the first months, almost all the staff of the maternity hospital had been ill.
- We have organized special boxes on the ground floor for women with coronavirus. Because sometimes they come with frequent contractions and there is no longer time to send an ambulance to a covid maternity hospital, they have to take delivery. Doctors put on anti-plague suits - and go. If the woman in labor has a positive test and has time, we call an ambulance, she takes it to the hospital, where there is a department for pregnant women with coronavirus.
The doctor says that sometimes women come who know that they are sick, but want to give birth in Khimki.
- This is a crime, in my opinion, but what if she gives birth?
Where he got infected himself, Kazaryan does not know: "I could have been in the hospital, but I could have been in the store."
It happened on June 5, on Friday - I was returning from work, feeling unwell, and on Saturday a high temperature rose. In order not to put his family at risk, Semyon Martikovich went to the covid department of his native Khimki hospital. He was hospitalized, in a few days the lung damage from 25% reached 95. For several weeks he practically could not breathe without a mask. But he says there was no despair even then.
- I am a doctor and I understand that everything has a beginning and an end. There was no fear, but for some reason I didn't think that this was the end. It was hoped that everything would be fine. I am very grateful to my colleagues who treated me and nursed me. For the first time in a long time, I had the opportunity to just lie in bed and read.
After being discharged, Semyon Martikovich was recovering for almost a month, and at the end of July he returned to work.
- We have a very good atmosphere here, it promotes recovery, - the doctor smiles. - Do you know what is my favorite occupation at work? At two o'clock in the afternoon, look at the street from your window, watch the discharge. See how happy people go home. People come to us for happiness. We have a joke that obstetricians are the only doctors who can tell patients, "Come again."