Voices of Women – perceptions of health, illness and health care service during pregnancy in Northwest Russia and Northern Norway in 2000 A questionnaire study among Russian and Norwegian women

Background: Norway has since 1994 supported health care directed towards breastfeeding and the wellbeing of mothers and babies during pregnancy and childbirth, and the immediate post-partum period in Northwest Russia. After five years of implementing the Baby Friendly Hospital Initiative (BFHI) 1994-1999 positive changes with increasing breastfeeding rates can be documented. While the BFHI concentrates on the immediate post-partum feeding routines for mother and baby, the project ”Family Friendly Maternity Care” launched in autumn 1999 primarily focuses on routines attached to health and health care during pregnancy and childbirth. Materials and methods: Women’s own views on health and illness during pregnancy and the quality of health care received were recorded in a comparative survey in nine Russian and seven Norwegian maternity wards, all of them situated in the Barents region during spring 2000. A total of 764 women completed a questionnaire on the degree of satisfaction with the health care received and whether or not they felt personally taken care of or coldly and routinely treated at the antenatal consultations. The article concentrates on women’s experience of health and illness during pregnancy, and their experience with the quality of the health care received. Results: There were marked differences between the two groups concerning age and parity. The Russian women were younger with a mean age of 25 years, while the Norwegians had a mean age of 29 years. 65% of the Russian women gave birth to their first baby. Among the Norwegian women only 35% did so. More Russian women (36%) reported suffering from a chronic disease of one kind or another as against 19% of the Norwegian women. Health before pregnancy was assessed as excellent or good by 76% of the Russians and 96% of the Norwegians. Both Norwegians and Russians reported a decline in perceived health during pregnancy, greatest however, among the Norwegians. Many of the Russians were admitted to hospital during pregnancy and stayed there for weeks in contrast to the Norwegian women who seldom stayed in hospital for more than a few days. Fear of premature birth was the most frequent reason given for hospital stay among the Russians. The results are discussed with reference to other health studies in the area and structural and cultural differences. Conclusion: The survey reveals a need for intensified work towards a more dignifying and friendly maternity care.