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Women are being forced to give birth ‘alone’ in post-lockdown Armenia

Photo: Yada Liao

Across Eurasia, women have reported mistreatment that defies World Health Organisation guidelines – and national policies. In Armenia, this means that women are not allowed to have a relative or companion present, and are sometimes forced to have unwanted medical procedures. 

This is an edited version of an article that was first published by openDemocracy’s Tracking the Backlash project. It is part of a global investigation into how women have faced ‘traumatic’ childbirths during the pandemic.

‘Non-essential’ shops and restaurants have been open for weeks in Armenia and Ukraine. Both countries eased their coronavirus lockdowns in May. But pregnant women continue to face restrictions and have suffered other mistreatment, in contravention of World Health Organisation (WHO) guidelines. 

‘I was crying all the time, and there was no one to hold my hand,’ says A.H., who gave birth in April in Yerevan, Armenia’s capital. Like many other women in countries across Eurasia during the pandemic, she faced a strict hospital ban against visitors and was not allowed to have her partner or a relative with her. 

A.H. says she was then pressured by hospital staff into having a cesarean section, which she believes was not medically necessary but would get her out of the delivery room faster. ‘You are not perceived as a woman. They treat you like a machine,’ she concludes, describing a traumatic experience that is, unfortunately, not unique. 

openDemocracy has found that women in most countries in the Eurasia region, including Armenia, Kazakhstan, Moldova and Ukraine, have faced bans on birth companions during the pandemic – contrary to WHO guidance as well as national regulations in each of these countries that encourage companions. 

The WHO says that women giving birth should be allowed companions of their choice and receive respectful treatment, clear communication and appropriate pain relief. Armenia’s guidelines add that moral and psychological support provided by companions can reduce labour times and the need for painkillers and surgery. 

Armenia’s national lockdown was lifted more than a month ago. Since 4 May, all non-essential businesses have been allowed to reopen – and stay open despite rapidly rising COVID-19 infections, which have soared almost tenfold from 2,200 in early May to more than 20,000 to date. 

Women giving birth in Armenia still face restrictions, however. This month, eight of Yerevan’s nine maternity hospitals confirmed to openDemocracy that companions have not been allowed – and are still not allowed – to visit maternity wards before, during, or after women give birth. The ninth hospital did not respond to the request for comment. 

In mid-June, Armenia’s health ministry also told openDemocracy that ‘to prevent the spread of the virus, the ministry offered health institutions [the possibility] to temporarily suspend visits’. It said that companions may be allowed if precautions are taken – but none of the hospitals we contacted in Yerevan offered this.

Meanwhile, three hospitals specified that women can have post-natal visits from other women if they pay for a private room (but men are still banned).

‘Extra fuss – that's how they feel about it’

In other countries, including the UK and US, similar bans against birth companions, introduced by individual hospitals and health systems at the start of the pandemic, were the subject of significant local controversy and were reversed. 

But in Eurasia, forcing women to give birth alone has deep roots. In the USSR, no relatives or partners were allowed to enter maternity wards. ‘Extra fuss – that's how they feel about it,’ says Olga Gorbenko, co-founder of the Natural Rights Ukraine NGO, while ‘it is actually dangerous for a woman who gives birth to be alone.’ 

In Armenia, even before the pandemic, many women who wanted to have their partner or another companion with them while they gave birth would have struggled to do so. Despite government guidelines recognising the moral and psychological support provided by companions, they were only allowed into private rooms, not public wards, and doctors could, at their discretion, refuse to let them in. 

In Yerevan, several of the women that openDemocracy spoke to also described feeling disrespected, humiliated or endangered while in hospital – before and during COVID-19. 

E.T., who gave birth in early May, described how ‘the doctor was shouting at me when I was in extreme pain.’ 

Another woman said that while maternity care is supposedly covered by the public health system, she had to pay some money to all the medical staff to be treated well when she had her first child, in 2014. ‘They were very kind to me, which I cannot say about the other woman in the room who hadn’t paid.’

Sona Burnazyan, a psychologist and founder of the online project Happy Delivery in Armenia, says that poorer women with less education are more likely to be treated disrespectfully – and may not speak up about it ‘because they are also treated disrespectfully in their families, where they always feel secondary’.

According to the most recent Armenian Demographic and Health Survey, 66% of women who gave birth in the country between 2010 and 2015 did not attend university, and about 40% had below-average living standards. 

‘Poorer women are more likely to be treated disrespectfully’

But when women do speak up, they may find it makes things worse. This was J.Y.’s experience. She gave birth in April in a Yerevan hospital where she says she was not supported to breastfeed – also against WHO’s guidelines. As a result, ‘I did it wrong and my child went hungry for about three days.’ 

‘Then the baby went into shock due to low blood sugar, ’ she says. ‘I can't describe what I experienced in that moment, when my newborn was making unnatural movements in my arms.’ When she asked for help, however, she says her doctor got angry and blamed her for the situation. 

Yerevan obstetrician-gynaecologist Ani Gasparyan told me that disorganisation during the pandemic has left doctors overwhelmed, but that even before COVID-19, they were performing too many ‘additional responsibilities: giving psychological help, taking care of new mothers and newborns’.

Syuzan Muradyan, another obstetrician-gynaecologist, says the restrictions imposed by the health ministry were supposed to prevent the spread of COVID-19, but that their consequences for women have been overlooked.

‘I want to ask my colleagues and some health workers to change their approach and attitude towards pregnant women,’ Muradyan says, ‘as it is our duty to provide a positive emotional environment for our patients.’

Additional reporting by Tatiana Kozak.

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