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Giving Birth to the New Soviet Man: Politics and Obstetrics in the USSR

Published online by Cambridge University Press:  27 January 2017

John D . Bell
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Extract

The “psychoprophylactic method” of preventing or minimizing pain in childbirth was developed in the Soviet Union in the late 1940s by Il'ia Zakharevich Vel'vovskii, a neurologist working at the Ministry of Transport's Central Psychoneurological Hospital for Southern Railroad Workers in Khar'kov. In 1951 the Ministry of Health adopted Vel'vovskii's method as standard procedure for normal births in all obstetrical institutions in the USSR and undertook a large-scale program to provide the facilities and trained personnel for its implementation. This decision was based on more than simple recognition of a successful medical innovation, particularly since Soviet obstetricians were far from giving it unqualified approval. It owed more to the political and ideological imperatives of Stalin's regime which were then intruding deeply into the work of Soviet scientists and physicians.

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Articles
Information
Slavic Review , Volume 40 , Issue 1 , Spring 1981 , pp. 1 - 16
Copyright
Copyright © Association for Slavic, East European, and Eurasian Studies. 1981

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References

1. Psychoprophylaxis in childbirth is more widely known in the United States as the “Lamaze Method,” after its French popularizer. Many programs called “painless,” “natural,” “prepared,” or “educated” childbirth are also derived from the original psychoprophylactic techniques.

2. Witt, Nicholas De, “Scholarship in the Natural Sciences,” in Black, Cyril, ed., The Transformation of Russian Society (Cambridge, Mass., 1960), p. 391.Google Scholar

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4. The scientific study of hypnosis and suggestion was begun by Charcot and Bernheim in France in the late nineteenth century. Their experience was brought to Russia by the physiologist Vladimir Mikhailovich Bekhterev, under whom K. 1. Platonov received his advanced training. After the Revolution Platonov returned to his native Khar'kov where he established the Central Psychoneurological Hospital. He trained Vel'vovskii, who became his associate and eventual successor as director of the hospital. An informed survey of the early history of hypnosis and suggestion in obstetrics may be found in L., Chertok, Les methodes psychosomatiques d'accouchement sans douleur (Paris, 1957), p. 1–29.Google Scholar

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7. Pravda, July 7, 1935.

8. It is not clear exactly when this council was established. Lur'e indicated that it was set up in November 1935 by the Scientific Medical Council of Narkomzdrav (Pravda, May 17, 1936), but a subsequent article refers to it being formed in March 1936 (Pravda, June 5, 1936).

9. Pravda, June 5, 1936.

10. Feigel', I. I., “Nekotorye soobrazheniia i fakty po voprosu umen'sheniia boleznennosti vo vremia rodov,” Akusherstvo i ginekologiia, 1937, no. 5, p. 20.Google Scholar

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12. Lee Buxton, C., A Study of Psychophysical Methods for Relief of Childbirth Pain (Philadelphia, 1962), pp. 3–13 Google Scholar; F. A., Syrovatko, “Teoriia i praktika psikhoprofilakticheskoi podgotovki beremennykh k rodam,” Akusherstvo i ginekologiia, 1957, no. 4, pp. 3–4.Google Scholar

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18. Vel'vovskii presented the general outline of his system in ibid., pp. 138-67. Ploticher and Shugom added detailed descriptions of the training procedures and the procedures used during birth itself (see ibid., pp. 168-257).

19. Nikolaev, A. P., ed., Obezbolivanie v rodakh: Trudy konferentsii Leningrade 29-31 ianvaria 1951 g. (Moscow, 1952), p. 41 Google Scholar.

20. Peter Osnos, “Childbirth, Soviet Style: A Labor in Keeping with the Party Line,” Washington Post, November 28, 1976.

21. David, Joravsky, The Lysenko Affair (Cambridge, Mass., 1970), pp. 137–38.Google Scholar

22. Pravda, September 27, 1949.

23. V. G., Butomo and V. A., Povzhitkov, “1. P. Pavlov i otrazhenie ego idei v akusherstve i ginekologii (K. stoletiiu so dnia rozhdeniia 1. P. Pavlova), Akusherstvo i ginekologiia, 1949, no. 5, pp. 3–7.Google Scholar

24. Pravda, June 22, 1950.

25. Nauchnaia sessiia posviashchennaia problemam fiziologicheskogo ucheniia akademika I. P. Pavlova, 28 iiunia - 4 iiulia 1950 g.: stenograficheskii otchet (Moscow, 1950), pp. 5-8.

26. Ibid., p. 11.

27. K. M. Bykov, “Razvitie idei I. P. Pavlova (zadachi i perspektivy)” in ibid., pp. 18-25.

28. lurii, Zhdanov, “Nekotorye itogi sessii po fiziologii,” Zhurnal vyshei nervnoi deiatel'nosli. 1, no. 1 (January-February 1951): 12–13.Google Scholar

29. Ibid., p. 15; Bykov, “Razvitie,” p. 16. The transformation of conditioned reflexes into hereditary, unconditioned reflexes through prolonged repetition was mentioned by Pavlov as a possibility. At the combined session this was held to be established fact. See Pavlov, I. P., Polnoe sobranie sochinenii, vol. 3 (Moscow-Leningrad, 1951), p. 217.Google Scholar

30. A. P., Nikolaev, “Teoreticheskie obosnovaniia psikhoprofilaktiki rodovoi boli,” Akusherstvo i ginekologiia, 1952, no. 5, p. 56.Google Scholar

31. The work of the commission can be followed in the regular reports published in Zhurnal vyshei nervnoi deiatel'nosti. An outside evaluation is given in Brazier, Mary A. B., Neurophysiology in the Soviet Union, 1958, National Library of Medicine Pamphlet, vol. 6468, pp. 1–11 Google Scholar.

32. Robert, Tucker, The Soviet Political Mind (New York, 1963), p. 91–121.Google Scholar A similar view may be found in Ida Lazarévitch, La médicine en U.R.S.S. (Paris, 1953), pp. 19-30.

33. Sessii, konferentsii i zasedaniia Akademii meditsinskikh nauk SSSR, posviashchennye tvorcheskomu obsuzhdeniiu aktual'nykh problem sovetskoi medilsiny (1950-1952 gg.) (Moscow, 1953), p. 5. In the Ministry of Health's newspaper, see also Bykov, K, “Uchenie 1. P. Pavlova i sovremennoe estestvoznanie,” Medilsinskii rabotnik, April 19, 1952, no. 29.Google Scholar

34. Tucker was undoubtedly correct in his evaluation of the alarming potential aims of Neo- Pavlovianism. As far as can be judged from published research, however, Soviet scientists in later years did not move in that direction. Tucker's paper was first prepared for the Rand Corporation in 1956, too early for a definitive conclusion about the combined session's ultimate impact on Soviet science.

35. “Uchenie 1. P. Pavlova—nauchnaia osnova dal'neishego razvitiia akusherstva i ginekologii,” Akusherstvo i ginekologiia, 1950, no. 5, p. 5.

36. The “horrors” of childbirth are a staple of imaginative literature from gothic romance to Shakespeare. Vel'vovskii singled out the experience of Princess Volkonskaia in War and Peace (see Vel'vovskii et al., Psikhoprofilaktika bolei, p. 130).

37. Ibid., pp. 129-30.

38. Vel'vovskii here referred to the famous experiment of M. N. Erofeeva. Working in Pavlov's laboratory in 1912, she conditioned dogs to salivate upon application of an electric shock. The relevance of this demonstration to Vel'vovskii's method is not clear. Since he maintained that the pain of childbirth was not real, but the product of conditioning, there is no parallel.

39. Vel'vovskii et al., Psikhoprofilaktika bolei, pp. 142-47.

40. Ibid., pp. 139-42; Nikolaev, Ocherki leorii, pp. 52-53.

41. Vel'vovskii et al., Psikhoprofilaktika bolei, p. 133; Nikolaev, Trudy konferentsii, p. 48.

42. Nikolaev, Trudy konferentsii, pp. 41, 75.

43. I. Z. Vel'vovskii, V. A. Ploticher, and E. A. Shugom, “Psikhoprofilakticheskoe obezbolivanie rodov,” Akusherstvo i ginekologiia, 1950, no. 6, p. 7.Google Scholar

44. Ibid., pp. 6-12. To evaluate the effect of the method, Vel'vovskii established a grading system: a “5” was given to women who gave birth with no signs of pain or unease; a “4” to women who expressed some feelings of pain, but who dealt with them solely by intensifying the exercises they had been trained

45. Nikolaev, Trudy konferentsii, p. 5.

46. Ibid., p. 7.

47. Ibid., pp. 48-62.

48. Ibid., p. 81. 49. Ibid., p. 71.

50. Ibid., p. 112.

51. Chukalov added that Izhevsk obstetricians had developed their own pharmacological method of pain relief that was harmless and almost always effective. “We make up a little liquor from pure spirits, flavored to have a pleasant taste. We give it in a tea cup” (see ibid., pp. 65-67).

52. Ibid., pp. 29-37.

53. Vel'vovskii et al., Psikhoprofilaktika bolei, pp. 125-37. A more recent survey of this question is P. S. Babkin, V. P. Kazachenko, and V. M. Pyliov, “Geneticheskie aspekty rodov u zhenshchin,” Akusherstvo i ginekologiia, 1973, no. 2, pp. 59–61.Google Scholar

54. Nikolaev, Trudy konferentsii, pp. 179-80.

55. M. A. Petrov-Maslakov and R. A. Zachepitskii, Psikhoprofilaktika rodovykh bolei (Leningrad, 1952), p. 3.Google Scholar

56. Persianinov, L. S., ed., Zhenskaiakonsul'tatsiia: Rukovodstvodliavracheiistudenlov (Minsk, 1958), pp. 21–73 Google Scholar; V. N. Shichkova, R. M. Bronshtein, and E. I. Ivanova, “Psikhoprofilakticheskoeobezbolivanie rodov,” Akusherstvo i ginekologiia, 1951, no. 2, pp. 25–34.Google Scholar

57. A. P., Nikolaev, “Osnovnye itogi tvorcheskogo primeneniia fiziologicheskogo ucheniia I. P. Pavlova v akusherstve i ginekologii,” Akusherstvo i ginekologiia, 1957, no. 5, p. 52.Google Scholar

58. Chertok, Les méthodes, pp. 151-55.

59. I. I., Iakovlev, “Elektricheskaia aktivnost’ kory golovnogo mozga i matki vo vremia beremennosti i rodov,” Akusherstvo i ginekologiia, 1951, no. 5, pp. 3–9Google Scholar; I. I. Iakovlev, G. M. Lisovskaia, and G. A. Shminke, “Elektricheskaia aktivnost’ kory golovnogo mozga pri psikhoprofilakticheskom metode obezbolivaniia rodov,” Akusherstvo i ginekologiia, 1954, no. 1, pp. 3–8.Google Scholar

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61. A. P., Nikolaev, “Obezbolivanie rodov v kapitalisticheskikh stranakh,” Akusherstvo iginekologiia, 1954, no. 1, pp. 36–43.Google Scholar The problem of limited staffing was solved in the West by having the father act as coach. This practice, one that has greatly contributed to the popularity of the psychoprophylactic method outside the USSR, was viewed as “not permissible” by Soviet obstetrics. See Dobbin, A. Kh., “'Estestvennye rody’ (opyt avstraliskogo vracha),” Akusherstvo iginekotogiia, 1957, no. 4, pp. 41–44.Google Scholar

62. Nikolaev, Ocherki, p. 151.

63. Henri, Vermorel, L'accouchement sans douleur (Lyon, 1955), p. 237.Google Scholar In 1956 Pope Pius XII, noting the “atrocious propaganda” that Marxist parties were making over the method, told an international congress of obstetrician-gynecologists meeting in Rome that there was nothing in the method that violated Church doctrine and that it should be evaluated from the point of view of medicine alone, without regard for its country of origin or the political views of its advocates.

64. Nikolaev, Obezbolivanie rodov, pp. 12-16.

65. In 1950 the Journal of the American Medical Association published an article ridiculing Dick Read's approach to obstetrics and concluding that his method “cannot be recommended for use in modern obstetrics except under controlled experimental conditions” ( Duncan, E. Reid and Mandel, E. Cohen, “Evaluation of Present Day Trends in Obstetrics,” Journal of the AMA, 142, no. 9 [January- April 1950]: 615-23).Google Scholar See also Niels C. Beck, Elizabeth A. Geden, and Gerald T. Brouder, “Preparation for Labor: A Historical Perspective,” Psychosomatic Medicine, 41, no. 3 (May 1979): 244–47.Google Scholar A survey of Dick Read's troubled career may be found in Noyes, Thomas A., Doctor Courageous: The Story of Dr. Grantly Dick Read (New York, 1957).Google Scholar

66. P. L., Shupik, “Sostoianie psikhoprofilakticheskoi podgotovki beremennykh k rodam i zadachi dal'neishego bolee shirokogo vnedreniia etogo metoda v rodovspomogatel'nye uchrezhdeniia SSSR,” Akusherstvo i ginekologiia, 1956, no. 3, p. 6.Google Scholar

67. Ibid., pp. 6-8.

68. A. P., Nikolaev, “Sostoianie i perspektivy obezbolivaniia rodov v SSSR,” Vestnik akademii meditsinskikh nauk SSSR, 16, no. 2 (1961): 64.Google Scholar

69. I. F., Zhordaniia, “Piaf let psikhoprofilakticheskoi podgotovki beremennykh k rodam,” Akusherstvo i ginekologiia, 1956, no. 3, pp. 38–47.Google Scholar

70. Vel'vovskii himself wrote that he had argued the case for his method with such “passion” that he , may have created misunderstandings. Vel'vovskii et al., Psikhoprofilakiika bolei, p. 111.

71. Tucker, Soviet Political Mind, pp. 114-21;

72. V. I., Konstantinov, “Teoriia i praktika psikhoprofilakticheskoi podgotovki beremennykh k rodam,” Akusherstvo i ginekologiia, 1956, no. 3, pp. 11–15.Google Scholar

73. Nikolaev, Ocherki, pp. 90

74. Petrov-Maslakov, M. A., “Obezbolivanie rodov,” Akusherstvo i ginekologiia, 1971, no. 5, 1 pp. 8–12.Google Scholar

75. Vel'vovskii et al., Psikhoprofilaktika bolei, p. 331.

76. Hedrick, Smith, The Russians (New York, 1977), p. 1977 Google Scholar; Osnos, “Childbirth, Soviet Style.”

77. Bradley, Robert A., Husband-Coached Childbirth (New York, 1974), p. 36–37.Google Scholar