Articles. Research

The discourse of anxiety and lack of trust medical institutions and social roles of obstetricians characterize attitudes of urban educated middle class women towards free of charge maternity care in Russia. Women as demanding consumers evaluate and choose among different paid options of childbirth, and they also negotiate relationships with professionals and conditions in maternity hospitals. Maternity hospitals advertise and supply their services including paid one, and they try to be attractive for women / parents. This article is based on in-depth thematic interviews with women and observations in maternity hospitals in St. Petersburg, I analyze what maternity hospitals offer for the purchase, how women make their choice, what are their demands and how they explain why they prefer to pay for the service which is available for free. I argue that women demand different kinds of care as well as their own and newborn child’s security. Firstly, they pay for the obstetrician’s and midwife’s professionalism and professional care, including pain and body management. Secondly, they pay for the emotional work of the medical professionals in order to receive emotional security and psychological support. Thirdly, they pay for the condition of private security and care during childbirth. Their payment is the strategy of insurance and securitization of childbirth though «paid care».

Keywords: reproductive health, childbirth, market, trust, security, care, professionals, emotional work, pain