Health Care for Mothers and Children

in the USSR, a system of government and public-sponsored preventive and therapeutic measures providing prenatal care and aiding in the prevention of childhood diseases, the comprehensive physical and mental development of children, the prevention and treatment of diseases in women, and the improvement of women’s health.

On Dec. 28, 1917 (Jan. 10, 1918), the Department of Health Care for Mothers and Children was created in the People’s Commissariat of Social Security. The department organized women’s and children’s consultation clinics, children’s nurseries, and homes for mothers and infants. The Labor Code of 1922 and other laws established the preferential labor rights of pregnant women and nursing mothers. In 1927 obstetric aid, previously supervised by the medical departments of the People’s Commissariats of Public Health and the Health Departments, became part of the system of health care for mothers and children, and in 1938 the Department of Health Care for Mothers and Children merged with the division of the People’s Commissariat of Public Health that was in charge of health care for children and adolescents. The decree of the Presidium of the Supreme Soviet of the USSR of July 8, 1944, On Increasing Government Aid to Pregnant Women, Mothers of Many Children, and Single Mothers and Strengthening Health Care for Mothers and Children created a material and legal basis for the further development of health care for mothers and children.

While there is a high level of labor guaranties in the USSR, Soviet legislation has special regulations ensuring certain preferential rights for pregnant women and mothers. It is forbidden to employ pregnant women, nursing mothers, and mothers with children under one year of age for night work (10 P.M. to 6 A.M.), overtime work, or work on days off, or to send them on official trips. When necessary, they must be transferred to less taxing work with continuation of their previous average earnings. These women, and those with children up to 12 years of age, may not be employed outside regular hours. The mother of a child aged between one and eight years may work overtime or be sent on an official trip only with her consent.

Breast-feeding mothers and those with children under one year of age receive, in addition to breaks for rest and meals, nursing breaks at least once every three hours, each lasting at least 30 minutes; if a mother has two or more children under one year of age, each break lasts at least one hour.

Women may not be denied employment nor may their earnings be lowered on account of pregnancy or nursing. Denial of employment or dismissal for these reasons is a criminal offense as stated, for example, in Article 139 of the Criminal Code of the RSFSR.

Working pregnant women, nursing mothers, and women with children under one year of age may not be dismissed by the administration, except when an enterprise is completely abolished. In this case dismissal is permitted, but employment must be found for those dismissed.

According to the principles of health care for mothers and children, leave is granted for pregnancy and childbirth to women working in industry, offices, the professions, and in kolkhozes, whether or not they belong to a trade union. They are paid government social insurance benefits for the period of leave amounting to their full earnings, regardless of their length of service. Under certain conditions legislation also provides payment of childbirth benefits to mothers of many children and to single mothers. Since Nov. 1, 1974, benefits have been paid for children of low-income families. In 1971 payments for pregnancy and childbirth, to mothers of many children and single mothers, and for the care of children in institutions amounted to 1,474 million rubles; the amount paid in 1940 was 179 million rubles.

All women are guaranteed medical care during pregnancy and childbirth in a hospital. Special forms of medical care such as prevention and treatment of premature birth and of disturbances of the ovarian cycle have been developed, as well as children’s gynecology and oncogynecology. Visiting gynecological consultation clinics, a new type of polyclinic service, have been instituted in rural areas.

Preventive examinations of women in industry are of great importance. On Jan. 1, 1972, the number of beds for pregnant women and for those giving birth was 224,000; in 1940 the number was 147,000. Special hospitals have been established for pregnant women with diseases of the cardiovascular and central nervous systems, endocrine disturbances, tuberculosis, renal pathology, infectious diseases, postpartum complications, and pregnancies with Rh incompatibility. The trade unions have special sanatoriums and rest homes for pregnant women. By Jan. 1, 1972, there were 157,500 beds for gynecological treatment (33,500 in 1940) and 43,700 obstetrician-gynecologists (10,600 in 1940).

A network of pediatric polyclinics provides continuous medical supervision of each child through age 14 and carries out preventive measures in the rearing of healthy children. By 1972 there were 455,800 pediatric hospital beds (89,700 in 1940) and 84,500 pediatricians (19,400 in 1940). Also rapidly developing are such specialized medical disciplines as pediatric surgery, otorhinolaryngology, ophthalmology, neuropathology, traumatology, and orthopedics. There is a yearly increase in the number of sanatorium pioneer camps, in which children with mild forms of rheumatism, chronic pneumonia, and diabetes mellitus or with such abnormalities as those of posture or speech take their vacations. The USSR’s state expenditures for children’s homes, kindergartens, nurseries, pioneer camps, and nonschool work with children, not counting capital investments, amounted in 1971 to 4,412 million rubles; in 1940 the figure was 423 million rubles. Twenty-two scientific research institutes for health care for mothers and children, pediatrics, obstetrics, and gynecology operate in the USSR.

The constitutions of the Czechoslovak Socialist Republic, the German Democratic Republic, the People’s Republic of Bulgaria, the Hungarian People’s Republic, the Socialist Republic of Rumania, and the Mongolian People’s Republic contain articles protecting the rights and health of mother and child. All socialist countries have networks of children’s nurseries and other children’s institutions. In a number of capitalist countries the control of infant mortality and the care of pregnant women, new mothers, and young children are generally implemented by insurance payments and by funds allocated by municipalities and philanthropic societies.