Zaruhi Ulikhanyan and Dr. Lynn Callister, Nursing Department
Dramatic socio-political and economic shifts which have occurred in Eastern Europe in the past decade have significantly influenced the health of women and newborns. High unemployment rates, low salaries, and inability to support more than one child are common challenges for women and families. High rates of abortion and most families having only one child has resulted in a declining population in Armenia. In addition, health care for women in Eastern Europe has been seriously fragmented since the fall of Communism compounded by a lack of health care resources.
For centuries Armenia had Muslim neighbors and Muslim culture highly influenced Armenian culture. Because of this Armenian women are not used to talking about such an intimate experience as child birth. According to Armenian culture women are not suppose to tell much about them giving birth. It is considered a taboo.
The purposes of this study were to:
1. Elicit the perceptions of Armenian childbearing women about the meaning of giving birth
2. Conduct an outcomes evaluation of the Erebuni Medical Center, Women’s Wellness Center
Fifteen women who gave birth to healthy newborns during the past year receiving health care services at the Erebuni Medical Center, Yerevan, Armenia were approached and invited to participate in audiotaped interviews. Questions were asked about the meaning of their childbirth experience and their satisfaction with the quality of health care received at the Center.
Armenian women are not accustomed to discussing their birth experiences and while study participants were reluctant at first to share, they became excited and enjoyed articulating their experiences with an interested nurse-researcher. Cultural traditions associated with childbearing included not cutting or coloring their hair during pregnancy, not smoking during pregnancy (though rates of smoking are very high in Armenia), not accumulating baby clothes or supplies until after the baby was born, and not having the father of the baby present at birth. Women appreciated the positive attention they received during pregnancy. Fourteen out of fifteen of the study participants gave birth unmedicated without the benefit of technology, and all of them breastfed their infants. Women expressed a desire to have more than one child to instill hope in the future in Armenia.
Most women were satisfied with the services offered by WWC at Erebuni Medical center. They noted that the service and the attention given to them were exclusive and that they personnel that were raking care of them were highly professional.
The nurses that I talked to were determined to help the patients no matter what even thought they are working for miserably low wages.
These findings are preliminary. Data analyses are in process. The expected time for termination of the analysis of the results is April 2005. The project is expected to be published in one of nursing journals under the direction of the mentor.
This research is an example of international collaborative work, conducted in conjunction with the American International Health Alliance (AIHA) who established the WWCs in Eastern Europe in conjunction with United States Agency for International Development. Outcomes data is very important in order to ensure the quality of health care provided. Clinical personnel found that evaluative data obtained were helpful in improving services to women and newborns.
The researcher modeled the conduct of professional nursing research to nurses working in the WWC, since research protocols are not equivalent worldwide. Listening to the voices of Armenian childbearing women is an important nursing intervention that had not previously been considered by clinic personnel.
Requested supplies were taken to the Erebuni WWC by the researcher. In addition, an ongoing relationship has been established between the Brigham Young University Health Center and the Erebuni WWC for the provision of badly needed health care supplies.