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Birth Rite: In-home deliveries sharply decline, but sometimes . . .“Isn’t there any other road?” No. And on this February morning, the car must stop on the main road, blocked by snow, a 50 minute walk ahead for the passengers. A villager opens her door to the visitors, and is asked for directions to the village nurse’s house. She obliges, then is asked, in effect, what these villagers do if there’s an emergency requiring transport. More specifically, she is asked if any babies are born at home in Nigavan. “No. All are born in maternity hospitals. It has never happened. There’s no such thing.” By the time nurse Tsovinar Sahakyan’s house is reached, she has received a phone call, warning that strangers have come, asking about in-home births. “Births in domestic conditions are prohibited, that’s why the woman did not say the truth,” the nurse said. The truth is that such a birth occurred just last month, when little Arman Poghosyan was born at home, after his mother turned back because the road to Aparan and the nearest maternity hospital – 10 kilometers away – was closed by snow. Last year two of the eight births occurred in the village (located in the Aragatsotn region), a dramatic drop in percentage from last decade, when nearly all births occurred at home. The number of births at home decreased due in part to a first-aid program launched by the Belgian arm of the Medicins Sans Frontieres in 2005, in the Gegharkunik province. Program director Tigran Varderesyan says that births at home now would not exceed 10 percent in the region of Vardenis, which once had the republic’s highest in-home birth rate. Until recently, about 50 percent of children were born at home in that province. “It wasn’t only a money matter, it was a mentality,” Varderesyan says. “Later, the people were educated on the need to have children in hospital and nurses were told that they should not assist in childbirths. Only urgent births are assisted at home now,” he says. The situation changed gradually, people’s situation improved a little, in the last two years roads are opened in winter more frequently and they began to take women in childbirth to maternity hospital. But on January 5, when Arman became Nigavan’s 726th resident . . . “They brought Kristine back home, I went and saw that she was crying because of pangs, and I helped deliver a child that way,” nurse Tsovinar says. “To be frank, we were unable to go to hospital, we were lucky that the snowstorm closed the road,” says 27-year-old Kristine, Arman’s mother. She means they were unable, financially. If they went they would have to spend, she figures, at least $200. They don’t have that much money. In fact, they were hoping that Arman’s birth – being their third child – would produce a financial windfall, as the Republic of Armenia offers financial incentives to families that have three or more children. Now they settled the matter with a 10,000-dram (about $28) “magarich” (a thank-you gift of sorts) to Tsovinar. They gave it from the 16,000-dram pension of mother-in-law Hripsime. The six-member family relies on one cow and several sheep. They haven’t repaid their 60,000-dram debt they have for fodder. Their second child, eight-year-old Hripsime, was also born in the village, on February 2. It was a snowstorm on that day too. “And that snowstorm was to my heart’s content,” says Kristine. They avoided expenses again. Health specialists in cooperation with international organizations continue to educate villagers to the health-related need for hospital births. Still, there are times when nature and nurture aren’t compatible. On this February afternoon, freezing weather begins at sunset and walking back to the main road is nearly unbearable. Reaching the highway we are met by two men, who ask what was our business for coming to Nigavan. We explain. One of the men is Kristine’s husband/Arman’s father, Gvidon. He has been to Yerevan (about 50 kilometers south) to apply for the state benefit that is offered to families who have three or more children – some 200,000 drams (about $560). He says he was refused; told that he should have registered before the baby was born. A welfare ministry official who wished to remain anonymous confirmed the regulation, adding that it feels unjust when needy people are expecting help, then are denied it because of paperwork. “We are deprived of the benefit,” Gvidon says. “Such is this country, brother.”
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