Navigating Moscow's Maternity Clinic Maze

For Olga Albanova, giving birth to a baby boy in one of Moscow's maternity clinics turned into her worst nightmare: lack of professional anesthesiologists and midwives, crowded rooms, filthy showers at the end of the hallway, rude doctors and nurses that ignored both her and her baby.

"I had made previous arrangements with a doctor, but when my contractions started on the doctor's day off, she refused to show up," she said in an e-mail interview. "What did I pay $600 for? In the end, I lost a lot of blood and even more nerve cells, not to mention that the baby and I left the hospital with a staphylococcal infection."

Let's face it Ч Russia's medical care faces a steep climb before it can reach its Western counterparts. But thanks to the market economy that has oozed into every aspect of life over the past 10 years, mothers-to-be can now count on commercial maternity clinics that offer comprehensive services. Finding them is simply a matter of being a demanding customer who asks the right questions.

Both the American and European medical centers can help. For instance, in the 36th week of pregnancy, the American Medical Center, which does not have its own maternity ward, helps its patients make arrangements at two of the most advanced maternity clinics in the capital Ч Roddom No. 29 and the Center for Family Planning and Reproduction.

"For example, at No. 29, $3,000 will take care of everything, including all delivery services, a tuberculosis vaccination for the baby, a three- to seven-day stay at the hospital in a private room and a postnatal home visit from a doctor," said Leila Nadgi, head obstetrician at the AMC, in a telephone interview.

Since its reputation is on the line, the AMC handpicks the doctors it recommends at both clinics. On the other hand, having the AMC do all the leg work will cost you a pretty penny: Giving birth at the same facilities will cost less than one-third the price if you choose to bypass AMC's help.

Bypassing the middleman is exactly what Judith Ingram, a news editor at The Associated Press, decided to do when she gave birth to a baby girl last March. The European Medical Center, which helped monitor her pregnancy, asked for $3,000 to prepare a contract with the Center for Family Planning and Reproduction. She and her husband paid $800 when they made arrangements directly with the center.

"I had a pretty good experience: My husband could be present during the delivery, the personnel were great, and I could keep the baby with me after the first night," Ingram said.

"The only thing that I didn't realize was that the birthing rooms were half glass, so everyone could see me," she added. "I felt like I was giving birth in front of a whole housing complex."

Keep in mind that regardless of how much you pay, you will share the clinic's doctors and facilities with Muscovites who are entitled to free medical care. Out of roughly 70,000 annual births in Moscow, less than 5 percent are commercial, Dengi weekly reports, citing the Moscow health committee.

But even if you have a local propiska, or official residency stamp, you may want to consider forking out the cash for a private room, the presence of your husband or relatives during delivery, a tastier dinner and some extra attention from the staff.

"I paid $800 when I had my first child, and I felt like my money was well spent," said Anna Sinichkina, a mother of two who is expecting her third child in August.

The women who received free care saw the same doctors and ate the same scrambled eggs for breakfast, but as a paid client, Sinichkina could keep her baby in her room, and "that in itself was more than enough [to justify the expense]," she said.

Sinichkina delivered her son at Roddom No. 4, one of the city's top-rated facilities, according to Russian-language Internet forum, which rates maternity clinics based on feedback.

The forum names several other Moscow-based facilities as being a "mother's dream." They include Spaso-Petrovsky Hospital of Peace and Charity ($300 to $500), Birthing Center at the Central Clinical Hospital ($1,000 to $3,000 depending on amenities), Roddom at Obstetrics and Gynecology Clinic (natural birth $500 to $1,000; cesarean $800 to $2,000), Roddom No. 4 ($500 to $1,500 depending on the doctor), Roddom No. 8 ($500) and Roddom in Lyubertsy ($300 to $500.)

All of these clinics offer traditional delivery services. If your heart is set on giving birth in water or in a candlelit room with soft music, you may want to consider finding a private midwife. Midwifery services in Moscow range from $300 to $500, not including an ambulance, which you may want standing by in case of complications.