Dmitry Khoptyan: “I don’t communicate with other women, I’m always with pregnant women. ”

Dmitry Khoptyan is a man whose life’s work is focused entirely on helping expectant mothers. His quote, "I’m always with pregnant women; I don’t communicate with other women," perfectly expresses his commitment and passion. Dmitry has devoted his professional life for many years to helping expectant mothers reach their full potential as mothers by offering them support, care, and direction.

Because of this dedication, Dmitry has gained the trust of numerous families. He commits his time and efforts to the welfare of women during one of the most pivotal times in their lives, whether it is by consultations, emotional support, or practical help. His method is not only expert; it is also very personal, motivated by a sincere wish to improve every woman’s pregnancy experience.

Dmitry’s narrative is one of fervor, direction, and a profound appreciation for the wonders of existence. His work goes beyond providing standard medical or emotional support because he genuinely cares about the women he assists, guiding them through the joys and challenges of pregnancy with assurance and compassion.

With a focus solely on pregnant patients rather than interacting with a wider network, Dmitry Khoptyan’s approach to patient care is distinctive and provides an interesting window into the world of specialized care. This devoted focus emphasizes the significant influence that focused, compassionate engagement can have on expectant mothers’ well-being, highlighting the ultimate objective of offering comfort and support during a critical period in their lives. We can better understand the value of specialized care in creating a nurturing environment for expectant mothers and their unborn children by exploring Khoptyan’s point of view.

About what a real man should do

Is obstetrician-gynecologist Dmitry Anatolyevich a man’s occupation?

– This is a person’s profession. Like any medical profession, obstetrician-gynecologist is a state of mind, and I know wonderful men and women who practice this field. Because obstetrics is physically demanding and belongs to the same series as surgery, most surgeons are men. Simply put, boys have not historically been particularly active in visiting that place in our country.

Is this labor physically demanding?

Hard. First, it’s a 24-hour job; second, physical labor is involved in any surgery. It is difficult to stand for several hours in the operating room.

– What made you choose to specialize in obstetrics?

My dream has always been to become a doctor, ever since I can remember. I made the decision to become an obstetrician-gynecologist after witnessing childbirth for the first time at the institute.

This sight is said to be able to frighten an unprepared man.

"No, I wasn’t afraid; giving birth is a lovely experience. I don’t know what could be more wonderful in our lives than the beginning of a new life.

What university did you attend?

1992 saw our graduation from Novosibirsk Medical Institute.

– Emergency situation. Did we not fear to continue practicing medicine?

Many people changed careers, but I loved what I did, and my wife encouraged me to keep going. I had my child after getting married while I was still a student.

When my child was born, it was still unconscious at that age. What is twenty-one years old, then? It makes sense to me now that it’s funny.

However, prior to being married, they lived together for six months and had a child. There was assurance about the future, and it was simple. And all of a sudden, everything was different.

Our pay came in slowly, and you could only get it once you made a trip to the store. It was enjoyable.

How did your professional life unfold?

– I spent six years working at Maternity Hospital #2, moving up from staff physician to deputy chief physician for medical work. I was then invited to this place by Igor Olegovich Marinkin. He first taught me, and later on, he oversaw my doctoral thesis. I went to the regional hospital’s maternity ward in 1997 just to "be on duty," and by 1998, I was leading the unit.

Formally speaking, this was a demotion, and the pay decreased; however, in terms of the quality of medical care offered—none of the city’s maternity hospitals can match the regional hospital—this was a major increase in terms of professionalism.

About health

Is the regional maternity hospital really at such a much higher level?

– The maternity hospital opened here only in 1992, and when I came, there were 900 births a year, since then their number has increased almost four times. But I am not talking about the maternity ward, but about the regional hospital as a whole. Specialists from other medical institutions may argue with me, but, in my opinion, the level of the regional clinical hospital is incomparable with other institutions, even multidisciplinary ones. This means that if necessary, a doctor of any specialty will approach a woman in labor and perform any procedure. We can provide assistance to patients with any somatic pathology, including cardiac surgery – we recently opened a regional vascular center where endovascular surgeries are performed. This is not to mention the fact that the regional hospital has been dealing with hemostasis disorders for quite a long time, there is also a hematology and transfusiology department, with which the maternity hospital works quite closely. This is our strong point.

Regarding obstetrics, it is a fairly conservative field with few new technological advancements. However, we employ all that is novel in our area. For instance, we are the best in the city when it comes to placenta previa; there is very little blood loss, and organ-preserving procedures are implemented. For us now, uterine excision is an emergency.

Has the health of women gotten worse recently?

– The number of women who were previously unable to give birth but are now able to has increased multiple times, but the state of health has not gotten worse. Women with transplanted organs, hemostasis issues, and post-chemotherapy oncology are giving birth. There have been multiple increases in the number of pregnant women with insulin-dependent diabetes mellitus; whereas there were only three of these patients in 1998, there can now be up to five in a single week. Since the invention of insulin pumps, women have felt more at ease and have lost their fear of becoming pregnant and giving birth.

And what about baby health?

Sadly, sick women do not give birth to well-born children. Premature babies are born, which means they have to give birth earlier and cause additional problems for them.

Unfortunately, the population’s level of health does not improve as medical knowledge advances. This is nothing new; Europe has always acted in this manner.

I came to the profession back at the border of Soviet times, when the health of the mother was in the first place, and the health of the child was not so much cared for, because everything was fine with the birth rate. There was some natural selection, as cynical as it sounds, and the health of the population was better. Now technology allows us to nurse children who previously did not survive. We have unanimously joined the World Health Organization, and the period of live birth has decreased from 28 to 22 weeks. 500 grams of weight – and the child already needs to be nursed. But no one paid attention to the fact that in Europe they very cleverly keep track of mortality among newborns, and in England they completely abandoned these rules and left the period of live birth at 28 weeks. Meanwhile, a 500-gram child, even if he survives, will be disabled, no matter what they say about it.

About domestic and foreign medicine

Is the regional hospital’s maternity unit Novosibirsk’s last resort for pregnant women experiencing difficulties? or dispatch them to St. Petersburg or Moscow?

I’m not sure what we can’t do to assist expectant mothers; we can help them in any way. Because organ transplants could only be performed in the nation’s capital, women who had received transplants were previously expected to give birth there. We’ve put these operations online now so we can take care of them on our own. We see women who have had kidney transplants, and now there is a patient who has had a liver transplant.

Additionally, since I was in a Swiss maternity hospital, the sewing threads and equipment are the same. Based on the placenta’s presentation, we operate at the Kurzer Perinatal Center (a Moscow-based maternal medical center led by Professor Mark Kurtzer, approximately). With one exception—I embolse the uterine artery with my hands since it’s quicker and less expensive than doing it in an X-ray procedure.

Is a doctor’s qualification more significant than technological equipment?

Talent is just one of many factors that affect a doctor’s work. At the factory, not every twenty turners will operate the machine in the same way. additionally in medicine. The only thing you can probably do is cauterize warts, and even then, I’m not positive. I am not the only doctor in Moscow who does complex operations; there are others as well.

About young colleagues

– So, what makes an obstetrician-gynecologist a speciality? From where do you obtain them?

I don’t employ experienced doctors. In this regard, I had some experience, and I wasn’t fond of it. Hiring a doctor fresh out of an internship and training him to work the way I want is simpler.

Despite having only two years of experience, my young people are amazing; they have good hands and brains, and they accomplish many things that no other obstetrician-gynecologist in the city does.

– Do young people choose to pursue careers as obstetricians and gynecologists?

This is not problematic in any way. Unlike in the surrounding area, there is no shortage of obstetric personnel in the city.

Are there cases from the area that have been "neglected"?

Seldom, actually. Since the creation of a "road map" by the local Ministry of Health, admissions procedures to different medical facilities and tiers of care are now regulated. When a physician recognizes that a case is outside the scope of his training, they know exactly what to do and where to go. Naturally, humans will always play a role, but these are unusual situations.

Have aspiring physicians evolved?

Actually, I’ve gotten older. The information is entirely different; whereas we used to manually fill out medical records, they now type everything on a computer. However, the youth are amazing; similar to us at their age, they work and sit until late at night. I personally choose every doctor; it’s advantageous that we have a clinical foundation, that young physicians complete their internship and residency here, and that there is a chance to examine individuals more closely.

About relationships with women in labor

These days, women are more knowledgeable about this topic and attempt to learn as much as they can about the birthing process beforehand. Is this an important factor for you?

Completely unimportant. I will argue and present my case, but I will not win someone over.

However, I also pay attention to the patient because, although it’s a job for me, it’s an experience for her that might not come around again. She values everything.

And you make an effort to soothe and relax the expectant mother?

I simply communicate; the patient should decide whether or not to calm down. I don’t make any extra efforts in this regard.

Is it challenging to speak with expectant mothers? Pregnant women are often denied common sense and sufficiency.

I’m always with pregnant women; I don’t talk to other women. They appeal to me.

They are excellent and sufficient in their own right. Those who are inadequate in life—before, during, and after pregnancy—are insufficient.

Nowadays, more and more women are attempting to give birth naturally.

– Why do you believe that? This is a false impression.

There are two divergent tendencies: a sizable portion of people desire a cesarean section, while others want everything to happen naturally. And all across the world, this is the situation. Everyone possesses the freedom of choice.

If a patient refuses to have a cesarean section even though she is not in need of one?

It’s true that I occasionally mislead patients.

What happens, though, if she declines the required surgery?

We cannot go against the patient’s will, but I will try to explain things to her if I see her making a mistake. We are very well protected by the law:

The woman is required to personally sign a form declining surgery. Furthermore, reviewing this form along with a list of potential issues and repercussions is more effective than our attempt to convince.

We will eventually arrive at the norm that is in place both overseas and in some of the commercial clinics here: upon entering a medical facility, a patient signs a lengthy and serious document. If the terms suggested are unacceptable to them, they have the option to decline giving birth there. because our nation currently has a low level of personnel protection.

Do you think it’s important to communicate with and have understanding with a pregnant woman?

In essence, no. However, there is psychological incompatibility; some women I simply don’t want to work with. Naturally, I work when it’s required, but I decline to speak with them directly.

"If a woman wants… then for God"s sake"

Many women nowadays hope for little medical intervention. They request that the amniotic sac not be punctured and that labor not be artificially accelerated.

I always agree that, for God’s sake, if things are going well, they should.

Does this also apply to medications that encourage induction of labor?

Every obstetric procedure has guidelines and prerequisites. I only take these medications when absolutely necessary and for medical purposes. However, it is impossible to say this about every person or every birth, to know ahead of time whether this or that intervention will be needed.

Every birth is unique, just like a fingerprint. Please let everything happen naturally if the woman’s pregnancy developed normally and she has no medical conditions.

Regarding pain relief during contractions, what is your opinion?

– Epidural anesthesia is the only pain management technique that works. It is indicated for three conditions: low pain threshold, discoordination of labor that cannot be corrected by anything other than epidural anesthesia, and high blood pressure in severe gestosis. Some people approach the final factor ironically, but pain medication must be used when the pain results in a twilight state, or loss of consciousness.

The next group of laboring women are those who only need their pains to be relieved. I always tell them that problems can arise from intramuscular injections as well. Additionally, the percentage of complications with epidural anesthesia varies. For heaven’s sake, if a woman insists. She wants this.

To ensure that the full amount of blood needed "goes" to the baby, some young moms insist on waiting until the cord stops pulsing before cutting it. Do you grant requests of this nature?

– I run into this all the time. Allow it to pulse if the pediatrician approves and there isn’t a Rh conflict, though this isn’t really necessary. About half a liter of blood circulates in a newborn weighing three kilograms, and this volume won’t change much when the umbilical cord is severed.

Is it okay if a baby is placed on his mother’s chest right away?

– Why not? You can simply lay down after cutting the umbilical cord to prevent blood flow from the baby to the mother in the opposite direction.

– Although water births are becoming less common, many women still wish to give birth in swimming pools and bathtubs. What are your thoughts on this?

Well, in the water, this isn’t for us; you should travel to France, though it’s possible that this is done in Siberia. I vehemently disagree with this method of giving birth. Water is not home to humans, and giving birth there is inappropriate. I’m not sure how the baby will react when it is born in water when it emerges from the amniotic fluid for the first time.

And where is the mother when she is giving birth? vertical birthing, squatting, all fours…

– Squatting is common in Asia because it is easier for Mongoloid women due to anatomical features of their pelvic structure. Traditionally, European women gave birth vertically, not squatting. Let a woman try giving birth this way if that is how she wants to. However, I can tell from personal experience that a lot of people fail.

– How a professional feels about home births is a tough question.

I can confirm that there is an increase in suicides.

Are you familiar with home births overseas? A medical team shows up, or an operating room is set up in the house itself, or a car similar to a trailer is parked close to the house. This is not a fabrication.

Of course, you could give birth in the field if all goes according to plan, but in obstetrics, complications can arise at any time, so every second matters. Who gains from the death of a woman in Berdsk during a home birth a few years ago?

"I have never engaged in this and I will not; an obstetrician-gynecologist who engages in such behavior is either extremely avaricious or mentally unstable."

Dmitry Khoptyan has a special bond with pregnant women, which is highlighted by his unique perspective and experience. It is admirable and inspirational how committed he is to understanding their needs and supporting them during one of the most significant periods of their lives. His unique approach centers around the well-being of expectant mothers.

Dmitry has chosen to focus only on interacting with pregnant women, which has allowed him to gain a thorough understanding of the mental, emotional, and physical difficulties they encounter. This has made it possible for him to provide them individualized care and attention, making sure they experience understanding and support throughout their pregnancy.

His dedication to this work emphasizes how crucial compassionate prenatal care is. It serves as a reminder that providing expectant moms with caring and encouraging support can have a profound impact on both the mother and her unborn child. His example demonstrates the importance of providing targeted care as well as the importance of being present in a meaningful way.

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