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May 17, 2015

International Birth Story – Australia

Welcome back to the International Birth Stories series.  If you’re just joining us, make sure you check out the other testimonies in the series: Germany, Senegal, Spain Switzerland, Japan, England, Djibouti, Northern Ireland, Brazil This week we have Peggy, with a birth story from Australia.

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Peggy gave birth in a private hospital due to insurance reasons. She says there are significant differences between private and public Australian hospitals. 

IBI - Australia

Intro: What brought you to Australia?

I had been wanting to live and work abroad for the past 4 years, and was looking for an opportunity in the UK.  Ultimately, I was offered a postdoctoral fellowship in Australia from my current supervisor and thought it was the opportunity of a lifetime, especially since the chance to live and work in the UK had fallen through just prior. It wasn’t until after all the contract and paperwork were signed that we had found out about bub, so surprise!  We had an Aussie baby! 🙂

1.)  What surprised you about prenatal care in Australia?

Nothing at all.  Prenatal care was identical to what I had received before departing the U.S.

2) What surprised you about giving birth in Australia?

It surprised me how supportive they were of natural birthing and breastfeeding right off the bat.  The midwives there were the biggest cheerleaders and had the best ideas to get you through the process.  It also surprised me that circumcision was never mentioned or offered for our son.  It’s just not done here.  Luckily we’d discussed it and decided to leave him intact before I went into labor!

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3) What surprised you about post-natal care in Australia?

They definitely take care of you here.  It’s not like the drive thru birthing back in the US.  The minimum hospital stay for vaginal birth is 3 days and 5 days for a caesarian section.  The midwives were super helpful in getting bub to latch the first 48 hours. And they had classes every day on breastfeeding, handling baby, bathing baby, etc.  I felt totally prepared and confident bringing our baby home after we were released.

4) Overall impression of pregnancy/birth culture

I thought the pregnancy and birth culture was wonderful, however they can be a little preachy/pushy on natural birthing and “breast is best”-isms. Even employers are super supportive of childbirth as they’re all legally required to give 6-months paid maternity leave if you’ve been employed long enough!

 

Stay tuned next week for yet another installment in the International Birth Stories series!

May 10, 2015

International Birth – Germany

 Welcome back to the International Birth Stories series.   If you’re just joining us, make sure you check out the other testimonies in the seriesSenegal, Spain, Switzerland, Japan, England, Djibouti, Northern Ireland, Brazil. This week we have Chamisa, with a birth story from Germany.
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Chamisa delivered in a public German hospital.
 
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Intro: What brought you to Germany?

We moved to Germany so my husband could do a post-doc after he finished his Ph.D. We lived there for four years, and we just moved back to the US.

The hospital where I gave birth was public. In the town where I lived, we did not have any private hospitals. I did not pay a dime for my son’s German birth. Granted, I did not have a c-section (but I did have an epidural), and I stayed less than 24 hours. German insurance pays for a shared postpartum room; mothers can elect to pay a bit more for a private room. Also, all well-baby checks (and postpartum midwife checks) are completely covered as are sick visits and vaccinations. 

1.)  What surprised you about prenatal care in Germany?

Prenatal care in Germany is set up to allow moms-to-be the freedom of choice. The mother is free to choose a gynecologist, a midwife, or both to oversee the pregnancy. This isn’t necessarily all that different from America; women in the US can do the same as long as that provider accepts the mother’s insurance or the mama is able to pay out of pocket. However, I was surprised to learn that for a hospital birth, the doctor (gynecologist) has nothing to do with the actual labor and delivery. He or she is responsible for making sure the mother is healthy before birth, and a professional at the hospital takes over shortly before the due date. If a woman chooses a midwife, all the prenatal visits can be conducted either at a birth center or in the patient’s home. On another curious note, ultrasounds are routine and occur often throughout the pregnancy. In the US, unless a woman is high-risk or pays out of pocket, pregnant mothers often only receive one ultrasound at twenty weeks. I received six or seven, and they were performed by the doctor, not an ultrasound tech.

2) What surprised you about giving birth in Germany?

An unexpected bump in the road was discovering that the mass exodus of Germans every August known as “summer holidays” affects mothers who happen to have due dates during that time. I was hard pressed to find a midwife available for an August due date, and the hospital was noticeably short-staffed during my stay.

Also, convincing a doctor in Germany to induce labor before your due date is next to impossible unless you have complications… or beg.  I somehow found myself with an extremely kind hospital obstetrician who agreed to put me on the drip just one day after my due date, but only because I had already had two other inductions.

And, for all the mothers who need, desire, or can’t live without epidurals – beware. German hospitals don’t give out epidurals like candy. In the US, the mother is encouraged to sign all the consent forms for an epidural before going into labor so that (ideally) at the exact minute she wants one, she can have it.  In Germany, doctors and midwives purposefully do not give the mother any information or paperwork for an epidural in advance for the express purpose of delaying the intervention as long as possible in order to (hopefully) avoid giving it to her.  The bottom line – if you want an epidural in Germany, you’re going to have to fight like mad to get it.

3) What surprised you about post-natal care in Germany?

I gave birth to two babies in the US, and one baby in Germany. In America, I had virtually no post-natal care other than the standard well-baby visits and a routine check-up with my ob/gyn at six weeks postpartum. If I had questions or concerns, either Google held my hand, or I wrangled a last-minute appointment from an already-overbooked pediatrician. Imagine my surprise when I learned that every mama in Germany is assigned a midwife that visits the mother and baby at home for as many visits as it takes to establish a healthy start to the little one’s life. I had an awful birth (which could have happened in any country – it’s not Germany’s fault), but the fantastic post-natal care nearly made up for it. My midwife ensured that I was healing properly after the birth and that my baby was adapting well to life outside the womb. She brought a scale to my house to weigh my son and answered all those questions that new moms always worry about (even when they already have multiple children!). She also went over exercises to help me get my body back into shape and encouraged me to join a post-natal fitness class, something that all German health insurance companies cover for moms. Amazing.

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4) Overall impression of German pregnancy and birth culture

One of the most striking differences between Germany and America is the trust that Germans place in the hands of the mother. I got the distinct impression that Germany gives mothers more freedom to choose in their pregnancies and childbirth. From being responsible for your own medical records to selecting where and how you want to give birth to experimenting with any and all labor positions, much confidence is placed on the mother and her instincts or convictions. I believe part of the reason why this is possible in Germany is the lack of lawsuits. The threat of malpractice and the high cost of provider insurance premiums in America prevent many doctors from the possibility of allowing their patients to choose the way they want their birth to be. Risk exists in any birth; but, in Germany, that risk generally seems to stay in medical realm and out of the legal arena.

But, perhaps the most amazing difference between birth culture in the US and Germany is a beautiful thing called parental leave. Legally, the mother can take up to three YEARS of maternity leave, and her employer must allow her to return to her position.  Also, if the employee and employer agree, one of those three years can be saved and taken when the child is between the ages of 3 and 8. Granted, most of those three years of leave would be unpaid.  But, paid benefits do exist.  The mother receives 14 weeks at 100% of her salary, starting 6 weeks before her due date.  After the 14 weeks are up, she is entitled to 12 months at about 65% pay. To sweeten this deal even further, if the father wants to take leave as well, then the couple has 14 months that they may divide among themselves.  Again, these 14 months would be at 65% pay.  Seriously, awesome.

Chamisa blogs about the marvels, miracles, and mishaps of a life spent traveling on the cheap with her husband and their three boys in tow at Thrifty Travel Mama.

 

May 3, 2015

International Birth Impressions – Senegal

Welcome back to the International Birth Stories series.   If you’re just joining us, make sure you check out the other testimonies in the seriesSpain, Switzerland, Japan, England, Djibouti, Northern Ireland, Brazil. This week we have Joy, with a birth story from Senegal.

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Joy delivered under a private OB in a private clinic.

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Intro: What brought you to Senegal?

My husband and I are missionaries here.

1.)  What surprised you about prenatal care in Senegal?

Prenatal care is not considered widely necessary,  at least in the more rural areas.  Generally,  only women with a history of difficult pregnancies see a doctor regularly.  I went to the capital city as I was able to see my OB and the care was similar to what I received in the States.

2) What surprised you about giving birth in Senegal?

My labor was so very quick (less than an hour) with my fifth child, that I didn’t have much time to observe the actual birthing differences.  I was glad that they were not quick to induce labor…I went nearly two weeks late without even the mention of induction. I wondered if my other deliveries would have been easier/quicker if I had been allowed to go late.  Right after he was born, they wrapped him up in this huge awful plastic like green sheet.

I am sure that delivering in a private hospital makes a difference in the experience.  Some of the things that happen in the public hospitals in Senegal are horrific.  For example, I have heard of instances where 3 women share one mattress on the floor.  Or those who have delivered stillborn babies right next to those with newborns next to those still in labor.   After birth, they basically do a d&c and then rinse the women out with bleach water!

3) What surprised you about post-natal care in Senegal?

They thought I should only drink hot beverages for a while after delivery. They wanted me to lie flat on my back for 24 hrs…no pillow even! Someone came in every couple of hours to massage my stomach and help with the shrinking of the uterus.  

4) Overall impression of pregnancy/birth culture

Children are highly valued…the more the merrier! This was evident in every aspect of prenatal care, birth, and postnatal care. Everyone was just so happy that I was having a child. My status as mother and woman became more obvious than that of “foreigner”.  I felt having a baby in this context helped me connect to the other women. 

Pregnancy is not talked about openly or asked about directly for fear of the spirits.  There are code words for these discussions though.

To acknowledge that someone is pregnant (once they are obviously showing) you can say:
You sure are eating a lot of rice lately.
Your feet are getting heavy.
Your dress is beautiful, won’t you give it to me when you are done with it?

To ask about their health…
How is your body?
How are your feet?

To ask when they are due…you still wouldn’t ask this at all unless it is a very close friend.  But you could ask:
When will your guest arrive?

To ask how many kids someone has..
You ask how many pieces of wood they have.

There is in general fear of evil spirits attacking bringing sickness or death,  but babies and children are thought to be especially vulnerable.  Most children have amulets tied to them at birth to protect them.  One of the most common fears is of complementing the child – This might make the spirits jealous so one of the most common amulets is intended to trap all the complements in the amulet itself so they are not associated with the child. For this reason you never say that a baby is beautiful.  Instead you could say they are not ugly or that they look like one of the parents. They often try to trick the spirits into not wanting the child, especially if the mother has had several miscarriages or infant deaths. They might name the following child “no one wants it” or something along those lines.

 

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 Stay tuned next week for another international birth story!

April 26, 2015

International Birth Stories – Spain

Welcome back to the International Birth Stories series.  If you’re just joining us, make sure you check out the other testimonies in the series: Switzerland, Japan, England, Djibouti, Northern Ireland, Brazil. This week we have Sarah, with a birth story from Spain.

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Sarah gave birth to two children in Spain in a public hospital (which according to her, makes a big difference in the type of care received).  She has also had 3 miscarriages and discusses the Spanish miscarriage culture in a bonus section below.

International Birth Story - Spain

 

Intro: What brought you to Spain?

I studied in Sevilla in college and made my way back to live and work a few years after college graduation. My husband is Spanish. 
 

1) What surprised you about prenatal care in Spain?

 I was surprised how spread apart the appointments are, at least in the public healthcare system, and that you don’t get your first ultrasound until 12 weeks.  Until then, they just trust that you’re pregnant!  Also, you aren’t given a choice about triple screening, they just automatically do it, and send the results to you in the mail!
 

2) What surprised you about giving birth in Spain?

 There is really no such thing as a “birth plan”.  You just have to put yourself in the hands of the doctors.  You can try to give them indications, but the public hospitals have their methods and protocols, and they don’t really deviate from them. 
 

3) What surprised you about post-natal care in Spain?

 It’s very hard to get any lactation consulting at the hospital.  If you’re lucky, a kind nurse will take some time with you, but they pretty much to leave you to duke it out for yourself, and if you run into any breastfeeding problems, you’re better off consulting with other women in your family than with the medical professionals.
 

4) Overall impression of the Spanish pregnancy and birth culture:

Spain’s public healthcare system is still a little behind the times in terms of medical advancements in all aspects of pregnancy and birth culture.  Once you have one experience behind you, you learn how to navigate the system and the best way to get things done to your liking, but it’s not easy.  
 

Thoughts on having miscarriages in Spain:

In terms of miscarriage (I’ve had 3 – the first at 9 weeks, the second at 15 weeks and the third at 19 weeks), my experiences have been that as soon as it is confirmed that you have lost your baby, you are sent to the hospital for a D&C. They let you dilate and go into labor, and when it’s delivery time, you go under general anesthesia and they perform the surgery. There’s no mourning and no one asks you if you want to see the baby. It’s all very medical and yet no one tries to investigate into seeing what went wrong – it’s just “la naturaleza”. Unfortunately, it’s possible that during your hospital stay you are on the same wing as or close to women who have just given birth which can be uncomfortable to say the least. Recovery is what you make of it. You have to make your own mourning rituals.
 
You can follow Sarah and her life in Spain as she documents it on her Instagram account Saritagemba.
 
Stay tuned next week for another International Birth story!