WHAT is "good" about the maternity care here?

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amother

Wed, Aug 22 2012, 5:48 am

I always see Israeli posters talking about how the maternity care here is great, the midwives are amazing, etc. Now that I've had a baby here I have to say I really don't know what you're talking about.

What is "good" about an OB system where unless you pay privately, you can't get an appointment more than maybe 4 weeks in advance, even in an urgent situation, and the doctors won't speak to patients on the phone? That's not good, that's irresponsible and dangerous.
And where if you call and they won't give you an appointment and you say "but it's urgent", they send you to the 24-hour place where I don't know a single person who has gone there and HASN'T had a horrible traumatizing experience.

These midwives know all about labor and delivery? Really? Then why do they make you be on the monitor for an hour lying down and then tell you you're not progressing and need pitocin? Make someone lie down flat on her back and don't let her move...well yeah, her labor will slow down. And then they tell you to lie on your back to push, but "they'll try not to cut." Well if you don't want to cut, maybe let me use a position that lets me stretch naturally. And btw, have you not read the studies that say a cut is much worse than letting the woman tear on her own, if she tears at all?

I could go on and on.
It's all nice and lovely that having to walk to meals and to the nursery and just to get yourself a pad is great for circulation and mood. It's not as nice and lovely when you give birth at midnight and no one brings you food and you don't get to eat until breakfast tomorrow. And it's not as nice and lovely when you have to nurse in the nursery at night, because you're not allowed to bring the baby into your room, and you have stitches and sitting on those hard chairs really really kills. Oh yeah, and those same chairs in the dining room are also great for sitting on with stitches, btw.

And don't even ask about the total free for all in the hospital for any nurse, resident, and whoever else to come on into the room and do whatever they want to you.

It's just not true that you will get great care here seeing a doctor through the kuppah and giving birth at the hospitals with whatever midwife you happen to get. You will get decent care at best, and really get messed over at worst.

ora_43

Wed, Aug 22 2012, 6:13 am

Wondering where anyone here said Israeli midwives "know all about labor and delivery".... or that everything here is wonderful... Most of the posts I've seen (in fact, all that I can remember) are more along the lines of "I had a bad experience at Hospital X but Hospital Y was great."

I'm sorry you had a bad experience Sad

.

I think that in most places if you don't challenge the doctors or midwives, you'll end up doing everything in the standard medicalized way - flat on the back, etc. And some hospitals are worse for that, you need to look in advance and see which encourage more natural birth techniques and which are known for discouraging it. But even in the latter, if you fuss they should let you walk around with the monitor, or even go off it, unless you want an epidural.

I'm not saying that what happened was your fault, the system really is bad especially in certain hospitals. It's just a note for the future, because unless you're done having kids here you may be dealing with the system again.

I don't understand what you're saying about appointments. Each kuppah has several OB/GYNs available in every city, so what appointment takes 4 weeks? I've lived in a few cities here and I never had to wait more than a week, unless I wanted only a certain doctor in a certain clinic at certain hours (eg. Dr Cohen is only in that clinic on Tuesdays and Thursdays, and I can't do Thursday and need something after 11 a.m.). And the norm is to make your next appointment as you're leaving, so that you don't have to call and wait each time.

If there's an emergency, the norm is to go to either the emergency room or the central branch of the kuppah for that city, AFAIK. I'm not sure what "24 hour place" you mean - Terem? I've never heard of Terem having a reputation as traumatic and awful, though What

amother

Wed, Aug 22 2012, 6:35 am

ora_43 wrote:

Here, for one:

http://imamother.com/forum/vie.....89158

HooRYou

Wed, Aug 22 2012, 6:38 am

I think a lot of it depends on the Dr you use for your pre-delivery care and your mazel at the hospital. My Dr was amazing. I was definitely able to make emergency appointments with him and he never would have just sent me to the ER. You probably just need to take a differnet Dr next time.

As far as being on the monitor, how long you can labor without progressing before they give pitocin and the like these are hospital policies and not created by the midwives. It also makes a difference which hospital you go to since the policies differ.

sister

Wed, Aug 22 2012, 6:45 am

you learn to become self sufficient
and that home birth rocks!!!
What could be better???

amother

Wed, Aug 22 2012, 6:54 am

I won't disagree with you about the hospital business, but personally I had a great dr. through the kuppa to whom I was able to make app. to from one week to the next. and if I wasn't able to, I would go in between patients. and was always able to speak to dr. on the phone (even at length when needed)
btw I'm in clalit

Inspired

Wed, Aug 22 2012, 7:17 am

sister wrote:

you learn to become self sufficient
and that home birth rocks!!!
What could be better???

Yep. Continuity of prenatal care in the kuppat cholim is a big problem.
An out of pocket homebirth is much cheaper here than in the states.
All your complaints about hospital birth exist in many locations, not just in Israel.

libramom

Wed, Aug 22 2012, 7:22 am

sister wrote:

you learn to become self sufficient
and that home birth rocks!!!
What could be better???

amother

Wed, Aug 22 2012, 7:24 am

Inspired wrote:

All your complaints about hospital birth exist in many locations, not just in Israel.

Inspired that's just not true.
This is what I have heard from my friends having babies in America:
They don't do episiotomies anymore, almost ever (unless there is a real reason to - and a real reason isn't "so you won't tear").
They have walking monitors. They don't strap you down on your back.
In America, you can pick your doctor. Yeah, some of them still make you lie on your back to give birth, but it's not hard to find one that doesn't. I know you can do that here too (pick a doctor) - but it's not covered by insurance then.
You can have your baby room-in without a fight. (and not just in only one hospital in the whole city, like it is here) There's no such thing as nurseries.
A lot of hospitals there - a LOT! - are becoming much more natural. They have things like bathtubs/jacuzzis for FREE, not for 3500 shekels. You can hire a private midwife and give birth in the hospital (not an option here....if you're using a midwife, you get who you get).

I don't know about other countries, but in America it's so, so different. Not the same at all.

peacemom

Wed, Aug 22 2012, 7:42 am

I don't know where you get your information from, but in America there is a much higher percentage of c-sections about 32% where here it varies from 19% to 22%. There is much more medical intervention in America. Sorry, but this is very true. However, I would agree that in the US, after birth care and comfort is so much better than here!

Liba

Wed, Aug 22 2012, 7:49 am

FWIW I was on a monitor my whole labor because I was induced with a sick baby, but I was not strapped to the bed. I was up sitting on a birthing ball or walking around as much as the wires allowed the whole time. I didn't even deliver in bed.

I do have many issues with how things were handled here, but being strapped to the bed and episiotomies weren't part of the equation.

Also, out of three, only one of my babies born in the states was delivered by my doctor (he happened to be the one on call when I gave birth). The other two one was a resident, one the doctor on call, and neither of them were someone I met before I was ready to push.

RachelEve14

Wed, Aug 22 2012, 7:54 am

A lot of it also depends on where you give birth. I had one episiotomy, and it was because twin B was in distress and needed an emergency vacuum delievery. She came out blue, with a first apgar of 4, I'd say it was justified. In the states I would have had to deliver them in an OR, and probably would have had a section hours before (my water broke 11pm on Wednesday, they weren't born until 4:40 & 4:50 FRIDAY morning).

I never had trouble getting an appointment with my OB. I actually like the fact that they don't see you so often, and there were no internal checks at all the whole pregnancy.

Three weeks ago I had a baby with a surprise congenital heart defect. The pediatrician on call not only knew what it was within a few hours, but knew exactly which problem (his specific problem is 1 in 20,000 babies, so not common at all, less than 1% of all congenital heart defects). He of course did not diagnos without confirming, but he called the pediatric cardiologist on call at 1am and told him we have a baby with TAPVR.

So no, I can't comment on the rooming in, but as far as the medical care, it was excellent. In American there are good and bad hospitals, good and bad doctors, and people with more or less wait times. I think also you have to remember people write to message boards usually when they are frustrated. When was the last time you saw VENT: My doctor saw me right away even though I had no appointment and he was super busy!!!

Wed, Aug 22 2012, 8:20 am

OP, I had one baby - and in NY. I had to fight for minimal monitoring, there was nothing to even talk about regarding delivery position, the doctor picked up the scissors even before I started pushing... I don't know where your friends deliver, but I have not heard about a single hospital in NY with such a reputation. There was no rooming in - you bet there was a nursery, and even when I requested that the baby be brought to me so I could nurse, they brought him after feeding him a bottle, because he was crying and the nurse who was supposed to pick him up didn't come on time.

I haven't had a baby here, so don't know what it's like. But one thing for sure - hospitals in NY are not all you're hyping them up to be.

amother

Wed, Aug 22 2012, 9:17 am

I'm totally w/ you on the appt situation.
go to Hadaasa if you want the bby w/ you

Inspired

Wed, Aug 22 2012, 9:32 am

amother wrote:

Inspired wrote:

All your complaints about hospital birth exist in many locations, not just in Israel.

It depends on the hospital. Just like here in Israel.

Quote:

They have walking monitors. They don't strap you down on your back.

Ditto. Some hospital have walking monitors, some don't. In every country.

Quote:

In America, you can pick your doctor. Yeah, some of them still make you lie on your back to give birth, but it's not hard to find one that doesn't. I know you can do that here too (pick a doctor) - but it's not covered by insurance then.

You can pick your doctor but you never know what will happen once you are actually in the hospital. Plenty of things are according to "hospital policy" and the dr. can't do a thing about it. In Israel too, you get to choose where you have your baby. There is a whole country full of hospitals, just like any other location- do your research about what is available.

Quote:

You can have your baby room-in without a fight. (and not just in only one hospital in the whole city, like it is here) There's no such thing as nurseries.

Israel isn't a city, it is a country. My local huspital has 100% rooiming in without a drop of fighting, even the ped. exam is at the mother's bedside. Again, ditto the above, it is about the location- do your research! Its your birth, your choice!

Quote:

A lot of hospitals there - a LOT! - are becoming much more natural. They have things like bathtubs/jacuzzis for FREE, not for 3500 shekels.

My local hospital also has juacuzzis, for free, nice big ones.

Quote:

You can hire a private midwife and give birth in the hospital (not an option here....if you're using a midwife, you get who you get).

Yes, I said continuity of care is a big problem.

Quote:

I don't know about other countries, but in America it's so, so different. Not the same at all.

It ALL depends on location and caregiver. You are way overgeneralizing to the point of being completely wrong.

merelyme

Wed, Aug 22 2012, 9:38 am

OP, you sound upset.

m in Israel

Wed, Aug 22 2012, 9:45 am

I have had 4 babies bli ayin harah in NY, and am about a month away from my first delivery here in Israel, so I can't yet comment on the differences. But I think a big part of it is that in the U.S., you have much more control over who is "calling the shots" when you give birth. So for example, even if overall C-section rates are high (which they are for various reasons including a huge increase in C-sections by choice in the overall population), you can choose to deliver with a doctor with a low C-section rate. Since you choose who delivers you, you can find someone whose style and approach match your needs, rather then being at the mercy of whomever happens to be on duty at the hospital.

When I gave birth in the U.S. I choose a doctor who was known to do whatever is necessary to avoid C-sections, almost never missed a delivery (I think she's missed under 5 births in her nearly 20 year career), etc. She was there for all of my births, and no one in the hospital did any exams or procedures on me (except for routine hooking up of an IV line which was required by hospital policy) except for her or with her approval. So I could be comfortable knowing that the person making decisions or recomendations was someone I had researched and trusted (not to mention had a 9 month relationship with already!)

If there was an after hours emergency, I would call the doctor who would meet me at the hospital, so again I wasn't just walking into Terem or an emergency room and hoping to end up with a competent doctor. And while it is true that I can get an emergency appointment at the kuppah with whichever doctor happens to be there, if I want to speak to the doctor who has been seeing me until now, it is very difficult to get a last minute appointment, or even one for 2 weeks from now.

The postpartum system in terms of "rooming in" at my hospital was also much more flexible then here. There definitely was a nursery, but you also had the right to keep the baby with you if you wanted to -- you didn't need to decide one way or the other before hand. If you sent the baby to the nursery for the night and you wanted to nurse on demand they would bring the baby to you when he was due for a feeding, and then come pick him up and bring him back to the nursery when you were finished if you wanted, so you didn't have to actually shelp to the nursery. (Unless the baby was in the NICU, in which case you could not bring the baby to your room, but they gave you a special pager and they would page you when your baby was ready to eat so you can go nurse.) (Not to mention of course all the "creature comforts" in the U.S.!)

I keep reminding myself that plenty of people give birth here, B"H, and the vast majority do just fine, but I certainly am very nervous about this upcoming birth, and I certainly understand the OP's position.

amother

Wed, Aug 22 2012, 9:53 am

I think m in Israel got what I was trying to say, but I hear you inspired, I guess you were lucky enough to have a very different experience from me. Can I ask what hospital you use?

Inspired

Wed, Aug 22 2012, 9:54 am

m in Israel wrote:

RE first bold- yep, hospital policy. Which varies everywhere.
second bold, again, you are generalizing. That is not the case in every hospital in the country. You can go to any hospital in the country. I have two friends that left their city to go to another city before their birth to hire a private doctor that only worked in a specific hospital. I have another friend (who happens to be a HBMW) who went to 3 different hospitals while in labor because she didn't like the options she was given in the first 2. Your birth, research your choices!!

Last edited by Inspired on Wed, Aug 22 2012, 9:57 am; edited 1 time in total

Inspired

Wed, Aug 22 2012, 9:56 am

amother wrote:

I think m in Israel got what I was trying to say, but I hear you inspired, I guess you were lucky enough to have a very different experience from me. Can I ask what hospital you use?

I have given birth in 2 different hospitals in this country and at home. I prefer not to say in public which hospitals, you can PM me if you'd like.
Or ask in LII.

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