I know I've posted bits and pieces about the differences between giving birth here and giving birth in the States. As I read more online blogs/forums about pregnancy and childbirth, as well as talking to many international friends from all over the world, I'm struck by all the differences that are out there and how we all are super convinced that our way is the best (and of course the only healthy way) for our child. I thought it might be interesting to highlight some differences I have seen and/or heard, if only to remind myself when I get back to the States that there are other choices out there.
(Keep in mind that I've never been pregnant or given birth back in the States so I am going off of what I've been told by friends back home and other people's experiences that I've read about, as well as my own research while pregnant).So, starting with pregnancy. . .You are typically given a big list of no no's from what not to eat, drink, or do while pregnant. Back home it's no alcohol (although more and more it seems some doctors are okaying it in small amounts), no deli meats, no raw fish, no smoking, and I'm sure more but these seem to be the big ones I see over and over again. In many other countries, alcohol is ok, specifically wine (in moderation), smoking is still a huge no (although you'd be amazed at the number of pregnant women I see smoking here), deli meats are fine and ask most Asian women and they will say they continued to eat sushi throughout their entire pregnancy. I've had friends here say that they've been told not to eat strawberries (could pass on an allergy to your child), who drink coffee and other coffee beverages everyday, if not twice a day and who enjoy a glass of wine with dinner. To me, it seems like you need to make your best judgement on what is best for you and your baby.
During your pregnancy here, you will see a midwife, unless you have some sort of complication. There's not another option if you have a normal pregnancy. The midwife will deliver you, whether you decide to give birth at home or in a hospital-again as long as everything is complication free. They do not weigh you...ever. They do not test your urine for protein except after you hit 40 weeks. They listen to the baby's heartbeat each appointment, take your blood pressure and send you on your way. I know back home it's routine for you to have your urine tested every appointment and to be weighed. They also only test you for gestational diabetes at 24 weeks with a blood test. No drinking the nasty stuff I've heard horror stories about. You also do not get a group B strep test, which they do in your 3rd trimester in the States. When I asked my midwife about it, she said it wasn't necessary if I had no risk factors. I know another big thing right now is the TdaP booster that the CDC is now recommending in your third trimester to pass immunity onto your baby for whooping cough. That also is not given here and actually not recommended for a pregnant woman. (it is one of the regular vaccines given at 8 weeks to your baby). I have heard of many people back home not allowing grandparents and other visitors to hold the baby unless they themselves get a booster shot.
When it comes time for delivery, you will deliver when the baby is ready to come as long as you and baby are still doing fine. Unfortunately, being big and miserable does not qualify for an induction. They only induce when medically necessary or after you are very near 42 weeks. I practically had to beg to be induced 2 days before I hit 42 weeks (luckily i went into labor on my own a few days before my scheduled induction). The rate of c-sections is very low here. If you're baby is breech and the conditions are right(your pelvis is wide enough,etc) they will try to convince you to deliver the baby vaginally. Ultimately that decision is up to you but a C-section is seen as a major operation and not a routine delivery, as it's becoming in the States.
When the baby is born, barring no problems, you will get to hold him and he will not leave your room until you are ready to walk out the door to go home (well this was my experience and again, everything went very smoothly with my delivery). They will weigh him(no measuring length), give him a vitamin K shot, and hand him back to you for more skin on skin contact. They do not put the eye gel on their eyes, no heel prick, no other shots, no bath. I believe in the States it's common (and sometimes required by law) for the baby to get the eye gel, receive their first Hep B vaccine and get the heel prick, within a few hours after birth.
As anyone knows who read my birth story with Ellie, because we had such a complication free birth and because she was born in the morning, we were sent home 4 hours after she was delivered. That is common here. They do send you home with a nurse aid type person, which I've already written a blog about back in October (see Kraamzorg blog for more details).
The midwife comes to your house every other day for the first week to check on your recovery. The kraamzorg records how the baby is doing, weights, food intake, diapers, etc. A woman from the health department comes and does a hearing test and the heel prick. Another woman comes from the consultatie bureau, which is where you go for vaccines, well child check-ups, etc(but not for medical things-you see a general practitioner not a pediatrician-for that) and does your first "well child check up" in your home and schedules your next one for a few weeks out.
This is getting super long! But one other area that I know a lot people are curious about that I will touch on briefly is vaccinations. We chose to delay Ellie's vaccines for numerous reasons and to opt out of a few that we didn't find necessary. And I know vaccines are a hot topic but I do think it's worth considering that every country has their idea about what is "necessary". For example, one of the reasons we chose to delay was because we didn't feel the Hep B vaccine was necessary for her at this time. She is at no risk for it (it mainly affects people in the health field, IV drug users, prostitutes, and people who have been in prison) and it is one that if she needs when she is older, than she can get it then. The main reason they do the Hep B at birth and then the few times afterwards is because the population who is at risk for Hep B, they are very difficult to vaccinate at 18, 25, etc. The drug users and prostitutes are not typically great at coming in for medical treatment. The Netherlands just transitioned to where they were recommending the Hep B vaccine be a part of the regular vaccination schedule, about a year or two before Ellie was born. The reason above is what they told me when I called to ask about getting the other vaccinations with the Hep B omitted. Also, in the States, the chicken pox vaccine is now a part of the regular vaccine schedule. That is not given here at all. It is still common to get your kids together with a child who has chicken pox so they can get it and get it out of the way:). There are a few other differences, though the main players (tetanus, diphtheria, polio, pertussis, etc) are given as they are in the States. I share this not to start a debate about vaccinations but just to show that there are differences, even in developed countries, about what is "absolutely necessary" for our children's health.
I'm sure there are a ton more differences but if you're still even reading this, I'll let your brain rest!:) I'd love to answer any specific questions you have about my experience getting pregnant and having kids abroad. In the meantime, I just think it's always good to think outside our own culture and realize that there are other ways of doing things that are equally as good. Annnd to remind myself if I ever have a child somewhere else, that I have options.
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