After Minnesotan Katie Murr read our Cribsheet post on post-partum pampering, she felt compelled to send us this piece about her son’s birth in the Czech Republic. Josh was born in October. All I can say is - Gives you Perspective.

As I said in Josh’s birth announcement, my labor and delivery experience in the Czech Republic was very comparable to the experience that I had had in the United States. The same type of equipment was used to monitor Josh and me and the reason that I didn’t get an epidural wasn’t that they didn’t offer epidurals, but that I progressed too quickly to get it started in time.

The doctor who delivered Josh was wonderful. She spoke excellent English, was very reassuring and put up with a lot of yelling from an irritating American.

So, after the birth I was feeling very confident about my decision to have a baby abroad. Josh was perfectly healthy, I felt great and I had even managed to have the baby in time to let Dan leave the hospital to pick up Ben from his babysitter before his bedtime. As is the norm in the U.S., the hospital staff let me recover in the labor and delivery room for a couple of hours. Then, the nurses gathered my belongings and wheeled me up to the maternity house, which is the postpartum ward of the hospital.

My postpartum room was dimly lit when the nurse opened the door. It was a high-ceilinged room with a tall window at one end. Three beds with small nightstands lined the room’s walls. In one corner was a dingy, wooden changing table complete with an imposing metal scale and a large, turquoise enamel sink. In the other corner were parked four metal cribs with mattresses. Two other women were already in the room, recovering from births that had taken place earlier in the day.

The nurse woke one of the women and made her translate from Czech to English for me. The woman groggily told me that because I was a second-time mother, Josh would be staying in the room with me. I should not expect to use the nursery unless something was wrong with Josh’s health.

I didn’t really know what to say at this point. All I could do was nod that I understood and then unpack my things. I had expected that I would be able to get a little bit of help the first night, especially because Dan was not allowed to even come into the room to help with Josh’s care. After a moment of panic, I tried to make a plan for what to do. I decided that it was important to find the bathroom before they brought Josh to me.

I hobbled out into the hall that ran the length of the ward and found a bathroom a few feet away. The bathroom was a communal bathroom that served the entire floor of women. There were two bathroom stalls, a few sinks and two showers. It reminded me of a college dorm with the odd addition of newborn babies.

I looked into one of the bathroom stalls, finding yet another unexpected surprise. There was no toilet paper. I should have known. It is frequent to find that toilet paper is not supplied in public bathrooms and hospitals apparently follow the same approach. Patients are supposed to bring their own supply. This was also true of towels, maxi pads, diapers, baby wipes, baby shampoo, soap, etc. This was definitely going to be a do-it-yourself operation.

After a quick phone conversation with Dan about my need for emergency provisions, I walked down the hall toward the nursery that I couldn’t use. I hadn’t seen Josh since he was born and I really wanted to hold him. I knocked on the door and a women brought out Josh. He was bundled in a thick, white comforter that tied up the front. Around his neck I could see the lacy collar of his tiny hospital shirt. The nurse looked at the numbered tag that had been tied to my wrist and made sure that it matched the number that had been tied to Josh. Then she handed Josh over.

A few minutes later, Dan arrived with Ben so that Ben could meet his little brother and so that Dan could hold Josh for at least a few minutes. Technically, Dan and Ben weren’t supposed to be in the hospital, but I stood by the locked door to the ward and let them in when they arrived. We sat quietly in the hallway, took a few pictures and then had to part ways. The nurses seemed increasingly irritated with Dan and Ben’s presence and we didn’t want to push our luck.

Over the next few days, my stay in the maternity house increasingly felt like a prison sentence. For example, each woman was expected to wear a hospital provided gown. The gowns were stamped with numbers that helped the staff to keep track of the linens, but that felt more like an identification number to me. One nurse became very angry with me when I grew tired of the nightgown and started wearing my own clothes. She was ready to kick me out of my own room because she thought I was a visitor instead of a non-compliant patient. One of my roommates had to explain that I was, in fact a mother, and that I simply was “out of uniform.”

Visiting hours also felt more like a prison meeting instead of a time for bonding between family members. Because all of the women shared rooms, visitors were not allowed into the rooms. Instead, all of the mothers wheeled their babies’ cribs out into the hallway and visitors sat on the few chairs and benches that were provided for them. There was no chance for intimate family connections to be made. This also meant that fathers were almost completely absent from their newborns’ lives in the first few days of life.

Much like I would expect in a real prison, there was also little sense of personal or medical privacy. Each morning, the obstetricians and pediatricians did their rounds. Just before the doctors arrived, a nurse would come in, put our medical records on our nightstands and then go and get the doctor to tell him or her that we were ready. Then, the doctor would come in and examine us or our babies. All of the exams were done in front of the other mothers and all of the conclusions were shared in front of the other mothers. This meant that we all knew exactly what was going on with the other babies in the room.

This situation created a lot of anxiety for one of my roommates. Her baby grew increasingly sick over the time that I spent in the hospital with her. It was extremely difficult for her to listen to the doctors discuss discharge dates with me and the other mother in the room when they wouldn’t even raise the subject with her.

Many of the doctors seemed to follow a “I will tell you on a need to know basis” type of philosophy. In the United States, I have always felt like I am free to ask doctors questions and that they have an obligation to work with me to take care of my needs or my son’s needs. In the Czech Republic, however, doctors seem to be more like authority figures who are not to be questioned. In fact, when I did ask questions of some of the doctors, they almost seemed insulted that I would challenge their treatment of my case. This was very difficult for all of the mothers in the room because we all had questions and needed reassurance.

Even the food reminded me more of prison rations than food that was appropriate for women who were breast-feeding (There was no question that ALL of the women would breast-feed. I didn’t see a bottle during my entire stay in the hospital.). Each night, for example, dinner consisted of either two or four pieces of bread and some source of protein. One night the protein was pate that looked more like wet cat food. Another night it was two hard boiled eggs and another night it was a package of salami. Fresh vegetables were never served and fruit only appeared in the form of bruised apples or tomatoes for breakfast. I admit that the U.S. has an obesity issue, but limiting the caloric intake of postpartum mothers seems a bit extreme.

By the time I reached Sunday, the earliest day I could be discharged, I was ready to break out of the hospital. I missed Dan and Ben and wanted the chance to bond with my baby privately. It was on Sunday, however, that the flip-side of this whole story surfaced. Dan and I carry international insurance. This means that we must pay all of our bills up front and then get reimbursed by the insurance company for the covered portions of our care. I received two bills for my stay, one for my obstetric care and one for Josh’s care. The total of the two bills was less than $1000. I literally paid for the birth of my child with cash.

This led me to rethink the whole experience at least a little. Is it better for hospitals to provide individual rooms, towels, free diapers, individualized meal plans, maid service, etc. and charge $15 to $20,000 for the stay? Or is it better for all of us to suffer a little more in order to reduce the costs for everyone? Of course, the question is more complex than this. For example, Josh may have picked up some sort of skin virus while we were in the hospital. It isn’t serious at all, but the pediatrician did note that there are periodic outbreaks in the maternity house.

Is this risk worth the reduced cost? In light of all of the discussions going on in the United States about reducing health care costs, my stay in the big house, I mean maternity house, certainly did provide some food for thought.

(Even the front gate looks more appropriate for a prison than for a hospital….)

For more on life in the Czech Republic, read Katie’s fascinating blog Adventures and Misadventures in Brno. The family returns to Minnesota in May.

This entry was posted on Thursday, February 19th, 2009 at 7:15 pm and is filed under Guest Bloggers. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.