Sunday, 1 March 2009

The European Birth Experience

My daughter was born in France. It was, I would say, a fairly classic birth scene, from a Western point of view: public hospital, epidural, electronic fetal monitoring, and I pushed the baby out while lying on my back (although they were nice enough to put the bed at a slight angle so that I was not lying completely flat!). I had to specifically tell the midwife that I would not consent to an episiotomy. Otherwise, she would have given me one as a matter of routine.

Oh, and their breastfeeding advice was the standard rubbish - the midwife told me to breastfeed maximum 15 minutes each breast every three hours - sore nipples and all that, you know.

There were some differences between my French birth and a standard North American birth. For one, there was no obstectrician present, just a midwife. I have learned from my experience in France and Italy that, contrary to what many natural birth advocates will tell you, women giving birth in countries who use midwives to manage low-risk births do not necessarily have more "natural" births. Not at all. In fact, what tends to happen is that the midwives are simply trained to be "general practitioner" doctors of childbirth.

Another small progressive aspect of my French experience: upon baby's exit into the world, the midwife immediately placed baby on my chest and left us for a while to bond. Also, the c-section rate in France was not too high at the time - about 20 percent in public hospitals, higher in private clinics. And in the hospital where I gave birth, they encouraged mothers to "room in" with baby - if only because the hospital didn't have the money or space to provide a separate nursery.

I haven't given birth yet in Italy but here is what I have learned so far from my yoga instructor, midwife and the many women whom I have talked to (not very scientific, I know!):

- As in France, Italy uses midwives for most births, but the midwives and doctors almost always work in teams (unlike in France where the doctor only shows up at the birth in an emergency).
- Most hospitals and clinics in Italy will encourage a woman to move around during the first stage of labour. The midwife is there to assist during the first stage.
- Electronic fetal monitoring is rarely used.
- Epidurals are not available at all hospitals and where available, it has to be "reserved" ahead of time.
- Women are encouraged or forced to lie flat on their backs during the second stage of labour, so that the midwife and doctor "can intervene more easily".
- Episiotomies are pretty much routine.
- The c-section rate is about 40 percent for all of Italy, much higher in the south (80 percent in some regions!) and much lower in the North.
- It is apparently difficult (at least in Rome) to find a hospital that will allow "rooming in" with the baby.

Personally, between an episiotomy and a cesarean, I think I might go for the cesarean. I'm hoping for neither one, though, as I have decided to forego the hospital battles and give home!