29 ms·

Interesting to read this here. When my son was born (naturally, normal weight, fully healthy, and around expected due date), the midwife in Denmark had educated

Interesting to read this here. When my son was born (naturally, normal weight, fully healthy, and around expected due date), the midwife in Denmark had educated us about the Danish way of handling the birth - as soon as the baby comes out, they literally put the baby on mom’s chest, and leave us(parents, and baby) alone in the room for about an hour. Nothing needs to be done other than the baby being in care of it’s parents! They believed it helps the baby form a natural bond, but also acclimate to the outside world better than being whisked away and cleaned. It was such a lovely experience. One of the many things I am thankful to Denmark for. Several things that I was surprised to learn while going through this in DK. 1. Childbirth is handled by midwives (Jordemothers) instead of doctors. Doctors are brought only when medication or any treatment is necessary. 2. Child birth is considered a natural process and never treated/thought of as a sickness or medical condition. This is reflected in the whole process. 3. The social healthcare system works great. It changed my perspective even more. Not having to think about hospital bills or insurance leaves us parents to enjoy the arrival of our little one. 4. If everyone in the country, regardless of their current financial condition gets such an experience for their childbirth, I will gladly pay my taxes, and never complain. Healthcare should not be a business imho.

kazen44 5y ago
using midwives is quite common in most European countries. in some countries people usually bear there children at home instead of in the hospital as well.
- reacharavindh 5y ago
  Yes, this way of care was new to me as I have only lived in India and the USA prior to moving to Denmark. It simply makes sense to have midwives be the specialized practitioners for this normal natural human care.
- snikeris 5y ago
  My son would probably be dead if we didn't give birth in a hospital. The cord was wrapped around his neck three times and he wasn't breathing when he came out. A small team of doctors (angels) came in and saved his life. An hour or so later, they had to do it again. It was a short part of their work day, but made all the difference for us.
  - gibrown 5y ago
    Don’t know your specific circumstances and it sounds like it was kinda a rough birth so sorry. I will say that the cord wrapped around the neck is super common and something midwives deal with all the time.
syntaxing 5y ago
I’m in the US and most hospital does the same now. They call it the golden hour where it’s just an hour of skin to skin just like you mentioned with no baby health routine until after such.
- afavour 5y ago
  ...and despite it being essentially a time period where the hospital leaves you alone, you still get billed for it.
  - throwkeep 5y ago
    Well, the bed and room itself is a limited resource of the hospital and it's one of their expenses.
    - LightG 5y ago
      Of course ... but it's incredibly sad to read how it is even a part of the thought process of childbirth in some countries.
      - pmiller2 5y ago
        > ... the thought process of capitalism in some countries. FTFY.
        Thorentis 5y ago
        Providing poor service and still making money isn't capitalism. That's a lack of competition. Plenty of countries have poor government run services and there's no alternative. Same deal - no competition.
        pmiller2 5y ago
        Charging for things just because you can is a capitalist mindset, however. Besides, hospitals will never be more competitive than an oligopoly in most cases, simply because only so many are built in any given geographic area, and most people can only travel so far for medical care. There are some services the “free market” simply can’t deliver efficiently.
gambiting 5y ago
Had a baby 3 weeks ago in the UK, it was the same. Baby was immediately on mum's chest.
t0mas88 5y ago
It goes like this in the Netherlands as well. Typically with only a midwife, and a nurse if you want pain reduction medication because the midwife is not allowed to handle that. The exception is if there are medical indications like an early birth (I think before week 36), then a doctor would be present from the start. Home births are a choice and a lot of people make that choice because it is a less stressful environment. We were told that the Netherlands has an above average amount of home births compared to the rest of Europe. However for my daughter we were offered an even nicer option: There are special "non medical delivery" rooms in the hospitals around here. It looks and feels much more homely than a hospital room, has some normal chairs in it, the walls aren't white, it has a nice bathroom. You go there with your midwife that you already know from all the checkups. The process is like you describe it in Denmark, they indeed give you a lot of time to relax before and after. But there is one thing different from home birth: It is right across the hallway from the medical delivery rooms, with full baby-ICU capabilities less than 10 seconds away and a red alarm button to press when you need medical help immediately. That was for us a comfortable feeling, because if things don't go right the natural way, you really don't want to be 15 minutes away from the hospital by ambulance. Luckily we didn't need any of it, but the fact that it's there when needed feels safe.
- reacharavindh 5y ago
  It is reassuring to hear that Netherlands works more or less the same. Today is my first day in the Netherlands(moved here from DK) :-) Just to add, we also had the exact situation as you described. An annex physically close but separated from the hospital. The child birth rooms are similar to normal room with a "help please" button. I'd also take this close proximity to the hospital over home births. Just in case something unexpected occurs and medical help is needed.
prionassembly 5y ago
> 1. Childbirth is handled by midwives (Jordemothers) instead of doctors. Doctors are brought only when medication or any treatment is necessary. This is perfectly rational in the context of publicly-funded healthcare; for many mothers (younger and in optimal health) pregnancy has little complications. On the other hand, we really benefited from high-intensity pre-natal care with frequent ultrasounds, as we were able to increase our kid's chances of survival with lung development-accelerating steroids. What I mean is that it's a wonderful cost-saving tactic which doesn't imply better care. In Brazil we have MDs handling sore throats in overloaded ERs, and it might be more cost-effective to have teams of RNs in a more distributed proactive fashion. I still can't think of a case where, individually, I would prefer a RN rather than a MD handling my sore throat. Billionaires might even have MDs clipping their toenails to care for fungi.
- mikepurvis 5y ago
  Surely frequent contact with a lower-cost specialist who is trained to monitor for situations requiring escalation very much implies better care? Maybe I'm misreading your tone, but it sounds like you're dismissing midwifery as being only about cost savings. I don't think that's true at all (parent of three; we did a midwife for the younger two), but even if that was a major motivation, it's like saying SpaceX is only about cost savings. The cost savings are a game changer in terms of access/frequency/etc.
- gregmac 5y ago
  I'm not sure why you're talking as if these are mutually exclusive? I'm in Canada, where midwives are publicly funded, but still not that common (there's a waitlist and not everyone gets in). The midwives have hospital privileges, and are basically the "primary care provider" (instead of an obstetrician or family doctor). They still do ultrasounds, and if there was a concern, they can turn over care to a MD. We actually did the birth in the hospital, and were just alone in the room with 2 midwives the entire time (no nurses / doctors involved). Our midwife did warn us that if a complication became up - especially at the end - that the room could get very busy very fast if they had to call in people, but thankfully that didn't happen. We have a friend that had their kids at home. The midwives notify the hospital and ambulance service this is happening. They actually had to go to the hospital for one kid who had a complication, and my understanding is the ambulance was there very quickly and things were turned over to the medical team for birth, then after everything was ok, care turned back to he midwife a few hours later.
njovin 5y ago
I had a similar experience in the US with a large private healthcare provider at a large regional hospital. They did some quick health checks but then quickly left the baby with my wife and I for skin-to-skin time. This was planned ahead of time and encouraged by the nurses and doctors. I’m not sure if it’s become commonplace across the country but our care was impeccable and the nurses and doctors were happy to recommend and support as natural a birth as possible.
- xen2xen1 5y ago
  I've heard / overheard from multiple women from multiple states that birthing has changed and the baby is put on mom as immediately as possible, to the point it seemed odd from my experience 20 years ago. Doctors in the states have read all this too and things have changed.
gibrown 5y ago
We had both our kids at a birth center in the US (actually both born in the same room three years apart) and it was a great experience. There are certainly cases where you can’t but I really liked not being in an overly medical setting. Also (as a new exhausted Dad) taking that first nap in the same bed your baby was just born in and your wife is beside you wide awake… magic. Then about 6-8 hours later we are back home for when my wife was ready to crash as the hormones wear off.
doggodaddo78 5y ago
I just watched the Frontline episode on the Healthcare Divide where US safety-net hospitals (accept anyone hospitals of last resort) have been closing or being sold to vulture investors who buy, trim costs, and sell them at the cost of reduced care. For-profit healthcare should be like for-profit prisons: illegal.
- OJFord 5y ago
  I'm not sure about that, I live in the UK with public healthcare and optional private for-profit; I think that's fine. Non-profit replacing the public is an interesting idea though, I've never heard that suggested before, people usually just argue about public being available or not. (And invariably quite pointlessly since neither side will budge!)
  - missedthecue 5y ago
    Most Americans don't know this, but in the US, most people have healthcare insurance through a non-profit such as BCBS or Kaiser or Wellmark. Additionally, 2/3 of the hospitals themselves are non-profit. The non-profit model is more prominent than the for profit model in the direct care area of healthcare.
blhack 5y ago
This sounds exactly like the process my wife and I are going through in the US right now. I’ve never heard of pregnancy being treated like an “illness” (??). Midwives are also extremely common here. Granted I live in Arizona, and I know much of HN lives in SF. So maybe this is unique to Arizona in some way?
- dieortin 5y ago
  Except for the bills part
- pasquinelli 5y ago
  My first kid in 2008 in Chicago wasn't like this, my second in 2012 in Portland was. I'd say America is adopting the approach; maybe it fully has by now.
- throwkeep 5y ago
  Not unique to Arizona. It's rather common throughout the country now.
- in_cahoots 5y ago
  The country’s c-section rate is somewhere near 33% when most estimates say it should be around 15%. That’s a pretty good indicator of systematic over-medicalization.
  - whall6 5y ago
    Lots of women I know elect to have C-sections.
    - GloriousKoji 5y ago
      I would not call it a "good amount" but I know women who elected for C-sections because they attribute too much value and significance to the date of birth.
    - deleted 5y ago
      [deleted]
lcfcjs 5y ago
Here in America, we have GoFundMe.
rootusrootus 5y ago
This is the experience we had 8 and 10 years ago, and I live in the US. I'm sure some people have had bad experiences, but there are exceptions to every rule.
jedimastert 5y ago
My wife had a couple of complicating factors, so we had doctors involved from the get-go. Fun fact for the unaware: if you're predisposed for diabetes or just unlucky, you get gestational diabetes because pregnancy does WILD things to hormones. But we've had instant skin to skin (after a quite o2 check, but within minutes) for both pregnancies, even the "urgent" c-section (not quite "emergency", but better safe than sorry, story for another time).
jeeeb 5y ago
This sounds very similar to our experience in the public hospital system in Australia. With both our sons the process was mostly handled by midwives including a lot of the pre and post natal checkups. The births were done naturally and immediately afterwards mum was given the baby to skin cuddle. They didn’t wash the baby and we were advised not to bath the baby for the first few days even. Mum was also given the option of how long she wanted to stay in hospital (anything from 6 hours to 4 days if I recall).
mensetmanusman 5y ago
The U.S. experience used to be this way, but about 100 years ago the medical industry realized they could make a lot of money off of child birth (our last bill was $40k). The hospitals released advertisements scaring women from voodoo (read: black) women/midwives helping with birth so that doctors and surgeons could take over, it worked fantastically. The doctors eventually chained women to beds and tested various chemicals to ‘cure’ their pain that resulted in profound unintended consequences. This history is still with us, and creates a lot of uncanny valley experiences. I.e. treating pregnancy like a disease. When we gave birth during covid, I had to use an elevator to get to my wife. When the elevator door opened, a group in hazmat exited with a patient clearly dying of covid. I was like: “are you fucking kidding me, this is still where we give birth in this country…”
- hallway_monitor 5y ago
  We did it in the hospital too but there's nothing stopping you from using a midwife at home right? Another thing that seems to be pushed a lot is epidurals. They expect everyone to get one and are very surprised when someone does not want it.
  - kevin_thibedeau 5y ago
    Then you have to deal with the circumcision sales pitch.
    - jjeaff 5y ago
      We never heard even the slightest hint of a sales pitch for circumcision. A single question of whether we were planning to do it or not was all.
      - Stratoscope 5y ago
        In fact, we had an anti-circumcision pitch. They showed a video of the process. It was horrible and makes me queasy just remembering it.
thorin1 5y ago
It's exactly the same in Canada. It was a great experience and we were so happy that we could be with our baby 100% of the time.
tootie 5y ago
It's pretty common in the US as well although not the norm. I think it's kinda dumb to be honest. Just get an epidural. My wife was induced twice due to risk factors and got two epidurals. We still got to cuddle them new born. We also had to bottle feed the first week pretty heavily to stave off jaundice although they were mostly breast fed afterwards.
- souprock 5y ago
  No, don't get an epidural. Pain has a purpose. It guides you to minimize injury. Be thankful you can feel pain. There are people with genetic defects that prevent feeling pain. These people constantly injure themselves.
  - sfink 5y ago
    They are constantly giving birth? That seems like a much more relevant medical condition. (But yes, I get your point -- it's just that it's not relevant when you're conflating burning a finger with giving birth.) Pain definitely does have a purpose. It alerts you to things you may need to know about. Once you're alerted, its purpose is mostly lost. And many, many people living with chronic pain can tell you that sometimes the message is worse than the cause. The fact that complete absence of pain is a problem in no way supports your imperative to not get an epidural during childbirth. I agree that getting an epidural before handling sharp objects is unwise.
  - tootie 5y ago
    Lol, you know epidurals only last as long as they're administered right? As soon as the baby and placenta are out, they stop the flow and feeling starts coming back pretty quickly. The doc can also adjust the level of meds on the fly to allow enough sensation to facilitate pushing. And mom just stays in a hospital bed until it's safe anyway.
    - souprock 5y ago
      It's not just about injury after the birth. It's about injury during the birth. As soon as the baby and placenta are out, it's too late to avoid injury during childbirth. It is no longer possible to let pain be guidance for minimization of injury. The chance was missed.
swman 5y ago
I resonate with #4. I'm in US, so healthcare is tied to employer. My first job ever paid 12/hr and I did not have health care and it was a part time job, so I'm glad I could rely on my mother's health insurance until age 26 (thanks Obama). I got my first "real" job after spending a year trying to find a full time job after graduating college, during which I was working that 12/hr job. Even at the new job which paid 80k a year, I had to pay $30/paycheck ($60/mo) towards healthcare. Thankfully never had to use that insurance while I worked there. Now at my current place I get HDHP (high deductible health plan) and when I messed up my leg the hospital I went to didn't even have crutches in their inventory.. got wheeled out to my car and I had to drive to a pharmacy to purchase crutches.. it was horrible, and I couldn't imagine what this situation must be like for someone without insurance. Anyway the worst part is that I still ended up paying about $1500 out of pocket, because the 1st X-Ray was covered, but the next two were $600 each....... $40 crutches ..............
- philsnow 5y ago
  > I could rely on my mother's health insurance until age 26 (thanks Obama) I don't know the particulars of what law enabled this, but I used my dad's health insurance until I was 26 as well, before Obama's first term.
  - kritiko 5y ago
    Are you from Massachusetts? In that case it was Mitt Romney's healthcare reform.
    - Broken_Hippo 5y ago
      Could have been the loophole for college students, too: I know back in the 90's, you could stay on your parents insurance until 24 or 25 if you were in college. If not, you were dropped at 19.
- reacharavindh 5y ago
  I am very sorry for what you went through. I lived in the US for 6 years, and worked at above average tech company and had excellent healthcare benefits through employer. I must admit it blinds people to say "country's messed up healthcare system is not my problem" because my employer took care of it :-( Before my move to Europe, I risked living in the US for a month without health Insurance, and I was very anxious about it. I can't imagine what most Americans who don't have that luxury of employer benefits feel daily. It's silly to think that the richest country on earth by far does not have a decent healthcare system that covers all of its citizens.
klipt 5y ago
> Childbirth is handled by midwives (Jordemothers) instead of doctors. Is midwife a female-only profession or are there male midwives too?
- OJFord 5y ago
  Are you objecting to 'mother' in the Dutch as if 'wife' in the English doesn't imply the same?
  - gameman144 5y ago
    I didn't read that as objecting to anything, it looks like an honest question...
    - OJFord 5y ago
      Fair enough. The quote made it seem like 'That's so non-PC why do you call it that' to me, so I was just pointing out it's not any different in English, quoting the Dutch is redundant!
quux 5y ago
Do they assist in cutting the umbilical cord and delivering the placenta before leaving the parents and baby alone?
- reacharavindh 5y ago
  Yes, I think the midwife gave me (father) a choice to cut the umbilical cord. I didn't want to, so she did it, and also removed the placenta, and sutured the mother(while the baby was in mom's chest). Once the suture was complete, the midwife and the helper nurse went out of the room and said they are available immediately if we needed them. That hour went like a minute :-)
mattlondon 5y ago
Same in the UK. Literally immediately as the kid came out he was on my wife's chest... umbilical still connected and everything. They banged on and on about the importance of "skin on skin" in all the ante-natal stuff. Even for the father they say skin on skin is beneficial. Apparently it promotes oxytocin for both parties.
durandal1 5y ago
We had 2 children within the last 5 years, both born at Stanford, Palo Alto, and both were immediately put skin to skin after birth, so I don't think it's unique to Denmark.
- cultofmetatron 5y ago
  Palo alto is not typical of America. Its one of the richest places in the country for one along with having a high percentage of liberal/educated people. IN America you have to be upper middle class at minimum to have the same standard of living as the bottom tier in Scandinavian countries.
  - ARandomerDude 5y ago
    Doubtless, you're leaving soon then...
    - cultofmetatron 5y ago
      I've been a digital nomad for about 4 years. got stuck back stateside for a few months due to the pandemic but I can't wait to leave again.
  - calvinmorrison 5y ago
    I always assumed poor people had midwifes Source: born in a house not a hospital like my whole family
  - jac241 5y ago
    I live in the Midwest. Skin-to-skin is the standard of care. It is not just the coasts that do these things.
  - durandal1 5y ago
    Thanks for educating me about Scandinavia, I only lived in Sweden for 30 years :) With regards to standard of living, I disagree that you have to be upper class to maintain a typical Swedish standard of living. If you derive "upper class" from the national median salary then yes, but that would put a lot of the California working class in the "upper class" bound as well.
pumaontheprowl 5y ago
2.8 million people die during childbirth every year. It's absolutely a medical condition. And you should absolutely have a doctor there.
- economusty 5y ago
  Thanks for saying this, most do it in the hospital because if something goes wrong we want to have the best chance of saving mom and child.
  - jac241 5y ago
    It's wild that on a site that educated people use that you're seeing people advocate for homebirths. I'm guessing that next to nobody on hacker news have seen a delivery go south and need an emergency C-section. If you're at home, the ambulance is going to be way too late to prevent serious harm to the baby (hypoxic brain injury) or the mom (hemorrhage, hypotensive shock). There's a reason why OB/Gyns don't have their babies at home - it's because they have seen it go wrong.
- kkwteh 5y ago
  Where did you get the 2.8 million figure? Wikipedia says "an estimated 303,000 women killed each year in childbirth and pregnancy worldwide", which isn't the same. https://en.wikipedia.org/wiki/Maternal_death https://en.wikipedia.org/wiki/Maternal_death
- dzhiurgis 5y ago
  I'd guess the stats favour non-hospital births because they are only done when deemed safe beforehand. No midwife will let you do it outside hospital if they spotted anything wrong.
franze 5y ago
Our midwife literally threw the doctor out of the room: "Everything is ok. You go now!" The doctors know that the midwife is in charge and respect this.
M5x7wI3CmbEem10 5y ago
how do you manage getting around the hospital system? seems overwhelming with having a different language, and it isn't as simple as going to the ER I assume
yupper32 5y ago
According to a recent study reported by Reuters, child birth in a hospital setting is far safer: https://www.reuters.com/article/us-health-homebirths-newborn-mortality/hospital-births-far-safer-for-u-s-newborns-than-home-births-idUSKBN20N0R0 https://www.reuters.com/article/us-health-homebirths-newborn... Skin-to-skin contact immediately after birth is pretty common in hospital settings now. You shouldn't care about it all being a "lovely" or "natural" experience. You should care that everyone gets out safely. Birth can be a brutal and deadly affair.
- gffrd 5y ago
  What's wrong with it being a lovely experience? Couldn't we assume that OP's hierarchy includes the "everyone gets out safely" box having been ticked? This is like saying cars should not be enjoyable because they exist purely to move us around.
  - yupper32 5y ago
    > What's wrong with it being a lovely experience? It shouldn't be a priority. At all. If it happens to also be a lovely experience, that's of course fine. But it's not something to plan around when it significantly reduces the chance of everyone being safe. > Couldn't we assume that OP's hierarchy includes the "everyone gets out safely" box having been ticked? They didn't have a hospital birth, so no. It's not a box that was sufficiently ticked. > This is like saying cars should not be enjoyable because they exist purely to move us around. This is like buying a two seater sports car and putting your child's car seat up front. It might be more enjoyable for you, and it'll probably be fine most of the time, but it's significantly more dangerous for your child. My post might sound harsh, but continuing to spout the "benefits" of a home birth is just plain dangerous when the facts don't support safety. I feel the harshness is appropriate.
- baby 5y ago
  Country A infant mortality rate in 2021: 2.86 deaths per 1000 births. Country B infant mortality rate in 2019: 5.75 deaths per 1000 births. Guess which country is which.
nthnclrk 5y ago
This is almost exactly reflective of our experience here in Australia, too. The midwifery service was genuinely amazing and our midwife also positioned childbirth as a natural thing, not a "medical event" (by default anyway).
watersb 5y ago
We got to do this, in the United States, when each of our kids were born, living in a village in desert Southwest. We were very fortunate. And as the area had been designated as economically distressed, there were other support policies in place, not optional, and covered by either private insurance (via my employer), or public grants (from state or federal government programs) -- 48 hours stay in hospital, a quiet, private room. It was a slow day for the hospital. And a social worker would come visit our house a few times, a few weeks later. Posting these personal anecdotes because it might be of interest to know how different things can be, out in remote locations of the US, different cultures and history.

kazen44 5y ago

using midwives is quite common in most European countries. in some countries people usually bear there children at home instead of in the hospital as well.

reacharavindh 5y ago
Yes, this way of care was new to me as I have only lived in India and the USA prior to moving to Denmark. It simply makes sense to have midwives be the specialized practitioners for this normal natural human care.
snikeris 5y ago
My son would probably be dead if we didn't give birth in a hospital. The cord was wrapped around his neck three times and he wasn't breathing when he came out. A small team of doctors (angels) came in and saved his life. An hour or so later, they had to do it again. It was a short part of their work day, but made all the difference for us.
- gibrown 5y ago
  Don’t know your specific circumstances and it sounds like it was kinda a rough birth so sorry. I will say that the cord wrapped around the neck is super common and something midwives deal with all the time.

syntaxing 5y ago

I’m in the US and most hospital does the same now. They call it the golden hour where it’s just an hour of skin to skin just like you mentioned with no baby health routine until after such.

afavour 5y ago
...and despite it being essentially a time period where the hospital leaves you alone, you still get billed for it.
- throwkeep 5y ago
  Well, the bed and room itself is a limited resource of the hospital and it's one of their expenses.
  - LightG 5y ago
    Of course ... but it's incredibly sad to read how it is even a part of the thought process of childbirth in some countries.
    - pmiller2 5y ago
      > ... the thought process of capitalism in some countries. FTFY.
      - Thorentis 5y ago
        Providing poor service and still making money isn't capitalism. That's a lack of competition. Plenty of countries have poor government run services and there's no alternative. Same deal - no competition.
        pmiller2 5y ago
        Charging for things just because you can is a capitalist mindset, however. Besides, hospitals will never be more competitive than an oligopoly in most cases, simply because only so many are built in any given geographic area, and most people can only travel so far for medical care. There are some services the “free market” simply can’t deliver efficiently.

gambiting 5y ago

Had a baby 3 weeks ago in the UK, it was the same. Baby was immediately on mum's chest.

t0mas88 5y ago

It goes like this in the Netherlands as well. Typically with only a midwife, and a nurse if you want pain reduction medication because the midwife is not allowed to handle that. The exception is if there are medical indications like an early birth (I think before week 36), then a doctor would be present from the start. Home births are a choice and a lot of people make that choice because it is a less stressful environment. We were told that the Netherlands has an above average amount of home births compared to the rest of Europe. However for my daughter we were offered an even nicer option: There are special "non medical delivery" rooms in the hospitals around here. It looks and feels much more homely than a hospital room, has some normal chairs in it, the walls aren't white, it has a nice bathroom. You go there with your midwife that you already know from all the checkups. The process is like you describe it in Denmark, they indeed give you a lot of time to relax before and after. But there is one thing different from home birth: It is right across the hallway from the medical delivery rooms, with full baby-ICU capabilities less than 10 seconds away and a red alarm button to press when you need medical help immediately. That was for us a comfortable feeling, because if things don't go right the natural way, you really don't want to be 15 minutes away from the hospital by ambulance. Luckily we didn't need any of it, but the fact that it's there when needed feels safe.

reacharavindh 5y ago
It is reassuring to hear that Netherlands works more or less the same. Today is my first day in the Netherlands(moved here from DK) :-) Just to add, we also had the exact situation as you described. An annex physically close but separated from the hospital. The child birth rooms are similar to normal room with a "help please" button. I'd also take this close proximity to the hospital over home births. Just in case something unexpected occurs and medical help is needed.

prionassembly 5y ago

> 1. Childbirth is handled by midwives (Jordemothers) instead of doctors. Doctors are brought only when medication or any treatment is necessary. This is perfectly rational in the context of publicly-funded healthcare; for many mothers (younger and in optimal health) pregnancy has little complications. On the other hand, we really benefited from high-intensity pre-natal care with frequent ultrasounds, as we were able to increase our kid's chances of survival with lung development-accelerating steroids. What I mean is that it's a wonderful cost-saving tactic which doesn't imply better care. In Brazil we have MDs handling sore throats in overloaded ERs, and it might be more cost-effective to have teams of RNs in a more distributed proactive fashion. I still can't think of a case where, individually, I would prefer a RN rather than a MD handling my sore throat. Billionaires might even have MDs clipping their toenails to care for fungi.

mikepurvis 5y ago
Surely frequent contact with a lower-cost specialist who is trained to monitor for situations requiring escalation very much implies better care? Maybe I'm misreading your tone, but it sounds like you're dismissing midwifery as being only about cost savings. I don't think that's true at all (parent of three; we did a midwife for the younger two), but even if that was a major motivation, it's like saying SpaceX is only about cost savings. The cost savings are a game changer in terms of access/frequency/etc.
gregmac 5y ago
I'm not sure why you're talking as if these are mutually exclusive? I'm in Canada, where midwives are publicly funded, but still not that common (there's a waitlist and not everyone gets in). The midwives have hospital privileges, and are basically the "primary care provider" (instead of an obstetrician or family doctor). They still do ultrasounds, and if there was a concern, they can turn over care to a MD. We actually did the birth in the hospital, and were just alone in the room with 2 midwives the entire time (no nurses / doctors involved). Our midwife did warn us that if a complication became up - especially at the end - that the room could get very busy very fast if they had to call in people, but thankfully that didn't happen. We have a friend that had their kids at home. The midwives notify the hospital and ambulance service this is happening. They actually had to go to the hospital for one kid who had a complication, and my understanding is the ambulance was there very quickly and things were turned over to the medical team for birth, then after everything was ok, care turned back to he midwife a few hours later.

njovin 5y ago

I had a similar experience in the US with a large private healthcare provider at a large regional hospital. They did some quick health checks but then quickly left the baby with my wife and I for skin-to-skin time. This was planned ahead of time and encouraged by the nurses and doctors. I’m not sure if it’s become commonplace across the country but our care was impeccable and the nurses and doctors were happy to recommend and support as natural a birth as possible.

xen2xen1 5y ago
I've heard / overheard from multiple women from multiple states that birthing has changed and the baby is put on mom as immediately as possible, to the point it seemed odd from my experience 20 years ago. Doctors in the states have read all this too and things have changed.

gibrown 5y ago

We had both our kids at a birth center in the US (actually both born in the same room three years apart) and it was a great experience. There are certainly cases where you can’t but I really liked not being in an overly medical setting. Also (as a new exhausted Dad) taking that first nap in the same bed your baby was just born in and your wife is beside you wide awake… magic. Then about 6-8 hours later we are back home for when my wife was ready to crash as the hormones wear off.

doggodaddo78 5y ago

I just watched the Frontline episode on the Healthcare Divide where US safety-net hospitals (accept anyone hospitals of last resort) have been closing or being sold to vulture investors who buy, trim costs, and sell them at the cost of reduced care. For-profit healthcare should be like for-profit prisons: illegal.

OJFord 5y ago
I'm not sure about that, I live in the UK with public healthcare and optional private for-profit; I think that's fine. Non-profit replacing the public is an interesting idea though, I've never heard that suggested before, people usually just argue about public being available or not. (And invariably quite pointlessly since neither side will budge!)
- missedthecue 5y ago
  Most Americans don't know this, but in the US, most people have healthcare insurance through a non-profit such as BCBS or Kaiser or Wellmark. Additionally, 2/3 of the hospitals themselves are non-profit. The non-profit model is more prominent than the for profit model in the direct care area of healthcare.

blhack 5y ago

This sounds exactly like the process my wife and I are going through in the US right now. I’ve never heard of pregnancy being treated like an “illness” (??). Midwives are also extremely common here. Granted I live in Arizona, and I know much of HN lives in SF. So maybe this is unique to Arizona in some way?

dieortin 5y ago
Except for the bills part
pasquinelli 5y ago
My first kid in 2008 in Chicago wasn't like this, my second in 2012 in Portland was. I'd say America is adopting the approach; maybe it fully has by now.
throwkeep 5y ago
Not unique to Arizona. It's rather common throughout the country now.
in_cahoots 5y ago
The country’s c-section rate is somewhere near 33% when most estimates say it should be around 15%. That’s a pretty good indicator of systematic over-medicalization.
- whall6 5y ago
  Lots of women I know elect to have C-sections.
  - GloriousKoji 5y ago
    I would not call it a "good amount" but I know women who elected for C-sections because they attribute too much value and significance to the date of birth.
  - deleted 5y ago
    [deleted]

lcfcjs 5y ago

Here in America, we have GoFundMe.

rootusrootus 5y ago

This is the experience we had 8 and 10 years ago, and I live in the US. I'm sure some people have had bad experiences, but there are exceptions to every rule.

jedimastert 5y ago

My wife had a couple of complicating factors, so we had doctors involved from the get-go. Fun fact for the unaware: if you're predisposed for diabetes or just unlucky, you get gestational diabetes because pregnancy does WILD things to hormones. But we've had instant skin to skin (after a quite o2 check, but within minutes) for both pregnancies, even the "urgent" c-section (not quite "emergency", but better safe than sorry, story for another time).

jeeeb 5y ago

This sounds very similar to our experience in the public hospital system in Australia. With both our sons the process was mostly handled by midwives including a lot of the pre and post natal checkups. The births were done naturally and immediately afterwards mum was given the baby to skin cuddle. They didn’t wash the baby and we were advised not to bath the baby for the first few days even. Mum was also given the option of how long she wanted to stay in hospital (anything from 6 hours to 4 days if I recall).

mensetmanusman 5y ago

The U.S. experience used to be this way, but about 100 years ago the medical industry realized they could make a lot of money off of child birth (our last bill was $40k). The hospitals released advertisements scaring women from voodoo (read: black) women/midwives helping with birth so that doctors and surgeons could take over, it worked fantastically. The doctors eventually chained women to beds and tested various chemicals to ‘cure’ their pain that resulted in profound unintended consequences. This history is still with us, and creates a lot of uncanny valley experiences. I.e. treating pregnancy like a disease. When we gave birth during covid, I had to use an elevator to get to my wife. When the elevator door opened, a group in hazmat exited with a patient clearly dying of covid. I was like: “are you fucking kidding me, this is still where we give birth in this country…”

hallway_monitor 5y ago
We did it in the hospital too but there's nothing stopping you from using a midwife at home right? Another thing that seems to be pushed a lot is epidurals. They expect everyone to get one and are very surprised when someone does not want it.
- kevin_thibedeau 5y ago
  Then you have to deal with the circumcision sales pitch.
  - jjeaff 5y ago
    We never heard even the slightest hint of a sales pitch for circumcision. A single question of whether we were planning to do it or not was all.
    - Stratoscope 5y ago
      In fact, we had an anti-circumcision pitch. They showed a video of the process. It was horrible and makes me queasy just remembering it.

thorin1 5y ago

It's exactly the same in Canada. It was a great experience and we were so happy that we could be with our baby 100% of the time.

tootie 5y ago

It's pretty common in the US as well although not the norm. I think it's kinda dumb to be honest. Just get an epidural. My wife was induced twice due to risk factors and got two epidurals. We still got to cuddle them new born. We also had to bottle feed the first week pretty heavily to stave off jaundice although they were mostly breast fed afterwards.

souprock 5y ago
No, don't get an epidural. Pain has a purpose. It guides you to minimize injury. Be thankful you can feel pain. There are people with genetic defects that prevent feeling pain. These people constantly injure themselves.
- sfink 5y ago
  They are constantly giving birth? That seems like a much more relevant medical condition. (But yes, I get your point -- it's just that it's not relevant when you're conflating burning a finger with giving birth.) Pain definitely does have a purpose. It alerts you to things you may need to know about. Once you're alerted, its purpose is mostly lost. And many, many people living with chronic pain can tell you that sometimes the message is worse than the cause. The fact that complete absence of pain is a problem in no way supports your imperative to not get an epidural during childbirth. I agree that getting an epidural before handling sharp objects is unwise.
- tootie 5y ago
  Lol, you know epidurals only last as long as they're administered right? As soon as the baby and placenta are out, they stop the flow and feeling starts coming back pretty quickly. The doc can also adjust the level of meds on the fly to allow enough sensation to facilitate pushing. And mom just stays in a hospital bed until it's safe anyway.
  - souprock 5y ago
    It's not just about injury after the birth. It's about injury during the birth. As soon as the baby and placenta are out, it's too late to avoid injury during childbirth. It is no longer possible to let pain be guidance for minimization of injury. The chance was missed.

swman 5y ago

I resonate with #4. I'm in US, so healthcare is tied to employer. My first job ever paid 12/hr and I did not have health care and it was a part time job, so I'm glad I could rely on my mother's health insurance until age 26 (thanks Obama). I got my first "real" job after spending a year trying to find a full time job after graduating college, during which I was working that 12/hr job. Even at the new job which paid 80k a year, I had to pay $30/paycheck ($60/mo) towards healthcare. Thankfully never had to use that insurance while I worked there. Now at my current place I get HDHP (high deductible health plan) and when I messed up my leg the hospital I went to didn't even have crutches in their inventory.. got wheeled out to my car and I had to drive to a pharmacy to purchase crutches.. it was horrible, and I couldn't imagine what this situation must be like for someone without insurance. Anyway the worst part is that I still ended up paying about $1500 out of pocket, because the 1st X-Ray was covered, but the next two were $600 each....... $40 crutches ..............

philsnow 5y ago
> I could rely on my mother's health insurance until age 26 (thanks Obama) I don't know the particulars of what law enabled this, but I used my dad's health insurance until I was 26 as well, before Obama's first term.
- kritiko 5y ago
  Are you from Massachusetts? In that case it was Mitt Romney's healthcare reform.
  - Broken_Hippo 5y ago
    Could have been the loophole for college students, too: I know back in the 90's, you could stay on your parents insurance until 24 or 25 if you were in college. If not, you were dropped at 19.
reacharavindh 5y ago
I am very sorry for what you went through. I lived in the US for 6 years, and worked at above average tech company and had excellent healthcare benefits through employer. I must admit it blinds people to say "country's messed up healthcare system is not my problem" because my employer took care of it :-( Before my move to Europe, I risked living in the US for a month without health Insurance, and I was very anxious about it. I can't imagine what most Americans who don't have that luxury of employer benefits feel daily. It's silly to think that the richest country on earth by far does not have a decent healthcare system that covers all of its citizens.

klipt 5y ago

> Childbirth is handled by midwives (Jordemothers) instead of doctors. Is midwife a female-only profession or are there male midwives too?

OJFord 5y ago
Are you objecting to 'mother' in the Dutch as if 'wife' in the English doesn't imply the same?
- gameman144 5y ago
  I didn't read that as objecting to anything, it looks like an honest question...
  - OJFord 5y ago
    Fair enough. The quote made it seem like 'That's so non-PC why do you call it that' to me, so I was just pointing out it's not any different in English, quoting the Dutch is redundant!

quux 5y ago

Do they assist in cutting the umbilical cord and delivering the placenta before leaving the parents and baby alone?

reacharavindh 5y ago
Yes, I think the midwife gave me (father) a choice to cut the umbilical cord. I didn't want to, so she did it, and also removed the placenta, and sutured the mother(while the baby was in mom's chest). Once the suture was complete, the midwife and the helper nurse went out of the room and said they are available immediately if we needed them. That hour went like a minute :-)

mattlondon 5y ago

Same in the UK. Literally immediately as the kid came out he was on my wife's chest... umbilical still connected and everything. They banged on and on about the importance of "skin on skin" in all the ante-natal stuff. Even for the father they say skin on skin is beneficial. Apparently it promotes oxytocin for both parties.

durandal1 5y ago

We had 2 children within the last 5 years, both born at Stanford, Palo Alto, and both were immediately put skin to skin after birth, so I don't think it's unique to Denmark.

cultofmetatron 5y ago
Palo alto is not typical of America. Its one of the richest places in the country for one along with having a high percentage of liberal/educated people. IN America you have to be upper middle class at minimum to have the same standard of living as the bottom tier in Scandinavian countries.
- ARandomerDude 5y ago
  Doubtless, you're leaving soon then...
  - cultofmetatron 5y ago
    I've been a digital nomad for about 4 years. got stuck back stateside for a few months due to the pandemic but I can't wait to leave again.
- calvinmorrison 5y ago
  I always assumed poor people had midwifes Source: born in a house not a hospital like my whole family
- jac241 5y ago
  I live in the Midwest. Skin-to-skin is the standard of care. It is not just the coasts that do these things.
- durandal1 5y ago
  Thanks for educating me about Scandinavia, I only lived in Sweden for 30 years :) With regards to standard of living, I disagree that you have to be upper class to maintain a typical Swedish standard of living. If you derive "upper class" from the national median salary then yes, but that would put a lot of the California working class in the "upper class" bound as well.

pumaontheprowl 5y ago

2.8 million people die during childbirth every year. It's absolutely a medical condition. And you should absolutely have a doctor there.

economusty 5y ago
Thanks for saying this, most do it in the hospital because if something goes wrong we want to have the best chance of saving mom and child.
- jac241 5y ago
  It's wild that on a site that educated people use that you're seeing people advocate for homebirths. I'm guessing that next to nobody on hacker news have seen a delivery go south and need an emergency C-section. If you're at home, the ambulance is going to be way too late to prevent serious harm to the baby (hypoxic brain injury) or the mom (hemorrhage, hypotensive shock). There's a reason why OB/Gyns don't have their babies at home - it's because they have seen it go wrong.
kkwteh 5y ago
Where did you get the 2.8 million figure? Wikipedia says "an estimated 303,000 women killed each year in childbirth and pregnancy worldwide", which isn't the same. https://en.wikipedia.org/wiki/Maternal_death https://en.wikipedia.org/wiki/Maternal_death
dzhiurgis 5y ago
I'd guess the stats favour non-hospital births because they are only done when deemed safe beforehand. No midwife will let you do it outside hospital if they spotted anything wrong.

franze 5y ago

Our midwife literally threw the doctor out of the room: "Everything is ok. You go now!" The doctors know that the midwife is in charge and respect this.

M5x7wI3CmbEem10 5y ago

how do you manage getting around the hospital system? seems overwhelming with having a different language, and it isn't as simple as going to the ER I assume

yupper32 5y ago

According to a recent study reported by Reuters, child birth in a hospital setting is far safer: https://www.reuters.com/article/us-health-homebirths-newborn-mortality/hospital-births-far-safer-for-u-s-newborns-than-home-births-idUSKBN20N0R0 https://www.reuters.com/article/us-health-homebirths-newborn... Skin-to-skin contact immediately after birth is pretty common in hospital settings now. You shouldn't care about it all being a "lovely" or "natural" experience. You should care that everyone gets out safely. Birth can be a brutal and deadly affair.

gffrd 5y ago
What's wrong with it being a lovely experience? Couldn't we assume that OP's hierarchy includes the "everyone gets out safely" box having been ticked? This is like saying cars should not be enjoyable because they exist purely to move us around.
- yupper32 5y ago
  > What's wrong with it being a lovely experience? It shouldn't be a priority. At all. If it happens to also be a lovely experience, that's of course fine. But it's not something to plan around when it significantly reduces the chance of everyone being safe. > Couldn't we assume that OP's hierarchy includes the "everyone gets out safely" box having been ticked? They didn't have a hospital birth, so no. It's not a box that was sufficiently ticked. > This is like saying cars should not be enjoyable because they exist purely to move us around. This is like buying a two seater sports car and putting your child's car seat up front. It might be more enjoyable for you, and it'll probably be fine most of the time, but it's significantly more dangerous for your child. My post might sound harsh, but continuing to spout the "benefits" of a home birth is just plain dangerous when the facts don't support safety. I feel the harshness is appropriate.
baby 5y ago
Country A infant mortality rate in 2021: 2.86 deaths per 1000 births. Country B infant mortality rate in 2019: 5.75 deaths per 1000 births. Guess which country is which.

nthnclrk 5y ago

This is almost exactly reflective of our experience here in Australia, too. The midwifery service was genuinely amazing and our midwife also positioned childbirth as a natural thing, not a "medical event" (by default anyway).

watersb 5y ago

We got to do this, in the United States, when each of our kids were born, living in a village in desert Southwest. We were very fortunate. And as the area had been designated as economically distressed, there were other support policies in place, not optional, and covered by either private insurance (via my employer), or public grants (from state or federal government programs) -- 48 hours stay in hospital, a quiet, private room. It was a slow day for the hospital. And a social worker would come visit our house a few times, a few weeks later. Posting these personal anecdotes because it might be of interest to know how different things can be, out in remote locations of the US, different cultures and history.