Really noticing a difference with pregnancy in different countries

[VagosaurusRex]

Firstly, sorry for the long post.

I had my first DD in Dubai, and knew from the beginning that the system was really keen on medicalising (I know that's not a word) pregnancy as much as possible. Had a scan every month, together with additional ones at 12, 25, and 32 weeks. Also had numerous blood tests, my glucose was tested umpteen times due to my being overweight, etc, and was constantly told to watch my weight (I gained 8 kilos altogether).

Then, when I went into labour, I was slow to dilate. My waters were broken, meconium was found, doctor said baby was under stress, then emergency C-section. Turned out it wasn't meconium at all, and baby was fine all along. Anyways.

Now I am 16 weeks pregnant. We are going private as I live in Hungary and not being Hungarian (or working) I do not have access to the state system. Doctor said at scan today (have been scanned an average of once every 3 weeks since we first went in at 9 weeks) that 16 weeks was far too early to tell the sex of the baby, and that we would know closer to 22 weeks. WTF?

He also said that my weight was of my own concern (he said to weigh myself at home; he has never weighed me) and that as long as the baby was growing according to expectations my weight didn't really matter.

Also, he recommended amniocentesis, even though the nuchal fold scan came back absolutely fine, because the Hungarian system encourages all women over 35 (I'm still 34, by the way, not 35 until July) to have it. He didn't mention the risks, though he did say that he'd done 'thousands' and never had a problem.

My head is spinning a bit after all this, and I don't quite know what to believe anymore. I do my research online, I regularly visit these boards, and talk to friends who have also had children, so I think I have a fairly good idea of what's what. But can there really be such differences in care? I'd be very interested to know if anyone else out there has experienced such disparity, and what you did to weed out the truth from the crap?

Yes I think there is a vastly different approach to pregnancy and birth in different countries.

We moved to France...and got pregant 3 days later, so all my experience is from France but I had a lot of friends give birth in the UK.

France has a very paternalistic approach to medicine. Home births are virtually unknown and elective caesarians are out of the question. No one has mentioned a birthing plan and doctors tend to tell me what to do and seem to find it weird when I ask them to defend their recommendations. Currenlty we are having very long discussions over collecting cord blood (at our own expense, but docs have to agree to do the actual collection).

On the other hand, medical care seems to be more easily available and there is less of a sense that you are costing the public health care system money. Hospitals have a dedicated maternity emergency unit, next to normal A&E. Maternity wards have their own anesthesiologists so epidurals are always an option (friends in the UK have been denied epidurals because there was no one to do them). You get 4 scans if all is well, more if you need them, monthly blood tests, monthly gyneacologist visits and 6 lessons with a midwife. At the slightest hint of a worry they will prescribe home visits by the midwife. In most areas you get a private room in hospital, you stay in for 5 days for a natural birth and 7 for a caesarian (fiends in the UK have been chucked out 48 hours after a caesarian and had to cope in rooms with 12 othe new mums and babies!) and get a breastfeeding consultant doing rounds 3 days a week.

Best of all supermarkets have priority queues for pregnant women (even IKEA does!)!

Forgot to add: the monitor weight very closely here, they seem to think that putting on too much weight is not a good idea at all. Amnio is recommended only if the statistical probabilities they figure out after the 12 wk scan suggest it. The information on chromosomal abnormalities, the tests, the statistics and the amnio was very comprehensive. There is a legal requirement that every pregnant woman has a consultation with an anaesthesiologist where they discuss the dangers of epidurals (and sign consent forms for epidurals, GAs and blood transfusions).

I am pregnant with my first in Singapore and here too everything is very interventionist.

I am getting a scan every 4 weeks and in the third trimester it moves to fortnightly and then weekly.
In addition I get the NT scan

Usually C-sections are the way to go, or if not then definitely episiotomies, etc.

They also actively monitor, so you are bed bound.

Midwives cannot make any decisions without the doctor's approval.

There are 1 or 2 doctors that do waterbirths. I am lucky that my Ob/Gyn is happy for me to labour in water and then give birth on land.

In Germany midwives are also not independent caregivers like in the UK.

Yes, definitely very different cultural ideas about pregnancy and childbirth. I think it also makes a difference if being abroad means you have private insurance as they will always give you more "care" as it means they can make money! I'm also in the middle east and they certainly are very medical and interventionist here, but there is a big difference between the private hospitals (where most expats go) and the public hospitals. The latter seem much more keen on natural births. They also do the GTT on everyone here which leads me to think they are much more likely to diagnose GD and worry about weight and diet. Everyone seems to be either "on the threshold" or diagnosed with it. It makes sense as diabetes in general is such a problem here. Big difference here is that in the public system men cannot be involved at all as they aren't allowed in to the women's section of the hospital (including delivery suites!).

I'm pregnant with my first in Germany and only know the UK system from MN.I've also had monthly scans,however,there doesn't seem to be such a need for statistics. Nobody has ever given me a 1 in x change of baby having something - docs just keep telling me he seems to be doing fine and measurements are normal. I think I prefer that,as I'm a big worrier and stats freak me out.

Also true about midwives not being independent,which means insurance pays for all meetings including birthing classes and minimum of 3 weeks after care if you need help with stuff.

Otherwise get the impression it's quite similar to UK system with big emphasis on tests and birthing plans being the woman's choice.

"Currenlty we are having very long discussions over collecting cord blood (at our own expense, but docs have to agree to do the actual collection)."

You have to pay? Where are you based? I'm giving birth in Paris and they're really pushing for cord blood collection, but have said it's free...

Are you collecting it to keep it for your child for later or just to give to the cord blood bank?

The only restriction I've been told about is that because I'm British and was in the UK at the same time as mad cow disease they might not want my cord blood...

If you want to donate the cord blood they will of course do it for free and almost every doctor/midwife will agree to do it for you.

If you want to store it for your own child's use you need to approach a private bio bank. They charge about 2k euros for 20 years storage. You also need to get the doctor/midwife to collect for you at the time of birth and some are reluctant because it violates 'solidarite' (go figure!).

Thanks for your replies everyone. It's a topic I'm very interested in all of a sudden - how different countries treat pregnancy and what that says about the country - lots of conclusions to be drawn!

I think the difficulty for me is going to be to trust that whatever scans/tests etc the doctor recommends are actually necessary, but that's going to be very difficult for me to do.

He has already said that because I've had one C-section, he doesn't recommend I have a vaginal birth. He did point out that it was up to me, but his professional opinion was that C-section is safer. Of course I've heard this loads of times before, but part of me couldn't help thinking that he was just after profit!