On giving birth in Prague

When I tell people here that Connery was born in Prague, I inevitably get the question of whether I was scared to give birth in a place like the Czech Republic. My answer is always the same: If it came down to a choice just of the better place to have a baby, I would do it in the Czech Republic again in a heartbeat. There's just no comparison.

I was reminded of this today when I visited Am's blog and noticed she had spoken her $.02 about the sorry state of America's healthcare system. Her impetus was a new report out by Save the Children that ranks the U.S. more or less dead last among industrialized nations in terms of infant mortality. As she says, we only beat Latvia. Japan is first (i.e. with the lowest rate), and guess which small Central European nation ranks second? That's right, the Czech Republic.

I remember at some point last year that a debate raged on Soulcysters about why the U.S. has such a high infant mortality rate. Some very nasty things were said about Croatia, as I remember, including (and I'm paraphrasing here) that the reason that the post-communist countries had such overall low infant mortality was because they had all taken on the godlessness of communism and were aborting potentially unhealthy infants instead of birthing them. There were other theories as well, though that one sticks in my mind most firmly. The crux of the argument that eventually caused the thread to be closed as a too-nasty debate came down between those who felt that so-called socialized medicine could in no way take credit for these countries kicking America's ass in this health standard and those who thought that just maybe those crazy Europeans were on to something.

I'll say this about my experience with socialized medicine: Bring it on. Absolutely I paid higher taxes in the Czech Republic while I was living and working there, but there is no way that what I paid in taxes even comes close to what we're paying out now in premiums, deductibles, and prescriptions. It's like night and day. And when I needed my insurance to work--when we had Connery--I didn't have to fill out any paperwork, file any forms, endure endless bills and statements of coverage and non-coverage, it was just covered. I paid cash for a private room for five nights--the standard maternity stay in the Czech Republic for a non-C-section birth--and everything else, from Connery's nursery care to painkillers to meals, was covered.

Oh, and that private room? It was about $100 total for the stay.

Before I gave birth, I went on paid maternity leave, as required by the state, about a month before my due date. After I got home from the hospital I had another six months of paid leave at two-thirds of my salary. After that paid leave was up, I continued to get "baby payments" of around $150 a month. I would have continued to get those so long as I remained in the Czech Republic, up to four years after Connery was born.

I chose to have a private doctor for my prenatal care, so I paid about $30 a visit to see her. That was my total cost, not a co-pay. When I developed a mild case of gestational diabetes, I had to go get weekly tests and have further appointments at the country's finest maternity hospital. That was free to me with my state insurance.

The barriers to accessing healthcare were very low in Prague, provided you were willing to learn the language. I didn't need to have a dime in my pocket to see a specialist, treat a cold, or have my annual exam. The hospitals may not have been as shiny as the ones here, but the care was great and the price was right.

When people defend our system, they often say that people from all over the world fly in to see our doctors and visit our healthcare centers, and they're right. Rich people will always get great care in the United States. If you have money, there is no better place to be sick. But if you don't have money and/or you don't have insurance, it's surely one of the industrialized world's worst places to be ill. Financial ruin is sitting in the background of nearly every decision an American makes about healthcare. If you don't think that causes stress, then you've probably never experienced it.

So why is it that Britons are healthier than Americans? Why do the Czechs have healthier babies? It couldn't be the scourge of socialized medicine, could it?

Comments

[Am]

I agree with you 100% babe...bring on the socialized medicine! I had a nasty but common complication after my c-section and the only positive thing about it was that I had home health nurses visiting twice daily for a couple weeks. Just having contact with caring medpros helped me feel less alone in the world with my new baby. And they were there to treat my wound, not to give me baby advice or help with nursing (although they did that too out of the kindness of their hearts.) Imagine if they'd have been there for reasons pertaining to new motherhood, as is common in many other modern nations! I think it would have been lovely.

And the leave you got? WOW!

[joe blow]

One note about infant mortality....

Although Europe does not engage in massive abortion campaigns like the nightmare scenario you describe, they CERTAINLY use different criteria for what constitutes a "live birth" and what does not.

In Europe, its commonplace for all babies born at borderline viability to receive NO supportive measures. If the baby comes out and its not breathing, they tell the mother the baby is dead/stillborn and thats that. There are no "heroic" lifesaving maneuvers to put the baby in a NICU at a cost of $50,000 per week.

European doctors routinely chastise America for being too aggressive in trying to save every premature struggling infant. They have a much more conservative attitude regarding treating babies--if its not screamin and hollerin when it comes out, they just let nature take its course, which invariably means death.

So, no, they dont activly abort live babies. But they dont support premature infants either.

[Nicole]

Well, Mr. Blow, I can't say that I have any statistics to fight that notion, though I have certainly heard of babies in the NICU in the Czech Republic and elsewhere. What I can say is that, at least in Czecho, there are fewer preemie babies because the medical establishment is borderline psychotic about preventing them. The "you must take maternity leave starting six weeks before your due date" attitude is just one part of that picture.

I had two friends who had babies right around the time I did who were considered high-risk. One probably would have been high-risk here as well, but she wouldn't have had the same setup that she did in Prague. As soon as it was determined that there was the slightest risk to her and the baby, she was put into the maternity hospital until her delivery. No discussion, no outpatient option. Bedrest at the hospital for several weeks before her delivery. She went on to have a perfectly healthy girl. The other mom was having twins, something that probably would not rank as truly high-risk here. There, it was into the hospital at 36 weeks to head off any potential issues. They just don't take any chances with moms or babies, and it shows in the numbers.

I heard at the time that I gave birth that it had been almost a decade since any mother there had died in childbirth. That is staggering. I think part of that has to be laid at the feet of super-cautious doctors who are willing and able to admit patients for potentially lengthy stays AND the belief that women should have the ability to relax (i.e. not work night shifts at the local 7-11) well before the baby makes its appearance.

[Alison]

if its not screamin and hollerin when it comes out, they just let nature take its course, which invariably means death.

Really, I live in Europe, and I can tell you this is quite wrong. It's like saying 'In Europe they don't drive cars'. It's just laughable.

So, no, they dont activly abort live babies. But they dont support premature infants either

Really, this is a remarkable statement. I once heard an american say that 'they don't have X rays in Europe', and this seems to be on the same lines.

I sometimes wonder how these bizarre myths arise in the US. I guess because most of you don't ever leave your own borders, you make up stuff about the rest of the world.

[Dianne]

Whether Mr Blow's claim is true or not, it does not explain the difference in perinatal mortality between the US and the Czech Republic as stillbirths are included in the perinatal mortality rate. See, for example, http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11394226&query_hl=3&itool=pubmed_docsum

(Sorry about the long link. I couldn't get the HTML tags to work.)

[Alison]

oops - I don't think my HTML tags worked the way I wanted them to, but I trust it's obvious which bits are my quoting Mr Blow and which are my comments.

[michael jones]

I agree with your post! It is very good! I undersand your opinion about maternity leave!