Ynet: Screaming Babies Ignored in Israeli Maternity Wards

In a personal column in the health section of Ynet, clinical psychologist Yair Tzivoni describes his experience in the hospital after his wife gave birth. While she went with a friend to the maternity ward, he brought the new baby to the nursery to await washing, blood tests and immunizations. His own daughter slept, but others screamed. The babies were supervised by one nurse, busy with her routine tasks. She completely ignored the crying babies.

Tzivoni was especially distressed by the cries of one tiny baby attached to a monitor. He cynically suggested that no one was concerned because the monitor didn’t register a problem. Finally, Tzivoni approached the nurse and pointed out that the baby had been crying for forty minutes. The nurse adjusted the position of the baby, who calmed down and fell asleep. Tzivoni also noted that none of the tasks were lifesaving and could have waited for another time (although health authorities might disagree–a blood test could uncover an urgent medical issue).

This morning on Channel Two radio show Seder Hayom, host Keren Neubach interviewed Tzivoni along with a nursing coach and former midwife named Orna Dan. Dan refused to say how many children she had, just that there were a lot and evenly distributed between ages 3 and 24.

Tzivoni strongly objected to the conditions in the maternity ward, where he and his wife had asked for full rooming-in (where the mother and baby stay together day and night). The room contained only an uncomfortable chair next to a narrow bed. He pulled the curtain and slept next to his wife, near the baby in the bassinette. It was like scout camp, because every time someone went to the bathroom or made a slight noise Tzivoni and his wife would wake up.

Tzivoni and his wife left the day after the birth for the “malonit,” a private, hotel-like arrangement right in the hospital. Neither Tzivoni, Dan nor Neubach pointed out that hospitals have a disincentive to improve conditions in maternity wards, because they will lose business for the malonit.

Neubach asked whether full rooming in was encouraged in the hospital. Tzivoni replied that the rooms are not suitable for rooming in as there is no place for a visitor to sit, or for father to stay overnight. Neubach pointed out the conflict between the father, who wants to be with his wife and baby, and the other women in the room (in this case two). She said the system held an anachronistic view of the father’s role.

Dan said that 90% of mothers are not aware of the situation in the nursery, because the baby is washed, calm and sleepy by the time he gets to his mother. The mother wants to nurse, but baby is tired from crying. Neubach pointed out that mothers don’t have energy to go to the nursery and collect the baby, especially when the staff may resist. She herself recalls a nurse telling her to go back to bed, and promising to bring her the baby later. (In my experience the memory of these incidents stay with a mother for many years.)

Dan noted that having the baby nearby does not take a lot of energy, and that mother and baby can rest together. She finally understood the situation after her first home birth when she took the baby to Tipat Halav at three days old for a blood test. The baby cried and cried during the long minutes while the nurse struggled to collect the blood, even though Dan held him the whole time. The baby then slept for eight hours straight. Dan now knows why her older children were so exhausted in the hospital.

Tzivoni quoted a nurse from another hospital, who said that mothers don’t want rooming-in even though the babies are more relaxed and cry much less. [Do mothers know this?]

Dan maintained that mothers rest better with the baby nearby. Newborns sleep so much at the beginning, and caring for the baby is not so difficult that it will prevent her from resting.

Neubach mentioned a mother who approached a nurse because her baby had cried for several hours, and the nurse said to give her 20 milliliters of M* formula–and everything will be okay. She promised to address breastfeeding on a future program.

When Tzivoni asked about the medical procedures, a doctor told him that the newborn doesn’t register pain. Tzivoni claims that the system ignores the baby’s emotional needs, and is only concerned about immunizations and blood tests.

Neubach read a response by email from a woman named Dorit. Before the baby was born, she requested permission for her husband to hold the baby during all of the procedures, and not lay the baby in the bassinette. The hospital granted the request. Dorit wrote that parents need to remember that the baby is theirs, not the hospital’s.

The health ministry’s response was that “hanosei nimtza bebedika,” i.e. the subject is under review. Tzivoni said they are looking into his specific situation, but this situation exists throughout Israel. The ministry did not appoint someone to appear on the program. I can’t really blame them–they would have been lambasted.

Related post: Why Baby’s First Gift Shouldn’t Be Formula from the Hospital
I Waited and Waited but They Didn’t Call Me
Women’s Hospital Center Devalues Mothers

Link to Haloscan comments

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Comments

  1. How does this random clinical psychologist/new father know which tasks these nurses were doing were lifesaving and which weren’t?
    I don’t think crying, even 40 minutes, is going to make or break a child’s emotional health. If you’re going down that road, I would imagine a brit would be much more traumatic. Which it isn’t, as witnessed by the million of men worldwide who seemed to have survived just fine.
    Also, the hospital doesn’t owe the father a spot because he’s not the one that gave birth. If it’s that important to the couple to be together, they should have had the baby at home or gone straight to a milonit. I don’t see how fathers in a maternity ward can work unless they switched to private rooms, which i don’t see happening any time soon.
    I think this article is more reflective of a worked up new father’s anxieties rather than significant problems with the system. Most moms who want to be with their babies 24 or at least 12-16 hours a day are able to (and in my experienced encouraged to. Meir and Haddassah woke us up at 5 am to take our babies and we handed them back at 9-10) I’ve never heard of a hospital that forbids a mom from taking her child unless they need to do tests.

  2. Lion of Zion says:

    i was also thinking of ברית מילה as i read this
    i never even heard of this rooming option in america. in general, shared rooms means two mothers in one room; fathers are never allowed to stay overnight. and i’ve never heard of babies staying in the room the entire time.
    i’m not saying the concept sounds bad. but where my wife gave birth the rooms were so crappy they should first improve them for the women themselves and then worry about making room for fathers.
    (besides, what new father *wants* to be stay in the hospital 24/7? these are his last few nights of freedom/sanity. he should enjoy them.)

  3. There is much improvement for care and services for new mothers and infants, in maternity wards (and in other pubic places – but that’s off subject).
    I think that the different hospitals and nurses vary in their care and what they think is best. My sister just had a baby and the ward there was very different than where I had my children.
    Also it seems that a nurse working with infants may “not hear” for lack of better word or filter out the sound of babies crying. There is a video going around of a nurse washing a newborn and it is bordering on cruelty. But in the end most mothers try not to argue and offend the staff.
    It is true, maternity wards are not designed for husbands to stay around. all there is between beds is a curtain and sometimes 2 beds share a curtain. So when someone needs to feed there may be someone else’s husband there.
    I am all for rooming-in bad even had my daughter with me when I had an IV in me and could not get out of bed. but there are many women who do not want this and the staff encourage leaving the baby in their care.
    This continues after the birth to breastfeeding and “tipat halav” clinics. I got such bad advice, and was told such horrible things by some while others were very helpful.
    I guess you just get wiser and more assertive with every birth and baby you have.

  4. Lion of Zion says:

    ABBI:
    “I don’t think crying, even 40 minutes, is going to make or break a child’s emotional health”
    maybe i’m not remember the context (i think it might have been a more extreme context), but i think you made a comment that would seem to the contrary a while back. (i was going to follow up on it with a post, but never got around to it.)

  5. I just came back from reading the articles in the link at the bottom. This what happened to my sister. She was planning for rooming in and then I guess the staff convinced her to leave the baby and go to sleep. When she came there they had already given her a bottle and then when my sister tried to feed the baby was full and sleepy and this messed up the breastfeeding. Then they told her something was wrong and she could/should not breastfeed and the baby needs formula.
    Only a week after my sister got home did she manage to feed. And that was only because she is very determined.

  6. mother in israel says:

    Abbi, let’s not go down that path: “I was bottle-fed/never wore a seat belt/watched eight hours of TV a day and I’m fine.” We want the best care for our children. Sometimes we have to make compromises, but growing up ‘fine’ doesn’t mean that the status quo should continue. A nurse refused to let me take my baby–I’ll tell the story sometime.
    Mia, things have improved, and I don’t blame the nurses for the current situation. Thanks for the real-life example of your sister. One bottle, especially at that early stage, can interfere with breastfeeding.
    LoZ, I gave birth to my first at Columbia Presbyterian, and had the baby with me at night. At one point he was crying in the nursery and asked me to come get him. (I had private insurance–those who didn’t had a different situation entirely.) AS for the fathers, I’ve heard some say, “we nursed the baby.”

    • Hey was just thinking about our experiences at Columbia before aliya. First two born there – and they have a program where you can pay for a private room, 9 years ago the price on that was up to $400 for the length of your stay. Worth it if (a) a first baby and the husband wants to sleep there, (b) you’d rather not room with someone whose culture brings with it 20 extended family visiting all the time or (c) you have a low tolerance for a roommate with TV-as-fireplace perspective (especially over Shabbat).

      I actually loved the rooming-in (this means baby) policy at Columbia: you could keep the baby with you except 6-10 am when they did the daily wash & checks. You could also push a screaming baby on the nurses because you don’t know how to comfort them yet and need some sleep. Last, if you’re exclusively breastfeeding and they decide the baby is hungry, they wake you.

      But here the wards are much fuller, so each hospital seems to have a policy one way or the other – we keep your babies or you keep your babies, either way we don’t have enough hands for the luxury of comforting them.

      • My first was born at Columbia also. Meals were brought to you. I remember calling the nurse and asking her to take him. Later the nurse called me to take him because he was crying. But in Israel, when I had to get my own meals, I felt better because I had to force myself to get up and walk around. There was always tension around having the baby with me though.

  7. this is a great post – makes me feel completely vindicated for reading stories/reviews about Jerusalem hospitals, and deciding I wanted a home birth, even though it was my first child. There is no way you are in any position emotionally or physically to argue with a lot of things they can do to you in a hospital. In my opinion taking a new born baby away from its mother for washing is very cruel – is it so bad it can’t be gently rubbed down in the mother’s arms and not taken away? then again I am very soft hearted and or a complete hippy. Although my husband felt the same way – the thing that convinced him about the home birth was that we weren’t sure we would get the rooming in option at any of the hospitals.

  8. sylvia_rachel says:

    I think you’re on the money (so to speak) about the disincentive for hospitals to improve postpartum wards for fear of losing business for the milonit.
    The hospital where I gave birth no longer has a nursery (though they do have a NICU, apparently one of the best in the country, though B”H we have no personal experience thereof). All rooms on the postpartum floor are private or semiprivate (2 patients per room), all babies room in, and fathers/partners are encouraged to stay overnight if they want to. The rooms have special chairs that fold down into a (very narrow) bed. Family of the baby (including siblings) can visit any time; for other visitors there are limited visiting hours. There are daily “breastfeeding classes” led by an IBCLC, and a breastfeeding clinic and hotline (also staffed by IBCLCs) that anyone who gave birth at that hospital can go to for help with nursing issues. The hospital’s policy is that the baby never goes anywhere without a parent (or other person designated by the parents).
    And you know what? They had many fathers staying overnight, and nobody complained about not being able to leave their baby in the nursery. (It’s true that the nurses kept swaddling the baby up and putting her in the bassinet, which made her wake up and scream, but I just brought her back into the bed with me every time, and finally they gave up ;^).)
    Should we ever be blessed with another baby, I would want to go back to that hospital. Except this time I would go to a midwife instead of an OB. If the only choices were homebirth and a hospital with no rooming in and people trying to give my baby a bottle all the time, homebirth would be looking awfully attractive.

    • Which hospital was this? It sounds great. I only was given full rooming-in after my fifth, but it was an experience I would like to repeat for the next birth IYH>

  9. I wanted my first baby rooming in with me ( and got it), and also wanted to leave the hospital immediately after the birth (I stayed one night). By the time I got to my third baby I let the nurses take care of her and wouldn’t have minded staying in the hospital for a week. But I did trust the nurses (I think there was one nurse for every three babies) and went to the nursery often (everytime a visitor came) and did not see constant crying with nurses ignoring babies. They also respected my decision to nurse and brought me the baby several times at night to do so.
    I guess I’m a spoiled American.

  10. Some of the American hospitals I was in were not very conducive to rooming in either. As I recall, even when I paid for the private room upgrade, there was no bed for anyone other than myself. And in a semi-private room there is really very little privacy with no overnight stay officially allowed for nonpatients.

  11. The irony of the 40 minutes of crying is too much for me…I left my baby for under 30 minutes and when I came back they had already given her a bottle..despite two notes on the bassinet that she was breastmilk only! They also claimed they had “looked all over for me”
    Arrgh…I hate maternity wards.

  12. I’m not clear how what I said was connected to “I was bottle fed etc”.
    I honestly don’t think some crying in a nursery will irrevocably hurt a baby any more than a brit milah or birth itself hurts a baby. The nurse in question obviously knew that the child wasn’t hungry, otherwise she would have fed him/her. Maybe the baby’s mother needed to sleep or wasn’t well and there wasn’t a nurse with a free pair of hands a the moment. The same thing has happened to me at home when I’m taking care of other children or things- sometimes babies have to wait, if they’re not hungry or dirty. And they might have to cry. It’s really not the worst thing in the world.
    I also agree with the previous comment that maternity ward nurses probably tune out a lot of the crying to get their paperwork done. I doubt it’s an inherent cruelty particular to maternity nurses.
    Are you arguing in this post that rooming in should be forced on all mothers so babies won’t ever cry in nurseries? Because I can’t really see that being accepted as the norm.
    I’m sure there are isolated cases of crazy controlling nurses. From all of my experiences, the nurses can’t wait to get the babies off their hands, unless it’s morning rounds or they want to do tests.
    Baila, I’m with you. With my third, I just wanted to sleep!

  13. Sorry, but the thing that bothers me most about this story isn’t the crying babies in the nursery. It’s the father’s complete lack of consideration for his wife’s roommates. I know that I would’ve been VERY upset and uncomfortable if it had happened to me. From my second birth and on, I didn’t let the nurses intimidate me, but I’m pretty sure that I wouldn’t have known what to do if someone else’s husband had been there in my room all night (even if he was behind a curtain)!

  14. Wow, maybe its really better out here in the ‘periphery’.
    I delivered in both Tsfat and Nahariya hospitals and both offered full rooming in for babies – there was no time they had to be inthe nursery, save the initial 2 hours after birth (and I nursed before that in my case).
    My first birth, i had a C-section and was only able to take my son into the room about 6 hours later but then i would have had the option for full rooming in except in my case, he was in the pgiya. Even so, at least one of the other 2 ladies in my room had chosen rooming in and i saw others as well…. and in fact, they didn’t want the babies in the nursery during the day (unless it was shortly after c-section or other reason the mother needed to do so). Tsfat did have, i recall, fairly comfy chairs for nursing in the rooms (one per bed).
    In Nahariya, I roomed in with my son by choice – and the nursery nurses were thrilled. (The nursery was overflowing at nights so they were trying to find other volunteers but most mothers weren’t interested). My roomates were not doing so – one had her baby in the pgiya and the 2nd was having some serious complications after birth). No comfy chairs alas but i was already adept at nursing in bed and headed home as soon as they’d let me out (and they let me sneak out a bit early since it was otherwise meaning to be stuck in for yom tov followed by shabbat).
    shoshana

  15. i’m not sure they have nurseries in Uk hospitals any more. certainly 2 out of the 3 hospitals in which i have given birth leave the baby with the mother the whole time and only offer help if she requests it. the other one, when i had my first child, took her away when i asked her to, but also brought her back when i asked. when i had twins (1 natural and 1 c-section) they left both babies with me and only came to help when i was pretty desperate! also, all very positive about breastfeeding. they wanted to give the first twin something to eat while i was having the second one and when i refused formula, offered sugar water, which in the end they also didn’t give because i wanted him to nurse first. no husbands in wards through the night though – which i think is a good thing!

  16. mother in israel says:

    Thanks to everyone for sharing their outlook and experience.
    Mrs. S., it depends on the hospital’s policy. I think some do allow husbands to stay overnight. Perhaps they should designate separate rooms for mothers whose husbands will be with them at night–maybe they do already?
    Abbi, I meant that I don’t accept the argument of “they turn out fine in the end” for excess crying or anything else.
    Sure babies cry sometimes, especially when there are other children to care for. But who would hire a babysitter that didn’t do more than give the baby a bottle, never picking her up? I don’t believe it’s acceptable for babies to be screaming all night with only the most minimal supervision, so that their mothers will not be “forced” to care for their own babies. As Mrs. Belogski says, the UK, which also has socialized medicine, no longer has nurseries.
    I don’t like being part a society that thinks it’s okay for newborns to be left to scream.
    Rooming in was new when I came to Israel, afrom 9am to 2pm. Until recently day-time rooming-in was the standard. Almost all of the Tel Aviv area hospitals now have night-time rooming in. There clearly isn’t adequate staff to care for the babies in the nursery. The hospital facilities are not really conducive to night-time rooming, but I still think mothers and babies will only benefit.
    By the way the health ministry put out guidelines for all the hospitals to have rooming in at night, about 4 years ago, but it was not enforced.

  17. I’m so interested reading this post… I spent the day yesterday in a Breastfeeding Symposium run by my hospital – including grand rounds and a workshop for anyone who wanted to come run by Dr. Bobbi Phillips of Boston Medical Center. She spoke about her hospitals transition to Baby Friendly. I think a lot of the problems mentioned in this post are widespread around the world, and that’s why the Baby Friendly Hospital Initiative has become so huge. While now it’s just a designation I imagine it wont be too long before it’s required.
    My hospital has many of the same problems mentioned here… but we’ve started taking (baby) steps at becoming baby friendly, so I’m hopeful.
    http://www.unicef.org/programme/breastfeeding/baby.htm#10

  18. I’m so interested reading this post… I spent the day yesterday in a Breastfeeding Symposium run by my hospital – including grand rounds and a workshop for anyone who wanted to come run by Dr. Bobbi Phillips of Boston Medical Center. She spoke about her hospitals transition to Baby Friendly. I think a lot of the problems mentioned in this post are widespread around the world, and that’s why the Baby Friendly Hospital Initiative has become so huge. While now it’s just a designation I imagine it wont be too long before it’s required.
    My hospital has many of the same problems mentioned here… but we’ve started taking (baby) steps at becoming baby friendly, so I’m hopeful.
    http://www.unicef.org/programme/breastfeeding/baby.htm#10

  19. sylvia_rachel says:

    Abbi — I don’t know if there are any hospitals in my city (Toronto, Canada) that still have a nursery on the postpartum ward, but rooming-in is certainly the most common policy here, and although probably there are some mothers who would prefer a nursery, full rooming-in is accepted as the norm.
    triLcat — I meant a midwife-assisted homebirth with hospital backup, of course! 🙂 But my first choice would be midwife-assisted birth in the hospital. I just wouldn’t want to go to a hospital where full rooming-in was not permitted.

  20. trilcat I think you need to differentiate between unassisted home birth (no birth attendant whatsoever, for loonies in my not so polite opinion), and most normal homebirths, which have a trained midwife or doctor in attendance. At my home birth, I had a midwife in attendance – she worked at Ein Karem Hadassah for 20 years – I think she knew what she was doing. We didn’t tell our downstairs neighbours we were doing a home birth – I let rip in the last half hour or so – our very sweet neighbour got worried and called an ambulance. It took them 4 minutes to arrive (well, to burst through the door while I was nekkid on the couch :). They looked at all the midwife’s equipment (for resuscitation, hemorrhages, etc) and were very impressed – they said she had everything she needed.

  21. oh and regarding Shaare tsedek – 2 hours seems an awfully long time for a mom to be away from a newborn baby if she is breastfeeding it – often times they just need to eat all the time.

  22. oh and sorry one last comment – any good midwife does follow up visits and checks the baby for everything it needs – thyroid, pku etc. I find a lot of people in Israel, including doctors, are very ignorant of home births — they think you’re just some hippy who doesn’t make sure your child has the proper medical care — something I find a little insulting really.

  23. mother in israel says:

    TC: But from 10PM-5AM, the babies are on their own except when the mothers are woken up to shlep over to the nursery. The baby may or may not want to eat then. Then, until 5, who knows what is happening? This is no improvement over the situation about 15 years ago.
    JC: Thank you for sharing that with us. Required by whom?
    SR: What about birth centers, separate from the hospital?
    Katherine–good to know about the four minutes! I think homebirths far from a hospital can be problematic. Then there is the midwife whose oxygen tank turned out to be empty, leading to very sad results.
    Sherah, thanks for visiting. Allowing a family member to stay over would especially help mothers after a c/section or with medical complications. Now, it’s almost impossible for these women to nurse at night.

  24. 1. With my first I had a homebirth, had a retained placenta and waited 40 minutes for the ambulance to take me to the hospital. I lost a lot of blood and had to have a d&c, but I survived and I am not sorry that I had a homebirth for all the other benefits it brought me, like freedom to labor how I pleased.
    2. We ended up at Caplan in Rehovot. My husband insisted on accompanying the baby everywhere and even brought her back to the recovery room, which is apparently forbidden. Many nurses commented on the fact that she was with us and shouldn’t have been, but we just ignored them. I was them moved to a room with 3 other woman. I did room in, but my husband didn’t stay with me because the room was so crowded. It was a rough night and it would have helped if he had been there. The second night we moved to a private room where he did stay the night with us. I think the key is to put your foot down and insist on having it your way. For instance, I have seen too many women give their baby’s formula when they mean to breastfeed because they let the nursing staff suggest that that will solve whatever issue they are having. In general, I think that the hospital is not a very friendly place for mothers who want a more natural approach to birth and breastfeeding.

  25. I agree with the comment about the malonit.
    The conditions in the ward in one of the hospitals with a malonit are terrible, as they put all their resources into the malonit.
    re the person who said to go to the Malonit if the woman wants her husband with her, you are not allowed there till after 24 hours.
    Also, if the baby is jaundiced or sick in anyway, they will not let the baby go up to the malonit.
    I personally found it very disturbing when the husband of the person next to me turned up at 6:00 in the morning.
    It is also true that hospitals do not have enough nurses to look after new born babies. People should be aware of this when they go to hospital to have a baby.

  26. mother in israel says:

    Thanks Keren, for your reply. After a cesarean section you have to wait longer.
    And I realized some time ago that I wrote milonit when I meant malonit. I’m off to change it.

  27. Lion of Zion says:

    i’ve been exposed to a lot of new ideas on this blog, but home births? i’ll never digest that.

  28. lion of zion – that’s exactly how I felt when I first read about them. I thought what kind of dirty hippy wants to give birth at home. After a LOT of reading – including studies in medical journals etc – I now hold similar views about hospital births 🙂 no not really, but they definitely are not for me, and I’m very happy I had the good health to be able to decide that way.

  29. Lion of Zion says:

    KATHERINE:
    my wife went unexpectedly from the delivery room to the operating room for an unexpected c-section. it wasn’t technically a pressing emergency (and she waited a while for an operating room to open up), but what if it were an emergency?
    what are the medical benefits of home delivery? (i’m not at all interested in any psycho-social benefits)

  30. MII: I basically “roomed-in” this time. I spent about half the night in the nursing room with my baby and had him next to me all day except during rounds.
    It’s not ideal, I admit, but it’s a lot better than leaving him alone until the nurses call me to feed a sleeping baby.
    Katherine: Your midwife may be well-equipped, but they can’t do an emergency c-section or an emergency D&C, either of which may be an absolute necessity and you may have less than 10 minutes to get to an operating room before real trouble begins.

  31. From my expirience with midwives, they know when things are going wrong and are very quick to call an ambulance if there is a need. As I said in my previous comment. I had a retained placenta in my homebirth and needed an emergency d&c. My midwife knew imediately that there was a problem and called an ambulance. The problem happened with the ambulance who took 40 minutes to get to us, although we were 5 minutes away. They thought that it wasn’t an emergency. Then when I actually did get to the hospital, they didn’t have non-latex gloves avaliable (I have a latex allergy) and ran all over the hospital looking for gloves wasting precious time. The doctor finally decided to do the d&c anyway with latex gloves because at that point my life was in danger. It wasn’t a 10 minute life or death situation, those are actually rare in birth situations. It was the 40 minutes wasted by the ambulance and the 30 minutes wasted at the hospital because they didn’t have proper equipment that put my life in danger. My midwife was extremely professional and took every right step to make sure that I was safe. Midwifes get mostly negative press and many people don’t know about the benefits of homebirths. It’s easy to say that homebirths are dangerous but in reality hospital births are just as dangerous if not more. Those figures don’t get published as much as botched homebirths though.

  32. mother in israel says:

    It’s hard to generalize about home births. The medical backup, the skill and experience of the midwife, and the proximity to a hospital are all important factors.

  33. Lion of Zion says:

    SHERAH:
    i think you are confusing skepticism about midwives with skepticism about home births. even your own personal story demonstrates why home births are dangerous. that it was the ambulance’s fault and not the midwife’s is completely irrelevant. (i’m glad that everything worked out well for you in the end)
    “in reality hospital births are just as dangerous if not more.”
    i doubt it. and before you cite any stats, please make sure that the sample study groups of each study arm are properly matched or distributed

  34. sylvia_rachel says:

    SR: What about birth centers, separate from the hospital?
    There’s only one of these in the city that I know of, and very far away from where we live (we don’t have a car, so close to home would be important). But, yes, that would definitely appeal to me!

  35. lion of zion, for the specific population of healthy normal woman with healthy normal pregnancies, they have found that home births actually have better outcomes for both baby and mother – i.e. better apgars, better weight gain after the birth, and other indicators of maternal and baby wellbeing. The reason is because with a home birth you avoid a lot of unnecessary interventions, which can lead to births taking longer than they should, or to babies being affected negatively. This could be from by too strong contractions caused by unnecessary inductions, or too early inductions, or less than good outcomes due to c sections – problems breathing etc, or due to breastfeeding problems because it takes a while for the painkillers to wear off in the baby, so they don’t manage to latch as well. mother’s also suffer fewer complications because of the reduced number of interventions.
    home births are certainly not risk free, but neither are hospital births – you are not 100% safe in either situation, and you can have a bad outcome in hospital. Not because anyone is at fault, but just because birth is risky – no-one can guarentee you a 100% perfect experience.
    Trilcat midwives are inherantly cautious, and will generally have you at the hospital long long before you only have a ten minute window. Even if it is ten minutes, it can take time to prepare an operating theatre, in which case it doesn’t matter if you’re being wheeled down the hall, or if you’re phoning ahead for them to prepare the theatre, and arriving 5 minutes later from home. A midwife can often also stabilise you until you get to hospital and can be treated.

  36. My birth would have been dangerous at the hospital as well. Plus there are a thousand other things that could have gone wrong there.

    Edited By Siteowner

  37. The problem about hospital births IN ISRAEL are the rules and regulations.
    In many cases, once you arrive you have to have a drip put in you that limits movement (the infusion may make your sugar levels too high too, I once read about this but cannot remember details precisely).
    Many hospitals make you be connected to a monitor all the time, which means you cannot be in a position that is best for giving birth.
    They often make you lie down.
    Making you not eat also causes problems.
    Some of this is changing now, and some hospitals in Israel are trying to let women have choices about things.
    Some hosptials have a natural childbirth unit attached to them which enable women to give birth with minimum of intervention. (but if all the rooms are full when you arrive then there is a problem).
    The most optimal thing would be to give birth in a birthing center which is near a hospital.
    I do not think that the situation in Israel is set up correctly to enable safe home births, I belive the situation in the US is more advanced.
    At any rate, again, I think the key is education. Know your rights, know what you can refuse to have.
    Shop around for hospitals and see what they offer, there are a lot of comparison tables on the internet about Israeli hospitals.
    Hospital staff do not like educated women who demand their rights (i.e I do not want an infusion, which they only put in “just in case”), but you should know enough to be able to make educated choices.

  38. Lion of Zion says:

    KEREN:
    “you have to have a drip put in you that limits movement”
    a drip in of itself does not limit movement.
    but iirc, where my wife gave birth (brooklyn), a drip is only standard if an epidural is administered. and once you have an epidural, then they certainly don’t want you walking around. so it’s not specifically because of the drip (note to readers: save me the mussar on epidurals)
    “Many hospitals make you be connected to a monitor all the time”
    why is this a bad thing?
    “which means you cannot be in a position that is best for giving birth. They often make you lie down.”
    as with an drip line, monitor lines don’t have to limit movement or positions.
    “Making you not eat also causes problems.”
    what problems?

  39. Lion of Zion says:

    SHERAH:
    “My birth would have been dangerous at the hospital as well.”
    yes, but even assuming all else is equal in terms of safety between home and hospital, home still adds an extra element of danger in terms of that long wait to get to the hospital.
    “Plus there are a thousand other things that could have gone wrong there.”
    no one says that a hospital is perfect. it’s a matter of relative dangers and where there is greater (and more rapid) control in emergency situations.
    MII:
    “Edited By Siteowner”
    bloggers should have separate blogs for all the censored material (like the deleted scenes and outakes on DVD)
    KATHERINE:
    “for the specific population of healthy normal woman with healthy normal pregnancies . . .”
    source?
    “unnecessary inductions, or too early inductions, or less than good outcomes due to c sections”
    these are not required in hospital pregnancies
    “it takes a while for the painkillers to wear off in the baby . . .”
    you don’t have to use painkillers in a hospital.
    and sometimes you want to have that option.
    “home births are certainly not risk free, but neither are hospital births . . .”
    again, we’re talking about relative dangers

  40. mother in israel says:

    Um, Trilcat, you did all the labor before you got to the hospital. So I don’t think you are a good sample.

  41. Shaarei Tzedek requires an IV line in your arm, but they only give you fluids if you want an epidural (in my case, I asked for the epidural, so I got the fluids, but I gave birth so quickly that they never took out the IV or got me the epidural.
    (it was 40 minutes from the time I got to the “front desk” at labor and delivery to when I had a baby on my chest)
    I had no monitoring, although policy is that they monitor for 10 min out of every hour. (Again, I was there less than an hour, so that may have made the difference.)
    Although I was lying flat on my back, I was able to get the baby out in three contractions from the time I felt the need to push, so I’m not sure all that stuff about ideal birthing positions is really true. YMMV

  42. lion of zion, I don’t have the time to go give you a bunch of sources. I wouldn’t say these things if they weren’t true – I’m not such an advocate for home birth that I need to spout things just to convince people. feel free to go to http://www.homebirth.org.uk/ and click on their research link, and browse the research there. If homebirth was so terribly dangerous I hardly think the UK’s NHS would be pushing it so much. Of course it is much cheaper, but they wouldn’t push something cheaper which was more dangerous, as they would just have to pay for any complications anyway.
    now I’m going to get obnoxious and ask if you’re a man (I think you are). Please go for 20 hours or longer without eating, all the while enduring some rather horrible pain, while being strapped to a bed/monitor and not allowed to move to deal with the pain. I think you would find it rather hard, to put it mildly. When women aren’t allowed to eat during labour they are deprived of the necessary energy to go through the process, and often maternal exhaustion is a cause of c sections, as is excessive unnecessary monitoring.
    I have to say, I don’t know why you’re both so completely dismissive of home births, and of the cited problems of hospitals. You could say, fine, it’s not for me, but other people have done a lot of research and concluded it is a better option for them. Look at the birth and maternal outcomes for Holland (where about a third of births are at home), and those of the US (which has a hugely interventionist culture in hospitals), and you should see that the US’s overly medical approach has not led to better outcomes.

  43. Katherine: I don’t have exact numbers, but a Dutch friend of mine asserts that it is almost all births are done at home in Holland, in any case much more than 1/3.

    My mother and all of her sisters were born at home as well [in the US, not in Holland].

    It is true that in most cases of normal, healthy mothers having normal, healthy babies a home birth is safe and in those cases where intervention is medically necessary there is time to get to a hospital.

  44. You know being in a hospital isn’t just about what YOU want or what’s “best” for the baby. Having two roommates means being respectful of them. So your husband stays…you keep your baby…..so between getting up to feed my baby (who is in the nursery) and listening ot your baby cry, I never get any sleep. ANd what if I have to go to the bathroom and i’m not perfectly modestly dressed at 2 AM when I have to bump into your husband as I pass through the small passageway…hti someone else’s bassinet and wake-up their baby in the process??? It’s a community environment which requires thinking about everyone’s needs.

    It’s really dispresctful…..and the nursing/formula issues aside…..i really don’t think—as ohter commentators have pointed out—-that a baby spending a few hours away from its mother in the first 48 hrs is damaging in the least (if you think so, you are welcome to evaluate my kids for problems) ….and if you want to argue that…then you are about to make anyone who has had surgeery, adopted etc….feel severly inferior. Let’s face it….if the hospital is adequately respecting your views to nurse…then even if you aren’t rooming in, you are not without your baby for than a few hours. I didn’t room in, (sharei tzedek) and I was never more than 3 hrs withoout baby…..and quite frankly…I needed that time to shower, eat, adn try to rest.

    ANd for all the people that said they needed their husbands to be there and help them with the rooming in…well that’s precisely the point…you are in a hospital–b/c you aren’t quite capable yet of being on your own—you have nurses who are willing to help…just not entirely on YOUR terms (i.e. in the nursery)–yet, you refuse their terms and then complain that it doesn’t work for you. I”m not talking about bullying disprectful nurses…I”m talking about hospital policies which are generally in place for a reason…whcih make it possible for a community of women and babies to function for a very short period of time.

    I’m not arguing against improvements….but everyone does things differently adn that’s why when you go home after 48 hrs when you don’t have to share space and resources wtih other women, you can handle things as you please. Until then……why is goingwith the community flow so difficult?

    • LG,
      “Why is going with the community flow so difficult?” Because mothers and babies deserve the highest standard of care, according to the WHO, which is full-time rooming in. The 48 hours are critical for a new mother and baby. Yes, there are practical issues that need to be addressed.
      In many countries with rooming in, only three mothers in a room would be considered a luxury. When the baby is in the nursery at night, moms get woken up by the staff , they wake up on their own and move around too. There is plenty of disturbance at night in a hospital aside from babies. Mothers get interrupted countless times during their hospital stay (think of all the sales visits and guests) . This is a much bigger concern than having the baby possibly disturb someone at night. What is the priority here?
      Babies are happiest and quietest with their mothers. There is plenty of research on the importance of babies being with their mothers. Here’s a start: http://whqlibdoc.who.int/publications/2004/9241591544_eng.pdf

      You could just as easily ask why it is so difficult for mothers to care for their babies at night after birth, because when they go home after 48 hours they can do whatever they like.

  45. LG- consideration would be nice, but I have had worse experiences with roommates not in rooming in and their older kids being around all day + spouse, older relatives, etc. than I have had with rooming in, where my roommate had a husband and parents there almost all the time, but they were quiet, considerate, and respectful of my privacy. Not doing rooming-in is not the cure for having or being a more considerate roommate. My last two births were half-rooming in (daytime) and full rooming-in and I and mybabies had much better experiences post-birth in terms of contentment, and the nursing taking off, than with the first three who were in nurseries.

  46. Marion Rosen says:

    I don’t even know where to start. Why home birth? Because half the stupidity at the hospital is in the policies. I think this is more true for first time moms who are less likely to know the differences between full explanations and partial ones. With my first I was certainly a perfect candidate for the “cascade of interventions”, and came *this* close to an unnecessary and unwanted c-section. The only reason I didn’t have one is ’cause I refused to sign the consent because I knew it was unnecessary. Each subsequent birth has been better because I know my body better and now have “based on my last birth” in my verbal arsenal. But yes, it’s STRESSFUL to argue with almost everyone around you when all you really want to do is birth your baby. As for rooming in vs. not…IMO it doesn’t matter. For me. More important is how you treat your roommate; it’s inconsiderate for your family to hang out from 7 a.m. until after 9 p.m. If you want to visit with them there are public visiting and dining areas. If you’re too weak to get up and go for a walk you’re probably too weak for over 14 hours straight of visitors. Next time I’m either doing it at home or going home AMA as soon as I’m mobile.

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