Where was your daughter born?

So while initially, after giving birth to my daughter, I was asked very often ‘where did you give birth?’ that question has definitely waned in the last 15 months. It just becomes the sort of question doctors ask you at initial check ups, I guess.

And so, oddly, despite everything, I kinda forgot where my daughter was born.

And then today, I was in Hadassah for a pediatric ultrasound (for… daughter, not me). The receptionist asked a bunch of questions for the computer.

What’s her name?

Your name?

Father’s name?

(You kept your last name?)

Your phone numbers.

Address?

And where was she born?

I puzzled at the question. I must have looked ridiculous. Are you her mother, ma’am? You don’t even have the same last name and now you don’t know where she was born?

And yet. The answer… I dug in there… no, it wasn’t at Hadassah, like her brother. It was…

“.בבית”

And as I said it… I felt compelled to look down… brace for impact… supplement it with a “in Tzur Hadassah,” as if having Hadassah in the answer might make it more acceptable to this woman.

But actually, she was pleasantly encouraging. Good for you! That must have been great! Was it a positive experience? Did you have a midwife?

Huh. So it’s all coming back to me now. That’s where my daughter was born.

New Israeli homebirth restrictions drafted (where’s midwife trust?)

From Haaretz:

Israel ministry drafts new rules to restrict home births
A woman planning to give birth at home will have to obtain a letter from her family doctor testifying that she is both physically and mentally sound, under new regulations being drafted by the Health Ministry that many believe are aimed at curtailing home births.

The letter would have to be submitted to the midwife or doctor attending the birth before the home birth can take place.

The thing is, I could be ok with some of this if it wasn’t such a clear witch hunt against midwives. If midwives had more of the benefits they deserve, if homebirthers got similar benefits, if the balance was more even – do what helps make it a safe homebirth while offering it as a totally doable option – that’s something to get on board with.

This seems pretty aggressive though. Maybe it’s not. No midwife should do a birth if it’s more than 30 minutes from a hospital anyway. A midwife’s license should include more rights, even if it means making it harder to become one (meaning, higher quality midwives). Does a doctor need to be involved in this? There should be more trust and support for midwives instead of paralyzing them further.

Registering your newborn after home birth.

In Israel, when you give birth in the hospital, the hospital takes care of the bureaucratic paperwork fun-time, otherwise known as getting a teudat zehut number for your newborn. They submit the papers which go to Misrad Hapnim to get processed for a birth certificate and ID number.

But when you do a leidat bayit – home birth – unfortunately, it’s not that simple. Both parents and the newborn have to shlep to Misrad Hapnim to get processed. We wanted to get this out of the way before Pesach starts because you can’t register your baby at a kupat holim until you have an ID number.

In the Jerusalem area, only the Misrad Hapnim in the center of town can do this processing; Gilo does not (even though the phone help line claims it does). Apparently Beit Shemesh can too.

The good news is, you don’t have to wait on the long lines that everyone else does. There is a separate office for registering newborns, which you can go directly to.

So, as someone who shlepped out to get it done on day 5 of newborn life, here’s what you need to bring so you don’t have to come back:

  • A copy of your midwife’s license
  • The midwife’s תצהיר מיילדת form, which she has stamped by a lawyer
  • The midwife’s טופס תיעוד לידת בית
  • Both parents’ teudot zehut
  • Proof you were pregnant; a printed ma’akav herayon will do (though he didn’t look at it)
  • The write-up from your visiting pediatrician/family doctor (though he didn’t look at it)

I made copies of everything and handed over the copies (but brought the originals). I also brought the טופס אומדן גופני של הילוד but I don’t think you need to.

A catch: You have to provide a name for the child. We happened to already have decided on the name, so we gave it, even though we haven’t officially named her at the Torah yet. But I suppose you could give a temporary one and change it if need be…

All in all, the whole thing took under an hour, including parking in Mamilla and walking to and from the office.

The only creepy thing was the large stack of תעודות פטירה – death certificates – sitting in a pile on the office windowsill next to me.

Birthing at Shaarei Tzedek.

Shaarei Tzedek has quite a different reputation to Hadassah Ein Kerem; offhand I can say that it is more of a hospital’s hospital, procedural, stiff. It’s very religiously-oriented in staff and patients. Less concerned with natural birth, more concerned with working with Hashem to get the baby out and move on (as summed up by the tour guide-midwife). There is no rooming-in option but it’s a better hospital for complications and premature births that require NICU.

Here are the notes I took from the hospital tour we did a while back and also the quick version of the hospital’s specs.

  • You would open a tik in the main hallway of Floor 9. The kabala is at the end of the hall. If you’re concerned about privacy and modesty, the beds here are curtained and hidden from others.
  • You’ll go into a labor room when available/necessary (4-5 centimeters).
  • Heparin lock is given and you don’t need to be connected to an IV if you don’t need it. Fetal monitor is used on and off if it’s a normal labor.
  • Pain relief: There are three methods offered. Laughing gas (nitrous) is available in every room and can be used as much as you want at your own discretion. A low form of pain relief but won’t effect the baby. The second is demerol (narcotic), which is heavier and does carry through to the baby. You’re essentially drugged and out of control. Lastly there is the lovable, huggable epidural – the localized numbness from waist-down. You are fully aware and can still feel pressure.
  • If you are going for a natural birth, tell them at the kabala so they can try and match you with a midwife who ‘jives’ with that.
  • There are 9 labor rooms and two more coming soon.
  • On any given shift there are 7-9 midwives (including at the kabala). There is usually one midwife per two women. There are English-speaking midwives. Doctors are always on staff for more complex situations.
  • Guests must leave the room while epidurals are given or vacuums are used.
  •  You can birth in any position on the bed.
  • They will put the baby on mother right away for skin-to-skin contact. Mother and baby hang out for about an hour before baby goes off to nursery. They suggest breastfeeding right away, in the labor room.
  • During the day the baby can be with you most of the time if you choose, but there is no rooming-in option.
  • There are up to three women in a recovery room in the maternity ward.
  • You are discharged at 48 hours after a normal birth.

As I said, it definitely gave me the feeling they are more procedural and rigid but in a way that if you’re into that sort of hospital experience, it can be very positive. I liked the labor rooms there much better than the ones in Hadassah, though the restrictions regarding rooming-in and the general attitude did not impress me. The staff seemed friendly; but I’m not sure it’s in my taste.

To register at Shaareit Tzedek, click here.

Disclaimer: I posted my notes to share with others who are also looking for info about birthing in Jerusalem. I know some people think Shaarei Tzedek is the devil and others think it’s amazing. At this point, all I can do is hope that I’ll have a successful birth wherever I choose for it to be.

Birthing at Hadassah Ein Kerem.

I have heard the horror stories: laboring in a janitor’s closet, giving birth in the elevator, no epidural available, recovering in the hallway. I have heard the beautiful stories:  sweet, caring midwives, a tendancy towards leniency, rooming in available,  wonderful aftercare.

While I cannot say for sure what it’s like to birth at Hadassah Ein Kerem (or as I like to cynically refer to it, the cozy lil hospital nestled in the woods) I can tell you what I was told on the hospital tour we did a while back. Continue on for a more in-depth version. This is as much as I could read from my feverish note-taking.

  • Philosophy: Mom and baby should be together and can be for at least 1-2 hours after the birth.
  • There are mostly women doctors.
  • You will be placed on a monitor (in intervals) which allows for a two meter radius to move around.
  • Epidurals are available; gas is too but one unit is shared across the floor.
  • You can be creative with birthing positions if they are working – as long as you are on the bed.
  • They are not fans of episiotomy.
  • You may have skin-to-skin contact with baby right away but it’s probably something you need to ask for.
  • They will cut the umbilical cord right away unless you ask beforehand that they don’t.
  • They claim they can’t do anything without asking; everything must be an agreement with the parents.
  • About 1-2 hours after birth, baby is taken to nursery for the approximatley 4-hour warming and checks (Hep B and vitamin K, etc., which you can disagree to). You and/or partner can join baby at this point.
  • Hopefully you will get into a room afterwards; the wait for getting into a room could be 12-18 hours.
  • At around 10:30/11 pm, babies are returned to tenokiyah (I love that word; otherwise known as a nursery). You can request to breast feed and refuse formula for your baby. You would then go to the tenokiyah to feed unless you have opted for rooming in, which they do provide if available. Also, you’ll be woken whenever the baby cries so you can go feed.
  • There are checkups every morning done next to you.
  • Two women to a room and no partners sleeping in with you.
  • Visiting hours for Dads are 7 am to 10 pm.
  • They have on staff two breastfeeding consultants, five days a week for three hours a shift. All nurses are certified in breastfeeding counseling as well.
  • You are released in 48 hours if all is well. After 24 hours you can move to the Hadassah Baby Hotel. After 36 hours you can sign yourself out with doctor’s permission. C-sections are released after four days.
  • On Shabbat, everything is the same – staff, service, etc. The Dads can be sorted out for staying over Shabbat.
  • Moms can go into the tenokiyah and sit with the baby whenever they want, at any time of day or night.
  • They could not stress enough that this – and all other info relayed – is applied to a regular, healthy birth.

I did get the feeling that there is more of a promotion towards the natural here; the midwives giving the tour mentioned it and compared to other hospitals, it seems to be better at that.

Something that everyone – mothers, midwives, doctors – have said to me is that it all largely depends on luck. Time of day or night, which midwife is on shift, how busy it happens to be. Hence the disparity between amazing stories and the traumatic ones.

Disclaimer: I posted my notes to share with others who are also looking for info about birthing in Jerusalem. I know some people think Hadassah is the devil and others think it’s amazing. At this point, all I can do is hope that I’ll have a successful birth wherever I choose for it to be.

To register at Hadassah Ein Kerem, click here.

Homebirth in Israel.

UPDATE (April 2011): After this post was written, down the road, for my second child, we did a home birth in our apartment in Tzur Hadassah. I’ve got more info on the subject now from firsthand experience and am happy to share:

At this point, I’ve dipped my toes into the third trimester and thus far have read a lot of too much research, visited two Jerusalem hospitals and met with one home birth midwife.

Needless to say, the water’s cold.

I’m caught in this tiring cycle of not knowing whether I should do the home birth thing or not. I mean, I do know I should, but between all the reservations of the people around me and the looming status of ‘first pregnancy’, my birthing confidence is crushed.

I figure, maybe if I can hear from women who have done it/do it, as opposed to just midwives and people who are anti, I could feel better about making a confident decision. Because either way, I feel confidence is key and I need to find it in myself within the next 10-12 weeks.

So… if you’ve been there, done that, labored through it at home, feel free to chime in with a comment about the following (or you can email me if you’d rather):

  • Where did you do it? Where did you live? House, apartment?
  • Did you use a midwife and doula?
  • Was your husband/partner into it? What kind of a role did they play at home?
  • What did you do about pain relief?
  • Did you check into a hospital after?

I’d love to hear thoughts from women who have given birth in Jerusalem hospitals, too. I realize it’s a very realistic situation that I could end up choosing to be in a hospital or end up needing to be in a hospital. Talking to women who are satisfied with their experiences either way and are willing to share can really help me at this point. Unfortunately, there aren’t many Israeli birthing stories on the web, at least that I could find.

I guess the problem is right now I’m so open minded, I don’t have any direction.

    Birthing in Jerusalem hospitals.

    As my third trimester quickly approaches, I’ve been getting serious about touring and registering at hospitals, considering alternative birthing options and doing the doula dance.

    Yep, this is the ‘bureaucratic’ and technical aspect of being pregnant.

    In the last month we’ve done hospital tours in two popular Jerusalem hospitals: Hadassah Ein Karem and Shaarei Tzedek. Truth is, all Jerusalem hospitals are popular; all four (including Hadassah Mount Scopus and Bikur Holim) are busy and at times over-populated. It’s just how it seems to be in Jerusalem, a crowded and baby-happy city.

    Unfortunately, there are no longer any proper birthing centers in the immediate Jerusalem area, as Misgav Ledach shut down years ago. If you don’t want to birth in a hospital and you don’t want to travel, it seems your options are limited to home birth.

    Here are my impressions of Hadassah Ein Kerem and Shaarei Tzedek after getting the inside view; I keep in mind that both tours were done on relatively quiet days.