Way back in July I posted about the early steps in the process of having a baby here in Italy (Florence/Tuscany). At some point in the near future I'll be talking with my friend Michelle for her Florence Birth Stories series, so I won't be sharing too much personal detail in this post. Instead, I'm here to talk about the options I had in choosing a hospital, the types of appointments I had in the "home stretch" and my very general thoughts about the birth process. Like I said, much more detail in my eventual chat with Michelle.
Choosing a Hospital
We are very lucky here in Florence that we have a handful of very good public hospitals (which are free to deliver at) to choose from, as well as one private hospital. Choosing can be tough. Why? Because you hear good and bad stories about each hospital. If there is one thing I learned, however, it's that one experience does not a reputation make. It's important research the hospitals for yourself -- take what you read and hear into consideration, but be sure to make your own decision.
For me, the decision was between Careggi's Centro Nascita Margherita and Ponte a Niccheri. Both hospitals take a very natural approach to birth (which was important to me) and had good reputations. I ended up choosing Ponte a Niccheri for a host of reasons I'm sure I'll chat about with Michelle. I was very pleased with my decision. You can really wait until the last minute to pick your hospital, but you need to do so by 40 weeks because you have a very important appointment at that mark.
Reality Check: The Epidural
There is one very very very very (yes, I said very four times) important thing that US expats in particular need to know: an epidural is NOT a given here. There is no guarantee unless you are at the private hospital. And I'm not talking about "oh, if you give them notice they will be ready." I mean, "NO, there is NO guarantee." My goal was a med-free birth so I was OK with this, but I know this can be a dealbreaker for some!
The Final Month
In the last post, I talked about how about once I month I visited the local health center for regular lab tests. In the last month of pregnancy, these tests increase to about every 12 days. You also get a few very particular tests done to help the doctors make decisions about your delivery. The strep test, in particular, is very important. It's one of the first tests that they asked me about at both my 40 week appointment and the day of my actual delivery. I went and saw my private OB-GYN twice in the last month, just to be safe.
The 40 Week Appointment
At my hospital these appointments are held 2x a week on specific days. You and a ton of other pregnant women show up and wait your turn for: (1) a review of all of your tests (2) a cardioecogrofia (ultrasound of the baby's heart) (3) internal exam. At my hospital they did them in rounds...test review, back to the waiting room, ultrasound, back to the waiting room, etc. It was a whole morning affair, so be prepared. It was the only time during my pregnancy where I had long waits for anything.
After this series of tests you are told when to return. For some women (like me) it was at 41 weeks, for others it was a few days later. They really personalize this to your exact situation, which was comforting because...
Reality Check: Induction is Rare Here
Unlike in the US where you can order up an induction at 40 weeks 1 minute (if not earlier), they are all about letting the baby hang out here. This takes serious mental preparation because, lets be honest, you are ready to have the dang baby at this point.
You are obviously induced if your 40 week appointment shows any issues that warrant one. Otherwise, get ready to potentially hang out until 42 weeks, when they typically will induce.
Again, not going into lots of detail because I will share it all with Michelle, but I went into real labor at 40 weeks 6 days. I spent about 8 hours laboring in the maternity/recovery wing before I was sent over to the sala parto (delivery wing) for the real deal. I experienced three shift changes during my long labor and really liked all of the midwives that tended to me. A friend delivered at a different hospital and had one midwife the entire time, so know that this can vary by hospital.
I could not have been more impressed with (1) the delivery suite...hello queen size bed that I got to lay in with Rob for that longggg labor (2) the midwives...fantastic people that have a very intense job and do it so well and (3) the recovery area...the care, comroderie and food were awesome. Livia and I were taken care of so very well.
I loved being pregnant and giving birth here in Florence. That's the long and short of it. Was it overwhelming at times? Yes. But, I was very impressed with the public medical system and the pregnancy/childbirth process. Honestly, if we decide to have another baby (or 5!) I would be very content to have them here. I'm sure people from Sweden, Denmark or France might think the Italian system is a little lacking, but I really could not have been more happy.
I am NEVER political on this blog, but for anyone that thinks universal healthcare is a sham that could never work in the U.S., I'm here to tell you it can work and Tuscany's model is fabulous.
Time to sound off...any fellow expats want to weigh in on my experience?