Baby Abroad

It´s safe to say that most people would rank having a first child up there with one of the more intense and nerve-wracking transitions in life. There´s no end of things to worry about – will you be a good parent, will you be glad you had that kid at all, will the procedure itself be a nightmare and so on… add to these common concerns the extra consideration of having your first born in a foreign country and it can quickly add up to sheer terror! Will the medical facilities be as good as they are at home? Will I be able to understand what people are saying in the delivery room if things start to go wrong? Will they do things to my body that wouldn´t be done at home – and can I stop them if I don´t want it?

While some people do decide to return to their homeland for labor, it´s not always an option. For one thing, it gets harder and harder to get onto a plane when you´re approaching your due date. And sometimes labor comes sooner than expected. For others it´s not a good option financially – perhaps they´re covered through insurance here, but not at home. Sometimes not both partners can get the time needed off from work, and leaving one´s partner behind at such a crucial time is not worth it, even when there´s a whole family waiting back at home. Birth is an important time for couples – they made the baby together, and they need each others´ support when the time comes to bring it into the world.

So imagine a couple like us – young, inexperienced, excited about our first child but not always confident in Czech institutions´s way of doing things. I, the mother, don´t care for medical procedures in general (at least not where a natural process like birth is concerned and would rather have a water birth at home anyday.) The father is a man who wants the best possible care in any situation, wants to be informed of every detail, and wants to be in control. Could there be two people more apprehensive of getting sucked into a big communist-era hospital with old equipment, domineering nurses, long empty corridors, depressing color schemes and terrible food? At a time that should be the backdrop for a precious memories to last a lifetime?

Imagine our overwhelming relief when we found ourselves in a pre-natal class led by a charming and very knowledgeable English woman who not only was able to answer every single question we could come up with about birth itself, but was able to explain how things are done here, arming us with information and the realization that it wasn´t as bad as we had feared – that we had options, that our wishes in delivery would be respected, that the medical procedures themselves were actually – at times – more enlightened and progressive than is common in, for example, the US or the UK.

The classes are a conducted in a fun workshop environment. At times the group is broken into the male team and the female team, and each is asked to come up with a list of things that will be gained or lost when a new baby enters their lives. Other exercises are meant for couples, like trying out all the recommended positions for labor. She covers the basics of natural birth as well as the various anesthetic options available in Czech Republic, without putting any pressure on parents to choose one way or the other.

The workshops we attended were held in the large downstairs area of her family´s own home, which made it very comfortable. We watched birth videos, munched on snacks, sipped many a coffee and tea, and at the end of the workshop Stephanie gives each set of parents-to-be an infopack full of helpful information.

These infopacks are loaded with things first time parents maybe hadn´t considered, like a chart for writing down what you think your post-partum responsibilities should be and which should be your partner´s, which helps a lot to clear up that kind of potential misunderstanding and foster team spirit before things get too hectic later on. Also included is a sheet that can help you determine who will be in your support network, and another to establish priorities.

We learned about everything from episiotomies, epidurals, and forceps and in each case explored the risks associated with the procedure, the benefits, and what alternatives might be available. We got down and tried the optimal positions for labor and for birth. The men were shown what massage moves worked best. We looked at different ways of managing pain and coping with the stress of giving birth in an environment that is perhaps different from one what one expects.

Best of all, however, is the encouragement. Many of us first-time parents don´t know what to expect from childbirth, but we pretty much all assume that things will be worse in a Czech hospital – and this is based on some very real, not so positive experiences we´ve had in this country. Many of us encounter difficulties in situations along the way as we try to establish residency here, grow a business, purchase property or, lord help us, build our own homes – the list goes on and on and does not bode very well for a situation like child birth. We fear out-of-date equipment. We fear cold, clinical doctors who won´t take our concerns seriously, and it´s not just us foreigners who are subjected to that kind of bedside manner – it is pretty much the norm.

We all know there will be pain: but we´re also worried about language barriers, the lack of decision-making power of the individual, and the way bureaucratic power trippers unwaveringly enforce the latest policy with little regard for the “feelings” of the individual. And having a child is very much about feelings. We all know there is pain involved, but most of us still would hope for an emotionally fulfilling experience, not some factory farming nightmare scenario. When you´ve heard other couples share beautiful experiences of empowering childbirth you know that it´s possible. The worst fear of all – worse than the physical pain- is the fear that labor will be a dehumanizing process where you and your newborn are at the mercy of people who just don´t care about you and think they know best.

That´s where this informational workshop really helps – Stephanie has done lots of research in her field abroad and in the Czech Republic, and has personally inspected most of the major child birthing centers in Prague, and interviewed staff at the leading ones – the ones most frequented by foreigners – to see what their policies are. And she has mostly good things to say about the Czech labor wards. Such relief! Compared to other “western” countries, things are sometimes even more progressive here – something I hadn´t expected but was very happy to hear. By progressive I mean there is much more willingness to let a woman try a drug-free birth is she wants, doctors won´t let you “schedule” a non-necessary c-sections, and the rooms themselves are equipped with the latest “goodies” like physio-balls, showers, and multi-position birthing chairs including the squat-bar “monkey bar” support for childbirth in a squatting position. Routine episiotomies are not performed, only when absolutely necessary. This is wonderful news – it´s quicker to bounce back after a normal vaginal birth than it is to wait for stitches to heal. And knowing you won´t be laying on your back as was common until recently and still happens even in “advanced” countries, is such a relief. One of the best things you can do for yourself while in labor is to move around and get into a variety of positions, and that means right up to and including the actual delivery. The last things you want is to Be on your back with your legs in stirrups – this increases pain.

Another very progressive and exciting bit of news how much support the institutions have for breastfeeding, in fact, this is one of the big reasons for the extended hospital stay.  In the U.S., you´re in and you´re out – and they´re happy to induce labor and intervene along the way if it´ll help speed things up – but mostly they want you out of that hospital bed. Here, you relax and recover as your new baby gets medically supervised care and the caregivers literally teach you how to care for your little one. Breastfeeding, for instance, is not always something that comes naturally; as with all things, there is good and bad technique. Czech neo-natal workers are so concerned with teaching the proper way to breast feed that release from the hospital is actually dependent on how well the newborn is gaining weight.

Other uplifting news is that you do have options, so if you know what you want to get out of the experience and bring to the experience, it´s probably okay with everyone in the hospital, as long as you´ve discussed it with your doctor. What that boils down to is: be informed. And a class like this really makes a world of difference. We went from “We´re in trouble!” to “Bring it on!” in a just a few matter of days.

Another aspect of being a new parent that could potentially be a source of insecurity and stress is how to care for your newborn. Not everyone has had the benefit of seeing relatives and friends with their new babies, for some of us the first baby we really get to be close to is our own. How are we supposed to know what to do with this new, delicate creature entrusted to our care? But Stephanie allayed most of our fears in this department, too, with a practical course involving dolls that covered how to breast feed, how to hold, change a diaper, pros and cons of different kinds of diapers, how to bathe a baby and how often, plus a slew of little tricks like tucking down a boy baby´s parts before you wrap him up in a diaper so he doesn´t wet his shirt all the time. Things we never would have thought of.

For people who have been too busy during their pregnancy to read up on all the latest baby literature, it makes a world of difference to get – in a single sitting – a breakdown of the most important safety findings, such as safe sleep position (on the back), how to minimize the risk of crib death (SIDS), things to look for in a crib, and so on. It´s also interesting to learn about the early reflexes babies have and the many kinds of markings there might be on their skin – all things which might be worrisome to a new parent. Babies are often born blue, they have funny shaped heads and screwed up faces, their arms and legs do unexpected, spastic things. Apparently, this is all perfectly normal, but it sure helps to be aware of this going into a delivery situation.