Tuesday, September 25, 2007

Adventures in Socialized Maternity Medicine

Just a moment ago I called to set up my first appointment with what amounts to my primary care physician here in Denmark. We received the Danish version of the social security number - a CPR number - the day after we arrived almost six weeks ago, and had to wait six weeks before we were covered under the national insurance plan. Being a Big Ol' HMO American this is my first experience with socialized medicine and I'm really curious to see how this will go. First to see just what the experience working within the general medical system is like, and second to compare the maternity care of Denmark with that of the U.S.

At this point I've been told that you have to be a bit more personally involved with your care than in the States. I gather that you carry around your own medical files and set up your own ultrasounds.

As far as maternity care goes, I've been told the Danes are very much in favor of natural childbirth - which makes financial sense when you think about how much an epidural and c-sections cost. In the States you have to carefully choose a doctor that is on board with your goals of non-intervention and write a birth plan for the nurses that says, "I have prepared for a non-medicated delivery and prefer that you do not offer pain relief to me" while in Denmark you have to go through a certain amount of hassle if you DO want drugs.

Someone asked before we left if I was nervous about giving birth in Denmark and when I thought about it I realized I felt more comfortable giving birth here than I would if I were back in the States. I was one of those granola people who decided to go the drug-free route with my delivery of John, and succeeded with the help of Michael and my doula friend Guinever [check out her blog on childbirth]. Here, I've been told, I'll have a whole body of medical staff who share the same childbirthing philosophy that I do and are much better equipped to help me achieve a safe birth with as little medical intervention as possible.

The phone call was like many other's I've made to set up doctors appointments in the States. Name, address, gestational age, CPR number, does October 10 work for me? So hopefully in two weeks I'll have something interesting to report.


Elizabeth said...

Just curious, Rebekah: do you know the c-section rate over there? I think it's around 30% here. Do they deliver breach babies naturally? My sister-in-law just had to have a c-section for that reason; no one would even consider anything else. I think I would be less worried about delivering in Denmark, too.

Rebekah said...

According to a practitioners blog I found citing a December 2006 article in the peer-review journal Birth, the 1998-2001 c-section rate in Denmark was 15 percent compared to 24.4 percent during the same period in the States.

I don't know how they handle breach births. I'm sure it would depend on the type of breach and if she'd given birth before. I gather that no doctors attempt to deliver a breach baby on an "untested pelvis" and that then only a few will attempt only if the baby is frank breech. My guess would be that a Danish doctor would just do the c-section and avoid the risk. But I'll try to remember to ask when I get to see a midwife.