Lost in Translation

James had his first home health nurse visit this morning. (I love, love, love that they come to your home to do this). I'm a little too tired to give you the nitty gritty details of his amazing growth but this story was worth sacrificing 15 precious minutes of sleep for:

I mentioned to the nurse that I was concerned about the content of James' poops (these are among the things that consume way to much of Michael's and my nighttime pillow talk since becoming parents).

Nurse: Poop. I don't know that word.
Me: You know. Bowel movement. Stool. Not pee, but the other thing.
Nurse: Oh, you mean making shit!

Yes. Precisely.

Speedy Baby James: A Birth Story

I have distinct memories during this pregnancy of three separate people telling me that the second birth is much faster than the first. They weren’t kidding.

They tell you labor is never how you expect it to be. With John I imagined a horribly long, unpredictable labor, and it ended up being a textbook labor that only lasted 12 hours. With James I was expecting the same experience except perhaps shorter. Ha. There was almost nothing about this labor that mirrored my first.

This birth can pretty much be summed up as “Zero to 140.” With zero being me sitting on my bed watching an episode of Veronica Mars while having mild contractions and 140 being the speed in kilometers per hour the cab was going down the Danish interstate about an hour later; me in the backseat trumpeting at the top of my voice, "I CANNOT HAVE A BABY IN A CAB! I CANNOT HAVE A BABY IN A CAB!"

The morning of my due date Michael and I got to sleep in until 9:30a because my sister Rachel had arrived two days before and took care of John when he got up at 6:00. Rachel and I made plans to stop by the mall before my midwife appointment at 1:00p. I started feeling a little crampy around 10:30 or 11:00 – around the time we started our half-mile walk to the mall.

We had lunch at Amager Centret and then walked a few blocks over to the midwife’s office. Camilla (my regular midwife) was on vacation so I saw her substitute. We had a brief talk about how Danes handle post-dates; at 10 days post-date you go to the hospital for a vaginal check and then at 14 days post-date they induce. Then she palpitated the baby who was still right-lying – and told me she could still move the head a bit which indicated it wasn’t quite engaged – typical of second pregnancies. She estimated James was about 3900 grams – or about 8 pounds 8 ounces.

We were planning to stop back by the mall on the way home so Rachel could go to H&M, but John had a diaper blowout so we headed home. I was kind of glad because I was feeling more crampy and uncomfortable. We got home at 2:00p and I was happy to see Michael was already back from the library where he had been working on some dissertation changes. John and Rachel both laid down for a nap. I was pretty sure at this point I was having true contractions that were going to amount to something later. I puttered around for a bit folding laundry, putting a few last things in my hospital bag and checking email. Michael was encouraging me to lie down but I told him I didn’t feel like it, so we settled on watching Veronica Mars while he insisted on timing my contractions. So we watched two episodes back-to-back; when I felt a contraction starting I would tap him on the leg, he’d start the stopwatch and then stop it when I tapped him again. We never paused the show though I started to ask him to put counter-pressure on my lower back at some point during the second episode.

Around 4:00p, John was up from his nap and, even though he wasn’t being disruptive, I really didn’t want to be around him in anticipation of the harder contractions to come. Michael and I moved into the bedroom and watched another episode while Rachel entertained John in the living room. Toward the end of the episode, I had to close my eyes and focus during contractions. Once the show ended close to 5:00p, Michael told me the contractions were floating around 45-60 seconds long and 5-6 minutes apart. Two weeks before Camilla told me to call in to the clinic when contractions were about 60 seconds long, 5 minutes apart and had been that way for about an hour. I decided to call in, though I thought it was a bit premature, in part because I felt like we needed to leave. The clinic picked up and told me to call the Hospital because they were so busy. This perturbed me, surprisingly not because I was so interested in doing the whole Danish birth clinic thing, but because I had this nagging feeling we really needed to leave.

I spoke with a hospital-side midwife who suggested that we wait another hour, though she made it clear we could come if we felt we should – just that we should call again before we left. I hung up the phone and immediately had two much stronger contractions much closer together that I moaned a bit through. I told Michael it was time to go and he immediately called a cab. I remember trying to give John a hug and kiss – he was playing with Rachel’s iPod and ran into the bedroom to show me. Then I called the midwife back and told her we were on our way.

I stepped into my Crocs and decided to use the bathroom before we left. While I was sitting there I felt like I needed to pass gas and then suddenly my water broke with a small pop and I realized that what I was really feeling was an urge to push just as I launched into a huge transitional contraction. Michael called out that the cab was there. I yelled at him to shut up. He came to the door and asked what was wrong. I expressed at the top of my voice that I was having a contraction, roared loudly and cried that I didn’t want John to see me like this. Michael later told me that he rolled his eyes at Rachel to let her know I was just freaking out and not to think anything was wrong.

I was completely torn by the strong urge to not move and the equally strong urge to get to the hospital as fast as we possibly could. But I hustled into the calf-length, black wool London Fog coat my friend Robyn gave me – the only coat that somewhat covered my baby belly – and charged down the stairs toward the cab. I called out for the cab driver and Michael to hurry and launched into another mind blowing contraction right as the wheels started to roll. It felt like I’d been picked up by a tornado.

The next 20 minutes are fragments of memories – holding myself off the seat with my arms and leaning toward my right side because it hurt too much to sit; waiting endlessly for the cab driver to turn left onto Amagerbrogade dodging bikes and two lanes of rush hour traffic; Michael patting my leg and telling me to relax; my expressing every thought that came into my head at the loudest possible volume; WE’RE NOT GOING TO MAKE IT; I CANNOT HAVE A BABY IN A CAB; I CANNOT HAVE A BABY IN A CAB; a car driving slowly and then stopping in the middle of the road blocking us; the cab driver honking insistently; between contractions my praying that God would make them move and get us to the hospital; the cab driver jumping out the car and telling the driver the situation before the punk finally drove off; blazing down the interstate; MY BODY IS PUSHING THE BABY OUT; I CAN FEEL THE BABY’S HEAD; I CAN’T STOP IT; Michael telling me that I’m doing a great job and we’re almost there; the contraction stops and I think "Yes, we will make it. Everything will be ok"; I drop my head back on Michael’s shoulder and see the most beautiful piece of Copenhagen sunset sky; I CAN FEEL THE BABY’S HEAD; OH GOD; I reach down and can feel the baby’s head crowning; I CAN FEEL THE BABY’S HEAD; IT’S RIGHT THERE; Michael calmly telling me that’s good because the stretching will keep me from tearing - we’re almost there - here’s the exit - you’re doing a great job; I struggle to follow my Bradley labor training – low pitched roars, allowing my body to do it’s work – yet doing so only seems to make the baby advance even more quickly down the birth canal; THE BABY IS COMING; I feel the ring of fire and pull off one of my pants legs and half of my underwear; I FEEL THE HEAD; the baby’s head is out and my palm is around it; the cab suddenly pulls up to the maternity wing of the hospital and the cab driver jumps out and runs in for assistance; THE BABY NEEDS TO BE BORN NOW; GET SOMEBODY; THE BABY NEEDS TO BE BORN NOW; Michael looks over and sees James’ head and shoulders, realizing for the first time what I was getting at when I said "The baby’s head is right there," then jumps out of the cab to run around to my side.

In those few seconds alone, I was suddenly gripped with the notion that I needed to push the baby out IMMEDIATELY and voluntarily pushed for the first time. James plopped out onto my coat just as Michael opened the door on the other side. Michael picked him up and handed James to me, and to my immense relief he immediately started to cry. I could see from the light in the cab that he was pink and healthy, and he quickly calmed.

A nurse entered the cab behind me and rubbed James with a towel and piled more towels on him to keep him warm. They brought a stretcher to my side of the cab and helped me maneuver around my coat, the part of my pants that were still on and the umbilical cord. We were rolled down the hall into a delivery room, with me holding a quiet James close as I watched the ceiling tiles pass above my head and sighed a huge sigh of relief. Relief that James was fine; that labor was over; that we were in the competent hands of medical professionals.

.

Ten days before James’ birth I read a fascinating blog post from a Brooklyn midwife about how the taxicab birth narrative can shape other women’s childbirth plans. Everyone seemingly has a friend of a friend who has given birth in a cab and it can fundamentally form their choice of homebirth or hospital birth, how they prepare for labor and delivery, etc. To be honest, I am somewhat compelled to tell this story in so much detail because I feel the need to justify the fact that I DID end up having a baby in a taxicab. I consider myself to be fairly ahead of the curve when it comes to understanding and being prepared for childbirth; from taking independent childbirth classes to reading extensively about birth to having experienced an unmedicated childbirth once before. Yet I was still surprised by the overwhelming force that is childbirth; unpredictable, powerful and unharnessed. And its ability to go from nothing to something in the blink of an eye.

But I also should say that as much as I was overwhelmed by the speed and uncontrollable force of James’ arrival, I sit here days later still unable to be "traumatized" by the experience. It was extremely uncomfortable bouncing along in the back of a cab during transition and my body’s involuntary second stage pushing, but being knowledgeable about the birth process helped considerably in my ability to control the one thing I could control about the whole experience – my reaction to it. It helped me focus when I was frantic. And I had some notion of what was normal and abnormal about delivery that gave me some peace of mind that James was ok even if he was exiting my body at 140 kilometers per hour.

I am a little sorry that I missed out on trying the labor tub. Not sorry enough to wish that I had been in labor much longer though.

My 38 Week Crash Danish Prenatal Class

My midwife double booked an appointment with me today so she could take some extra time to answer any questions I might have about birthing under the Danish system. I wasn't able to take any Danish prenatal classes since they are all in Danish, so this was quite thoughtful of her. Michael was there with me to listen in and ask any follow-up questions thought he primarily held a recuperating John during our visit.

I had already asked my most pressing questions related to childbirth in Denmark at my first appointment back in October. Besides delivering a healthy baby, my two main goals in any childbirth are to avoid a c-section and avoid undo trauma to nature's intended exit for the baby. Those goals ultimately led me to train for an unmedicated childbirth with my first, American hospital birth. (And believe me, you do have to "train" for labor just like you would train to run a marathon). So early on I had some specific questions answered about standard Danish hospital policies regarding such things as second stage labor and episiotomies.

So today's questions were more about just figuring out basic practices, a What To Expect When You're Delivering in Denmark. Here are a few highlights:

• They recommend you call the hospital or birth center (which ever place you plan to birth) when your contractions are about five minutes apart and lasting about 60 seconds. At that point they will ask questions about the progress of your labor, listen to you have a contraction over the phone and advise on how long you should likely wait before you come in.
• Labor tubs are available in the birth clinic and some midwives are willing to allow you to proceed with a water birth. I gathered that there is some internal controversy about water birthing and it is neither encouraged nor discouraged.
• The standard post-birth is for the parents and baby to be left alone to rest in the birth room for an hour or two following delivery of the placenta, any necessary stitching and confirmation the baby is fine. If the baby has trouble getting started post-birth, it appears that they go to some length to insure that baby and mother are not separated. If the baby requires transfer to the NICU, the father goes with the baby and the mother is encouraged to follow the baby as soon as possible.
• The minimum stay post-birth is six hours. If you opt to leave at that point, your midwife will do two home follow-up visits. If you opt to leave after 12 hours, your midwife will do one home follow-up visit. The normal stay is two nights though that can be extended if you are having trouble with breastfeeding.
• At 11:30a (during weekdays?) a physical therapist from the hospital holds a meeting with new moms demonstrating postpartum exercises.
• I was given a booklet outlining various pain relief options available including: the labor tub, massage, happy gas, acupuncture and, way at the back, an epidural.

There were a few other questions related to where the taxi should drop us off and what time the kitchen closes so we can be sure to order food if it looks like the baby won't make an appearance before then.

After today's visit, I feel like I'm ready to have a baby again.

Home Health Nurse

Remember my great home health nurse postcard? I did send it in just before Christmas and on Monday received a call from Helle (Hell-uh) scheduling a meeting this morning for a prenatal home health nurse visit at the apartment. Over tea, she explained how she would be doing what functionally are well-baby visits in the States – weight checks, general newborn assessments and breastfeeding support – no later than eight days after the baby is born.

Today’s visit was primarily a chance for us to meet her and ask any questions we had about newborn care, how the system works, etc. She let me know that the home health nurses also play an active role in setting up groups of other young moms in the area – an interesting role for a health care provider – playgroup coordinator.

Oh, and A Baby On the Way

It's been over a month now since I last referenced my pregnancy on the ol' blog. We are one month and counting from the estimated arrival of sweet baby James and I've had two midwife appointments over the last many weeks and a general practitioner appointment this morning that I've neglected to mention.

Both my midwife visits were fairly routine. One was on Thanksgiving Day and the other a few days before Christmas. The office does not have a nurse staff so the midwife does all procedures for the visit - blood pressure taking, fundal height measurement, palpitations for position and checking the fetal heart rate. In the four appointments I've had, I've been impressed by how they always start on time if not ahead of schedule, how technically detailed the midwife's questions are regarding how I've been feeling and despite being on a 20-minute per appointment schedule how I've never felt rushed through my visit. A student midwife has assisted at two of my appointments and I got to see her practice using a wooden Pinard Horn to hear the baby's heart beat. It reminded me of my uncle who would teach his nautical students to use the old school nautical navigation tools less their electrical navigational equipment ever gave out.

Certain things are interesting regarding the standard of care. Testing for gestational diabetes is not part of the standard prenatal screening process. At the midwife visits (but not the general practitioner visits) patients perform their own urine tests for protein and sugar and are instructed to relay abnormal information to their midwife if the color strip is off. My midwife has never asked me to step on a scale at any of my visits, though my GP today gave me the option if I wanted to be weighed. Because I'm Rh blood factor negative and Michael is Rh-positive, I had blood drawn today by the GP to check for antibodies; in the States I believe they do this test earlier. And testing for Group-B Strep is not standard. I asked my GP about it today and she said it was elective. I elected to be tested because it takes 10 seconds, is hardly invasive and if there is a problem I'd rather know about it up front and deal with it. And while in the States I'd be seeing my doctor every week from here on out, my next midwife appointment isn't until week 38 (I'm 35 weeks plus three days as of today) and I'm not sure when the next visit after that will be.

In general I'm feeling fine. This has been an even easier pregnancy than the first one. I'm starting to get the standard tiredness, swelling, heartburn, trouble sleeping and self absorption that tends to come this late in pregnancy. And every day I am increasingly taking on the shape of a water barrel. At least this time I know that post-birth I'll shrink back down to normal compared with the first time around when I had the serious suspicion that was just a comforting lie people tell huge pregnant women.

Deep greens and blues are the colors I choose

I remember being in Denmark last September mourning the fact that John had already stopped looking like a newborn and listening to the song "Sweet Baby James" and, rather than thinking of the sweet baby I was holding, I was thinking about my second sweet baby. We'd decided long ago to name our second son James.

We found out this morning that we’re expecting a boy. :)

I’ve seen my fair share of baby ultrasound pictures and have to say – without bias of course - that he is one of the cutest ultrasound babies I’ve ever seen. This doesn’t really do him justice.

Michael and John were both there with me for the ultrasound. It turned out to be a very good thing because our ultrasound technician was Belarusian and barely spoke any English. So she spoke to Michael in Danish and he translated for me.

Baby James is healthy as can be though his head is still measuring a little larger than normal. To me that just underscores the fact that I’m gestating the product of both Michael’s and my genetic material. Both the ultrasound tech and her supervisor were satisfied everything looked good so that should be our last ultrasound of this pregnancy.

I must say I’ve been very pleased so far with the Danish medical system. The attitude is "if you need it, we give it to you" and not "Well, your insurance will only pay for one ultrasound." Especially in my case I thought there was plenty of room for them to decide that the first ultrasound measurements were close enough within range that a follow up ultrasound was unnecessary. The biggest complaint I usually hear about socialized medical systems is they don’t provide adequate care in favor of saving the state money, but so far that hasn’t been my experience here.

Seriously. He’s so cute.

Photo Friday & Maternity Forms

Super Home Health Nurse!, originally uploaded by TilleyShots.

Isn’t this great? It’s a postcard I received at my first midwife visit. If you want to meet your home health nurse who will be providing all of your in-home well-baby visits before your baby is born, you fill out the back and mail it in. The graphic cracks me up every time.

This is one piece of a fairly significant amount of literature I received from my midwife yesterday. At my first OB visit in the States back when I was pregnant with John I received a little booklet on pregnancy that looked like it had been written in 1984. Lot’s of big, permed hair and so forth.

The Danish counterpart is another small booklet filled with colored pictures of ultrasounds, in utero pictures of babies at different stages of gestation, fitness instructions and side shots of the same very naked woman as her belly grew throughout her pregnancy. The Danes, shall we say, are a little less modest than Americans and a bit freer with their bodies. And that was certainly reflected in the rest of the pamphlets I was given.

A short review:

• A basic black and white piece about the different places you can choose to birth your baby described here.
• A short piece on homebirth.
• A pamphlet for the breastfeeding mother with a picture of a tiny newborn fast asleep on her mother’s very exposed nipple.
• A pamphlet on breastfeeding for fathers.
• A pamphlet on breastfeeding for grandparents.
• A pamphlet on breastfeeding for families.
• A full color pamphlet on chemicals you should avoid while pregnant, like paint fumes.
• A piece of paper with the hospital’s visiting hours for non-immediate family members. They are quite limited by American standards (4:00PM-5:00PM, and 7:00PM – 8:00PM) and the midwife explained that they strive to keep that time protected for the family as they learn to nurse and generally bond with their new baby.
• A full color pamphlet titled “When 2 Become 3” which tells you what to expect your sex life to be like during and after pregnancy. It had this great graphic of a egg and sperm uniting. It definitely made me realize that there is part of me that still hasn't advanced beyond a 13-year-old maturity level given the time I spent giggling over that piece.
• A full color pamphlet on exercise, diet and weight gain during pregnancy.

In addition to my four pamphlets on breastfeeding, I was also given a sheet to fill out that my postnatal hospital nurses will be looking for regarding my breastfeeding plans. It asks questions like, “Do you plan to breastfeed?,” “Does your spouse/boyfriend support your plans to breastfeed?,” “Did you have any problems nursing any previous children?” "What questions about breastfeeding do you hope to have answered?" etc. I had heard that the Danes promote breastfeeding quite a bit but am still surprised by how much thought and support seemingly go into it. I was trying to find some recent, comparative breastfeeding data between Denmark and the United States and the best I could find were two studies from 1993-1994 that found that after three months 60 percent of Danish mothers were still exclusively breastfeeding their children while only 27 percent of American mothers were doing the same [WHO]. I know breastfeeding is much more culturally accepted here - as in you won't get kicked out of the Danish version of Applebees for nursing your baby - but wow.

Earth Mother

This morning I had my first appointment with my Danish midwife, which in Danish literally translates into "Earth Mother." I was surprised when I received my letter to find my midwife appointment was in my neighborhood. I though for sure I'd have to take a 45 minute bus ride to Hvidovre Hospital where I'll be giving birth. I learned that while all the midwives work out of the hospital and do birth ward shift work, they also have one day a week where they come out to their satellite clinic to meet with patients for their prenatal work. Thus, all my midwife appointments from here on out will be on Thursdays at a small office about a half mile from my apartment. Very convenient and a nice walk.

I arrived early and had a cup of tea while I waited. (Incidentally I've noticed that just about everywhere you go in Denmark you'll find some type of warm drink waiting for you.) My midwife's name is Camilla, she was trained in Great Britain, and has been working as a midwife since 2003. Today she was working with a student midwife who took a more thorough medical history, took my blood pressure, measured my fundal height and listened to the baby's heart beat. She did a check of the old uterus and woke the baby up in the process. S/he began kicked in what I swear felt like annoyance. It was so naptime.

Since this was my first visit, midwife and student took some time to go over some of the basics of giving birth in Denmark. There are three different places you can give birth: the fødegang (more like a typical American hospital setting), the fødeklinik (more like an American birth clinic), or hjemmefødsel (at home). The hospital-like setting and the birth clinic are both in the same wing of the hospital and situated close to one another. In the hospital setting is where you birth if you want an epidural, or need a c-sections or other forms of treatment that may require closer physician supervision. It's not as private as the birth clinic version and you don't have access to a private room afterward unless you had a particularly traumatic birth.

In the birth clinic you are given a private birthing room [a 360 picture is here; scroll down a bit and look for "360"]. I am uncertain whether or not the hospital side patients have private birthing room. My midwife did mention that you can at least hear the other birthing women there and that can be a distracting. The birthing center room doesn't look that much different than my birthing room back in the States with two exceptions: the infant warming bed is right next to the birthing bed instead of far across the room and there is a big labor tub.

Since 2002 Danish mother's have had the option to birth at home. My midwife couldn't tell me how many Danes choose this option though the midwife student joked that all the students gave birth at home. (Perhaps because they didn't want to give birth at work?) The benefits here are you are able to have a baby in the comfort of your own home and the midwife who does all your prenatal visits attends your birth. With the hospital or the birthing center options, you are assigned whichever midwife is working in the pool the day you give birth and it is likely that it won't be the midwife you've gotten to know during your prenatal visits.

I honestly toyed with the homebirthing option a little just because I thought it would be really interesting to experience something that is functionally illegal in the United States (the mother cannot go to jail for having a baby at home, but her birth attendants can depending on how a particular state's laws are written). I have had one successful fairly uncomplicated birth which would make me a good candidate for homebirth. But I can't quite pull the trigger on this one. To be quite honest, I tend to be a pretty vocal laboring woman and I know it would really bother me psychologically knowing that I was probably disturbing our neighbors or scaring John. And we're renting our apartment from a private individual and I would constantly be on edge that something would stain the couch or mess up the wooden floors. I'm also really interested in experiencing the Danish version of managed childbirth in a setting that is more familiar to the American system. And there is always that big labor tub...

There are some other interesting things to mention too, but I'm going to save that for a special Friday post as this is already long enough.

Congratulations to my friend Rochelle who I just found out is expecting her fourth child!

Ultrasound I

I had my first Danish ultrasound this morning at the hospital where I'll be delivering Number Two. The hospital is set up like a airport terminal with obstetrics in Wing 4. I didn't have any trouble figuring out where to go which is abnormal for me since I'm basically illiterate. I arrived about 30 minutes before my appointment time because I was taking the bus and wanted to give myself extra time for getting lost. I only had to wait about 10 minutes before I was called back for the ultrasound. I must say the Danes are very prompt if not ahead of schedule when it comes to medical appointments.

My ultrasound tech was a sweet Danish lady around 50. She seemed a little uncertain of her English though I rarely had trouble understanding her. I always feel a little badly about putting people in these situations as my Danish vocabulary is limited to Yes, No, Good, Hello, Goodbye, Thank You, Thank You Very Much, You're Welcome and, as I said one day to a Danish man at a cemetery, I Am The Little Danish Language (I was going for I Know Very Little Danish).

I received the guided tour of my uterus and am happy to report that we have one very healthy baby with a "beautiful spine." Also, lucky me, a very large head. The ultrasound technician debriefed me on the ultrasound report after spending some time clarifying how my US OB/GYN came up with my current due date: February 7. She finally came back and said that the baby's femur was measuring right on target, the head larger and the body smaller. They believe the due date is probably right but want me to come back in two weeks for another ultrasound to see if the rest of the baby's body catches up with the head. I'm pretty sure it won't if this baby is anything like his brother.

Finally I can tell you that we are having... an International Baby of Mystery. Little 009 has his/her legs situated in such a way that the ultrasound tech couldn't even get near the baby's tail. I watched her spend about 5 minutes trying to go at it from every angle and she finally gave up. The good news out there for those of you that have money riding on this is we get another shot in two weeks and hopefully Space Monkey will be feeling a little less mysterious.

You've Got Mail

Perhaps it's just because I've not had the most prompt experiences when my Stateside doctors would tell me they were sending my paperwork anywhere that I was so surprised when I came back from a library/grocery excursion this morning to find a letter from my hospital where I'll be birthing Number Two. When G.P. said she'd be sending my paperwork over to the hospital, I thought it would be at least a week or two before I heard anything from the hospital - especially since next week is the annual "Potato Holiday" where Danes celebrate the days where they used to take a week to bring in the potato harvest.

The letter tells me that I'll be giving birth at Hvidovre Hospital and that I'll receive a letter shortly with my first appointment with my midwife. It also requests that I call and set up an appointment for an ultrasound. Apparently they typically do two ultrasounds here; the first around 11-14 weeks to measure the neck fold to diagnose Downs Syndrome and another around 20 weeks.

I've been told that Hvidovre is one of the best maternity hospitals in Denmark and I was hoping that I would be placed there. I found an interesting description of Hvidovre from a midwifery student who was observing at the hospital for a few weeks a couple of years ago. Hvidovre also has what looks to be a fairly informative website but, unfortunately for me, it's all in Danish.

Meet the G.P.

This morning I had my first appointment with our G.P. – General Practitioner. The office is about a half mile from our house and I had an appointment with a native English-speaking doctor in the practice. Promptly at my appointment time, the doctor, who I’ll call G.P. from here on out, came out to the waiting area and called my name. Back in her office, G.P. herself took my medical history and did my basic evaluation – blood pressure, etc.; something nurses usually do in the States. And her office was exactly that – a desk with a printer, computer, files and other trappings of someone’s office space – along side an exam table, medical equipment and toys for children of various ages.

I learned that during a pregnancy, the mother usually sees her G.P. three times. First at the beginning of the pregnancy, second around 20 weeks and finally at 35 weeks. After the first visit, the mother is assigned to a hospital and a midwife. I’m not sure how often they usually see the midwife at this point though I’ve heard that it doesn’t follow the States general standard of every four weeks with increased frequency toward the end of the pregnancy. I’ll be 23 weeks tomorrow (or around 5.5 months) so I’m getting into the system a little late.

After the first visit, the G.P. sends my paperwork to the closest maternity hospital in my area and, in a week or two, I should receive a letter with the name of my midwife and the time of my first appointment with him/her. In the letter, I’m also given instructions on where to go for an ultrasound. G.P. was suggesting that they do two ultrasounds in Denmark, the first at 11-12 weeks and the second at 19-20 weeks.

Because during a pregnancy you work with a number of different medical professionals you get what was described to me as a walking diary. I had a vision of a Hello Kitty diary complete with padlock but it is really just an envelope with two sheets of paper in it at this point. The vandrejournal has information on my blood workups, my height, weight and other stats, and space for other general comments. It’s basically my medical file and I’m responsible for taking it with me to appointments with G.P., the midwife and the ultrasound technician. I like being able to read my own chart.


After answering my many questions about the prenatal process and a few about how to handle John’s well-baby visits, I sat outside the nurse's station for a few minutes waiting for a nurse to draw a blood sample. G.P.’s comment on my Stateside blood workups was something like, “they test for a lot...” but they didn’t test for hepatitis which is commonly done here. So a nurse drew my blood sample then, while I was sitting in the same seat where she drew my blood, scheduled my appointment for my next visit with G.P. and John’s 15-month visit. It was interesting to me how so many of the nurse’s functions were performed by the doctor and then how many of the lab and receptionist functions were performed by the nurses. The system was very efficient though. I didn’t have to wait very long for anything and I was out of there in slightly over an hour.

One other noteworthy thing: none of the doctors wore white coats and none of the nurses were in scrubs. In fact I had a really hard time telling nurses, doctors and patients apart. They all wore the more casual side of business casual clothes. And seemingly everyone in Denmark is on a first name basis. My doctor was referred to by her first name by all the staff and she introduced herself to my by first name only. I had to look at the plaque on her door to finally discover her last name. At the end of the appointment, I finally asked G.P. if I should refer to her by her first name or Dr. M and she told me she went by her first name as did all her colleagues. I gather this is common among doctors, PhDs and other people who might normally go by a particular title back in the States. I’m not sure how much this has to do with a certain Danish cultural taboo against bragging that I’ve heard mentioned. It’s definitely very different from a few people I’ve met who become rather upset if you do not refer to them by their hard-earned title!

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.