Impact Insights

Labor & Delivery in a Private, European Hospital

Mary Mikes

My daughter lives in Europe where healthcare is provided by the government to all individuals at no cost. Healthcare is considered “free” and a right for everyone; just what proponents for the Affordable Care Act are hoping to have here in the USA. However, her first child’s delivery in the public hospital five years ago did not live up to her expectations for a good birthing experience. So, as she and her husband planned an addition to their family, she decided that she would like to utilize a private doctor and hospital.

My daughter purchased an individual insurance policy with a monthly premium of €38 (~$45) about a year ago.  This premium included maternity and newborn care with a private doctor and private hospital. There are no copays, at least none that have been applied to date.

She was able to see her doctor at regular intervals, was prescribed prenatal vitamins and a hormone to address a deficiency. During the pregnancy, she was monitored monthly. She gained an appropriate amount of weight and had various blood tests and sonograms to ensure all was progressing normally. She maintained a healthy diet consuming limited sugar and no alcohol or chocolate for the entire pregnancy.

There were some differences of note from the USA standard maternal/childbirth/newborn care:

  • Admission through the Emergency Department – very quick registration
    • In the USA, Maternal Child units promote a direct admit to Labor & Delivery –
      •    No stop in the Emergency Department
      •    Experienced Labor and Delivery personnel are first to see the patient
      •    Results in quicker assessment and care of the mom and baby
    • Very helpful with precipitate deliveries (childbirth that occurs with such speed or in such a situation that the usual preparations cannot be made) – one happened that night!
  • Staff Ratios
    • Only two staff in Labor & Delivery: Mid-wife, Registered Nurse
      •    Precipitate Delivery arrived at the time my daughter was “ready” to deliver
      •    Delay for my daughter’s delivery of 30+ minutes
      •    Potential impact to baby, heart rate depressions during monitoring
      •    Baby was very blue when delivered with “nuchal cord x 1” (loop of umbilical cord around the fetal neck, posing risk of intrauterine hypoxia, fetal distress, or death)
    • No on site Anesthesiologist or Obstetrician – arrived within 15 minutes of call
      •    No IV (even though admitted) until epidural (pain block regularly delivered to laboring moms) was ordered
      •    No Pain Medication until epidural was ordered
    • No employee transport for patient from
      •    Emergency Department to Labor & Delivery Triage
      •    Labor & Delivery Triage to Private Room
      •    Private Room back to Labor & Delivery
  • Private Room/Bedside Nursing Care
    • No nursing assessments prior to delivery
    • Instructed to “call on the phone when the pain gets unbearable”
    • Five Medication Rights not followed
      •    No Identification of Patient Name or Date of Birth
      •    No allergy confirmation
      •    Meds left on the bedside table
  • Newborn Security/Surveillance
    • No nurse station visible on the Post-Partum floor
      •    Located behind a closed door
      •    Signage “Call by phone from your room if assistance is needed”
    • Outpatient clinic co-located on the same floor as laboring and post-partum patients
    • No security in place for newborn access
    • No ID checks when transporting baby (to ensure right baby is with right mom)

My daughter considered the private hospital an improved experience from her first child’s delivery in 2010 at the state’s public hospital since she was able to have considerably more privacy. The outcome was great.

While my daughter’s experience was good, it was a little scary at times for me. Of course that could just be my own maternal instincts kicking in with nursing knowledge. In any case, I am not certain most healthcare consumers in the USA are ready for “real” socialized medicine.

 

Meet Robert Ballester Mikes, a healthy 3.93 Kg baby boy!

Baby Mikes

Leave a Reply

Your email address will not be published. Required fields are marked *

*