Pregnancy in Israel

 

A little secret...about a week before my Ima's yortzeit, I took a couple around to see Beit Shemesh and really didn't feel well. I couldn't tell if it was the heat or something else. A friend back in the states encouraged me to take a pregnancy test. The plus sign immediately appeared. 

Pregnant in Israel. The road to our sabra. 

First Trimester

After having four pregnancies in the United States (one blighted ovum early miscarriage), I really wasn't sure what to anticipate in Israel. Except for the horror stories we'd hear in the United States of Israeli friends laboring in the Emergency Room or in the hallway. Sorry to say, but with my second pregnancy, I almost had a baby in the lobby. I was given a room at 8pm and our daughter was out at 8:30pm. With our third child, I thought I would deliver in the car. That labor was 4 and a half hours and he was born in the hospital I was registered at. 

This post will not focus on generalizations, because that's really unfair when crazy stories happen everywhere. I'll be as objective as possible and be honest with what I'm experiencing since it will account for the pros and cons. 

Since I'm 35 years old, the category of high risk is applicable now according to Israel standards. In the United States, it is 36 years old (if I recall correctly and my Google result this morning to check that was accurate). What this means is that a 35-year-old in Israel gets offered an amnio (you can reject it), 5 routine ultrasounds (in the United States there were three), and various other tests / advanced screenings. 

Unlike a private doctor, the Meuchedet clinic is packed with women of all ages, anticipating their new bundles of joy. While it somewhat feels like a factory (we do live now in Beit Shemesh, where the birth rate is high), the clinic is very clean, timely, no one has walked into any of my examinations or time with the doctor. It's a completely different experience from being interrupted while seeing my PCP in Israel or Pediatrician. 

The OB I am seeing is male and told me my last hospital was a hotel compared to what I'll find here. And that the midwives deliver, unless a doctor needs to get involved. In the United States the nurses do all the support work the doctor only shows up at the end, very close to when the baby crowns. If the doctor was in the room the whole time and in Israel, not, then it would be a very jarring difference. But, Gd willing I should get to that point, I'll be able to say one way or the other. 

Observations:

1) The ultrasound tech is allowed to tell you everything that they see (week scan 6 and 8 -- so far). This is great. In the United States, I was always nervous during the scans and they wouldn't say anything. Just a bunch of pictures, while sitting very quietly, and then the doctor would come in and report the findings. When I had my miscarriage, it was awful because I knew the sac was empty (with no embryo) and kept telling the technician, "it's empty! it's empty!" and she just kept saying "well no, there's the sac and the yolk." It was the most ridiculous, painful experience. 

The scans are also all done in the clinic. In the United States, at least, in Boston, I had to get the scans at a private scan clinic (not within the doctor's office) and for my most recent pregnancy, at the hospital. It was always nerve-wracking and a delay in communication. 

2) In the United States the fetal pole or heart rate is measured in the first scans. It is believed that the heart rate, be it strong (or weak) can indicate if the fetus is ok. I remember looking up on Google often what a heart rate of X would mean and if I was at risk to miscarry. In Israel,  they check to see that the heart flickers. That's it. 

3) In Israel you don't choose your doctor based on hospital affiliation. If you can get to any hospital, that's where you can deliver. And if you can't get to a hospital, then Hatzala delivers you (and they take great pride in it!). However, that means that I can go to Tel Aviv, Haifa, Be'er Sheva, if I really wanted. 

4) There are hospitals that have private recovery rooms and the spouse can stay overnight (some for free, some at an added charge). Two hospitals in Tel Aviv (currently) offer this (Ichilov, Assuta and there's also Tel Hashomer). There are women who enjoy staying at the baby hotel in Jerusalem and not everyone has the luxury to be a few nights from their kids. Being with my spouse every time is all I know. With our first, he was born on Sukkot. With our daughter, she was born Friday night, and our third child also Friday night a week before Pessach. Also, sharing a bathroom during recovery does not appeal to me (ew). 

5) The weight scale has a place to run through your magnetic insurance card and will show your weight in kilo. But but, if you tell the nurse you need to know it in pounds, what do you know, they have a different scale just as you've seen in the United States that works just fine. It just doesn't link to your file. 

6) As of yet, at 8 weeks (writing this draft post on November 17, 2020), the doctor I see sits behind his desk and hasn't touched me. Not once. I'll update if this changes or they do any measuring tape checks. I've been used to doctors in the past touching my stomach, offering pap smears. This is very interesting and will observe if this changes.

7) I needed an ultrasound mid December and contacted the Doctor via the health app, a text messaging like service (or email). While I am sure there are women that can contact their Doctors directly, this has never been the case for me, with any Doctor. It's a nice feature. He immediately put a hafnaya in the system (referral request) and I came in when I was ready. Ready Gd, bih everything is ok. 

8) Twelve-week scan is done by an expert, within the clinic. Mine was funny. He kept picking up his cell phone calls from his 90 year old mother. I didn't mind, but culturally, that's a big difference. A scan is done and results signed by the doctor's stamp. My mix up was that I didn't do the blood test and found out 5 days later that I needed to do it (this is different from NIPT, which is a private genetic test). After finding where the miscommunication was (my bad, not understanding the system here), I went to a more ultra-orthodox demographic clinic where I didn't realize that the male phlebotomist was subtly trying to tell me reasons not to do it. And here I thought we were having a conversation about the differences of our community groups. I ended up doing the blood test since I was already there, and following Doctors orders. The doctor was not pleased to find out that what seemed like an innocent conversation, seeped doubt. 

9) Same day as the blood test, I had a follow-up and the Doctor used an ultrasound machine adjacent to his office to check for the heartbeat. This makes scan number 5. It's kind of nice to be able to see the baby and literally watch it grow from week 7, 8, 11 to 12. Something with any previous pregnancy I didn't have as much access to. 

The downside, my Interstitial bladder cystitis is acting up. Will have to track that. 

10) Secured a doula. The country gives what's called a "sal" (literally meaning basket) that reimburses the 3000 shekel fee from 1800-2000 shekel. We got a doula since there's a medical knowledge gap between what they do in the United States and Israel. Plus, the doula knows of several hospitals, what I'm looking for and will do her best to make sure I make it in time! (and if not, she knows how to deliver babies).

I get a little break now till January for 2nd Trimester screenings. Hope to continue sharing good news.

PS. I miss fresh raspberries. My go-to for pregnancy cravings. This has been such a struggle for me. That and UTZ BBQ rippled potato chips. List goes on for the many comfort foods I just can't find a replacement for here (and I have tried -- with Kiwi, blueberries, and imported BBQ corn chips).