Hospital Research

Labor and Delivery in Israel

Unlike the United States (or at least in Massachusetts, where a doctor is found matching a hospital of your choice) here in Israel there's no direct affiliation (unless you see a private ob-gyn who performs delivery as well). 

Hospitals here vary tremendously in size, philosophy, and amenities. 

Having had two children born at Beth Israel Deaconess in Boston that was very industrial (no tubs, but private recovery room) and the third at Newton Wellesley Hospital in Newton, MA, there's a huge perk to have a tub to help ease contractions and a private room for recovery (why hospital recovery rooms are even shared now during a pandemic is mind-boggling). 

Zoom tours have made it particularly easy to see what the different hospitals offer. My two priorities while researching these Israel hospitals are as follows:

1) That my spouse can stay with me overnight (whether in a private room or shared) and

2) That there be a tub option, ideally, to labor in (not birth in).

Here's a rundown of what's been gathered:

St. Joseph -

A good friend had several deliveries there. The hospital offers inflatable pools to help ease labor. The hospital also allows full on water births, for aroma candles to be lit, soft music, and dimming the lights. For 700 shekel extra a night, a private room for recovery is possible (depending on availability -- though this sounds ideal and necessary). 

Possible considerations against St. Jospeh are that it is in East Jerusalem, which is Arab, although it's not too far from Ramat Eshkol. There's also no kosher food (buffet style, where the hospital staff makes the woman get up to get food herself), so plan ahead if you go on Shabbat (otherwise, in Israel, ordering food is possible). The hospital is also Christian, the head midwife a nun. Without knowing how to navigate and drive in the Arab areas (especially if labor starts in the middle of the night), and parking at the hospital apparently being limited might be a consideration. 

The small, intimate hospital may be a good choice for more Jerusalem and Ma'aleh Adumim area locals -- especially those really looking for a full-on natural birth. As far as compared to the other hospitals in the holy city, this one appears to provide the most hands-off, natural philosophy experience (wireless monitors too). 

Parking costs 15 shekel for the day and there are three restaurants where food can be ordered from. Up to 100 shekel. With a private room, ordering for yourself and a spouse, up to 200 shekel. Given that in the United States food also has to be ordered, more of less this is the same idea.  

Again, from what it sounds, delivering at this hospital is better when having a private room to recover in....

Hadassah Har Hatzofim and Ein Karem - 

Unfortunately, the coronavirus pandemic caused these hospitals to close their natural birthing rooms (and a funding issue at Ein Karem). Har Hatzofim recently had jacuzzi tubs installed, though unclear that they are currently available for use. 

Ein Karem's natural birthing room is also closed but offers some rooms with tubs. However, these tubs seem more like an afterthought, alongside a wall and very exposed. They also cannot be used during corona. The tubs also are not to be used to birth in. 

The hospital has a reputation for being very medicinal and having strict visitation hours for spouses (who can't stay overnight -- though if you happen to not share a room by chance, there's some flexibility -- overall the policy is no). To try to convince women otherwise for the perks/amenities, the first night at the hospital in recovery is shared (men are not allowed to stay overnight and have visiting hours) and the second night can be spent at the baby hotel. There are mixed reviews of this hotel stay. There are women who opt to go home or simply stay in regular recovery until released. 

There is a mall on the hospital grounds if after having a baby anyone feels up to it. Another interesting fact -- Hadassah Ein Karem's delivery rooms do not have windows. This is purposeful in the case of war, making it a safe place. Many women deliver at Hadassah Ein Karem and most say their experience was just "ok." There is also zero separation to partial rooming-in options with your baby after delivery. 

Tel Hashomer - 

This initially seemed like a good option, given the natural birthing center. Roughly the same distance as it would be from Beit Shemesh to Jerusalem, Tel Hashomer was ranked as one of the top 10 worldwide hospitals list. 

Joining a Zoom tour, we learned that the natural birthing center only has one room and has a nicely shaped tub. Being in this room also means no epidural -- if you want it, you're out. There is no way to reserve this room in advance.

The other rooms in the hospital do not offer tubs. 

Presumably, a husband can stay overnight. Said presumably because the midwife ignored my question, so not entirely sure and was turned off by the wide array of options that made the hospital labor and delivery seem scattered.

A friend in Petach Tikvah had three deliveries at Tel Hashomer, as well as a distant relative of ours. Both had great experiences. For a delivery outside of the Tel Aviv area (minimal traffic), it seems like a good option. 

Ichilov - 

Have had a hard time registering for a Zoom, though they nearly put us down for an in-person tour (fascinating, again, given corona). To my dismay, only one room offers natural birth with a tub. 

Not sure why having a tub to the medical system here means that the woman wants a birth inside the tub -- a tub can be great for laboring, relaxing, easing contractions and then go to the bed to go through the delivery process. 

The recovery at Ichilov hospital looks very thought out. The room boasts a private shower, bath with a towel warmer. By the patient's bed is another normal bed for the spouse to stay. 

The issue with Ichilov is the distance. It's all the way within Tel Aviv, which limits many Jerusalem goers.

More from the front desk:

At the hospital  there is an emergency room operated 24 hours 7 days a week. It can be approached by any pregnant woman from week 20.

There is also an outpatient screening designed to perform end-of-pregnancy and excess pregnancy screening starting at week 39 plus 1. There is no reference or form 17 required.

The Lis Maternity Room has 15 active delivery rooms. Each room has an adjustable bed, an armchair for the attendant and a care stand for the newborn. Each room has an en-suite toilet and shower. You can request a wireless monitor, and a physio ball.

There is also a natural birth center.

In the center there are 2 delivery rooms, the hole is designed with a homely atmosphere and a wide bath, a physio ball, an aromatic oil, pillow, a chair suitable for childbirth, a dangling rope and an adjustable bed. Monitor the fetus through a wireless monitor, alternately, in any position you choose.

After the birth you will be transferred to the ward for hospitalization in the way you choose: zero separation or partial of your choice.

We have 2 new wards with personal hospitalization rooms about 70 total.

In the ward you will receive in addition to your care and monitoring counseling for child care / nursing your baby.

Assuta Ashdod - 

This new hospital seems to strike somewhat of a balance. One room has a tub, not related per say to a natural birthing philosophy (which is good, since it seems most hospitals thus far, except for St. Joseph, view wanting a tub = no epidural and wanting a full on natural birth). This means that getting an epidural request in the room is possible at any time and doesn't require a sudden transfer. Other rooms do not offer this tub but have a shower and toilet. 

The hospital itself is small, presumably calm and has lush garden grounds where walking around before getting admitted could be possible. There is also a NICU, if Gd forbid necessary. 

While a private room recovery isn't a given, the husband can stay overnight. Private rooms from the start are only selected for women who undergo a cesarean section. 

Video tour link. 

Assaf Harofeh -- Baby Asaf -- 

https://www.shamirbaby.co.il/tours/
https://www.shamir.org/he/clinics/gynecology/pregnancylinks/maternityclub/baby/
https://my-dna.co.il/listing/shamir-asaf-harofe/
https://www.shamir.org/melonit/pricing/
https://www.shamir.org/melonit/faq/

Room number 1 has a jacuzzi...Now it apparently isn't a popular room, since they are concerned that women can have issues with infection being in the tub. Right now it is being used to store birthing balls.

There is an option to bring your own pool and the hospital also has some pools on hand that can be rented for 200 shekel. You must ask for this in advance.

There are three options after the baby is born -- a room that is zero separation from the baby (known an אפס הפרדה). A competent, alert spouse or escort must stay at all times. The midwife seemed to be very much pro this option. A bed is provided for the spouse. The room is shared with one other woman, but there is what they call a kir geves (a wall) separating both. The bathroom is in the room, but shared. That said, this is more ideal than the curtain separating between beds and hearing everything going on the other side. 

The baby hotel can be stayed at 12 hours after a safe, healthy delivery. 

The regular recovery room is shared with 3 other women. The baby goes to the nursery when desired. The husband is not allowed to stay overnight past 10 p.m.

Changing your mind at any point in time is possible. There are 13 rooms for אפס הפרדה.

Assaf Harofeh seems to have by far the best approach between aiming for a natural birth, choice of medical intervention and aftercare. The hospital offers many online zoom courses at various times and were very encouraging in regards to their flexible approach.

As far as getting to the hospital in time from Beit Shemesh, they have ample grounds to walk around, and rooms to shower in, till ready to be moved to a delivery room. 

הקריטריונים לידת מים:

 

• הריון בשבוע 37-42 עם עובר יחיד במצג ראש
• יולדת אשר ביצעה מעקב היריון רציף
• יולדת בריאה ללא מחלות רקע או מחלות פעילות
• יולדת אשר לא עברה ניתוחי רחם בעברה
• הערכת משקל העובר לא עולה על 400 גרם
• ניטורי עוברי תקין בקבלתה לחדר לידה

*כדי להבטיח בטיחות בקטריאלית ,היולדת נדרשת להביא עימה

 ועל אחריותה בריכה מתנפחת חדשה מדגם 58480 INTEX

בתום הלידה הבריכה תימסר חזרה .

אנו ממליצים ליולדת להביא מגבת גדולה , כפכפים וחלוק ממגבת .

כדי גם למלווה להביא בגדים להחלפה וציוד מתאים

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In summary, there are many hospitals in Israel that all have different protocols and amenities. In the United States there are plenty of hospitals that don't have tubs and women share rooms. The question is why the country hasn't figured out (when building new hospitals) to simply make sure every delivery room has a standard tub, toilet and that even if there are private recovery room pods, that it be private. The hospitals are in constant competition in Israel to get women to come to their wards. That's what makes researching the hospitals in advance necessary so that you run into less surprises.

After review, Assuta and Assaf Harofe seem to be the most balanced choices. In speaking with contacts at both hospitals, there's little traffic to get there from Beit Shemesh, where we reside. The spouse can also stay overnight, even with the room being shared by another patient (unlike the Hadassah hospitals, which also have strict visitation hours). A plus for Assaf Harofe is that there is a baby hotel. 

Hope that for any expectant mama in Israel, that this information proves helpful. And maybe any new hospitals that will be built, will be able to match all the different things women are looking for to have the best experience possible. 

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Best Prenatal gummy, Smarty Pants. For those in Israel, iHerb sells it.