This week I had the privilege of visiting St. Joseph's Maternity Ward with an expecting client of mine. The mother, who is going for a VBAC for this birth, is just one of many moms I've met who feel they are stuck between a rock and a hard place when it comes to birthing big babies, and birth after cesarean, in Israel. Most Jerusalem hospitals have a policy of not allowing a "trial of labor" if the baby is over 4 kilogram in some hospitals, 4.5 in others. While this policy completely rubs me the wrong way, not only is it infuriating, but so impractical. Big babies are born. So, so often. The number of friends I have had who birth big babies is countless, and I don't know how we can put a cut off on the growth of a human, when everything else is healthy and normal.
The hospital is located in East Jerusalem and on my short 5 minute walk from the train there, I had two separate little old Jewish Men stop me, and ask me if I knew where I was going. While I know this is a sensitive topic, I believe it's important to recognize that with the tension in our country, sometimes lines aren't clear, and it's hard to know what's acceptable. Everyone I passed on the street though, Muslim or Jewish, was friendly, and went about their regularly scheduled activities, not seeming to pay any attention to me walking through. The best part of that short walk was definitely the bus that drove by me, displaying the Arabic Name for French Hill, and then when flashing over to English, reading VERY clearly: "French Hell." I got a great laugh out of this, and wondered if it was someone's prank, or just some terrible spell check.
Upon approaching the hospital itself, it looked a bit run down from the outside, covered in chairs, with people smoking, and sitting for visits, and comes off relatively small; but as you walk inside, with the maternity ward straight ahead, it is beautifully renovated, and spacious. We were greeted by an extremely friendly, if not a bit confused, secretary, who immediately took us into the Labor rooms to meet the Head Midwife on staff. She was an extremely kind and patient woman, who let us look around the room, and talked to us about all of their policies. She mentioned to us the same line that I had heard Sister Valentina say, another midwife, "While the bed is in the center of the room, we don't want you to be confused, we don't see it as the center of your birth." She went on to tell us that the midwives have delivered babies from mothers in all different positions, even in the shower! They have a birthing pool that can be used upon request, for low risk labors (so not VBACs, unfortunately,) and they have portable, waterproof monitors! This is one of the hugest advantages in my opinion, monitors that don't cause a greater risk to the baby, and allow for great movement. Movement is key in all births, but especially for VBACs of potentially large babies, where monitors are kept on almost constantly, nothing will help them move down more than being on your feet, or constantly changing positions. These monitors even allow the mother in heavy labor to relocate to the shower (which by the way, had a rainfall head on it that basically looked like heaven.)
The room itself was pristine and clean, and had beach decals on the walls to help mothers get themselves into that relaxing mode. One of the rooms had fairy lights, to help create a calming atmosphere. While the rooms were fabulous and spacious, the staff kind and caring, I have to say that the most important and magical part about the place was that there are only about 5 delivery rooms and there are 4 midwives on staff at all times.
Now you may think that this makes them unqualified, since they have such "little experience", and such little space, but what I hear is personal attention! Unlike in the bigger hospitals, where they have 30,000 births a year, (read: 2500 births a month!) St. Josephs admitted they only have about 200-250. And they aren't lacking any important equipment, or not following safety measures, they just have more staff available to each laboring mother. They have experience, they have ability, and they have TIME, which is something not many other hospitals have. When we're dealing with the laboring mother, "experience" can be a dangerous word. Experience is often confused for "more births," when in fact, a hospital with such a high quantity of births can quickly ruin the quality of those births if they aren't careful. And it's not because they want to, often it's because they are understaffed, or following their own self inflicted safety measures, which are impossible to keep up with at such a volume of births. St. Joseph's has the advantage of being small, and having a small-town feel, so they are able to treat every birth as a story unto itself, without worrying about the 15 others, happening next door.
If that sounds like an excuse to you, let's look at numbers. St. Joseph has a 8-9% primary C-Section rate, the SMALLEST rate in the country, and it's not because they have less births, people, lets be honest, that's not how statistics work. For VBACS, they are ranking in at WHOPPING 91% success rate, as touted by Dr. Yazan Al Rafai, who showed us their charts. (He's had 9 babies named after him, because the women loved him so much!) They have up-to-date state of the art operating rooms, but they also have doctors and midwives who know how to let birth happen the way it's supposed to. They have an anesthesiologist on staff 24 hours of the day, and emergency nurse and doctor teams if things aren't going the way they planned.
Postpartum rooms are just two women a room, and an option for a payed private room, for seven hundred shekel a night. (I'm still looking into seeing if it's possible to get money back from the Kuppot for that private room, though I haven't figured it out yet.) In the private rooms, husbands are allowed to stay the night, and in the other rooms, visiting hours are from 8am to 12pm, and then 4pm-8pm, 9pm for husbands. They have a state of the art NICU, and a beautiful, updated Nursery as well, (filled with delicious babies!) but highly encourage rooming in whenever the mother feels she is up to it. Again, the nurses and midwives in the postnatal ward were beyond kind. Here is where we ran into Sister Valentina, one of the head midwives, who quickly recognized my client, from having spoken to her on Facebook. She ran over and gave us both a big hug, and welcomed us to her hospital. You could tell the midwives and nurses spoke lovingly to each other, as well as us, and seemed to have a great atmosphere in the ward. Each of the staff on the postpartum ward, (just one floor up from delivery,) was a Midwife, and each of them trained extensively in breastfeeding support, and adjustment to life after birth.
After the tour, they offered my client a check up with the doctor. As opposed to waiting for hours, like in any other general hospital. We sat down for maybe five minutes, before she was called in to the doctor. Doctor Yazan took time to speak to my client, making both her and her husband laugh with appropriate jokes, and was extremely sensitive to all her needs. He explained to us a bit about his drive to have a low c-section rate, and encouraged her that she was a good candidate. He made us all feel at ease, and helped answer any questions the Mother had, regarding her upcoming birth. Overall, he was completely non-alarmist, and definitely knew what he was talking about. He has been working on staff at the hospital for the 3 years of its existence. The staff felt like a family, in that they all seemed to get along great, and work very well together. Dr. Yazan himself performed an ultrasound, pointing out the various healthy aspects of the baby, and the perfectly functioning placenta, again, showing encouragement, and belief in my client and her spouse. They left feeling so positive, and excited about their birth. As a Doula, no one blinked an eye when I came in. They were highly encouraging of me being there, of involving me, all the midwives and doctors were excited to have another supportive staff member there. When I walked into the doctors office with my client and her husband, the doctor personally ran out to grab me a third chair, so I could be involved. How amazing!
Overall we had a very positive visit of the hospital, and all of us left feeling on cloud nine, knowing there was another option. My only question is, how has this secret been kept from the women of Jerusalem so long?! Every expecting mother needs to know about this hospital, if they are looking for a place that supports a positive, natural birth experience! I hope women will read this article and consider birth there. It is completely covered by all of the Health Insurance companies, like any other hospital. I strongly encourage all those considering elsewhere to go take a look. This hospital really begs the question, "Why can't some of these small things be implemented in other hospitals?" Why can't the use of ONLY wireless fetal monitors be encouraged, and why can't we expect more from our hospitals, than they give us. The answer is we can. The more we ask, the more they will know it's a necessity, and the better we can make birth everywhere.
Have a meaningful, and easy birth,
Your BirthBuddy Doula
Are you nervous, overwhelmed or anxious about your upcoming birth? Do you wish you could feel empowered, educated and supported instead, so you could focus on being the best mom or dad possible? Call or Email BirthBuddy Doula now, to schedule your complimentary 20 minute "Next Steps to Your Empowered Birth" phone call! Reach out by email here, or call 054-6148675.