Tuesday, August 31, 2010

having a baby, New Zealand style

  feet at 10 weeks (we're a little over 9 weeks)

Today was my first visit to the midwife. Her name is Shirley and she was my last hope.

Prenatal care is quite different here - for starters, it's called "antenatal" care. Secondly, every pregnant woman in the country is required by law to have a midwife. You're permitted to have an OB in addition to your midwife, but OBs are hard to come by here. Thirdly, Kiwi medical care is totally free for residents and for visitors on a visa of 2 years or more. Our visa is for just under two years - alas.  So we are "paying customers" for our maternity care, a rare phenomenon in New Zealand. So rare, in fact, that it was almost impossible to find someone willing to take our money.

our baby is about the size of a grape, so these fingers are TINY

With nothing else to go on, I called the first few names I found in the phone book. Midwives here operate alone or in small groups, but you contact your midwife directly on her cell phone or home phone, rather than at an office. I made several calls and left detailed messages about my situation. No one responded. Days passed. I called the coordinator of a midwife group and explained my circumstances to her - only to have lists of costs read off to me: each visit will cost this much, your first blood test will cost this much, your scan (ultrasound) will cost this much, etc... I got the distinct sense that she was politely worried that we would not be able or willing to pay these costs. Possibly this is an ongoing problem with non-citizens. Flustered, I blurted out my too-spontaneous attempt at a reassuring answer, "Oh, it's ok, we have plenty of money to cover those expenses." She laughed a bit awkwardly and responded gently, "Well....well, aren't you lucky?" But she did give me the names and numbers of a few midwives who "might be willing to work with you...."

Only one was. She had definitely been debriefed beforehand about this boastfully wealthy & potentially unstable American lady, and she was cautious. Our entire phone conversation revolved around the tactics we could use to keep costs down. I appreciated her daredevil spirit in giving me a try, and I was grateful for her desire to help us make the experience more affordable, but I hung up feeling uneasy, like the object of suspicion.

A friend here, also pregnant, told my plight - my whole plight  (why we are here, what we are doing, when we are leaving - the whole plight)  to her midwife, Shirley. Shirley was not terrified. Shirley would see me. Shirley cared for LOTS of foreign women and knew the ins and outs of navigating the international medical insurance scene. But Shirley's location required me to learn how to drive on a highway. I balked.

Finally, I called. Shirley was happy to hear from me! She didn't sound distrustful or worried about me at all. She was more than polite - she was openly friendly. And she didn't ask me a single question about how I intended to reimburse her for her services - instead, she asked me how I intended to get my Folic Acid. I loved Shirley. Shirley cared about my baby, not my finances. For Shirley, I would learn how to drive to Tauranga. And I did.

Today I finally met Shirley face-to-face. I was wearing a t-shirt that read "Jesus rocks". It's Richard's t-shirt, actually, but all of mine are in the hamper and I've been too exhausted to do much laundry lately. Shirley's face lit up and she said, "I LOVE your shirt! I'm a Christian too." I loved Shirley even more. In a country where all is private and reserved, Shirley did not find it a bit weird that I would wear something so outlandish. Shirley was willing to be outlandish with me.

Shirley asked me straight away if I was planning a home birth or a hospital birth (because of the different form required for each option). There is nothing in the world I would prefer less than a home birth. I expressed that preference (tactfully). Then, less tactfully, I burst out, "Look, I am SO grateful to you for seeing me. I had such a hard time finding someone to see me - everyone was so concerned about how I would pay them. I don't want you to feel any anxiety on that front, and we'd love to pay you up front so that you know that you won't get stuck at the end." Shirley's face was peaceful, sincere and joyful as she said, "Oh, no, you're here as a missionary. I'm not charging you anything." Needless to say, Shirley and I had a little friendly argument over that, which no one won and which will be continued.

we're about a week past this point

I spent an hour in the office talking to Shirley while Maria laid quietly on the floor, lining naked baby dolls of various sizes up against the door and periodically announcing "I have to make pee-pees". Shirley graciously waited through our excursions to the ladies' room. Richard stayed in the waiting room with Bernadette, who called out for "MAMA!!!" so frequently that he did finally (unsuccessfully) try to find us.

We left with grateful hearts and a little "pregnancy packet" of free samples, including one free BabyLove brand Newborn Nappy for babies up to 5 kg, complete with a heart-shaped "poo-poo pouch" in the back (apparently it "traps poo without spreading"), some Huggies (internationally trumps Pampers???) wipes, and a week-by-week pregnancy guide containing helpful tips such as the following: SHEEP WARNING - Pregnant women should avoid contact with ewes and newborn lambs. They may carry an infection which can cause miscarriage.

There are ten sheep for every human being in New Zealand and this is good information to have. But it was the information that was missing from this packet which was the most interesting. In the entire 144 page, advertisement-laden pregnancy magazine, there was not one single ad for formula. Vaccines, baby lotion, toys, strollers, diaper pails, baby & maternity clothing, wipes, prenatal vitamins....but not a single formula ad. In fact, the ads for the baby stores, which always include that handy checklist of the 138 purchases that you will come to think essential before welcoming your baby - those ad checklists had no mention of bottles, sterilizers, brushes, formula or anything associated with bottle-feeding. I think someone told me that up until very recently it was actually illegal to advertise formula here. Furthermore, these ad checklists were not even a quarter of the length of a condensed Babies R Us list. And still excessive. I mean, who really needs four sets of sheets for the bassinet? Both of my girls exploded out of both ends so frequently in their first months that I could do a full load of wash almost daily consisting only of items soiled by their dainty feminine newborn eruptions. But then again, that was before I knew anything about BabyLove Newborn Nappies with Poo-Poo pouches. I bet if I had been using those, it would have cut my wash load in half. I bet then I just might have needed that fourth set of bassinet sheets after all. But I'm not sure - I'll think I'll talk it over with Shirley.


  1. New Zealand is honoring the "International Code for Marketing of Breastmilk Substitutes", which does prohibit the marketing of formula. It is amazing how many people think that formula is in any way comparable to breastmilk--that's marketing for you. The United States is one of the countries that did not sign on to this agreement--so we do have marketing of formula in this country. But the guidelines are observed by lactation consultants. We do not allow "code violators" to exhibit at lactation conferences. I am also prohibited by my code of ethics from accepting any gifts--including lunch--from formula companies. Their marketing is intense and competitive in this country. One lactation consultant said one of the best opportunities that she had to bring the facts about formula out, was when she invited more than one formula company to talk about their product. In criticizing each other's products, they made quite an impression about the risks of formula use.
    One thing we try to stress more than "Breast is Best" is "Breastfeeding is Normal". When you think about it--formula feeding is what is more "normal" in our culture--but it really isn't.
    Okay--I'll get off my soapbox. I was interested that the difference was so noticeable.
    I really enjoy your blog and read it often.