Tuesday, September 22, 2009

A Daughter's Experience With Canadian Healthcare

I have a grown daughter with two children, one delivered in the US, and the other delivered in Canada. She and her family have lived in Canada for five years, so I asked her to describe her experiences.

Here you are:

After living in Canada for 5 years now as an ex-pat, I have a unique perspective from which to compare the two countries and their differing approach to caring for their citizens.

Not many women can brag about having each of their children in a different country, but that's exactly the privilege I have. My son was born in Arizona under the care of an OBGYN that was very well trained and had an impeccable bedside manner. He also took copious notes, spent adequate time with me during each of my pre-natal visits and made sure to put me at ease. It was my first pregnancy and he did all he could to allay any fears a typical first time mother would have.

When it came time to head to the hospital, there wasn't much I had to pack except clothes for me and the baby and the usual essentials (baby book, magazines, etc). My son was 8 days late, and the Dr. was happy to induce me. During the labor, there were plenty of nurses available, all friendly and reassuring. In fact, they were the ones doing most of the leg work, calling the Dr. only when the delivery was near.

My Dr. showed up just in time to “catch” my son, and was as professional as I'd come to expect him to be. He stayed and visited following the delivery to ensure the baby and I were fine. He even recommended I take advantage of the baby nursery overnight because "you will have plenty of time to change diapers when you're home" Sage advice on his part! In fact, our son did spend time in the nursery so that I could rest.

There were no complaints on my end of anything that could have been done to improve my experience. When we left Arizona three years later, I was pregnant with our second child. One of my saddest thoughts was not having my OB to deliver my baby, and the stress of trying to find a new Doctor in Canada.

Luckily, when we arrived in Canada, we had friends living in the same city, and the wife had just delivered her third child. She recommended her Doctor and we arranged a meeting with him immediately. As a Doctor who had been practicing for several decades, he had his fair share of patients. I was fortunate to be told by him "one of my greatest loves is delivering babies, so I’ll take you on as a patient". Boy was I lucky! I'd later been told by several people that finding a Doctor is difficult, as many aren't accepting new patients (too few Doctors for too many people).

My pre-natal visits were less than thorough; weigh in and measuring my belly for uterine growth. The Doctor kept a piece of loose leaf paper in a manila folder and wrote down these numbers, but nothing more that I was aware of. The exam rooms were old and cluttered.

As we approached my due date (Dec 18) I was concerned about being in the hospital over Christmas. By Dec 22 there was still no "action" so I asked to be sent for an induction, and my Doctor hesitantly sent me to the hospital. The on-call Doctor there checked me out and reported that at "0 dilation, there is nothing that can be done for you" and sent me home frustrated and upset.

Having been induced with my first child, I knew there were options, but for some reason they would not use them. Finally, on Christmas night I began to have contractions and phoned my Doctor. His suggestion was to bathe in some warm water until things calm down. Looking back, I'm not sure if this was his desire based on finishing his Christmas celebration, or really allowing nature to run its course!

By 11:30 pm I was in tears and begged my husband to take me to the hospital, regardless of what the Doctor said. Once at the hospital, it was apparent there wasn't much coverage in labor and delivery. Two nurses at most were visible and the first one we approached was less than friendly. She hooked me up to the monitor and let me sit in excruciating pain without offering any means of comfort. She finished with the monitor and then explained that I was free to go until "more" had happened with my labor.

Thankfully my husband spoke up and asked if there wasn't "something you could do for her?" Only then did she mention laboring in the tub they had available. It was while on the bed during this conversation that my water broke - a true blessing that I finally was taken seriously by this nurse.

The anesthesiologist wasn't even in the building and had to be called in, and that alone took 2 hours or more. By the time I received my epidural I was spent. Everything took longer, and no one was very helpful. I'm not sure if it was the Christmas night issue or that they were always this aloof. My Doctor came in after my water broke and spent the entire time with me and my husband (from about 1am to the delivery at 6am). Now that was amazing!

After my delivery, I was reminded there was no nursery for the baby (lack of funds) and would need to have her near me at all times. Did I forget to mention how I had to pack EVERYTHING for baby and me from diapers, to wipes, to maxi pads - if I needed it, I had to have it packed. The hospital provided nothing of the sort. My husband was kind enough to video tape my delivery and in it I whispered (in between pushing) "quote me now, I will never have another baby in Canada". The experience up to that point had obviously been very negative.

Some months later, I discovered that this particular hospital, in their deliveries, takes a more "natural' approach, and tries to do less inductions and scheduled c-sections and more of the laboring at home approach. It all came together for me upon hearing that.

Now however, I have an entirely new perspective. From a cost standpoint, this is their goal - to have as few patients as possible, in for as short a time as possible, with as little intervention as possible. They achieve this by having you come in at the last minute, not offering many comforts, and even by keeping the anesthesiologist out of the building!

On a personal level, I never felt that my delivery mattered to the nurses and staff with my second child. Their attitude made it appear to be more of a "job" than a "passion." Is this a result of socialized healthcare? If so, how do you explain my Doctor, who was happy to sit with me all night while I labored? His passion for his line of work was rare, and was welcomed by someone like me who was new to the country and the system.

You'd be surprised by how many American women that move here for their husband's job plan on delivering their babies in Buffalo (over an hour away!) because it's difficult to find a Doctor and they feel more comfortable in their home country where they know what to expect in a hospital.

I don't blame them.

1 comment:

  1. I wonder what was the cost was per baby ... to you, the government and to your employer .. high end service is great if you can afford it .. we have great service here but unfortunately only a few people get to experience it ... I am guessing if we are not to go broke that stripped down doctors and hospital is all we will be able to afford ...