I am blessed... February Part II. Having a baby in Australia.

Life is good.

Morgan Anne Jones was born at 6:44 pm on February 17 at Royal North Shore Hospital in St. Leonard's, Australia. We were blessed with an incredibly healthy and happy little girl, again. So much more than we deserve, yet something we had prayed and dreamed of for a long time... a little sister for Emma. A few days after Morgan was born Emma said, "Thanks for letting me have a little sister, mom." Oh my heart. One day she will understand how much we wanted this for her too (well a brother would have been pretty good too).

My due date was Thursday, February 18, so I greatly appreciated Morgan's timeliness, especially in comparison to Emma (she came about 9 days late). Nonetheless, it was a day we waited for much longer than just nine months. The path to parenthood varies greatly for every parent and I think most of us never realize how difficult it might be until we start down that path. Ours has been far from smooth, but I know not near as bumpy as others' paths. We have lost three other babies along the way early in pregnancy, and many times I have thought that a family of three might be what God had planned for us here on earth. Each time we lost one it tested us, our relationship with each other, our trust in God, and made us question whether or not we would try again. But we never know God's plans. We are thankful we did try again and feel incredibly blessed that He sent Morgan to be here with us in this life.

Almost there... 38.5 weeks.

After all the months of waiting, the care of a great doctor in the US that got us through the first 18 weeks safely, and taking on the adventure of figuring out Australian healthcare for the second half of the pregnancy, we were very anxious to meet our little girl or little boy. As nervous first time parents with Emma we happily waited for 41 weeks for her to arrive. This go around, feeling more confident about the new adventure we were about to embark on, and being aware of my additional risks during pregnancy we were more ready for this baby to come. I certainly felt more worn out at the end of this pregnancy than I ever recall feeling with Emma (perhaps it had something to do with taking care of three year old Emma), so with my parents safely in town just prior to my 39 week mark there was no need to wait for this baby to come.

The official stats of our "gorgeous girl."

The official weigh in...3.575 kg (7 lb, 14 oz)

With the help of the doctor and midwives I saw towards the end of my pregnancy we were hoping to avoid inducing me (again). At 34 weeks Morgan had measured quite large as well so we didn't want to go too far over my due date. I was scheduled to be induced on February 19 and I was sure that the baby would make me wait it out. Despite the fact that I had quite a few contractions in the week leading up to the birth and felt quite a bit different than I remember feeling with Emma, I figured nothing would happen. I even had an appointment with a midwife that Wednesday morning (only about 8 hours before Morgan's birth) and she didn't give me much hope despite having a lot of contractions the night before. Yet, within a few hours of my appointment I was in enough pain to tell Steve to come home. I really didn't believe I could be in labor for some reason (the induced 36 hour process with Emma was such a different experience). Evidently I must have been too calm for the midwife I called at the hospital to think I was very far along either. I even thought for awhile that I didn't know how to time my contractions accurately. Nonetheless I think both Steve and I were too afraid of having a baby at home that we would rather go to the hospital and have them send us home.

Love at first sight is a pretty accurate description.

Proud papa.

The labor & delivery ward was quite busy and once again, I must have looked fairly calm upon arrival because we waited what felt like 30 minutes, but probably only 10 or 12 minutes, before they could get me into an assessment room. When they finally did I was so surprised and relieved to find out that I could already start pushing! The midwives didn't even think I would make it to the actual delivery room, but after about 30 minutes of pushing they changed their mind, to my disappointment. Turns out Morgan was "sunny side up" as some people term it, not the ideal direction to come out. I knew it was all going a bit too smoothly up until that point. So instead this little girl made me push for 2.5 hours instead. Not really my idea of fun, and I might have subtly or not so subtly mentioned that to Steve a few times during the process and my thoughts on whether or not I would consider doing this again. Yet, God has a funny way of making you forget about all the pain pretty quickly. This little person comes out and you realize just how amazing life is. While it might be pretty scary to know you are fully responsible for this little person, it is guaranteed to be one of the greatest rides of your life.

Family photo minus Emma.

Emma had the best two weeks with Grandma & Grandpa. It was a relief to not worry about her at all when I was at the hospital!

Something was funny I guess.

So you might ask, two babies, born in two different countries, neither being the US - which was better, were you happy with both and were they better than the US? Well, while both my pregnancies began in the states, neither finished there so it is difficult to fully compare but I can make some educated guesses. So here is a look at some of the differences I experienced in Switzerland and Australia.

1. Insurance Coverage
First, it's probably important to address insurance and how this impacted my experiences. In Switzerland we were fortunate to be on an international health insurance plan by Steve's company and it provided us care by a private doctor and delivery in a private hospital. In Australia we had more difficulty as we had to obtain Australian health insurance (just like in Switzerland, insurance must be obtained personally and your employer does not normally provide coverage, we just had a special scenario allowed when we were in Switzerland). We had difficulty finding one to cover the pregnancy as it was a "pre-existing condition" and our visa status, as a temporary resident, further restricted our options. We finally found one that was willing to waive the waiting period, but coverage was in a public hospital. So it's hard to equally compare private coverage in Switzerland vs public coverage in Australia, but I'll do my best to address it. For instance, with Emma I stayed in the hospital five days after her birth (typical for a healthy delivery in Switzerland), with Morgan I stayed for 24 hours before heading home. However, if Morgan had been born in a private hospital in Australia we likely would have stayed 4-5 days, just like I did with Emma.

The first day of life. So much to take in...

Which baby is real? We did confuse the midwife momentarily.

2. Doctor vs Midwife
In the states it seems that antenatal care is still predominately handled by a doctor, although I think it is transitioning a bit as I know more people that are seeking out care by a midwife. In Switzerland it was a blend. I saw a doctor for all of my regular pregnancy appointments, but a group of midwives handled the majority of the birth and care in the hospital, with the doctor primarily there to "catch" the baby. In Australia it seems you can easily seek care by either. Private obstetricians are commonly used by those with a high level of health insurance coverage throughout the pregnancy. The private doctors can deliver the baby in either a private or public hospital with the assistance of midwives. Otherwise a large majority of the population makes use of the fabulous coverage afforded to them through the medicare system at the public hospitals, which was similar to the coverage we were able to obtain through our insurance. In this scenario unless you are deemed high risk you see midwives at all of your pregnancy appointments and for the delivery. The biggest downside is the inability to consistently see the same midwife (or doctor if you are high risk) at the public hospital. Without a doubt, I struggled with this the most and it wasn't until the last 6 weeks of the pregnancy I figured out how to ensure I could more consistently see the same midwife or doctor.

One proud big sister.

3. Hospital Experience 
I think overall the difference in actual hospital maternity ward experience and the amenities and services available in the US vs Switzerland vs Australia is minimal. Albeit, someone who is actually in the medical profession might say otherwise, to me they appear fairly similar. This is largely due to the fact that when you have a baby it is one of only a handful of medical instances when you have significant time and ability to choose the hospital you utilize. As a result I think all hospitals I have seen in each country offer some of the best things possible - the delivery rooms are modern, spacious, technologically savvy and are full of a variety of options to improve your labour experience. I just recently read an article that compared what women around the world packed in their hospital bags for the birth of their baby, and let's just say that I am know even more fully aware that I am blessed to have given birth in some of the best countries in the world. I cannot even fathom the experiences of those in many African, South American and some Asian countries where access to clean water, sterile equipment, and adequate space and privacy both during and after delivery are significantly limited.

24 hours old - time to go home!

Big sister duties include keeping a tally of fingers and toes.

4. Pregnancy Assessments
My pregnancy appointment experiences have varied greatly in each country. In the U.S., as many of you know, you often first see an ultrasound tech if you have a scheduled ultrasound (which I have found from both personal experience and in talking to others vary greatly in regularity based on doctors), then you see a nurse or someone in training for an initial assessment, followed by your doctor, and potentially yet another person to do your labs. You are weighed, blood pressure taken, given the delight of peeing in a cup, and sometimes blood drawn in the early stages.

In Switzerland I saw only the office receptionist prior to the doctor. The receptionist/nurse filled multiple roles and typically also weighed me, took my blood pressure and took my blood. From there it was straight to the doctor, who did everything else. My doctor even sometimes did my labs if the receptionist was busy and he performed the ultrasound, every single appointment.

Australia was probably the most different (but keep in mind this was my experience at a public hospital, it likely would have been significantly different if utilizing only a private doctor). As I mentioned earlier I primarily saw a midwife, only a doctor on occasion depending on the situation. The midwife would take my blood pressure and listen to the baby's heart rate. I was never weighed at an appointment, and as a result I have absolutely no idea how much weight I gained with this pregnancy! I have been told that if you are not overweight then you are often never weighed. Also, if I needed an ultrasound it needed to be scheduled at a separate time at an actual radiology clinic. This to me seemed extremely strange, but as I have come to find out it seems that there is rarely a "one stop shop" when it comes to Australian healthcare. Only if it was an emergency would you get an ultrasound actually at your regular appointment. I have heard that many private doctors will do a "quick scan" just so you can see the baby at your regular appointment, but you still have to go to a separate radiology clinic for a more thorough scan.

Contentment on grandpa's lap.

First of so much love from big sister, little sister might be just a little unsure.

5. Newborn Care
In Switzerland we stayed in the hospital for 4 days after Emma was born, so much of the critical newborn monitoring that requires follow-up visits to the doctor's office in the US within the first 5-10 days is omitted. After we went home we did not need to visit Emma's pediatrician until her one month check-up. In comparison, in Australia we went home quite quickly, but they have a tremendous follow-up system in place. They have in-home midwife visits available to you for up to two weeks following the birth. In our situation they visited us each day for the first three days following our discharge from the hospital and had a phone call follow-up on the fourth day. If I had wanted more visits I simply needed to call. A representative from the local early childhood health centre also visited about 10 days after her birth and they have a nearby office where we can go free of charge to weigh and measure Morgan as well as visit with someone about any concerns we have. They also have monthly vaccination clinics in each suburb of the city, where vaccinations are free of charge. You also do not take your child to see a pediatrician unless it is a referral from your general practitioner for a very specific concern.

First full family photo.

Grandma & Grandpa with their two granddaughters.

6. Breastfeeding
I'm starting to be pretty convinced that anywhere other than the US is more encouraging of breastfeeding, especially in public. Switzerland and the rest of Europe seemed pretty laid back, but in Australia they really encourage it. And if you don't feel comfortable out in public, many places have "Parents/Family Rooms" where there are private areas to nurse as well as changing tables (often better cleaned than many regular restrooms), sometimes child-size toilets, microwaves and even small play areas or TVs for older siblings that may be in tow. The nicest ones are often at malls, but we have also found them at airports and libraries and I'm sure there are many other places we have yet to experience. However, I have heard some stories that for the amount of encouraging they do, that in some situations it puts an unnecessary guilt on mothers who cannot or choose not to breastfeed.

Can't get enough of that new baby smell.

7. Maternity & Paternity Coverage and Post-Baby Work Life Balance
Another area that I'm pretty sure the US is at the bottom of the totem pole with is by only offering 12 weeks of maternity leave, but none of it guaranteed at being paid. Switzerland's leave isn't much longer with only 14 weeks maternity leave, but they do pay 80% of your wages, which makes it much more financially possible for a woman to leave the workforce. However, they offer no paternity leave. When Emma was born I wasn't working in Switzerland so it didn't matter for me, but Steve benefited from the way his contract was structured and he was actually allocated the US paternity leave benefit, which at Ernst & Young is an impressive two weeks.

And while not the best in the world, Australia is by far still the best of the three countries. Either parent can take up to one year leave with 18 weeks fully paid. Once again, with me not currently working we were minimally impacted, but Steve did still qualify for his EY paternity leave, which was this time three weeks, even without being the primary caregiver. We felt absolutely spoiled by this as it allowed us good time to spend adjusting to being a family of four without the stress of Steve heading back to work immediately. While I never envisioned myself as a stay at home mom my mindset has changed a lot as a result of our experiences around the world. I can no longer envision myself possibly going back to work only 6, 10 or 12 weeks after a child is born as many of my friends have done. I am spoiled getting to see Emma & Morgan develop and grow everyday. While it isn't without its challenges I can no longer imagine not being able to spend the first year or so at home with them.

It was hard to get this one back from Grandpa.

Pretty content with grandma.

A photo of all of us before grandma & grandpa had to fly back across the ocean.

My heart is full.

My month of February was absolutely perfect. I pray I might never forget that feeling of absolute joy and contentment from when I first held Morgan. While parenthood can be more than challenging at times, all I have to do is look around me to realize it is more than worth it. I have a beautiful family of four.