Expecting in Hungary

Content: Prenatal care in Hungary, how to find and choose the right hospital/doctor/midwife for you, who is the védőnő and what is her function, what kinds of maternity benefits (if any) are you eligible for, how to register a baby’s birth in Hungary if one or both parents are foreign nationals, what’s your due date and why is determining it correctly important, thinking ahead to your birth experience, and how much you can expect to pay for a birth in Hungary

Handouts: list of English-speaking obstetricians in Budapest, list of hospitals and clinics with maternity wards, birth plan worksheet, list of registrars, registration and maternity benefits information sheet.

Cost: €30 (app. HUF 8500) / occasion / coupleor €20 (app. HUF 5500) per person. Pay at the door or pay in advance by PayPal.

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Sunday, August 28th, 2011, 10 am – 2 pm

Labor and childbirth

Content: mother and baby at term, how does labor start, when to go into the hospital or call the midwife, inducing labor, what are the stages of labor, what to expect during them, what does it feel like at each stage, what can the helper do at each stage, the importance of positioning for mother and baby, natural and medicated pain management, how to avoid an episiotomy, what to expect at a Hungarian hospital, what to expect during a C-section, what to expect during a premature delivery, recovery from birth

Handouts: what to pack for the hospital, English-Hungarian shopping list of baby supplies, birth plan worksheet, What Is Labor Like article, What About the Pain in Childbirth article, C-section article

Cost: €30 (app. HUF 8500) / occasion / coupleor €20 (app. HUF 5500) per person. Pay at the door or pay in advance by PayPal.

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Unscheduled

Breath and Touch

Content: Practice different labor positions for maximizing comfort and efficiency, try relaxation and massage techniques for loosening muscles during labor, discuss and try various breathing patterns and their usability during labor. This is a very hands-on, practical workshop where we TRY everything. Wear loose and comfortable clothing!

Cost: €30 (app. HUF 8500) / occasion / couple or €20 (app. HUF 5500) per person. Pay at the door or pay in advance by PayPal.

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Unscheduled

Newborn care

Content: what is a just-born newborn like, what does the Apgar score mean, when to cut the umbilical cord, cord blood banking, what do newborn babies expect from the world, why is skin-to-skin contact important, why is early and frequent breastfeeding important, baby’s secretions: what’s normal and what’s not, feeding and expected weight gain, burping, sleeping, dressing, bathing, umbilical cord care, crying and comforting, types of babies, learning, playing, baby wearing, how to survive the first six weeks

Handouts: English-Hungarian shopping list of baby supplies, breastfeeding cheat sheet, registration and maternity benefits information sheet

Cost: €30 (app. HUF 8500) / occasion / couple or €20 (app. HUF 5500) per person. Pay at the door or pay in advance by PayPal.

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Unscheduled

Breastfeeding

Content: why is breastfeeding good for the baby, why is breastfeeding good for the mother, how to get off to a good start and avoid problems down the line, how does milk production work, how to ensure you have enough milk, how can you tell whether baby is getting enough milk, feeding on cue versus feeding on schedule, sore nipples and other breastfeeding complication, lots of pictures and videos about how to get the baby on the breast correctly (to avoid damage to the nipples and ensure proper milk flow), when to express milk, how to express milk, how to safely store milk, using artificial nipples (bottles and pacifiers), herbs and foods to increase supply, breastfeeding and illness, breastfeeding and medications

Handouts: breastfeeding cheat sheet

Cost: €30 (app. HUF 8500) / occasion / couple or €20 (app. HUF 5500) per person. Pay at the door or pay in advance by PayPal.

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Location

Életkör, XII. Hertelendy u. 1/b. 1st floor #14 (Életkör buzzer) Here’s a map.

Please RSVP by email (reka@budapest-moms.com or +36 20 455 5836) so I know how many handouts to bring! (If you pay by PayPal, you do not need to sign up separately.)

Payment

You can either pay as you go along, in cash at the door, or pre-pay a number of classes at a discount.

Pre-conception

Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health

Fertility awareness is a scientifically proven, but little known method of birth control. It can also help you in optimizing your chances of conceiving. The book comes with thorough and practical explanations of your cycle, and how to tell when you’re most fertile.

Pregnancy

What to Expect When You’re Expecting

Some people call this book alarmist, but I say if you’re not looking at it as a list of mandatory pregnancy problems that you must check off one by one before you have your baby, than it can be a really valuable resource to provide reassuring answers to all your pregnancy related questions. If you’ve ever wondered “is it normal that…” then this book is for you.

The Complete Book of Pregnancy and Childbirth

Sheila Kitzinger provides an in-depth look at mother and baby’s emotional and physical development during pregnancy, and a candid view of what happens in birthing rooms at hospitals, how to have a woman-centered, positive birth experience, and how the birth partner can help.

Labor

Ina May’s Guide to Childbirth

Ina May is an amazing midwife in the United States. She and others like her established The Farm birthing center, where intervention and C-section rates are so low that hospitals go there to learn how they are doing it! In this book, Ina May begins with dozens of birth stories from women who have given birth on The Farm. The second half of the book is a clear, and unique, discussion of how birth works, and how women can prepare for a natural, satisfying birth experience. She also discusses the scientific evidence – or lack thereof – behind many obstetrical procedures.

Natural Childbirth the Bradley Way

This book has given me so many “yes, yes, YES!” moments as I was reading it, both as a mother and as a childbirth educator, that I can only recommend it. It gives really concrete, tangible, practical tips for having a natural, intervention-free birth, and clearly explains the risks associated with routine hospital interventions. Most importantly, it provides very concrete instructions for both the mother and her partner for what to do before and during labor for a good birth experience.

Baby care

Your Baby and Child: From Birth to Age Five

Penelope Leach provides clear, sensitive descriptions of baby’s physical, emotional, social development and also offers unbiased discussion of parenting choices. Best of all, she also includes very practical tips for how to, for example, calm newborns, make bathtime enjoyable, how to decide where baby should sleep, how to handle sibling rivalry, and much, much more. The book includes gorgeous color photographs that are very instructive (like the picture of the difference between colostrum, foremilk and hindmilk).

Breastfeeding

The Ultimate Breastfeeding Book of Answers: The Most Comprehensive Problem-Solving Guide to Breastfeeding from the Foremost Expert in North America

Dr. Jack Newman is one of today’s foremost lactation experts. His book provides practical information on how to overcome any and all breastfeeding difficulties you might run into.

If you’re newly pregnant and unfamiliar with the Hungarian health care system, you might wonder what your options are in this country for prenatal care and giving birth. The system is confusing even for those of us who speak the language. I tried to summarize the available options below.

1.  You go into the Hungarian health care system, visit the local clinic (szakrendelő) and see whichever obstetrician happens to be on duty there. Your prenatal care would be coordinated by your health visitor (védőnő) , the obstetrician at the clinic, and your general practitioner. Between the three of them, they send you to all the appropriate lab tests and exams. Then when it’s time for you to give birth, you go into the hospital and you’ll be attended by whoever is on duty that day.

The money: All your care is covered by the Hungarian health insurance (TB). Doctors and nurses may still give you the feeling that they expect something for their services, though.

The reality: It’s totally luck of the draw what kind of experience you’ll have. It can range from being totally ignored to being perfectly well attended. If you choose this option, prepare yourself for long waiting times at the clinic, which will be old and run-down and possibly dirty. Hospitals are also old and run-down with not enough staff on duty, and also possibly dirty. Get to know your local hospital to see if their methods and facilities are acceptable to you. Many hospitals, especially those outside of Budapest, still have shared labor and delivery rooms, so you might find yourself giving birth in the same room with 2 other women, separated only by a curtain. In most hospitals, you will not have a private room for the 4 days you spend at the hospital, but rather share a room with 3-7 other moms. Teaching hospitals allow medical students to wander in and check your dilation. Over 70% of first-time mothers receive an episiotomy. Many hospitals do not allow you to move around during labor. Many hospitals still do not allow rooming-in. VISIT YOUR HOSPITAL!!!

The pros: Cheap. Also, if you would like an unmedicated, uninterrupted birth, having no designated doctor may actually work in your favor, since there will be no doctor feeling obligated to “do something” during your labor so as to earn their fee.

The cons: Impersonal and luck of the draw. The doctor on duty may have very different views on childbirth than you. Staff will most likely not speak English. And sometimes you still need to pay to get things done.

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2. You choose/designate a doctor who oversees and coordinates your prenatal care and sends you for all the lab tests he deems necessary. “Designating” a doctor is completely informal, a matter of a verbal agreement between the two of you. You go to wherever he holds his visiting hours, either at the hospital or at a private medical office (rendelő), and pay for each visit. Sometimes these fees are implied rather than stated outright, especially if your doctor holds his hours at a hospital. You will most likely NOT get an invoice for the money you pay. Doctors who do not hold their hours at the hospital will usually rent an apartment at some central location, and hold their office hours there, and the quality of these offices will vary wildly, as will waiting times and your impression of their service. When it’s time to give birth, you go to the hospital that your designated doctor works at, and he will come to oversee your birth. In addition to designating a doctor, you may also choose to designate a nurse who will stay with you and give you a bit more attention at the hospital during your birth. Typically, the doctor, even a designated doctor, only comes in once in a while to check on your progress, and then at the end for the pushing.

The money: You pay your doctor his stated or implied fee after every visit, and you also pay for the birth. Fees these days range from HUF 5000 to HUF 12 0000 for a visit. Almost always, there is also a fee for the birth itself, which is typically 10x the visit fee. So if you find a doctor whose visits cost 5000 HUF, his expected fee for the birth would be 50 000 HUF.  If you designate a nurse, she will also expect some kind of money for attending your birth, usually around 20-30 000 forints.

The reality: Doctors are constrained by the hospitals they work at. (See point 1 for a description of Hungarian hospitals.) It is really important to visit the hospital your designated doctor works at, and inform yourself of what’s possible at that hospital. When you designate a doctor, you are essentially paying so that one person instead of three coordinates your care, and hopefully in order to have someone attend you whose views on birth are similar to yours, not a random person on duty that day. Some doctors (though certainly not all) will give you a cell phone number that you can call with your questions. You’re also paying for him to come into the hospital for your birth, day or night. This can work against you if you happen to have a lengthy labor in the middle of the night after a full day of work for your doctor. Very few doctors are able to resist the temptation under these circumstances to try to speed up your labor by some means. This is an especial danger with doctors who are very popular, or who work at multiple hospitals/clinics.

The pros: You stand a better chance of finding a doctor that you can communicate with, and whose views on birth coincide with your own.

The cons: More costly, and often you won’t find out what your doctors views on birth really are until after the birth.

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3. You go to a private clinic like Rózsakert or First Med Centers, and pay a package fee for their prenatal care.  Most often, you will have a list of doctors to choose from who work at this clinic. This is usually more inclusive than the standard Hungarian health care system protocol, so there are more tests included, and often with the added convenience of doing the labwork on site, so you only have to go to one place for all your prenatal visits and tests. It is also very expensive, and as far as I know does not actually cover your hospital fees. You then still have the choice of going into a public Hungarian hospital (see point 1) where your chosen doctor works, or going to Telki (the one and only private hospital in Hungary) and paying their birth fee over and above the prenatal care package at the clinic.

The money: I just looked up Rózsakert, and right now their prenatal care package is 200 000 forints. Telki’s birth package is approximately 600 000 forints. If you do not have Hungarian health insurance (TB), then a vaginal birth at a public hospital costs around 80 000 forints, a C-section around 160 000 forints. The good news is your private health insurance may cover these fees.

The reality: The clinics claim that they operate at Western European or American standards, but feedback from moms has not been that glowing. Without a doubt, these clinics look nicer than your average Hungarian szakrendelő, but they may not be any more efficient. Also, not all the staff may speak English. For a fact, most of the nurse-midwives at Telki do not speak English, which can be a real problem during and after birth.

The pros: You get all your care in one place where most of the staff speak English. More tests and procedures are included than in standard Hungarian health care. Telki hospital truly feels more like a hotel than a hospital, cannot even be mentioned on the same page with a Hungarian public hospital for level of service.

The cons: Very expensive, especially if your insurance does not cover it. Also, they operate on an extremely medicalized model, and if you want to avoid unnecessary tests and procedures, may have these pushed on you. Having an unmedicated, natural childbirth at Telki is virtually impossible.

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4. You go to a home birth midwife. She will discuss and recommend which tests are necessary for you, and you go back into the health care system to get these done, either at a private clinic or through the public system. Then she will attend your birth at home or wherever you choose.

The money: Home birth midwives range between 50 000 and 140 000 forints for providing all your care, including birth.

The reality:  You have to understand that home birth in Hungary is unregulated, and home birth midwives may be prosecuted for providing care, so they all pretty much work underground, whether they are credentialed midwives from other countries, or licensed obstetricians/nurses. There are very few of them in Hungary. Their fees and their style of care vary depending on their background.  Some will offer you individual prenatal visits up to 90 minutes in length each time, others have one communal week-long course for all their clients. You still need to get all your lab tests done through the health care system, possibly at additional cost (depending on what provider you choose). Getting your child registered after a home birth will take extra steps. The responsibility to find a pediatrician who is willing to examine a just-born newborn outside of a hospital falls on you. The responsibility for getting yourself to a hospital and procuring your anti-D shot if you are Rh- and your baby is Rh+ falls on you. If it becomes necessary to go into a hospital, staff may be hostile to you.

The pros: Practically the only way you can be assured of a natural birth in Hungary. Birth in the comfort and safety of your own home, with the minimum of interventions. Individual, non-invasive care.

The cons: Extra administrative hassle. The risk that if there is the kind of life-threatening emergency where every second counts, you may not make it into a hospital in time.