This is a story about two babies, two mothers, and two health care systems. One of the mothers lived in the UK and received her care at government-run clinics and hospitals. The other lived in the United States, where health care is a private enterprise, which makes it more efficient and responsive and improves the quality of care through competition.
Both of the mothers had babies due at around the same time in early 2008. One, we’ll call her Mom A, had her child on schedule, with a relatively easy delivery. The other, Mom B, had not delivered after over two weeks and had to have labour induced. The delivery was very difficult, with unusually long labor and many hours of pushing, and was traumatic to both the mother and child.
Both babies were boys. Both developed rapid breathing shortly after birth–an indication of a possible life-threatening infection requiring hospitalization in the Neo-natal Intensive Care Unit. Baby A was hospitalized for two full weeks, while Baby B only required a little over a week.
Two days after the birth of her child, and in spite of having not recovered from the unusually difficult delivery, Mom B had to leave the hospital due to rationing of care. She spent the next week following a schedule of getting up and going to the hospital in the morning, staying through the day and into the evening, going home at night, and waking up every two to three hours at night to pump her breasts (which took at least half an hour each time) so that her milk would come in for her baby. Fortunately, a friend was available to take her back and forth to the hospital. Other mothers with hospitalized babies who didn’t have someone available often had to wait for their partners to come home from work and bring them. This meant that they spent only a few minutes each day with their babies.
The hospital staff were not thrilled that Mom B was there that much. Due to chronic under-staffing, they were very busy with their routines and seemed to find her presence as an interference. Throughout the time, there were different nurses, each with her own way of doing things. Mom B tried to follow their routine but was frequently reprimanded and lectured by whichever nurse was on. While the hospital’s official policy was to encourage breastfeeding, the nurses pushed her to stop the breastfeeding as it was easier for them to monitor the baby’s food intake if they just gave him formula. She resisted this, citing data that shows breastfed babies have much lower infant mortality rates than formula fed babies. She was not allowed to stay with or hold her baby in between feedings, but was given access to the ‘parent lounge’–a small, windowless converted storage room with cast-off furniture. One day, she went to the cafeteria to get lunch, leaving her mobile phone number in case her baby woke up and needed her. On returning, she found him crying and the staff angry with her for not being in the ‘lounge.’ When she asked why they hadn’t just called her, she was told that they didn’t have time to ‘hunt parents down.’ At this point, she broke down and cried. Following her son’s release from the hospital, she was exhausted and struggled with post-partum depression for several months, which is quite common for mothers who are separated from their hospitalized babies.
When Mom A heard about Mom B’s experience, she was shocked. How inhumane, she said, what a messed up system.
She had a very different experience. In this case, her presence and breastfeeding were considered a part of the infant’s treatment–because her health care system was based on the latest research and focused on quality service. She was allowed to sleep at the hospital and was provided a bed and access to showering facilities. When her baby was hungry, she was able to go feed and hold him. While staying in the hospital was not easy, she was able to bond with her baby, get as much sleep as possible, and prepare to take him home.
As you may have guessed by now, Mom A was cared for at a large, government-run hospital in the United Kingdom. Mom B was me. I gave birth to my son in the United States, at a very well-run private hospital. I had the best possible insurance coverage. The birth and my son’s care netted the hospital over $100,000.
Now, I ask you, which system would you choose?