Saturday, February 19, 2011

Being pregnant in Sicily

Here I am back in Milazzo, after a four month absence. I went back home to have our baby because the Sicilian hospitals – and staff – were not at all convincing. I stayed until the end of August, doing my duty through the high season, carrying my seven month bump through the humid terrace where curious diners congratulated me, and sat under the air-conditioning near the till when not dealing with customers.

The best thing was that no one smoked any longer inside the bar. I just had to move my bump nearer to the would-be smokers and they would lover the cigarette and go scuttling outside, usually with a shamefaced smile, most unlike the typical defensive attitude I met with before. The other, most interesting phenomenon was how attitudes towards me changed. No longer the north-European foreigner, to be regarded with suspicion and kept at a distance, I was embraced by one and all. Neighbours who had never exchanged a word with me, nor looked directly at me (while staring and observing my strange foreign ways from behind their shutters, be sure) suddenly started smiling and greeting me with a barrage of questions. Not necessarily a change for the better. In this strange community, the less your neighbours know about you, the better. But I couldn’t help smiling back and giving them the kind of information they wanted. I desisted, though, from revealing whether we were having a boy or a girl. It was always the second question, hot on the heels, after how many months pregnant I was, so that they could judge whether I had put on a lot of weight or not (I grew a lovely cartoon bump, or designer bump as someone called it, and didn’t put on much weight elsewhere). Whereas in Ireland/UK often it is hospital policy not to tell you the sex of your baby, here it is considered the norm to find out. But I didn’t think it was anyone’s business, much to mio marito’s amusement – and frustration – as he was dying to tell the world we had produced the heir. My duty was done in the eyes of my in-laws, who magnanimously said they would have been equally overjoyed if we were having a girl, the important thing, of course, was that the baby was healthy.

Luckily, after the first few months of slight anaemia and morning sickness, I enjoyed a healthy happy pregnancy, blossoming, as they say you do. Work at the restaurant became more fun, as any table I served wanted to get the lowdown on all the pregnancy details they could wheedle out of me, depending on the hunger levels. The difficult thing was the antenatal care. Nothing stateside can ever be simple in Italy, and of course it started out with the fact that I had mislaid the piece of paper with my doctor’s name on it (never having been to see him before). You would think such things would be registered on a computer system, but no, we are in Sicily … so when I went to the health centre to get the piece of paper printed again, the clerk told me non EU citizens had no right to free health treatment. Such was his lack of desire to print the measly piece of paper. I looked round me. Whom was he talking to? One Geo-political lesson later, and I got the required paper. I should have changed doctors while I was there though, because the dottore di famiglia turned out to be useless. He wrote me the script for the usual first blood/urine tests to be done, but when I showed up at the blood clinic (everything is separate in Italy … how I longed for the NHS) the receptionist told me I would have to go back to him for an amended script since he had omitted some of the blood tests. Two of the main ones, to be precise. When I took the results to him he turned almost as pale as me in my lightly anaemic state, and told me I needed to eat more meat despite the fact that I am a pescatarian. This was obviously too challenging for him so he told me I needed to get myself a gynaecologist for the rest of my antenatal care. He then gave me the script for the 12 week screening tests, the only free one in Italy, but he got the entitlement code wrong, as we found out when we went to Messina, the regional capital, requiring a further visit to amend the script and return to the hospital in Messina. …

In Italy, like in the US, antenatal care is provided by a gynaecologist, which you pay for privately upon each monthly visit. It’s a whole money-making game, since as my doctor friends told me, you don’t really need a monthly check-up, if it is a healthy pregnancy. Plus, the care consists of numerous expensive blood tests, a visita – internal exam, and scan, each month. All my UK/Irish doctor friends confirmed that all of the above were unnecessary, that the usual 5 or 6 blood tests and 2 or 3 scans during the course of the pregnancy were more than sufficient. The internal exam cannot reveal anything which can affect the gestation period, or birth, and the traditional hands-on-tummy and measuring tape were as good as the scans. So. You can imagine how overjoyed the gynaecologist was to have me as a patient, with all my awkward foreign questions and disagreement over her treatments. It was hard enough to find a female gynaecologist, there were only 3 or 4 in total, and the one we ended up with was a nervous creature. She was convinced I needed many blood tests, despite my healthy record, and an internal exam at every visit, which added €50 to the fee, or subtracted since I declined her the pleasure. This was a huge deal for her and when I would phone to make appointments, she would immediately ask whether I intended to have one or not … plus when I skipped a monthly appointment, since we had the 20 week scan with another sonographer who was able to assure us that everything seemed fine, she joked that I was skimping on checkups. I assured her there was no need … all about making money. One time I left the images of the scan behind, and when I called her to ask her to send me them, she said there was no way I could do that because she hadn’t given us an invoice. She was terrified our 28 week scan pictures might fall into the hands of the finance police who would then jail her for not paying her taxes … this does happen, actually. My friend’s doctor, a specialist in hip replacements in the neighbouring town of Patti, has just been sentenced for making thousands in this way.

But my main reason for wanting to return home (to civilisation) was that during the birth here no pain relief is offered. By that I mean they have nothing from the most basic gas and air, to pethidine, remifentanol or epidurals. In fact, the ‘parto con epidurale’ is known as c-section because you only get the epidural if you are having a caesarean section. Not that I wanted a drugged birth experience. I wanted a natural birth (and had one) but wanted to birth somewhere my hypnobirthing techniques would be understood, and somewhere with pilates balls and birthing pools. None of which is available in Sicily. Unheard of. My doctor feigned disappointment when I said I was leaving, said she had been imagining a wonderful birth with her obstetrician friend. They don’t even have midwives here, which for me, was fundamental in my vision of an unmedicated, intervention-free birth. Here, at the slightest whiff of a complication, you get a caesarean section. So take into consideration that my baby didn’t move into position until 37 weeks (described as breech until then, though most first time babies don’t move until between 34-37 weeks), and the fact that he was big, weighing 3.8kilos at the 40week term appointment, I would have been politely told that it was in my best interests to have a c-section. The fact is, that doctors in Sicily do not want to take the risk if any complication presents. Or is it the fact that the hospital gets paid for every caesarean performed? Or perhaps the fact that the doctor in question gets the job done in half an hour, rather than a 24 hour labour? I had only just arrived home when a local case made international headlines. A certain gynaecologist got into an argument with an obstetrician about whether a labouring mother should have a caesarean or not. The obstetrician told him that it wasn’t up to the gynaecologist to decide anymore, his job having ended before labour commenced. It came to fisticuffs and the gynaecologist put his fist through a window in front of the poor woman in labour and her partner. Meanwhile her labour got complicated and she ended up having an emergency caesarean, and the baby was born in a coma … The gynaecologist was struck off. He did my 12 week scan.

1 comment:

  1. Hello,
    i will be heading to Cefalu Italy in a few weeks and have been debating if I could or should have my baby there. I need some advice.

    Help!!

    Vanessa
    vanessarimmer@hotmail.com

    ReplyDelete