Finding the right birth journey in Cyprus
Where to begin? The general overview of childbirth in Cyprus.
There are two main models of care and support for birth in Cyprus. We are talking about medical and midwife models.
In the midwife model, labor is regarded as a physiological process. All actions of the staff are aimed to support the mother, who is to be in the center of attention. Her needs and decisions are well respected. In the low-risk group, the midwife is the main specialist during the birth. The doctor is asked for opinion and assistance only if there is a risk for the mother and child. In countries with this model, along with the system of maternity hospitals, it is common to give birth at home and maternity centers.
The medical model views labor as a pathological process. The woman is under close supervision of the staff. The beginning, rhythm, duration of labor is strictly regulated by protocols. A woman is perceived as a patient and is often limited in the ability to follow her needs. Childbirth leads and decisions are made by an obstetrician-gynecologist doctor. The report on perinatal health indicators for 2014 gives an opportunity to see the general picture in the field of obstetric care.
In 2014 in Cyprus, 9552 women were in labor. 63% of these women gave birth in private clinics and 37% in public hospitals. This means that the higher percentage of woman were able to choose their private clinic and doctor. With public hospitals, there is no such wide choice, since the number of hospitals is limited.
According to the law, if a woman comes in childbirth, the state hospital is obliged to accept her, and the future mother will give birth with doctor and team who are currently on duty.
Let’s look more closely at the statistics of the labor:
BEGINNING OF LABOR
Planned CS prior to the labor
Total number of births
What do these figures mean? One of the most important indicators of the attitude to the process of delivery is the level of COP (caesarean section). In accordance with the recommendations of the World Health Organization, the frequency of cesarean section should not exceed 10-15% of all births.
The figures say that almost half of the births in private clinics in Cyprus are planned COPs.
In public hospitals, this indicator is slightly lower – almost 30%, but still significantly higher than the recommended level of WHO.
If we add to these figures an emergency COP, it turns out that two out of three women in private clinics in Cyprus give birth through CS, and every second woman gives birth through CS in the public hospitals.
MODE OF DELIVERY
Total number of births
Another important indicator of routine interventions in the delivery process is an episiotomy a surgical cut in the muscular area between the vagina and the anus (the area called the perineum) made just before delivery to enlarge your vaginal opening.
Statistics of episiotomy in Cyprus are as follows:
EPISIOTOMY IN VAGINAL DELIVERY
Carried out episiotomy
Not carried out episiotomy
Total number of births
From the table we see that episiotomy is a routine procedure in childbirth. Almost 65% of all women who give birth vaginally in private clinics, have an episiotomy. And 75% - in public hospitals.
The above data indicate that the medical model of obstetrics is common in Cyprus.
It is interesting to note that in general in private clinics the attitude towards women is client-oriented. During pregnancy, doctors are friendly, willingly communicate with clients, tell what is happening, readily prescribe at the request of women additional tests, ultrasound. After delivery, comfortable conditions to new mums are provided: bright, clean, single rooms. Visits are allowed, if you wish, you can give the child to the children's department and relax.
The system of obstetrics in Cyprus is strongly medicated.
Pregnancy and childbirth are tightly controlled by midwifes.
In comparison with other European countries, the choice of place for childbirth is severely limited. You can give birth either in private clinics or in a public hospital.
There is no possibility legally with midwifes help give birth at home or in the maternity center.
In private clinics - only 40% of women get the opportunity to wait for the start of labor. In public - slightly more than half.
The practice of routine interventions such as episiotomy is widespread.
There is a general atmosphere of benevolence and comfort.
If you need to make a planned CS according to the indications, it will be relatively easy to find an experienced surgeon.
If you want to give birth with anesthesia, then you will easily be given such an opportunity.
If you want to give birth, after waiting for the spontaneous start of labor, vaginally, avoiding interventions as much as possible, this task will be much more difficult to achive.
What exactly do you want?
Every woman comes into motherhood with her own expectations and has her own understanding of what conditions are important for her to give birth.
What is important for you? How are your priorities arranged?
According to statistics, the medical system in Cyprus provides a relatively high level of global safety for mothers and babies. The tables give examples of different countries and their statistics on maternal and infant mortality.
7 / 100.000 births
9 / 100.000
25 / 100.000
7 / 100.000
11 / 100.000
$ 138 / 100.000
178 / 100.000
INFANT MORTALITY AT 1 YEAR OF AGE
8.1 / 1000 born
Make a list of factors that could potentially be important to you in childbirth. Rate all the items listed in the table below in terms of importance for you: Very important, Not important, Not at all important.
1. The need for respect, how they talk with you, whether they explain it clearly, or listen.
2. Need for making decisions. How much the doctor listens to what is important to you, provides complete information, respects and acts in accordance with your right to make decisions for yourself and for the child.
3. The similarity of the attitude to pregnancy and childbirth between you and the doctor:
Pregnancy and childbirth is a pathological process, the doctor as an indisputable authority, and you are a patient;
Pregnancy and childbirth is a natural, unpredictable process, the doctor and you are a team;
4. Need for a sense of peace and security. How comfortable you are psychologically next to this doctor.
5. Room comfort, the need to be comfortable with the cleanliness, comfort of the room.
6. The possibility of a scheduled COP at your request.
7. The possibility of a soft planned and emergency COP, when the mother is in labour, the baby to be immediately put on the chest, let the umbilical cord to pulsate, possibly the presence of a partner in the operating room.
8. Possibility of free access to epidural anesthesia.
9. Ability to receive physical and moral support.
10. The possibility of spontaneous onset of labor. Lack of pressure in stimulation, if everything is good with the mother and the baby is all right.
11. Lack of routine interventions (stimulation of labor, routine CTG, amniotomy, episiotomy).
12. Possibility to bring partner to birth.
13. The possibility of free behavior in labor.
14. The ability to drink, eat during labor.
15. The ability to take any convenient position during labour.
16. Ability to take the baby on the chest, stomach immediately after birth.
17. The possibility of both active and passive management of the third stage, the nonmedicinal waiting for the exit of the uterus.
18. The possibility of delayed suppression of the umbilical cord.
19. Possibility to stay with the baby.
20. Ability to give the child to the nurses.
21. Ability to receive high-quality pain killers after surgery as needed.
22. Well-equipped emergency room.
Collection of information
Now that you know what is important, you can proceed to the preliminary search for information. Friends, doctors, forums, Facebook pages devoted to matters of motherhood, clinic sites. At the same time, you are not just asking about a good doctor, but with the help of clarifying questions you select the specialist most appropriate to your request.
When you have a preliminary list of doctors, you can choose few, and arrange appointment to meet them. You can treat this meeting as an interview with your potential employee. In this case, you are no longer a patient, but a client.
The process itself looks like this.
You ask and listen, check with yourself, ask again, listen, make the decision to continue searching or to hire this person.
It makes sense to prepare a list of questions in advance, based on those factors that are of the greatest importance to you. For example, you can ask how the doctor relates to natural birth, or what is his personal statistics on this? Feel free to ask questions, give yourself time to listen.
There is one more point that, in my opinion, is important in this process. No matter how we choose or plan, there is a large share of unpredictability in childbirth. That's why it's healthy practice to define a plan B, C, and even D. Discussing your various scenarios in advance with potential candidate doctors can also tell a lot about their relationship and practice in childbirth.
Who else to invite to the team?
In private clinics, there is an opportunity for the mothers to accompany them. The results of the studies indicate that continuous support in childbirth reduces the number of interventions and increases the satisfaction with childbirth. It can be any close person, mom, girlfriend, partner, able to support you physically and emotionally.
There can also be professional support. In Cyprus, at the moment, there are two certified midwives.
In conclusion, I want to wish the information provided in this article will ease the search for a suitable place and a team for delivery, with a doctor who you can trast and Feel comfortable. Happy birth everyone!
Sofia Zdanovskaya, a sociologist, a family social worker, a true professional assistant in childbirth and mother of three.
This article was originally published here. (www.cyprusmoms.com)
You can search for Gynecologist in Cyprus here.