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Comment by mensetmanusman | Hacker News Reader

The U.S. experience used to be this way, but about 100 years ago the medical industry realized they could make a lot of money off of child birth (our last bill was $40k).

The hospitals released advertisements scaring women from voodoo (read: black) women/midwives helping with birth so that doctors and surgeons could take over, it worked fantastically. The doctors eventually chained women to beds and tested various chemicals to ‘cure’ their pain that resulted in profound unintended consequences.

This history is still with us, and creates a lot of uncanny valley experiences. I.e. treating pregnancy like a disease.

When we gave birth during covid, I had to use an elevator to get to my wife. When the elevator door opened, a group in hazmat exited with a patient clearly dying of covid.

I was like: “are you fucking kidding me, this is still where we give birth in this country…”

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There is no "U.S. experience" because of the absolute mess of our healthcare system. There are birthing centers that work very much like the process described above.

Indeed - I have to give a plug for UPMC Harrisburg in Pennsylvania.

My wife gave birth to all three of our kids there, and while it was more institutional than what's described above, they were big on skin-to-skin contact and leaving it to the parents to parent while the nurses and docs took care of medical needs. Staff was uniformly great throughout all of our births.

how much did it cost if you dont mind me asking?

Of course no country of the size of the US has a single experience of anything. But in this case, it's about as close as it can be: 98.4% of births are in hospitals, with 0.52% in birthing centres [1].

[1] https://www.ncbi.nlm.nih.gov/books/NBK555484/

We did it in the hospital too but there's nothing stopping you from using a midwife at home right?

Another thing that seems to be pushed a lot is epidurals. They expect everyone to get one and are very surprised when someone does not want it.

The epidural costs $6000. A 10 minute procedure.

I saw my wife before and after an Epidural so I could not dispute it's effectiveness.

But I generally can't see a reason why we need to spend 12 years in school to learn how various needles and rules of thumbs work.

Only the US has such an education burden, and only does the US have such a strong physician cartel to mandate it..

Edit, and even with midwives you will be hitting max out of pocket with 1 night stay.

The training length for physicians is pretty much the same in all countries. In the US to become an anesthesiologist: 4 years undergrad, 4 years medical school, 4 years residency. Total: 12 years. In the UK to become an anesthesiologist: 6 years medical school, 2-3 years of general postgraduate training, 5 years specialty training. Total 13-14 years. Why did you not look this simple fact up before saying it authoritatively on here?

There's more to it than you think, and it's easy to think that it's a simple procedure whenever you don't know what can go wrong, why things can go wrong, and how to fix things if it does go wrong.

Also, the doctor isn't why it's expensive. Doctors don't set the prices, hospitals and health insurance companies do.

Then you have to deal with the circumcision sales pitch.

We never heard even the slightest hint of a sales pitch for circumcision. A single question of whether we were planning to do it or not was all.

In fact, we had an anti-circumcision pitch. They showed a video of the process. It was horrible and makes me queasy just remembering it.

If they were trying to convince you against it, I'm guessing they weren't giving you a video of the average procedure. Kind of like how peta videos aren't exactly representative of how most of the farming industry operates.

I watched the one on my son, and while it wasn't nothing, it was a tiny amount of skin and it was healed up very nicely before even his umbilical cord had fully dried and fell off.

I should have been more clear in my comment. I don't think they were trying to convince people against it, just that it had that effect on me personally.

>but about 100 years ago

It wasn't really an issue for the most part until laws were changed in the early 70s - by Nixon.

That was when for profit health care took over here.

Person not alive in the 70s here (and not researched it), but curious why our heath care system is so bad. Could you elaborate on your point / give some sources? It seems interesting to me.

Immediate skin-to-skin contact has reemerged based on data in the United States. Some hospitals made the switch years ago. Immediate skin-to-skin contact and the newborn, unless there is a medical reason to do otherwise, is never removed from the presence of the birth mother.

In some cases this requires re-tooling and renovating the birthing wing of hospitals as they were previously optimized for immediate incubation by default. It takes time and money.

Midwives are the way. My first child's prenatal and birth was < $5k, born at home.

Amazing. In the Netherlands it is free. You get a midwife, hospital and medical staff when required. You get a box of goods for the first days of baby care. We get 4-6 weeks paid leave as a father and 16 as a mother. There is help in the house for about a week to take care of baby and mother and do checkups.

The only thing you pay a symbolic amount of money for is some to borrow tools like bath chairs.

Probably some pain meds require a contribution but you never pay the whole thing.

Children up until 18 are insured on your own insurance policy without additional fees.

It must be hell to live in a cold place as the US where everything costs tons of money out of pocket.

> We get 4-6 weeks paid leave as a father

this is technically true, but for context: it started in 2021. Before it was 2 paid days and 3 unpaid days _in total_.

Also the last 5 weeks are 70% paid (at least for me)

Parental leave in the Netherlands, both for women and man, is the lowest in the EU. By a wide margin. So, while we get some things right, leave and the conseqences that implies for the carreer of the mother is not something we can boast about.

In 2018 we were indeed among the lowest but not the lowest: https://www.capital-ges.com/wp-content/uploads/2019/01/1.png from https://www.capital-ges.com/maternity-paternity-and-parental...

I am not sure the career consequences are better elsewhere. What makes you say that pregnancy/motherhood has less effect on careers in different countries?

That graph does not represent the actual situation, it might include just full-paid leave. In countries like Germany, France and in Scandinavia, you get a shared budget: e.g. in Germany as a couple you get 14 months of which one parent can take 12months max, at ~65% pay. That's a whole different ballgame than the Dutch 5 weeks, even if fully paid.

I lost access, but I seem to recall this [1] article covers it quite thoroughly: low paternal leave is a likely explanation for the low (again, lowest in the EU) number of woman working fulltime. Then there's [2] and [3].

It seems obvious that once you enable the partner to take care, you enable the couple to make their own choices, whatever they may be.

[1] https://www.ftm.nl/artikelen/kasboekje-vrouwen-financien [2] https://decorrespondent.nl/8071/vind-jij-ambitieuze-vrouwen-... [3] https://decorrespondent.nl/8071/vind-jij-ambitieuze-vrouwen-...

Lowest in the EU? The father has 1 week off in Italy, and this has been increased from 3 days in the last 2 years. Mother has up to 2 months I believe (I'm a father and was shocked by this. If you had a kid, you'll laugh at anyone presuming 1 week is enough)

I really don't get that sentiment though, as a German citizen for example health care insurance is mandatory as in you pay a certain percentage of your salary each month towards health care insurance. So by any means it isn't the land of free healthcare some people made it to be. Also in the US there is the Charity Care Policy that applies when you make under a certain yearly salary.

In essence if everyone pays it through their income it is free as it will effect the buying power of everyone. Also because everyone chips in the individual contribution is lower.

Most people have good health care plans through their employer that pays for most of this stuff. I paid a few hundred dollars to the hospital when my child was born and we were there for several days. There are just a lot of people who for one reason or another do not have those benefits. It’s a very multimodal experience here unfortunately.

Given my experience with both the US and Swedish healthcare systems, I'm not sure I would rate even the absolute best healthcare plans as good. Growing up, my healthcare plan was about the best possible (both parents were doctors in the same hospital so we got a sort of deluxe super plan better than even the regular doctor families got with only one doctor parent), but I would still say it was about as good as Sweden's setup.

I don't mean this as an attack on you, but I think Americans overestimate the quality of their healthcare. The US system really is pretty bad from top to bottom. There are of course people who have it _worse_ (e.g. those not insured at all), but I don't find any aspect of the system particularly impressive. And considering the fact that it's by far the most expensive per capita of any healthcare in the world, it really becomes totally inexcusable. American healthcare is a national disgrace.

But if your employer is holding your insurance they can do all kinds of things. You are afraid to quit because you will lose insurance.

I have also read here on HN someone from SF paying a $4000 fee per month and still having to pay for a large part of hospitalisation. So it appears to be not so rosy even for the well off.

That was about the total for each of our hospital births.

Medical experiences and costs in the US really are crazy variable.

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