Pregnant in Bermuda

I am not, but the wife of one of my husband’s colleagues has just had a baby, which led me to thinking about how antenatal care and childbirth is managed here on the island.

 

The Queen visited in 1953 and was introduced to  Bermuda triplets. The paper reported that they were the first in over 200 years but the Outerbridge family had triplet boys born at a home on the North Shore Road in 1927. I tried to look up how common triplet births might be here but the search term triplet births in Bermuda led me to a page on raising goats!
( http://www.weedemandreap.com/2013/01/a-simple-guide-to-raising-milking-goats.html )

Although Bermuda is a British Protectorate the medical system is more akin to that in the States. So the bulk of maternity services are private and financed through insurance which is compulsory (the company has to organise health cover for employees).
The Bermuda Hospitals Board lists 9 Obstetricians on the island, (http://www.bermudahospitals.bm/bhb/find-physician/index.asp )
though the September 2013 Healthcare Directory states there are 7 (issuu.com/bermudasun/docs/health_care_part_3_-_july_2013 )
and there are around 600 births per year. In 2009 there were around 840 births annually, the drop probably reflects the reduction in population and loss of expat-workers during the last 5 years.

Unlike in UK where midwives are the primary carers during most normal pregnancies, here the obstetrician model of care persists. It is common to be delivered by your obstetrician and, perhaps not unrelated, the instrumental deliveries are higher than one might expect.
It seems to have taken a great deal of pressure and effort by concerned groups of midwives to enable them to practice as independent professionals and to offer the option of home births.

Antenatal medical checks are apparently more frequent than in UK and the tests include things such as cervical smear in early pregnancy, which in current UK practice is usually not done. (on the basis that the hormonal changes will affect the cervical cells so diagnosing pre-malignant change is inaccurate during pregnancy). It is difficult not to think that this is driven by the way healthcare is funded, but thats another issue and one it seems that even caused trouble for President Obama so I will avoid it! However you will have all the usual screening: Quadruple test for assessing Downs risk, ultrasound, Foetal heart rate monitoring, usual blood tests, glucose test, and if you should need it they have facilities for chorionic villous sampling in early pregnancy or amniocentesis in mid pregnancy to detect genetic abnormalities. If anything you will be seen more often and tested more often than if experiencing UK antenatal care and you will have access to a midwife and an obstetrician for all of this care – GPs do not tend to take on anything but the most routine antenatal checks.

Back in July of this year two Bermudian doctors (Dr Alton Trott and Dr Yusef Wade) set up a new and modern OB-GYN service at offices close to the hospital. They are both American trained but decided to return to Bermuda once they started their own families. Both can trace their families back hundreds of years on the island. The reporter who interviewed them was impressed by the comfortable clinic room “lined with bookshelves and with a fire place”. They have a website: http://contemporaryobgynbermuda.com

Prenatal classes are offered at the hospital, on Tuesday evenings, a four-week programme. You are permitted one birth coach (they were called husbands when I did this).

Baby Showers are customary
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Gibbons stock absolutely everything you might need and many baby gadgets you don’t. There is no Mothercare or Early Learning Centre and the M&S only stocks a small selection of baby clothes. An overseas trip might be recommended for variety and to avoid turning up at a coffee morning with babies in identical outfits!

What are your options for delivery?
There have been 42 home births, some of them water births – but this is in the last 9 years, so clearly not widely available yet. If you are contemplating this you should speak with Sophia Cannonier, who was Bermuda’s first doula, or look up http://www.consciousbirthbermuda.com/ConsciousBirth/Welcome.html

The maternity unit has four delivery suites, each painted attractively, but the process is likely to be quite traditional. I don’t think they do six-hour discharges over here. Visiting times are strict and siblings can only come between 4pm and 6pm. The wards are locked and have a security guard – it sounds severe to write that but I suspect this is in fact reassuring.

There is a neonatal unit, but I cannot find out how many incubators or cots it has. They do send babies with more complex needs across to Halifax, Nova Scotia
http://www.iwk.nshealth.ca
No direct flights that I can find, a cost of around $300 each way and a journey time of at least 6 hours. My daughter, currently working in neonates in UK, told me of a poor mother in labour recently who had to be taken to another hospital to deliver because all of their neonatal beds were in use – I don’t think that would be a wise move from Bermuda. That does mean that if you have any difficulties with your pregnancy or the baby needs extra monitoring then you might need to consider being abroad for periods of time.

What about working in Bermuda as a doctor? Both UK and US have accredited training posts here for their programmes in most areas of medicine, including O&G. The issue of malpractice insurance needs to be looked at closely. Obstetricians tend to expect to pay more for this cover than some other specialties, in part because the child has until they are 21 to sue for problems that may have occurred during the pregnancy or delivery. So the premium on Bermuda for an obstetrician has risen in the last few years – around $200,000. The birth rate on the island is too low to compensate for this. The solution reached just last year was for the obstetricians to become employees of the hospital (King Edward VII Memorial Hospital) and receive cover under the umbrella of the local insurer. This allowed maintaining a threatened obstetric service on the island.

Once you have had the baby – it is a wonderful place to bring up children!:)

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