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Beating the delivery line

After being turned away from crowded Prague maternity wards, couples fight to find a hospital

By Curtis M. Wong
Staff Writer, The Prague Post
July 16th, 2008 issue

VLADIMÍR WEISS/THE PRAGUE POST
Katka Hovorková (with husband Jan and daughter Amálka), was urged to find a ward just weeks after learning she was pregnant.
VLADIMÍR WEISS/THE PRAGUE POST
Katka ultimately chose to give birth in the nearby city of Benešov, which has no early registration rules, after facing difficulty getting checkups.
Sitting in a café near Wenceslas Square, Jan Hovorka and his wife, Katka, seem like your typical new parents, doting endlessly over their 7-month-old daughter, Amálka, as she shifts restlessly in a buggy.
“It’s a real joy,” Jan said of his experience as a new father. “It’s something just extraordinary.”
Katka adds, “You can see she’s growing every single day. And, as she’s getting bigger, it’s becoming more and more fun to be with her.”
While life is mostly blissful in the Hovorka family these days, the months leading up to Amálka’s birth last December were not so easy. Just two weeks after discovering she was pregnant, Katka was advised by colleagues and friends — many of whom had recently become parents — to register with the maternity ward at Podolí Hospital or risk being turned away from the delivery room prior to giving birth.
“It was an extremely stressful scenario,” Katka said. “The situation in Prague hospitals is so bad that, even when you register, there’s no guarantee that a bed will be available for you. The whole registration procedure doesn’t make any sense to me.”
Scheduling prenatal checkups and screenings in the final weeks of her pregnancy also became an issue. During one visit, she was told by her doctor that a follow-up appointment wasn’t available for up to six weeks.
“If you don’t ask questions, no one tells you anything,” she said. “You feel like a piece of meat. It’s all very impersonal.” In the end, Katka became so frustrated that she opted to deliver her baby at a smaller hospital in the nearby town of Benešov that didn’t require early registration. There, she says, she received a more personalized level of care as well as alternative birthing options.
Katka is just one of many new mothers to experience the problems Prague-based hospitals have faced as a result of a recent baby boom. Indeed, the birthrate has steadily increased since 2003. In 2007, the Health Ministry reported a total of 114,500 births, the country’s highest figure in 25 years, compared with just 93,685 in 2003.  
As a result, Prague hospitals find themselves strapped with a problem of overcrowding in their maternity wards. Some of the city’s biggest hospitals, including Podolí and Thomayer’s, were forced to stop admitting expectant women preparing to give birth. A warning on Thomayer’s Web site indicates their maternity ward capacity is full through Jan. 6, 2009, and that no expectant women will be admitted before that date.
Whereas hospitals previously required women to register shortly before giving birth — often as late as the 36th week — expectant mothers are now urged to reserve a date at their hospital of choice as early as 10 or 12 weeks into their pregnancies.
“It’s a serious problem, especially for those mothers-to-be who don’t register in time,” said Tomáš Peterka, head physician of the gynecological department at Thomayer’s Hospital, which introduced its new registration system in February. “Often, these women have to find another hospital that is situated far from home and they have to commute there in the last month of their pregnancy for their checkups.”
Health Ministry officials say no measures are currently being taken to address the overcrowding issue on a national level, calling it “a temporary organizational problem … that is up to the individual hospitals and management.”
Many local doctors say they welcomed the early registration requirement, saying it helps them to plan their time appropriately. Still, the system has its fallbacks: Some doctors say they have had to refer expectant patients to other hospitals even when they register early, with the maternity ward already booked to full capacity on their expected due date.
“We want to be able to handle all births, but [after a certain number] we’re unable to provide new mothers with quality care at the appropriate standards,” said Lukáš Rob, chief of gynecology and obstetrics at Motol Hospital, which began pre-registering expectant mothers in October 2007. “This situation became quite acute in the past year. … We’ve received some complaints from mothers about the system, and they were often absolutely right.”
Rob recalled a particularly high number of complaints when the hospital was forced to move mothers to other departments shortly after giving birth because there was simply not enough room in the maternity ward. This was an unpopular measure as it required many mothers to be considerably separated from their newborns, he said.
 As for Thomayer’s Hospital, Peterka said it has only had to turn away two expectant mothers in the past year, though he expects this year’s figure to be higher. Needless to say, his staff has already experienced emotional reactions from many expectant mothers.
As Health Ministry officials expect the current boom to last another two to three years, some hospitals are considering more permanent solutions.
Officials at Thomayer’s Hospital say the maternity ward is currently undergoing an extensive renovation that will increase patient capacity by 13 percent. Others, such as Motol, are unable to accommodate such measures due to ongoing renovations in other wards.
While officials urge new mothers to take the registration system in stride, many women who are preparing to deliver a second or third child find the situation especially unbearable. When she gave birth to her first child four years ago at Motol Hospital, Prague resident Jana said she received satisfactory prenatal care. As she prepares for her second child, due in January, however, she finds the situation vastly different.
“I’m not sure if we’ll soon be giving birth to our babies in train stations or what,” she said. “The care and attitude toward mothers needs to be more sensitive.”  

Curtis M. Wong can be reached at news@praguepost.com


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