Where to have a baby in Jozi

Okay. Last mommy blog post, and then we'll be back to the regularly scheduled programming. 

Genesis was amazing. If i have another baby, I'd like to do it in Johannebsurg just so I can go back. It's just a birthing centre, that various health professionals work out of; slightly different from hospitals. It was a fabulous place - the focus is on natural births (though they do emergency C-sections), you get a big, comfortable, private room, with a big bath, shower, chest of drawers, music, garden, etc. The food is good, the staff are *incredible*, and the experience is, all in all, unbeatable. Oh, and it is fully covered by medical aid, without payment upfront, or any paperwork.  And they have a full contingent of related services, from breastfeeding support to antenatal classes. I can't say enough good things about it. 

It's the only place I've ever had a baby, so I can't comment first hand on the places, but I do know people who've chosen other locations:

- Brenthurst and Park Lane. I'm lumping these two together, because they seem quite similar (though Park Lane has a 'stork's nest', which is handy). They're clinical. There's good quality care. C-section rates depends on individuals involved; no particular support or opposition to natural birth. You have to pay for a private room. It's generally functional, and not terribly unpleasant, but not an enjoyable environment. The bigger downside is that it seemed impossible to find any information about how much it would cost and what insurance would cover.  The paperwork headache seemed substantial and thankless.

- Joburg gen and helen joseph. Public hospitals. In general, these have gotten positive reviews from friends who had uncomplicated births and aren't looking for bells and whistles. In Johannesburg, service seems often as good or better in public hospitals than private ones, and c-section rates are actually quite low, since most births are attended to by midwives. Lack of capacity, in an area that's generally over-medicalised, has perks. If my insurance coverage weren't as good, I'd give it a try - I was more worried about the unknown than quality of care. I didn't want to have to learn how to negotiate a difficult system while in labour. Downsides reported is that they're a bit crowded, and you need to sort out all the extras yourself. 

Care work decisions

I got a job offer last month that I feel ridiculous about having turned down. It should have been perfect. It was a part time job. It was flexible. It paid well. I said no. At that point, I hadn't arranged child care (I still haven't), and they wanted someone to start immediately. It was for 8 months - which isn't long in the scope of my career, but seems like forever in the childhood of baby. The problem is, I'm going to have to make the decision at some point. As I'm starting to reconnect to the work world, some things I'm learning seem quite obvious:

- Leaving your child with someone else is really hard! I suppose this is to be expected. But….holy cow! It's really hard! I feel like that ought to be a sign that maybe it's not the way to go….

- One of the blessings of living in South Africa is that good quality child care is readily available, and affordable. Finding it is tricky, since crummy child care also abounds.

- Taking care of a baby is work, even when it's so fun it doesn't feel like it. It's amazing how much you can get done in the 15 minutes snatches where she hangs out on the play mat, but basically, large tasks (and scheduled meetings) have to happen after bedtime (happily, I've now entered a baby stage where there IS a bedtime!). *This* is why mothers are sleep deprived. That may get better when she has a nap schedule? Or a nanny...

- I feel like I'm in a bit of a chicken and egg situation. I can't make arrangements to work without child care, and I can't arrange child care without knowing what my work arrangements will be like. At the moment, I have a corps of babysitters that are great for occasional gap-stopping, but nobody who's slated to come on a regular basis. Obviously, that suits me for the time being, but won't as I step up work commitments.

- I want to raise my own child. And I want to work. It seems like this is just not done. What a bizarre world we live in! 

Having babies in Johannesburg

Having a baby in another country has a serious learning curve. Having a baby anywhere is quite an experience….but when you add to it a new healthcare system, and no family around, there are stories! I'm sure all of this is completely obvious to anyone who grew up here....but it wasn't to me.

Things that I learned:

- Unless for some reason you have a high risk pregnancy, not only do you not need an ob/gyn to be your first point of call, chances are you don't want one. Find a good midwife. It is more flexible, cheaper, easier, more informative, less medicalised, and an all around friendlier experience. In the hunt for someone to provide medical care, I visited 7 different ob/gyns, and was unhappy with *all* of them for various reasons. Most of them were perfectly competent health professionals, they just weren't what I was looking for. The issues ranged from being too busy to talk to me during a 15 minute appointment, only having 2 free slots for appointments in the whole 9 months of my pregnancy, costing 20x what my medical aid would cover, trying to schedule in a c-section when I was only 20 weeks pregnant, would do the check ups but not the actual delivery, to being an hour's drive away. I was absolutely fed up in a search for an ob/gyn, really wondering how anybody in Johannesburg had children…until I found a midwife! It was such a relief. She was friendly, had time both for appointments, and to talk to me, explained everything, and had what I see as a perfectly positive and balanced approach towards natural childbirth.  I never looked back!

By coincidence, when I found a midwife, she came with a place to have the baby! More on that later...

- Depending on where you go for delivery, they come with lots of 'extras' - lactation consultants, ante-natal classes, and so on. I didn't particularly feel like I needed any of them (or was possibly too busy to take advantage of any of them), but other people I know would have benefitted from them. If you are looking for these things, pick a place accordingly. Otherwise, you'll have to hunt around for these separately....and hunting around for things is low on the list of things you want to be doing when you can't fit into any of your clothes.

- Getting decent information about what your insurance covers and what it doesn't is virtually impossible. After many hours on the phone, I gave up, and concluded it's  better just to save up a little extra money and cross my fingers.  I'm insured by Discovery, which is supposed to be about as good as it gets, and would be impressed if anyone had a different experience with other insurers.

- Being obviously pregnant is a fabulous conversation starter. It's as good as being obviously white on a taxi. This does have a downside (WHY do people think it's acceptable to talk to you about their hemorrhoids?), and the volume of unsolicited advice is astounding, and amusing, but the amount of good will is really lovely. 

- There are hundreds of lists out there of things you need for a newborn. You don't really need any of it, and even if you have all of it lined up, you're still going to have to make a last minute run to the shops, so chill. 

Where to go for baby shots

There are certain things that, no matter how long I've lived in another country, I never seem to understand quite as well as my country of origin. Examples: taxes, retirement savings, and health care systems. I didn't understand how much I didn't know about the health care system in South Africa until having a baby. The pregnancy and delivery lessons are for a different day. For now, the check ups.

I've taken the baby 5 different places now for her vaccines, and have now settled on Genesis, the clinic where she was born. Reviews:

- Meldene Medicross. It was advertised online as a public clinic, but in fact, you do need to pay, and was actually the most expensive of the places visited. The nurses are nice, but people weren't terribly clued up - I called to ask if I needed an appointment for vaccinations and was told no; when I showed up with the baby, I was told yes, though accommodated anyway. Otherwise, the place seems fine.

- Parkhurst public clinic. The wait was just over 2 hours, not bad, and there is a separate 'well baby' area. The downside was there was almost no communication about the baby's general health - more of an assembly line setup. For shots, it would have been fine. However, I was told that since I didn't live in the area, I couldn't come back, and had to start the baby's file at the clinic closest to where I live. If i lived the area, I'd probably go back.

- Bez Valley public clinic. I went twice, once at 11 in the morning, once at 7, and both times was turned away and told to come the next day (after nearly a 2 hour wait) because the crowd was so big. Others in the queue told me that this is a new state of affairs, but this is decidedly the most over-crowded place I went to. May be that I tried to go once on a week with a public holiday? Avoid at all costs.

- Yeoville public clinic. The lines are long, but they move fast if you arrive early. The wait was under 2 hours. The downsides are that the baby must wait with all the sick people, staff are far from friendly, and the xenophobia makes me irritable. On one hand, a good way of connecting to the 'hood. But with a 2 month old baby, just not quite what I was looking for.

- Genesis. The private clinic where she was born. A woman comes Thursdays and Fridays to give vaccines; you text her in advance, and she gives you a time slot. She's incredibly knowledgable, and visits for vaccinations have basically made a visit to the pediatrician unnecessary, because she's so thorough.  It's not cheap, but it's also not much more than health insurance rates.

Conclusion: Private care, in this case, doesn't cost much more than public (if you have insurance). If you don't, the Yeoville clinic was probably the best of all visited so far, but coughing up the extra for Genesis is worthwhile. I see all my principles slipping away with the arrival of the baby....

Carless days are over

I have been bullied by the charming 3 month old into buying a car. This is it.

After one taxi ride from Eastgate in which child screamed for the longest 15 minutes of my life, I decided it was time....that, and my inclination to leave home moved from 2 to about -10. 

It's like a different city with a car; and a different rhythm of life. No longer having to plan around dusk, taxi routes (which fill up quickly at different times of day, which route will let you change taxis in the safest, most convenient place), weather...it makes going out so easy that it's no longer fun!

I'm terrified - of spending all my life moving between malls and gates. Of the way interactions with people asking for money on street corners is bound to change. Of hijackings (I was thrilled that I had discovered a 100% guaranteed way not to be hijacked. I've just given it up...). Of not walking any more. Of raising a child who thinks private car ownership is 'normal'.

But, I'm also very grateful, that at this particular time in my life, I have the choice to have a car. I'm slightly resentful that it's necessary to maintain my independence and live an active life....but, that's where I am right now, and I wasn't getting anywhere pretending it would work to have a kid and not a car. What it has given me is a whole new perspective on the city (more coming up).

New City

She is why I haven't been writing lately. But now that she has a whopping 15 weeks of experience on the planet, I can resurface. She has already shown me a dramatically new side of the city; Johannesburg as a mother! 

Moving weekend

Moving weekend is always a particularly fun time to sit on the balcony and watch the neighborhood go by....there are always amazing things being transported down the street, usually by hand. Sometimes, the stuff itself is entertaining (Saturday, there was a wardrobe that had been converted into a chicken cage). Sometimes, the transport feats are incredible (on Sunday, 6 couches in a row paraded by, on 6 men's heads. I wonder who needs 6 couches, and I wonder how hard it is to see with a couch on your head). Sometimes, the stories created in my head are the highlight (a particularly masculine man went by, carrying a humongous heart shaped glass plate, delicately etched in flowers. I tried to imagine where he lives, and how it will fit in).