Postpartum Care Abroad: When the Nurse Midwife Is Too Hard-Core

One of the supposed joys of having a baby in Switzerland is the eight free visits from a midwife during the first few weeks after your baby arrives home. Although I babysat every weekend during high school, I hadn’t changed a diaper in almost 20 years. Two months prior to our due date, I learned that my wife, Vicky, hadn’t changed a diaper in her entire life. After our midwife’s first visit, we quickly realized that diaper changing was the least of our worries.

Throughout Vicky’s pregnancy, a growing list of anxieties was exchanged across the dinner table: How do we bathe a baby? How many layers of clothing does a baby need to wear in the house? When can we start bottle feeding? When can we take a baby outside? And, can a baby really sleep in the cardboard box that Vicky purchased on the internet? As first-time parents, the thought of having a professional come to our home and answer these questions was reassuring.

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Having grown up in the U.S., I didn’t even know what a midwife was until Vicky and I went to a two-day birth primer — also free — at the hospital where our baby was to be born. The midwife teaching the course was pleasant enough, but we weren’t enamored by her responses to our countless questions. When we asked how soon we should go to the hospital after contractions started, she shrugged and replied something along the lines of, “Oh, you will know. But don’t rush, just take a bath.”

Vicky didn’t welcome these vague answers, and after two days of similar responses to our queries, we still hadn’t learned much more than the fact that this particular midwife had a thing for baths prior to labor and that during contractions, I should rub Vicky’s back while she rolled on a therapy ball. When I suggested a bath to Vicky after she woke me up at 3 a.m. on the day our son would be born, she scowled at me. And when I placed my hand on her back during a particular painful contraction later that morning in the hospital, she growled, “Don’t touch me.”

Unbeknownst to me, a midwife, not a doctor, would be delivering our baby. During the last hour of labor, a doctor arrived because our baby’s heart rate dropped, but other than keeping an eye on the baby’s vitals and giving me a play-by-play, the midwife did most of the work. I couldn’t have asked for a better experience.

Like all things Swiss, the midwife we hired for home visits showed up for our first meeting exactly on time. Vicky; our baby, Aksel; our Bernese Mountain dog, Sierra; and I greeted our midwife at the door. Our cat, Nimera, watched crossly through the patio window. After rehashing the birth and first few days at home, we gave the midwife a tour of the house — careful to point out all of our top-of-the-line baby gear. Surprisingly, she loved the cardboard box. After weighing Aksel and performing a quick exam on Vicky, we were finally free to bombard the midwife with questions.

Vicky and I initially thought that the midwife’s keenness for our cardboard box was a harbinger of our parenting acumen, but her responses to our next few questions gave us serious pause. When we asked about taking Aksel outside for a stroll, she said, somewhat sternly, that Aksel shouldn’t go outside as he didn’t have an immune system yet. When we asked about using the breast pump so that I could take over some of the feedings, she said that while it’s medically safe to start at six weeks, she wouldn’t recommend pumping or bottle feeding, ever. Our next question about pacifiers was answered with a brusque, “Never.”

The midwife’s second visit centered on bathing Aksel and inspecting a serious case of diaper rash. After she praised us about the quality of our rash creams, which we had shipped from England, and Aksel for his amazing weight gain, Vicky and I sensed we were gaining ground and felt confident to raise the possibility of taking Aksel for a walk later in the week. Without taking a breath, the midwife replied, “No.”

Prior to the midwife’s third visit, Vicky and I ran around the house like college kids hiding contraband before parents’ weekend. We stuffed the Ergobaby carrier, which we had just used to take Aksel on an hour walk in the forest near our house, into the bottom of a laundry bin; shoved the pacifier, which was used the night before when Vicky and I were dying for some sleep, in my sock drawer; and, heaved Aksel’s outdoor clothes behind his bedroom door.

At the end of her visit, the midwife suggested coming back later in the week. Vicky and I stole glances at each other and quickly responded that we wanted to try and make it through an entire week on our own and hoped she could come back the following Monday. She seemed to think this was quite a long time between visits, but we insisted that we really needed to practice on our own. Less than 24 hours later, Vicky, Aksel, Sierra, and I boarded a train for a three-hour journey to Andermatt, a small mountain town in the Swiss Alps where we rented an apartment.

We arrived home a few days later confident that having 24 hours before the midwife’s next visit would give us enough time to hide any sign of our trip. Nimera’s smirk, again through the patio window, suggested otherwise.

For all of our furtive activity before, during, and after our midwife’s visits, we are glad to have taken advantage of this unique, at least by American standards, post-natal coverage. With Vicky’s and my parents living thousands of miles away, it was reassuring to have a midwife in the house to ask opinions and questions, even if we disregarded most of what she said. If our parents did live next door, though, I doubt our first month with Aksel would have been much different. Ultimately, we would have asked the same questions and still have chosen to do what we felt was right for Aksel, and for us.

As Aksel embraces toddlerhood and gains more independence, the tables have now turned, and Vicky and I are experiencing firsthand how even the most well-meaning guidance can go unheeded.

Tommy Mulvoy is an American expat living in Basel, Switzerland, with his wife, Vicky, and son, Aksel. When not chasing after Aksel, or keeping the peace between the family’s pets, he teaches English and Special Education at the International School of Basel.