Sunday, September 9, 2012

Things don't always go as planned

In fact, they usually don't.  I had planned for another home birth.  I had also planned for the trip back to America to only last a year.  Let me back up a little...

We lived a simple, quiet life out in the wild, wild West Bank--as some liked to call it.  Felt like the last place in Israel where one could be a "pioneer" and farm a piece of land without spending three lifetimes' worth of savings to do so.  Even though the generator broke down rather often, no one had air conditioning, and the few scraggly trees kept getting eaten by an absent-minded neighbor's animals...we were out of the rat-race, unplugged, living off the land.

There was a sense of satisfaction that came from such a life.  One that had absolutely nothing to do with politics, but you can't run or hide from them.  In 2005, the 8,000 Israeli residents of Gaza were uprooted from their homes for the simple reason that they were Jewish.  Violent clashes, wounding hundreds of people in Amona, followed in the same month that Puriel was born.  We kept hearing rumors that our town was "on the chopping block."  After all, we were on the "wrong side" of the fence that was going up.

Around that time, my husband had finished his seventh year in yeshiva and mastered the practice of shechita (kosher animal slaughter).  He started talking with the school's founder, Rav Adin Steinsaltz, for guidance on how to best put his education to use.  Since he is a descendant of benei anusim, we set out for the American Southwest to help others in that same boat who are reconnecting to their heritage.

It wasn't your typical shlichut.  There was no house, job or car waiting for us; no cohesive community.  Just scattered pockets of a dozen or two people here and there, greatly lacking local educational resources.  We planted ourselves in San Antonio quite by accident after a visit that was only going to last a couple of weeks.  One year passed, then another.  I found a great job and my husband taught classes.  We bought our first-ever new car and had a nice house that sometimes slept guests in the double digits.  Gone were the days of clothes made from old bedsheets; we shopped at outlet malls now.  We had air conditioning.  The plumbing and electricity always worked.  It was quite comfortable.  A third year began.

Happy third birthday!
Puriel had his first haircut.  My baby was growing up and was already the same shoe size as his sister.  I stopped preventing pregnancy, unsure of when the next one would come but very sure that I wanted another at some point.  Within a month I had a bun in the oven.

We're going to get stuck here forever, I thought...not altogether dreading the idea.  Many Israelis go to the US for a season and stay until retirement.  The cushy life was nice, although the thought of paying $10,000 for my daughter to attend Jewish kindergarten in the coming year was not so appealing.  Ultimately, I wanted my kids to grow up in a Jewish environment with a good education and friends who share our lifestyle.  Israel still seemed like the best place to make that happen.

We're moving back--now, we decided...and started packing up the house.  A container was too expensive, even to split the cost was out of our reach since we needed some funds to land with while looking for work and settling in.  Whatever couldn't fit in our suitcases had to be sold or given away.  This would be my seventh time moving overseas and starting from scratch.  I promised myself it would be the last.

I had the worst morning sickness ever this time and subsisted off little more than soda water and matza for the entire first trimester.  Got in touch with my midwife, who warned me so severely to avoid sugar (because my last baby was big) that she said I shouldn't even eat fruit.  Something didn't feel right about that but I tried to obey, hoping this baby wouldn't top Puriel's 3.9 kg birth weight.  I dropped from full-time employment and lost my medical benefits.  Aaron became a taxi driver for the summer while I packed with two little ones underfoot.

By the time we arrived in Israel, I was finishing up my second trimester.  We lived in two temporary apartments before settling into a third.  Ended up back in Tekoa, but in the main part of the town with a few hundred other families instead of out on the edge like before.  We rented the upper floor from old friends and our kids played together everyday after school.

Back in Tekoa
In the meantime, I had no health care.  We had filled out the proper forms before leaving to suspend our national insurance payments and should have been eligible to pay the hefty fee of NIS 9,000 to get back into the system.  This law exists to keep people from leaving the country and only coming back in cases of severe illness to receive expensive medical procedures at little to no cost.  Because I had a midwife and planned for a home birth, I wasn't so worried--at first.

But something felt very different about this pregnancy.  Felt very wrong.  I hadn't been able to do any of the usual screenings or tests and started looking for a place to do basic blood work and an ultrasound.  When you give birth at home, I believe it's a good idea to make sure that there are no surprises.

Private health care was too expensive.  It would cost NIS 800 (over $200) just to get an appointment with a doctor who could order the tests (which, of course, each test had its own high price tag).  With a lot of help from my mother, I finally found a Catholic hospital in East Jerusalem, where an Arab doctor who works at Hadassah hospital runs a clinic one day each week.  His fee is a quarter of the going rate and the tests are done in-house, also at a much lower cost.

Surprise!  At 32 weeks I learned that my baby was already over 3 kg and breech, and that the reason it looked like I had twins from the outside was because of an abnormally large amount of amniotic fluid.  That ruled out a home birth for me.  But a hospital birth without insurance costs upwards of NIS 15,000 for a natural, uncomplicated birth.  If a cesarean was needed, it could end up being double that amount.  Suddenly the "redemption fee" for the insurance didn't look too bad.  But they wouldn't even let me pay it.

One trip after another to Bituach Leumi (the National Insurance Institute) left me with a different answer every time.  I kept going back, hoping for a miracle.  And one day the first of miracles came.

"Your husband is out of the waiting period," said the middle-aged woman with reddish-purple hair.  The waiting period is six months from when you return from a 2+ year absence, but almost three months after my due date.  "Did you leave and come back at different times?" she wondered.  No, we were on the very same flight as each other.  "Do you want me to fix the problem?" she asked with half a smile and the first hint of sweetness.  No, no thank you.  She even moved the kids, from being listed under my name, to being with my husband.  Now everyone in the family had health insurance again...except me.

A follow-up visit to the doctor--right after we moved into our third apartment--revealed that my tush-down breech had become a 36-week, 3.5 kg, footling breech.  What doesn't kill you makes you stronger, I kept telling myself.  But I still cried everyday from the stress of it all.  My husband was working a night-shift in Jerusalem even after our car broke down.  Then he found a local job, but they never paid on time.  Puriel was getting bullied in preschool.  Teneya was the only one who was settling in well.

The next trip to Bituach Leumi yielded a new development.  They would finally let me pay the redemption fee and come out of the waiting period early.  Better late than never, I sighed with a fair amount of relief.  But by then our savings were all used up.  We would have to use our credit card.

Bituach Leumi accepts foreign credit cards, but their payment system was down that day.  Try again after the weekend, they told me.  First thing Sunday morning, I was on the phone.  Sorry, it's still down--do you have an Israeli card?  We had just opened a new account upon returning to the country and the card had a NIS 500 limit.  Nope.  First thing Monday morning, I was on the phone again.  That's when the next miracle happened.

"What are you trying to pay for?" the lady asked me, with no amount of patience in her tone.  "You're not in the waiting period anymore."  Another glitch.  Another wondrous computer error.  I went that very same day to the clinic to get my insurance card printed.  "But you're in the waiting period," came the conclusion after nearly an hour of unsuccessful attempts to register me.  An hour more of phone calls to the main office of Maccabi and Bitach Leumi finally cleared things up.

It was official.  I had health insurance.  Slept better than ever that night and woke up the next day with a bit of spring in my step...something that had been missing for a long time.  I scheduled an appointment, curious about external cephalic version (ECV) and eager to avoid a c-section, but it would take a week to see the doctor.  A friend who had high-risk pregnancies took me in person the next day to her doctor in Jerusalem, who worked out of a clinic attached to the hospital.  He was over-booked already, but had some great advice for how to get a checkup without waiting for an appointment.

"Go upstairs to the maternity ward and tell them you're having contractions.  They'll take good care of you right away."  So that's what I did.  Turned out that baby had flipped head-down on his own and that's why walking was suddenly easier.  Hurray!  But by my checkup later that week he was breech again.  ECV was scheduled for 38 weeks and he stayed that way until the very end.

Bundle of miracles
My little bundle of miracles was born on a Shabbat morning, after 7.5 hours of labor, at the end of Hanukah.  He weighed in at 4.08 kg and had loads of strawberry blonde hair down his shoulders and back.  From all the excess water and freedom of movement, his muscles were developing ahead of schedule and he was holding up his head from that first hour.  It was like he skipped the newborn phase.  I had given birth to a month-old baby.

The land of Israel is often described as eretz hemda, a desirable land; a land that we returned to when we did because of this little boy.  We named him Hemdiya (G-d is my desire).  I added Imanuel (G-d is with us), in gratitude for the miracles that were done for us in our days, at that season.


  1. It's so awful what you had to go through... and that you came through it so strongly. Sometimes things in this country, the bureacracy in particular are just unbelieveable.

    Were these bituah leumi, health care funds all in Yesha? I had heard that services in the "center" (Jerusalem, Tel Aviv, etc.) are run so much better than what we are used to up in north and other periphery areas....

    1. Thanks. I went to Bituach Leumi offices in Jerusalem and the clinic in Efrat. They're making efforts to improve the service each year all over the country, but you're right that there is (maybe always will be?) an overwhelming amount of bureaucracy to overcome.