Living and Delivering in Bangkok.

We are taking the weekend off and hunkering down at home in order to try and work on Anna’s nap schedule and get a routine established before we head into the whirlwind that is March and April (lots of regional trips planned and lots of visitors coming to Bangkok!)

I wanted to take a minute and talk about my personal experience being pregnant and delivering in Bangkok. 

I came to Bangkok well into my second trimester.  All of my genetic testing and screenings had been completed stateside before I arrived.  I also had two previous, completely unremarkable pregnancies — resulting in normal, healthy deliveries (and two beautiful boys).  I thought I would be coasting through my third pregnancy.  Bangkok is known for having pretty good medical care after all.  I was wrong!  The process was not as smooth as I had hoped.  The cultural issues that come up when expecting in Bangkok can be overcome but they certainly shouldn’t be ignored.

There are a few major international hospitals located in Bangkok (BNH, Samitivej, Bumrungrad, etc).  Because Bangkok can have some pretty horrendous traffic, typically,  you pick the hospital nearest your home.  I had a history of rapid labor and knew my only hope of making it to the hospital (vice delivering in a tuk-tuk) was to pick a hospital that was close by.  The hospital we chose was only a couple of miles away.  It was clean and modern with a nice labor and delivery section/nursery.  Overall, the hospital care was very similar to that I received during my first two pregnancies back in the United States.

My biggest issue was my doctor.  At our first meeting we discussed my medical history and how I wanted to follow the American standard of care.  We discussed my rapid labor and made a plan for how to deliver… that plan did not last past that first meeting.  Throughout my pregnancy we missed standard tests (including gestational diabetes and Strep B).  I was also denied other care which I requested and which was covered by my insurance (such as a toxoplasmosis test).  It became clear overall that he did not really want to discuss my care or my concerns.  My doctor was not going to stick with our original delivery plan.  Eventually, my husband and I wore our doctor down, we stuck with the plan, and we had a very smooth delivery.

Overall, I was glad that this was not my first pregnancy and that I knew what to expect and what tests I wanted done.  This ensured I could be my own advocate and fight to received the care I wanted.  But I did not like feeling like it was a fight (especially since it was a fight with the man that would be delivering my baby!)

This is just my experience and I know other mothers who have had much more positive experience with their own deliveries here in Bangkok.  But it did make me think that it would have been nice to have a heads up that this is how it could go.  Below is my list of things I wish I had known before delivering in Bangkok!

Things to keep in mind for prenatal care (again, completely based on my own experience):

• Unlike in the United States (where you might go to a large OBGYN practice and see many different doctors throughout your pregnancy) in Bangkok you will have one doctor assigned to you throughout the duration of your care.  This is the doctor that will deliver your baby.  Their office is associated with and located in the hospital where you will deliver.
• The checkout process can take a VERY long time.  I had to allocate at least three hours for every prenatal appointment.  This included time to get to the appointment, spend 10 minutes talking to the doctor, then completing the long and arduous check-out process.  At our hospital this process included waiting in the doctor’s office for your medical certificate (needed for submission to insurance company), walking to the cashier location, checking in with the cashier, and then waiting for your insurance to be cleared and for the cashier to get through the large queue of people ahead of you.  Allocate your time accordingly!
• Most importantly, you need to be proactive about your care.  Know what tests are standard and if you want to receive these tests.  Remind your doctor of upcoming tests and have them scheduled ahead of time.  Do not rely on your doctor to order the appropriate tests.  Some tests are not required in Thailand and the doctor may not automatically administer them.

Things to keep in mind for delivery and postpartum care (again, all based on my own delivery!):

• Your husband may not be able to stay in the room with you.  During my last OBGYN visit we made the decision to induce the next morning and were told to go to reception and register for a room.  During registration we found out that Chad would not be able to stay overnight in the room under our insurance.  To stay overnight he would have to pay extra for a luxe suite.  We did not pay extra.  Chad would be sleeping at home.
• If your community in Bangkok is mostly expats, you may forget that most people in Thailand don’t speak English.  Your doctor will likely speak english (you picked him/her after all) but your nursing staff may not.  My husband speaks Thai.  My care was very smooth while he was around.  But he was not authorized to stay in the room overnight (and he had to get home to our two older boys anyway).  So, nights were sometimes rough.  At times it was difficult to communicate.
• It is not automatically assumed that you would like to room-in with your baby.  In our case, Anna was taken away to the nursery for some time after she was born.  The plan was that she would be brought to me when she needed to be fed.  We did not like this arrangement and asked for Anna to be placed in our room.  The staff granted this request immediately and Anna was placed near my bed… right where she belonged!

During the pregnancy there was certainly a lot of stress.  Now, a month after Anna’s birth we are just beyond happy that she is here and healthy.  If she would sleep through the night that would be great, too.