Wednesday, November 2, 2011

Our Prenatal Adventure in China: Part I


Before we left for China, the plan was always to have a baby while abroad.  We wanted to hit the ground first though, to know the healthcare circumstances of our location.  Being “crunchy” parents though, and having already had one perfectly normal (and natural) birth experience, there wasn’t going to be much that could change our minds.  Chinese people have babies all the time!

We live in a fairly rural area, though our closest hospital, the Sanmen People’s Hospital, is only 35 minutes away.  Ironically, the issue here doesn’t seem to be having medical support, but getting the medical community to leave us alone.  We don’t view birth as something requiring a medicalized experience.  We actually only had LiLi at a hospital, instead of a birthing center, because we wanted to go local and utilize the Brockton Neighborhood Health Center’s midwives, who are required to deliver at the local hospital.  However, our midwife fully supported us through a natural birth, kept the nurses at bay, and even let us do skin-to-skin so long after birth we didn’t even know Elli’s length or birth weight when we called our family!  With midwife and pediatrician approval, we were out of the hospital by 30 hours after her birth (she was born at 1AM, so it was nominally 24 hours).  It seems we are going to have to fight pretty hard for a similar birth experience here.

The norm for expats expecting babies in China is to go to a Western hospital in a major city for their prenatal care and birth, which for us would mean going to Shanghai.  However, Shanghai is 4.5 hours away (by car or train), making it a couple day affair (and about $200 out of pocket).  Additionally, as China has modernized, they seem to have taken some of the worst aspects of the Western medical community while limiting some positives.  For instance their C-section rate is over 50% and you are legally required to deliver your baby with a doctor in a hospital.  While the Chinese infant mortality rate has significantly decreased in the past decade, that seems to be related to prenatal care becoming more widely available in rural communities and better education.  There is no data that can link the decrease in infant mortality to hospital births.  That’s a whole other point for discussion though…  Short story: I think China is making a mistake swinging so far in the “medicalized birth” direction, particularly since the vast majority of Chinese women only get to experience one birth.  It makes me sad that they cannot enjoy the beauty of the birth experience without so much medical intervention.

Anyway, we have decided we do NOT want to have go to Shanghai for prenatal care, particularly since at the end of the pregnancy the visits are so close together.  In fact, it appears that we would have to stay in a hotel there for the last two or three weeks.  Instead, we have opted to obtain prenatal care at a Ningbo hospital.  Ningbo is 2 hours away (1 hr. by train) and is a large city (3.1 million pop. in the city proper), but it is not a Western city by any means.  We opted to not just go to the local Sanmen hospital because they do not have any staff that can speak English, and their system already seems overwhelmed.

I found a Ningbo hospital website with a decent English translation, so I e-mailed them to ask if any staff spoke English, about health insurance, etc.  They responded, reassuring me they could assist me (though I would have to pay out of pocket – they don’t do insurance), and told me to call to schedule my first appointment.  I scheduled my first appointment for later that week, 2PM on a Thursday, their first appointment time after lunch, when I was 9 weeks pregnant.  I brought LiLi’s ayi with me, who speaks no English but can use our electronic translator pretty well.  More importantly, if they tell us to go to the fourth floor she can lead me there.  When we walked in, I asked a few hospital staff, “Nǐmen shuō yīngwén ma?” (Do any of you speak English?), but always encountered blank stares.  At that point, my ayi took over since she knew I was there for a prenatal visit.  She helped me to register.  They couldn’t enter my name into the computer system since it required Chinese characters, so my name on all my hospital records is now Huì Lì – which means “beautiful - benefit”.  We were then sent to the 5th floor.  There was a sign in the elevator in English that said that floor was for maternal care – a good start.  However, when we got off the elevator, still 30 minutes before my appointment, I quickly realized that there were 50+ pregnant women, mostly dressed in pajamas (the preferred “pregnant” attire here!), all waiting here for a 2PM “appointment”.  We were supposed to be catching a 3:30PM bus home.  Not looking good…

At 2PM, a nurse appeared and all the pregnant woman (and my ayi) rushed the desk to grab a number.  Soon, an electronic board about the nurses’ desk started displaying groups of patient numbers and room numbers.  My ayi directed me into a room, with about ten other women, where we were weighed and had our blood pressure taken by a machine that would spit out your values.  You would then give this “ticket” with your stats to the nurse in that room and she entered it into the computer.  We then went and sat in the hallway again.  After a little bit, I was directed to a room with a bunch of other pregnant women, where I now know we were meeting with a doctor.  After a lot of animated talking (that didn’t include me!), my ayi was able to translate (via my electronic pocket translator), “when was your last period?”  After I gave the date, I was told to leave.  Maybe they could help me tomorrow.  Apparently I wasn’t pregnant enough to be there for a Thursday appointment.  At that point, I was very disappointed and angry that I had been told they could help me, that I told them how many weeks pregnant I was when I scheduled the appointment, and that in the end I was turned away after driving 2 hours to the appointment.

The next day I sent an e-mail to the hospital, letting them know how disappointed I was after having been reassured that they could help me and explained to them my experience.  I received a phone call a few minutes after I sent it from one of the English speaking nurses, who apologized and said that I was never supposed to be in the maternal clinic, but to have gone to the VIP clinic, where I DID have a 2PM appointment.  I had never received these instructions when making the appointment though, and none of the staff directed me there.  Ironically, it turns out I was literally 15 feet from the VIP clinic when waiting in the maternal clinic.  Since going to Shanghai was even less appealing than trying to navigate the confusing Ningbo hospital, I scheduled another appointment – this time being told to call when I arrived and they would send someone down to meet me.

As a side note, several employees here at the Sanmen “site” (i.e. the nuke plant where we live) are actually expecting babies.  However, none of them are currently planning a China birth, which means I am the pioneer here on this.  The one wife, due the beginning of January, already retuned to Iowa with her two kids to await the birth of her third baby.  Understandably, since her other two were both preemies (7 & 8 weeks early) that had to spend time in NICU after birth, she decided she felt most comfortable with a U.S. birth.  She is planning to return to China once the new baby is two months old.  Another wife, due in February, is in Vietnam with her family.  While her husband, a Vietnamese American, speaks English, her English ability is limited.  Since this is her first baby, she thinks she wants to have the baby in Vietnam.  However, her husband thinks the prenatal care system there is worse than China, so he is actively trying to convince her to come back to China for the birth (which would be in Shanghai if he can convince her to return).  And finally, there was another wife here who had planned on a China birth (first baby), but decided after 6 weeks of living in China she hated it here and flew back to the States.  We can only imagine her husband is actively looking for a new position in the States.  Anyway, that currently leaves Mark and I as the sole expats navigating the prenatal medical system.  While we could go the “simple” route and just go to Shanghai, I think regardless of where we go this is going to be an interesting cultural adventure.

Read Part II

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