Friday, April 13, 2012

Our Prenatal Adventure in China: Part VI


This is Part VI of a series.  Click here to read from the beginning.

Since baby #2 may arrive at anytime now, expect a marathon session of prenatal blog updates.  We've been delinquent in posting these...

Although we are planning to have our baby in Shanghai, we were told by United Family Hospital that it was no problem to do the ‘unimportant’ prenatal checkups more locally in Ningbo.  Since these ‘unimportant’ visits are only supposed to consist of 1) weight check; 2) blood pressure; 3) belly measurement; and 4) urine sample (check for proteins) I had considered asking the local site doctor if I could do it here so that I didn’t have to even go to Ningbo (2 hours away), but decided I really only get one chance to experience prenatal care in Chinese hospitals and I should just make the trip.

Since I hadn’t actually been to the Ningbo hospital in a little while because I had done a couple of appointments in Shanghai, I e-mailed the hospital to ask who I should call to schedule the appointment because I knew the nurse’s number I had should have already had her baby and was likely no longer working.  Sure enough, I was directed towards a new contact person.  I called the nurse on a Thursday and scheduled my appointment for the following Monday: Feb. 13.

My new English speaking nurse contact – “Jany” – meets us shortly after our arrival and brings us to meet with the doctor.  Jany’s English abilities are better than the previous nurse’s and she is very friendly.  However, her English is still fairly limited, which makes her translating for the doctor a bit of a scene.  I try explaining right from the start that we have been going to Shanghai, but that Shanghai said we could still go to Ningbo for the normal prenatal checkups.  I’ve had the Level-II ultrasound as well as my glucose screening already.  I was only here today for a regular prenatal checkup.  I also mentioned that Shanghai moved my due date.  By the Shanghai hospital’s due date I was 29 weeks but 31 weeks 5 days by Ningbo’s estimate.  The Ningbo doctor insisted their due date was correct and Shanghai was wrong.  She also didn’t understand why I was splitting my care and seemed to think I was an incompliant patient for not having come back sooner (though I had been to Shanghai!).

Again, they asked if I had eaten already.  It’s nearly 3PM, of course I had eaten.  So they ask if I can come back the next day for ‘fasting’ blood work.  I feel like it’s groundhog day again.  They ask me every visit to return the next day for blood work that requires fasting and I always refuse.  Not only is it impossible to by short notice train tickets like that, it is a long trip.  Besides, I was only there for four things: weigh in, blood pressure, a belly measurement, and a urine test!  I knew no blood work was needed, but we also knew that would get lost in translation and I would appear belligerent again.  So instead we inquired if we could just go to the local Sanmen hospital for the blood work if it is routine.  The doctor agreed that was fine and wrote down the blood tests she wanted in Mandarin.  We really had no intention of getting them, but at least it would allow the appointment to progress.

Next, the doctor did do what I came for: she measured my belly and listed to the baby’s heart rate. And another nurse did my blood pressure and weight.  Since this was a Chinese hospital, we were next taken for an ultrasound, because they do them every time… not just as medically indicated.  However, since the ultrasound is an assembly line process, it is not very special.  We didn’t even bother asking the nurse if Mark could come too, because we already knew the answer.  Besides, we didn’t think the ultrasound was needed anyway.   We waited a few minutes in line before I was bumped to the front (because $13 buys me VIP status…) and went in for the ultrasound.  Since it is an assembly line process I don’t even actually get to see my baby on the screen because the ultrasound tech doesn’t turn the screen at all – the next person in line does though!  It is such a strange process.

Next the nurse takes me to do the urine sample.  I am given a little plastic cup with a stick handle to pee into and then instructed to carry it out of the bathroom to the nurses’ station.  Again, the notion of a clean catch is non-existent here.  Thankfully, I remember to bring my own toilet paper into the bathroom with me though!  I must say, weaving my way to the nurses’ station from the bathroom with an uncapped cup of pee in a little plastic cup is an interesting experience.  The nurse at that station then takes it from me, dumps it into a test tube, labels it, and gives me a corresponding label with a barcode.  I am instructed to wait there for about 20 minutes and then walk up to a machine and scan the barcode.  If my test is done, the machine will spit out my results.  At that point, I am told to call my English speaking nurse friend and she will re-meet us in the VIP clinic.

This whole process actually went rather smoothly and we beat Jany back to the VIP clinic so I just gave my ultrasound paperwork and urine sample results to the doctor when we got up there.  Jany was along shortly and the doctor had already had a few minutes to review my results so things went a little quicker.  I was told the urine sample was fine but that the ultrasound says I am measuring one week smaller then my due date.  I need to pay better attention to my nutrition and eat four more eggs a day and drink two bottles of milk.  I love their nutrition suggestions.  However, since our due dates are all over the place, we have a really hard time caring that the baby is supposedly one week small.  Wouldn’t that make him one week big by Shanghai counting then? 

We thank the doctor for her assistance and then ask the nurse if it is possible to see a birthing room at this hospital.  We tell her that we may still be considering delivering the baby in Ningbo and would like to see their facilities.  She asks us to wait for a little bit because she has something else she needs to run and do, but meets us again (right about when we thought we had been abandoned) and takes us to a neighboring hospital building where they do the births.

As we take the elevator up to the VIP birthing ward, she tells us that they have three levels of VIP rooms that cost Y800, Y1200, or Y1500 per night.  When we get to the VIP recovery floor, it is really quiet, big, and open.  She talks to the nurses’ station there and we find that the more expensive rooms are currently occupied but she gets a key to show us the cheapest VIP room.  This room is actually quite nice.  It is big, with two hospital beds (so the spouse can sleep over), a TV, microwave, refrigerator, and Western style bathroom.  It seemed like a perfectly acceptable place to recover post delivery.

The nurse, Jany, also takes us to the regular recovery room floor, where there are two people per room for Y90/night or three people per room for Y70/night. 

When we asked how long they keep their patients post-delivery, we were told 10-14 days for a normal vaginal delivery.  She didn’t seem amused that we left the hospital with LiLi at 30 hours post-delivery!  We’re not really sure why they want to keep the women and babies that long.  The wards are crowded, so wouldn’t it make sense to let everyone go a little earlier and have less overlap?

We also left there a bit confused about where the actual delivery takes place.  Do patients change rooms?  It sounded like there was a laboring room, a delivery room, and a recovery room – at least for the non-VIP patients.  It also seemed like men were only allowed in the recovery rooms.  Mark thought he was told he could be present for a Ningbo birth though because the VIP patients do all three in the same room.

We didn’t follow up on this though because we decided that, even though the facilities seemed good enough, we didn’t want to 1) be in the dark about everything because of a language barrier with the medical staff and 2) have to fight for our desired birth experience because of language and cultural barriers.  If there was a medical emergency, how could we make an informed decision?  We don’t consider “failure to progress” (in most cases) to be a medical emergency, but many hospitals quickly jump to a c-section over it.  With China’s c-section rate over 50%, we decided we couldn’t risk a language-barrier situation resulting in a c-section because we can’t argue effectively (and believe me, we enjoy arguing with OBs).

That 29 week visit really confirmed for us that a hospital birth in China would have to be in Shanghai if we wanted a non-medical birth experience like LiLi’s.  Since we were just going to Ningbo for routine checkups now, the nurse suggested we just get someone in Sanmen to translate for us and go to the local hospital, since any local hospital can do these routine visits.  And so with that, we ended our prenatal care relationship with Ningbo…

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