Having a baby in China: 38-week appointment

This would be our 12th and most likely final appointment. It was a Sunday afternoon, the sun was shining and Mr T and I were enjoying a lovely day together. We thought it was funny when our translator greeted us by saying; “You’re in a great mood today!” I just laughed out loud, amused by what she must think of me.

It was a simple appointment, vitals, urinalysis and fetal heart monitoring. We did have a bit of a scare when the monitor stopped recording, the nurse had to come in and replace the cord but all was fine from there, though the new cord only recorded heart beat but not fetal movement. I could still feel the baby moving so I wasn’t concerned, we were just hoping we wouldn’t have to sit through another 20-minute session of monitoring.

In with the doctor she said my stats were good and she did a physical exam, not surprised to find baby still in breech position. The doctor said she would like to preform a cesarean birth between the 9th and the 16th of June (39-40 weeks). We expected this and said we would schedule for the 16th, still leaving some time for birth to start naturally but accepting the doctor’s wishes not to go past 40 weeks. It was amazing how quickly they were ready to process us in for the surgery, forms were filled out in no time and I had confirmation text messages before we had even left the building!

Although we had succumbed to scheduling the cesarean, I still came with two lists of points that are important to us whether it is a cesarean or natural birth and as much as they were probably annoyed with me, I took the time to go through each one. It was a kind exchange this time and Mr T and I feel that we understand what the hospitals procedures are and that they understand our wishes. I have since typed up my own birth plan and had a friend translate each point so we can have a clear quick reference on hand, just in case.

So that’s it, next installment should be about the birth of our baby!!

-Mrs T

Having a baby in China: 37-week appointment

As it often happens in the small world of expat living we by chance met a couple that had recently (one year ago) had their baby at AmCare. It was just after our last appointment and we were still feeling a bit negative. They had had a great experience at the hospital, I think this was because of two factors: the woman was Chinese, so there was less of a dependency on the translators and the man was very up front and asked for (and got) what he wanted. Before committing to the hospital he wanted to meet with the president of the hospital and would settle only for the lead doctor in the hospital to care for his wife. It was nice to speak to another couple who had used our hospital and hear some positive things. The woman has continued a personal relationship with her doctor and made a few calls and got us an appointment with her. We were unsure what this appointment would be like. Our translator canceled with our original doctor and scheduled us with the new doctor. We didn’t know what type of dialogue (if any) had occurred between the doctors or the translator about us. Had she been warned to watch out for the moody, demanding westerners or were we just another patient to her… This appointment was a very simple one with just vitals, urinalysis, fetal heart monitoring and then a visit with the doctor. It did seem as though the translator was being a bit kinder toward us, and I as well had vowed to come in and stay calm and accepting. The new doctor took great care to explain everything to us, starting with the fetal heart monitoring report, describing what each line meant (contractions, heart rate, and fetal activity) and told us all was normal. Upon her examination she found the baby to still be in breech position and she took the same stance as our previous doctor, but with a bit more sensitivity in her delivery of information. She also did not recommend acupuncture to attempt to turn the baby. She is willing for us to wait to go into natural labor, but would not feel comfortable going past the 40 week mark. We made it clear that we were not expecting anyone to try to vaginally deliver a breech baby, because we think that they think that is what we want, (from what we can tell it is just not done in China), but we would like to give the baby as much chance as possible to turn or let us know it is ready to be born by labour beginning. She explained how the hospital would define cesarean and emergency cesarean and the costs that accompany it. We asked how many days in advance did they need to schedule a cesarean (they can do it the next day). We left the appointment feeling secure in the care we were being given. We know we have done what we can to help the baby move and if it sticks in breech there is a reason for it. What is most important is not how the baby is born but that the baby and mum are safe and healthy. -Mrs T

Having a Baby in China: Research

Soon after arriving in Tianjin I began looking into our medical coverage and options for having a baby in China. I knew that within the next few years it would be something we would be considering and I would much rather be proactive than reactive. We do receive health insurance from our jobs however there is no coverage for maternity.

After a bit of digging we found that there were four options:

-Go to one of our home countries for the birth

-Increase our medical insurance by taking out an additional policy

-Go to a Chinese public hospital

-Go to a private hospital

We spent our first year speaking to others, and researching these options and this is what we discovered:

Give birth in the UK or the US

We did not do extensive research on this option, as it did not feel like a real option for us. Many expats here in Tianjin that I spoke with did go home for their births but most of them had less complicated situations than us. For example, firstly we would have to choose which home country would we go back to? If that choice was the UK, I (the prospective birthing woman) am not a UK citizen nor a resident, what kind of services would I get from the NHS? Without being there we could not pinpoint the answer to this question.

For similar reasons the US did not seem like a good option, I could imagine the costs quickly adding up for a non-insured woman giving birth. But besides these financial reasons giving birth in our home country was never an option as it would mean there would be a chance of Mr. T not getting back in time for the birth, which is a risk I would not be willing to take. Not to mention being away from our home (in Tianjin) at such a special family time.

Increase our medical coverage

I initially thought this would be the way. I did approach our employer to ask if it was possible to add maternity coverage and if it was something they would consider doing as a benefit for staff. Unfortunately at that time it was not an option. I did get in touch with the insurance company and taking out an additional policy was possible, a full policy, including the maternity coverage, would cost around 30,000 CNY per year (£3,190/$4,830). Not too bad of a price considering what you got, the catch was that the policy had to be in effect for 10 months before using any of the maternity benefits, therefore requiring two years of policy to be purchased to span the length of pregnancy and birth.

Go to a Chinese public hospital

Being the adventurous type I did not initially shy away from this option. My teaching assistant was very encouraging to me and she had supported many a pregnant western teacher over the past few years. She was willing to accompany me to appointments and translate for me. And of course the cost would be very low. We had heard that the queuing could be extensive and often long wait times for appointments. The standard of cleanliness would most likely not be up to our standard (not in all hospitals of course), we even heard it was common practice to pass a red envelope (full of money) to the Dr to ensure you were well looked after. We decided that we didn’t want to have to depend on (or burden) someone to help us every step of the way, we craved a bit more independence.

Go to a private hospital

Upon first glance we thought there was one option here, United Family Hospital, which is a very good option. It is where most expats go for any medical care, although our insurance does not cover maternity care. We were lucky in our time here that we had no reason to visit, our first time was to tour the hospital and have a look at the birthing facilities. We were very impressed with what we saw. It is a lovely hospital with organized friendly English speaking staff and good facilities. The drawback here was that all this comes at a price. Prenatal care is 13,600 CNY (£1445/$2190) plus 42,888 CNY (£4,556/$6907) for a vaginal birth and 72,888 CNY (£7743/$11,740) for a cesarean birth.

Through our school we were made aware of another option, AmCare, a hospital new to Tianjin but well established in Beijing. We thought it would be worth a look. It was a bit challenging to get someone speaking English on the phone to arrange a visit but finally we got it sorted. As we were walking up to the hospital we heard our names shouted from across the street, we looked to see one of our old colleagues from our school in Qatar, with his very pregnant wife. We knew they were here in Tianjin however we had not seen them. We crossed over to say hello to discover they had just came from their 39-week check-up at AmCare and would be giving birth there very soon. This moment was very valuable to us as what recommendation can be better than one from someone you know. We were toured around by one of the two translators on staff. AmCare is a women’s and children’s hospital so its sole purpose is prenatal care, birthing and caring for small children. The majority of clients are Chinese, those who do not wish to have birth in public hospitals and choose to pay privately on their own. Again we found the facilities to be modern, clean and organized. Something a bit different than the traditional room with loads of infants that you can look into, they have a viewing area where they bathe and massage the babies each day. We were there in time to join in a large family oohing and ahhing over their new addition. We got a laugh from one rogue English speaker when Mr T asked if they have the same facilities for adults! Our overall impression was a good one, the main difference we found from United Family was that most of the staff do not speak English, however there is support from the translators on staff for every appointment. The cost for the package from 12 weeks to birth was offered at a discount, as they were still a new hospital here in Tianjin. 38,151 CNY for a vaginal birth and 48,888 CNY for a cesarean birth.

Our decision

We decided to go with a private hospital, AmCare. We felt the service provided would be just as good as United Family and at a lower cost. We even had a bit of further discount; we have paid 36,244 CNY (£3850/$5837) for prenatal care from 12 weeks to birth, with 3 nights stay.

We will keep you updated as things move along!

Mrs T