Thursday, December 29, 2011

Having a baby in Taiwan

In the last year we've learned a lot about having a baby in Taiwan, heck, we've learned a lot about having a baby in general!  We went the doctor/hospital route, so I don't know anything about other forms of prenatal care and birthing.  I'll outline what we learned... if anyone has questions feel free to contact me.


Medical
When we decided to have a baby here we didn't know where to go at first.  A representative from Kuang Tien had come to our school and explained their international program for foreigners - translators and specialized services offered.  Translators in particular caught our attention - if we were going to have a baby we wanted to make sure the doctor and we were communicating clearly (not always the case when you go to the doctor here, though most do speak medical english).  The hospital was a bit of a drive away from us, so we decided to try it and see if it was worth the drive - it was.  There are, however, lots of hospitals and clinics available.

I called the international phone number at Kuang Tien and asked for an appointment with an obgyn.  The man who answered the phone didn't know what an obgyn was: maybe not the best translator, but once I told him the point - we wanted a baby - he figured it out.  I told them the times I could come in and he recommended a doctor for me who had clinic hours at the times I could come in - turns out he picked a great doctor for us, Dr. Su Chi Feng (we'll always be grateful for that choice).

Once I was pregnant we went in for doctor visits on the same schedule as one would go in the states.  I got an ultrasound every visit so we got to see our baby a lot.  At first we had a translator that went with us to each visit but our doctor's english was great so we didn't need the translator.  Almost all visits and treatments were covered under the national health insurance NHI.  We paid about $3US a visit, and out of pocket for a few extra optional tests (maybe $30US? - not much).  I wrote more about a typical prenatal doctor visit in my last post.

We flew back to the states around 20 weeks and back to Taiwan around 28 weeks - we got a letter from the doctor in english and chinese saying I was safe to fly during that time but had no problems with the airlines.  We also got copies of medical records to take back with me in case something happened while I was home.

When it came time to have the baby we requested private rooms.  At our hospital women labor in a common room with curtains and then are moved into a delivery room.  We preferred our own room - we paid extra for this and are glad we did.  We also paid extra for a big private recovery room and again were happy with this choice.

I had asked our doctor earlier who would deliver our baby if he wasn't available - he laughed and said it was his job so our course it would be him, and it was.  I'm not sure if this is always the case or if we were a special circumstance.

It was important that though labor, delivery and recovery we advocated for what we wanted and how we wanted things to go.  We noticed people got stuck on doing things a certain way simply because that's how its been done before and some of what we expected was different from what the nurses and doctors were used to - anything from bigger medical decisions to simple baby care - and we had to request for things to go a certain way (I'm sure everyone breathed a sigh of relief when we were finally discharged :).

Typical hospital stays after birth are 3 days or 5 for c-section.  We had our baby room in with us and nurses and doctors were always coming and going.  Often when only 1 nurse was required 2 or 3 would come so they could pool their english knowledge.  Doctors would come and translate forms for us, and once even a young ENT resident came to translate for us.  There was a place for Jeremiah to sleep and he only went to work the last 2 days (much to the nurses dismay - who would take care of me???  um.... them!).  Breastfeeding was supported and encouraged.


Insurance
We have National Health Insurance - NHI.  It covered almost all my prenatal visits, though when I went over the standard amount of covered visits our cost was still only about $9US each visit.  Health insurance for the baby is covered under mom the first 2 months (this is the same for Taiwanese moms/babies too).  However, foreigner babies have to be in Taiwan for 4 months before they can get NHI.  This leaves a gap of at least 2 months (we're having a hard time determining if it is 4 months from birth or 4 months from the time they get their ARC). We looked into private insurance to cover the few months in case something went wrong but this proved difficult.  We will pay out of pocket for health care until NHI kicks in for her.  The out of pocket cost of the birth for us was under $100US and we had the added expense of the private rooms we requested, though this still was so cheap compared to home.

Clothes/Supplies/Stuff
I bought maternity clothes from home.  Sizes and styles here didn't really suit me.  I also bought my prenatal vitamins from home though I did see them available at our local pharmacy (not sure of the quality or what is in them though) and a friend bought some at costco here.

As it got closer I packed my hospital bag with recommendations from folks in the states.  Some supplies needed were not provided by the hospital but we could purchase there so we did that.

We bought a Chicco carseat at SOGO.  We mostly see moms here holding their babies in the car (I was told a law is changing this) and a few people laughed at us when they saw we had it in the car early in case I went into labor.  We bought most of her clothes from the states - baby clothes here can be expensive or just not what we are used to.  We also brought basic medicines from home as well as cloth diapers.  There are many baby stores in Taichung that are well stocked with just about everything you could want - some familiar brands and many Taiwanese brands.  Our nursery is furnished from Ikea.


Legal
Soon after birth we went to AIT for her passport, SSN and consular birth certificate - their website is very helpful in figuring out all you need and though you can't call to ask questions they are very quick in responding to emails.  what the website doesn't say is you may have to prove that you lived in the states for a period of time (even if both parents are US citizens) and I was told college transcripts is the easiest way to do that, though they didn't actually ask to see ours when we went.  Passport came in the mail in a few weeks, SSN a few weeks after that.  Our employer applied for her ARC (we were told this must be done within 30 days of birth).  The hardest thing about all of this was getting a suitable passport photo of a newborn - we took about 100 pictures to get one of her that met standards.

Other miscellaneous cultural things
-I think our baby will never be dressed warm enough for the moms and grandmas we meet.
-I was asked many times who would take care of my baby after she was born - typically the month after birth is a time for the mom to recover and she has help taking care of the baby, sometimes even staying at a special clinic.  It appeased some when I told them my mom would come visit for awhile.
-No one ever came up to me and touched my belly as often happens in the states but many people were curious and had questions
-Warm water is always better than cold (as is the case also when you are sick) though I stuck to my ice water and cold drinks
-Special foods are given to mom to help her recover from birth - soup is key.
-People laughed when they saw all the baby furniture we had and our nursery set up.
-We get a lot of advice from people when we go out with the baby

I admit I was nervous at first about having a baby abroad but as soon as I met my doctor and got some information I felt very comfortable and we are so happy with the way everything turned out.

*Edit: we also found this forum helpful: Parent Pages

Tuesday, December 27, 2011

Prenatal care in Taiwan - visiting the doctor

Since I have gotten many questions about what our health care is like I thought I'd share a typical prenatal appointment experience.  I also posted this awhile ago on our other blog. 

We have been going to Kuang Tien Hospital and work with the international department who provides assistance to foreigners - a huge plus for us!  For this particular visit, I emailed the international coordinator and asked her to make an appointment for me, I received an email back the next day telling me I was #9 for August 2nd and could show up any time after 9:30am. We got to the office a little after 9:30 and the nurse checked me in - weight, blood pressure, etc. She then took my file, baby book that tracks my development and health card to the doctor and we went in a few minutes later.

In the doctor's office I had an ultrasound (I have one every visit). He measured Baby O's head size, femur bone and abdomen to help determine due date (still around October 22nd). He measured the heart rate (normal) and checked for any problems (none). Finally, we discussed that she is breech and what that may mean down the road. For now, however, she has plenty of room to turn around.

After the ultrasound we went to the computer where he noted information in my file. He explained the blood test that I was to get next and sent us on our way with a nurse to get my blood test, and for Jeremiah to get his blood type determined since we didn't know it.

The nurse took us to the blood drawing area and we took a number. After about 10 people it was our turn and the nurse translated for us when needed. The nurse took us back to the obstetrics waiting area while they processed Jeremiah's blood type. 30 minutes later they called us in and told us I would need to get a shot today and one after I give birth. The nurse walked us to the pharmacy to pick up the injection (she waited in line for me to get it) and then took us to the injection room. We took a number and waited our turn. This was the craziest part of the day - I was called into a good sized room that was filled with people. One man was sitting in a chair getting bandages on what looked like road burn on his back and arms. There were 5 beds with people in them getting various treatments - a young boy getting an IV, someone getting a burn bandaged, an old man getting blood and a few others. Everyone out in the open. I was showed to a bed and while everyone else was out in the open getting more intense procedures than I was, the nurse closed the curtain around us, then gave me the shot in my arm and we were sent on our way home.

We paid about $3US and it included everything. The interactions with the doctor were all in english and the nurse who took us around translated for us when the other nurses didn't speak english. A productive and satisfactory visit.  We have found that with the right doctor, who understands there are some cultural differences in medical practices between America and Taiwan, and is flexible around those differences, everything can go very smoothly.  We are very fortunate to have such doctors.

Wednesday, December 21, 2011

Missed us?

So apparently being pregnant and then having a baby means I cannot maintain a blog - or at least not 2 blogs (see: www.teamosullivan.blogspot.com).  In case anyone is wondering we are doing well and enjoying new baby time.  I'm thinking I will do a post soon about having a baby in Taiwan from an expat's perspective in case there are others in our shoes.  And as we start to get out again more there will be more fabulous Taiwan pictures and stories to tell!