Photo by Keith A Kelly

CHOOSING THE HOSPITAL

We work and live in Phnom Penh, and wouldn’t feel comfortable with the specialists / facilities here in case of complications during delivery. The nearest city with internationally accredited care is Bangkok, so there we went at 35 weeks 6 days gestation, the latest we’re allowed to board a Thai Airways flight (with a fit-to-fly certificate from the doc).

Most of Bangkok’s well-known private facilities have high quality patient-oriented care and great customer service. They have translators, can take care of extending  visas, take the baby’s passport photo (this isn’t easy so do get this done at the hospital!), get the birth certificate officially translated and documented at the Ministry of Foreign Affairs, and liaise on documentations necessary to register the birth at your particular embassy etc. Many people go to Bumrungrad Hospital; read this post and follow the link to her birth story at Bumrungrad here. This hospital is located in the neighborhood of Sukhumvit where many Arab nationals live, so the third spoken language is Arabic.

The delivery packages she quoted for Bumrungrad are comparable to those at Samitivej:

• Natural birth/Water birth (3 days admission) 55,000Baht / US$1800 on exchange rate 30Baht=US$1
• Natural birth with Epidural (3days admission) 68,000 Baht / US$2267
• C-section (4days admission) 78,000Baht / US$2600

So I’d heard there is a ~90% c-section rate in private hospitals in Bangkok..? At any rate it’s high, but that’s due to a lot of other factors (including the Asian quest for luck, leading parents to schedule c-sections on the most propitious time and date for birth).I aimed for a natural birth; we chose Samitivej for its “baby-friendly” seal from UNICEF. Plus, it’s gotten great reviews from the mothers who’d given birth in Bangkok and physicians I’d talked to in Phnom Penh. We were very happy with our decision. The medical care, facilities, support and services were all excellent and we’d go there again in the future. It is located in the area of Sukhumvit populated by Japanese and Korean nationals.

DOULA

Why’d I get a doula? There’s a lot to keep track of and learn about when you’re pregnant. I talked with other women who recently had a baby. I bought and read pregnancy, childbirth and parenting books. I read the blogs and consulted the websites. I took a birth preparation course in Phnom Penh with Denise Love, an Australian doula who has decades of experience supporting women and their midwives/doctors in childbirth. But putting all this into practical perspective was hard. I was overwhelmed and especially anxious about the pain – my doula helped me through my fears of the unknown.

Also, while I had  friends and colleagues who’d recently given birth, and I work in the health sector where maternal health is a national priority, I didn’t have a dependable support system of experienced women during pregnancy through labor and the post-partum period. And finally, giving birth in a country where I wasn’t at all familiar with the childbirth culture and norms is unnerving. It’s my first real engagement with a health care system as a patient, and working with a doula who lived in Bangkok, was familiar with my chosen hospital, its doctors and childbirth protocols, put my mind at ease.

It isn’t about not trusting the medical staff to give me good care, or bucking the clinical protocols. It’s preparing for and planning the birth.

Bangkok had many western doulas a few years ago, but after the recession most went back home. At the time of writing there are two who have significant experience, and I went with Sylvie Philips from the UK on recommendations.

Sylvie helped me draft my birth plan, explained the hospital protocols so I’m aware and know what to expect, gave us advice about positioning during labor, coached me on pain management techniques, and helped my partner to help me. She also helped me understand the pelvic girdle pain I was having, when the medical doctors I’d seen in Phnom Penh and in Bangkok all brushed it off as “normal” during pregnancy (my pelvic pubic joints expanded 1-2cm more than needed – this is not normal). We had several sessions together, when she helped put all the information I’d read and learned into practical use, and she was present at the birth. Her confidence in me, great sense of humor and competent presence helped me and my partner focus on the birth because we knew someone was there to help us communicate our wishes with the staff when we were too emotionally preoccupied to make or communicate decisions.

FINDING A PLACE TO STAY

I looked for a serviced apartment because I didn’t want to purchase pans or bedsheets and I wanted some help with the cleaning. Expect to pay around US$1000+/month plus utilities for a studio or 1bedroom, but certainly there are more frugal options. Here are a few ways to find a place:

• Thai Visa is the English-language forum for anything Thailand. Go to the classifieds real estate section
• The Parent Vine is still new but worth posting at in case the mamas already there have any ideas:
• Real estate agents
• Hospitals have a list of nearby hotels and condos with special rates for patients and families
• Find a hotel or guesthouse you like and negotiate rates with the manager
• Use personal networks in Bangkok to spread the word that you’re looking – This is how I found my 2bedroom condo at Thonglor-Ekkamai area at a much more reasonable cost than through the other options above.
• Hire a taxi or walk around the hospital neighborhood – there are many options if you’re in town – Since the 13th and 20th week scans would probably be done in Bangkok too, it’s a good idea to check for rentals then.

SUPPORT and SERVICES

Lactation consultants are available at the hospital you choose for the delivery. At Samitivej you can ask to see one while you’re recovering, and you get two complementary visits with the coupons they give you upon discharge.

BAMBI (Bangkok Mothers and Babies International) has a great list of resources in Thailand for expectant/mothers. The site requires membership (1000Baht or ~US$33/year) but there are some good info accessible to non-members.

Prenatal Yoga – The Pilates Studio (Phloenchit Road, Patumwan)

Breastfeeding Café meetings every Tuesday at The Big Knit (Soi 49)

La Leche League meetings every Wednesday at Isis: Social Club for Mothers in Bangkok (72/1 Sukhumvit 51, access from Sukhmvit 49/2 as well; tel. 022587077)

Babywearing Club meetings every 3^rd Tuesday of each month at the Pilates Studio

It’s a good idea to find out in advance the documentation requirements of your Embassy to register the birth abroad and acquiring citizenship and passport. US-Americans can get all the info here. It took a week and a half of processing, once we presented the necessary applications and documents to the US Embassy in Bangkok, to get the baby’s passport.

SHOPPING RESOURCES in Bangkok – Maternity, Baby, Nursing

If you’re shopping out here, brace yourself for the sticker shock. I bought a Medela Pump-In-Style back in the US for US$275 that in Bangkok retails for US$700. I bought a carseat and stroller travel system that retails for US$240 in the US, but in Bangkok it is US$600. Dr Brown’s bottles are US$24 in the US and US$50 in Bangkok.

For items that you need international quality standards for (eg imported), the best places I found to buy them at were at these department stores along the Sukhumvit BTS skytrain line:

• Emporium (BTS Phrom Phong)– 5^th floor
• Central Chitlom (BTS Chitlom)– 6^th floor
• Central World (BTS Chitlom) – Toys R Us and other baby boutiques on 5^th and 6^th floor
• Siam Paragon (BTS Siam) – 5^th floor
• I hear there’s a nice boutique shop at Bumrungrad Hospital..? Since I went to Samitivej, I know the area around there more. The small sois (streets) around the hospital area are dotted with boutiques selling different maternity, baby, and nursing gear.
• The ParentVineNetwork was begun this year by a doula in Bangkok to network and provide information about services in Bangkok to people who will deliver in Bangkok. The site is still new, but it’s becoming a great resource as more and more people get on and contribute, and they’re compiling a nice list of shops so check it out.
• Keep an eye out for the baby buying fairs held intermittently throughout the year at Queen Sirikit Convention Center (MRT Queen Sirikit Station)– There was a Baby Expo in September and the Baby Best Buy was in January this year.

Maternity and Nursing Wear

The maternity clothes were the hardest to splurge on since I’d wear them only a few months. I tried to get clothes that can  double for nursing, but I didn’t check whether the nursing part is useful. Some of the access slits on the clothes, especially those from Mothers En Vogue (Phnom Penh), are uselessly small or not practically designed. MEV clothes are made with eco-friendliness in mind, but they didn’t last a long time because the materials were a bit flimsy. My purchases from Belli Belli (Bangkok) were equally priced, better designed and made of more sturdy materials.

The Bravado nursing bra tank top was the best purchase I made for nursing. It’s practically designed and made to last through many washings. It isn’t cheap, but I plan on getting more of them. I bought them at Naturally Bebe (Bangkok).

Nursing bras are available at the department stores listed above. They seem to only carry Mothercare (sports, no-wire, underwire) and Wacoal (underwire)..?

Breastfeeding and Pumping

Pumps and supplies are available at the above department stores, and the lactation consultant can also arrange purchases. You can rent a pump from Samitivej to try out before you purchase, and you can also do a trial run with their hospital-grade pump. Medela has a representative in Bangkok so if you need supplies and spare parts get on the website and make an appointment.

Babywearing

Naturally Bebe on Soi Thonglor 13, Sukhumvit 55, will let you try a variety of slings, pouches, and carriers before you buy. It’s on the soi that faces Samitivej Hospital, so it’s an easy walk after an appointment.

Warning: Be well-informed on babywearing! There have been incidents of newborn deaths from being carried with their chin to chest, the weight of their own heads blocking air passages. There are many YouTube videos and informational sites on proper infant positioning. Here’s one.

BOOKS I LIKED

While in Bangkok check out the Kinokuniya bookstores on the 5th floor of Siam Paragon (BTS Siam) or the 3rd floor of Emporium (BTS Phrom Phong).

I agree in minimizing medical interventions during childbirth, but am not opposed to it. I like the attachment parenting approach. These are my go-to books for the birth and parenting.

Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices by Sarah Buckley and Ina May Gaskin

Ina May’s Guide to Childbirth by Ina May Gaskin

All books on the Sears Parenting Library. They also have a blog with a tremendous amount of info for parents, including a forum.

Dr. Spock’s Baby and Childcare: Seventh Edition by Benjamin Spock

The Nursing Mother’s Companion 6^th Edition: 25^th Anniversary Edition by Kathleen Huggins

Like the huge blowup pumpkin, decorated like a Christmas tree at one of Phnom Penh’s local bookstores last Christmas.

Like the bunnies, traditionally associated with Easter, which seem to take center stage in every Christmas Season set in Bangkok (here’s one at the Emporium on Sukhumvit). Edited to note: Asia is about to welcome the Year of the Rabbit in a few weeks, so this is the reason for all the bunnies in the Christmas sets :-) With Christmas over, the bunnies’ costumes and sets are being adjusted for Valentine’s Day marketing.

Photo by Keith Kelly

We spent a week in Jom Tien, Thailand, to check out a hospital and the ob-gyn there. Loved the doc. Loved the seafood – here we’re at a fisherman’s village gorging ourselves on the fresh catch.

About four weeks ago I started looking sufficiently femme fertile where people feel my tummy is public property and they can just reach out and touch the bump. Go away. This trimester’s more interesting than the first. The little rambutan’s stretching my tummy skin like a drum, he’s growing so fast! I’m starting to waddle, I need help turning over in bed, and did you ever notice those tailbone muscles? I didn’t til they hurt all day.

Sometimes we just sit back and marvel at this little tenant taking first dibs on my blood and nutrient supply. And I just have to poke at it a little bit hehe. Keith has been very supportive and indulgent, and my go-to griping board :-)

19 weeks

20 weeks

We spent a week in Bangkok too to check out another hospital. Samitivej Hospital is rated a baby-friendly hospital by WHO and UNICEF, meaning significant breastfeeding support with limited or no bottles allowed in the nursery. The hospital doesn’t accept for distribution to new mothers any free or low-cost formula.

Do you know there’s around a 70% caesarian rate at these hospitals out here?! Parents ask for it. They want an auspicious date and time for the birth. Seems like you’d screw up your kid’s astrological alignment doing that. Anyway I LOVED the birthing suites at this one hospital which is where many foreigners who work in SE Asia beeline for to have their baby. They have dim lighting, music, birthing pools, ladders, ropes and swings, aromatherapy oils, diffusers and candles, etc. Maybe I just haven’t visited a real hospital in a long time. Sure is the first time I have an intimate engagement with a health care system from the patient side. The docs at this hospital have a 3% caesarian rate [two thumbs up!].

20 weeks

20 weeks

21 weeks

22 weeks

So we’re planning for the delivery now. Going the natural birth route was a great idea before I got pregnant. It gets lousy the more you think about how big the sperm donor is, haha, although that supposedly isn’t a contributing factor (by size he’s already 1 1/2 weeks larger than the average). Diet? Low birthweight is the way to go? Induce early? Sigh. My own concerns, like the sneeze-and-pee side effect of a shattered pelvic floor, are suddenly so much less important now. I guess the joy of parenting is about beating these silly narcissisms out of you.

We’re also starting to look at baby things. Poor little guy have the most minimalist parents (maybe we’ve been working out here too long). I don’t understand why it needs a crib, a baby bathtub, baby shampoo, bibs, pacifiers etc…?

But I do notice the recent meltdowns savvied up this niche’s purchasing experience. It’s feel-good shopping on a gratuitous new scale.

An ergonomically awesome baby carrier created by a good ol’ mom-n-pop American shop? Gotta have it. Designer breast pumps and glass bottles, fashioned by professional moms using the latest evidence-based clinical specs, materials and sense? Click – BUY! And check out these adorable little haute couture ensembles for all his potty needs! I can just see the trendy little multi-cultured, fair-labor-, eco-geared, breastmilk-fed bambino being slung about the paddies in organic fitted sherpa (dip-dyed deep sultan!) and matching hand-knit sustainably harvested hemp/bamboo terry blend cover.

The more the buzzwords defy definition the better for you, your baby, the exploited 90% of the world, and the beleaguered planet.

(That narcissistic nimrod will go down fighting.)

So things are progressing quite well for us, thanks for all the emails! Hope everyone’s well! We miss you all!

Christmas Eve 2010

2 days old

 Above is Tristan’s passport photo, taken by the hospital’s photographer at about a day old.

We flew to Bangkok at 35 weeks, since the airlines don’t let you travel any later into the pregnancy than that as a precaution against having to deal with a woman in labor on board. Other mothers in Phnom Penh have driven either down to the border at Koh Kong (via a road that goes off the grid for a solid hour, as of 2010), or else up north through Poipet into Aranyaprathet, Thailand, and then bus/train it to Bangkok. But I just didn’t think I could handle that! The road to Poipet border crossing has much improved since I’ve been through it last, but decreasing the number of uncertainties while I’m heavily pregnant is a good thing!

My first groggy thought after waking up out of anesthesia and meeting Tristan was a dismal, “they mixed ours up with this cross-eyed Chinese baby”, but Keith reassured me that from the time they took him out the Chinese-looking baby hasn’t left his sight. Tristan’s filling out his features now, so my mixup worries are going away :-)

We had an unplanned c-section. First contractions were at 8am and by 1030am when we arrived at the hospital I was already 6cm. Between the pelvic girdle problem I’ve been having in the last trimester and the contractions, there was no respite from the pain so I asked for an epidural. Three hours later I was fully dilated but he wasn’t coming down fast enough and his vital signs were rapidly dropping, so I was wheeled into the OR. Apparently the cord had wrapped around his neck and arm, and he was losing oxygen rapidly. WHEW!

He came with big lungs and a small stomach – they say this is normal :-\ Thankfully he doesn’t use his lung power much :-) except when he’s getting his BCG shot :-(

Here he is in his bassinet :-)