Fifteen years ago, having a baby in Beijing wasn’t an option for most expat moms. Now, with a range of world-class facilities and professionals, moms-to-be can expect family-friendly private rooms, longer stays and midwife support. But navigating the system still involves some trial and error, which is why beijingkids is here to walk you through one of the most important times in your life.
In the Beginning: Conception
As a general rule, couples should start planning for a baby long before they actually conceive. First things first: Does your insurance provider cover you and at which hospitals? Once you’re up to speed with your health insurance coverage, you can move on to the fun stuff.
Mother and nutritionist Olivia Lee says it is vital for women to start taking prenatal vitamins months before conception, in addition to ensuring that they have enough calcium and magnesium in their diet. Lee also advises women to keep up the habit "right through to the months following the birth."
Dr. Masoud Afnan, recently appointed chairman of OB/GYN at Beijing United Family Hospital (BJU), has extensive experience in general obstetrics and gynecology. He also specializes in infertility and assisted conception. Afnan has some basic rules all parents-to-be should follow. He advises couples to have a health check prior to conceiving. People with rare blood types such as Rhesus Negative, high blood pressure, diabetes or epilepsy require different prenatal and delivery procedures – the earlier your doctor is aware, the better. Couples should also be checked for sexually transmitted diseases like syphilis, gonorrhea and HIV. They should not smoke and should limit their intake of alcohol. Women should be vaccinated against rubella and take 0.4 milligrams of folic acid one month prior to conceiving and three months after conception to prevent spina bifida in the baby.
It’s important you tell your doctor about any over-the-counter and prescription medicines you are using, including dietary or herbal supplements. Some medicines and supplements are not safe during pregnancy but abruptly stopping them can be harmful to your health.
When at home or in the office, avoid contact with toxic substances or materials. Stay away from chemicals and hand over the kitty litter and hamster cage duties to someone else as they may carry viruses that can be fatal to your unborn baby.
For couples who are having difficulties conceiving, In Vitro Fertilization (IVF) treatments are offered by Afnan at BJU. Alternatively, you can visit Jiaen Hospital: a private clinic overseen by Western-trained physician Dr. Jiaen Liu. The IVF fees at Jiaen are half what you could expect to pay in the US, but the clinic does not provide birthing services.
A Bun in the Oven: Prenatal Care
The average term of pregnancy is between 37 and 42 weeks. Standard prenatal exams are done every four weeks during the first 12 weeks of pregnancy, every two weeks following 28 weeks and once a week after the 36-week mark.
If a patient is deemed "low-risk" (high risk includes underlying conditions, history of multiple miscarriages or previous ectopic pregnancy), Afnan’s plan of care includes an integrated test at 12 weeks. This test is designed to detect Down syndrome with 90 percent accuracy. It consists of an ultrasound scan and blood test followed by another blood test at 16 weeks. Amniocentesis (also referred to as amniotic fluid test or AFT) will confirm the diagnosis; however, there is a 0.5 percent possibility that the procedure will result in a miscarriage.
While there are few warning signs of fetal abnormality during pregnancy (despite elevated blood pressure and spotting), regular fetal movement is a good guide. Ten movements or more a day is normal; any decrease should be reported to the doctor immediately.
Ready Or Not, Here I Come: Birth
Midwives offer care to women throughout their pregnancy, labor and birth, as well as during the postnatal period. They are specialists in low-risk pregnancy, childbirth, and postnatal care.
At BJU and Amcare Women’s and Children’s Hospital, midwives are an integral part of the delivery team. They join the mother once she is admitted to the hospital and stay with her throughout the delivery up until she is ready to go home. Many times, the midwife will deliver the baby – with the doctor on-call to step in if complications arise.
A birth plan is a document the mother (and father) draw up detailing her wishes in regards to the delivery. This includes how things should be handled during the labor, monitoring, labor augmentation or induction, anesthesia, Caesarian, episiotomy, delivery, post-delivery breast-feeding and even photos. The mother, doctor and midwife should go over these details during a prenatal check-up.
The percentage of women who choose to have an epidural or significant pain relief during labor hovers between 50 and 70 percent. Afnan explains your options: "Pain relief comes under four main headings. [First are] general measures, such as walking, rubbing the lower back, taking a bath, and breathing through the pain. Second is Entonox, also known as laughing gas. This takes the edge off the pain, and is generally given towards the end of labor. Research shows that women find it useful but it may not be very effective in actually lessening the pain. Third is Pethidine injections, which are stronger and longer-lasting. And lastly is an epidural: a regional analgesic or anesthetic that is injected into the lower back. [It’s] very effective in taking away the pain."
All forms of pain relief have pros and cons, and these should be discussed during childbirth classes and again when the woman is admitted in labor. It’s important for mothers to be aware of their pain relief options. "Many times the couple will come in thinking ‘definitely no’ to one option (usually an epidural), and then get really disappointed and upset when they need one. Having the knowledge and being open [minded]are critical to being prepared," says Afnan.
Fifteen percent of caesarians are unplanned. Afnan stresses that the couple should choose the delivery method that is right for them. BJU does allow moms who had a Caesarian the first time around to deliver their second child vaginally, should she wish to and providing it is safe.
If a medical crisis should arise, BJU has a Neonatal Intensive Care Unit (NICU). Other hospitals that do not have this facility usually transfer the infant to the 301 Military Hospital’s NICU for treatment.
Happily Ever After: Postnatal Care
The golden rule for mothers is: Don’t do it alone. Seek and get hands-on help and advice from family, friends and housekeepers. Allow others to take care of your baby so you can rest and recuperate. Beijing Mamas is an online forum for mothers moderated by mom-of-three Liora Pearlman. Sign up and find other Beijing-based moms to connect with.
Both babies and mothers gain many benefits from breast-feeding. Breast milk is easy to digest and contains antibodies that can protect infants from bacterial and viral infections. Research shows that women who breast-feed may have lower rates of certain breast and ovarian cancers. It also burns up energy, helping you shed unwanted pregnancy weight.
One the most important ways to prevent disease in your children is to make sure they receive recommended childhood immunizations. A baby should receive over 20 immunizations by the end of their first year. Keep an immunization guide and booklet on hand and bring it with you for every shot. The controversy stemming from a 1998 study published in The Lancet medical journal linking the measles, mumps and rubella (MMR) vaccine as a cause for autism has recently been disproven after scientists could not replicate the test. The Lancet issued a full retraction and the author of the study, Dr. Andrew Wakefield, went on to face ethical charges.
Postnatal depression (PND) is a clinical condition. If you feel you aren’t able to cope, whether emotionally or physically, don’t wait for it to tide over. Go to your doctor immediately for advice and treatment.
Beijing’s Birthing Facilities
Amcare has joined BJU as the preferred provider for delivery due to their state-of-the-art facilities and well-trained staff. Other popular facilities for delivery in Beijing include Peking Union Medical College Hospital, American-Sino OB/GYN Hospital and Mary’s Hospital.
At BJU, English is spoken by all professional staff, nurses, midwives and administration. Other clinics and hospitals have staff with varying levels of English. Patients who do not speak Chinese should bring or ask for a translator.
We asked mothers who delivered at BJU and Amcare to share their experiences with us.
What was your impression of the midwives?
Brooke Allen (BJU): Both of my children were born four weeks premature. The midwives’ and nurses’ attention to my health, and the health of my unborn boy’s, was phenomenal.
Stacey Andell (Amcare): Nurses, midwives, doctors, all were extremely competent and efficient. They knew what they were doing and did it without any hesitation.
Sharon Hill (BJU): I couldn’t say because Dr. Brooks [former chairman of BJU’s OB/GYN]was there the whole time. When I had my first child in Canada, the labor and delivery nurses do most of the work. At BJU, it seems the physicians are really involved in the labor and delivery.
Candy Pollydore (BJU): I liked the fact that a nurse or midwife was by my bedside attending to my every need during labor. My husband was also allowed to be with me during labor and delivery.
Did you try any traditional Chines medicine (TCM) during pregnancy?
Stacey Andell (Amcare): They gave me a special herbal medicine to help my uterus contract after the birth, and they gave the baby a massage after her bath every day.
Did you attend prenatal classes in Beijing?
Stacey Andell (Amcare): We attended a hypno-birthing series with Kathy Levitan at BJU which we enjoyed very much. When we found out that we would need to have a [Caesarian], we contacted a lactation consultant [recommended by Levitan], called Bronwen Smith to learn about how we could breast-feed successfully after [the Caesarian].
Did the hospital give you postnatal care instructions?
Brooke Allen (BJU): For both of my deliveries, my boys had jaundice and most of the postnatal care revolved around getting them in the light as much as possible. After my second delivery there [was a big]emphasis on breast-feeding. [A lactation consultant] came for a chat and a follow-up during my stay. She even phoned me once I was out of BJU to find out how things were going and I really appreciated it at the time.
Do you think the delivery package was good value for money?
Stacey Andell (Amcare): Yes! Amcare is a fraction of the cost of other foreign hospitals. [It would have been] a big financial strain to go to BJU, but Amcare was well within our budget. At the same time, we don’t feel like we compromised on the level of care. All the staff we interacted were extremely competent. There are a lot of Chinese-only speaking staff; however, you can request a translator if you need one. I’d estimate at least 50 to 75 percent of staff can speak English well enough to talk about the specific things they are doing with you. Dr. Tina Zhou is an English-speaker. Whenever I asked a serious medical question that was beyond my ability to ask in Chinese or beyond the nurse’s ability to answer in English, they would call Zhou and she would explain it to me. I also saw her for several prenatal appointments; she was in charge of all the follow-up care after my [Caesarian].
Why did you choose this hospital?
Candy Pollydore (BJU): I decided to have my baby at BJU because I was concerned about having to receive blood in the event of an emergency during delivery. My blood type is O negative, so I can only receive blood from someone with the same blood type. BJU has a relationship with the Beijing Blood Bank. This relationship would have made any blood transactions easy.
Any advice for pregnant moms in Beijing?
Susan Hoch (BJU): I had a really good experience at BJU considering the birth did not go as planned. Prenatal care at BJU was also very good. For first time moms, I would recommend that you do as much research as possible, and have a clear idea of your expectations for prenatal care and birth. Then communicate that to the staff at the hospital. For women hoping to have a birth experience that is similar to that in the West (home births, water births, or birthing in a non-hospital environment), Beijing is really lacking in support, qualified people and facilities.
RESOURCES
Hospitals
Beijing United Family Hospital
www.unitedfamilyhospitals.com
Amcare Women’s & Children’s Hospital
www.amcare.com.cn
American-Sino OB/GYN Hospital
www.asog-beijing.com
Mary’s Hospital
www.mary.net.cn/en
Peking Union Medical College Hospital
http://english.pumch.cn/
IVF Clinics
Jiaen Hospital
www.jiaenhospital.com
Beijing United Family Hospital
(see website above)
Online Tools
Swap stories and get advice from savvy Beijing parents
www.beijing-kids.com/forum
Create a birth plan
www.birthplan.com
Connect with moms at the Beijing Mamas Yahoo group http://groups.yahoo.com/group/Beijing_Mamas
Track your pregnancy online for free (and no sign ups!)
www.bbc.co.uk/health/tools/pregnancy_calendar/
Visit La Leche League International’s local Beijing site
Llli.org/Beijing
Books
What to Expect When You Are Expecting
by Heidi Murkoff and Sharon Mazel
The new fourth edition of what is arguably the most famous English-language book on pregnancy is as exhaustive as it is thick. The 600-page tome discusses topics ranging from pregnancy tests and month-by-month fetal development to diet, illness symptoms and even advice on sex during pregnancy.
The Expectant Father
by Brott Armin
Aimed at fathers-to-be, The Expectant Father comes with a month-by-month explanation of the different stages of pregnancy and gives an overall view of the different hurdles (ranging from physical to financial) that first-timers can expect to face.
Your Pregnancy Week by Week
by Dr. Curtis Glade
This book offers all the medical background and information a young mother needs. Organized by week, the chapters outline the individual stages and the changes in a mother’s body during pregnancy.
Baby Love
by Robin Barker
Australia’s bestselling babycare book gives expert advice for the first 12 months of a baby’s life. Full of Robin Barker’s wisdom and humor, this guide has been fully revised, including new material on nutrition, food allergy and intolerance, and updates on safe sleeping, breast-feeding, "reflux" and immunization.