"Do you need this baby?"
Back in March, I was grateful that I had packed an American home pregnancy test during one of my trips back from the US. Two years ago, when I was first pregnant-but-not-quite sure with Maeve I purchased several home tests from local Chinese drugstores. Not one of them gave me either a positive OR negative result. Randy told me to relax and wait a few days until I returned to the US, becuase either I was or I wasn't, and I could keep buying and using up these cheap and crummy tests, but it wouldn't change a thing. Of course, I was, and withing 24 hours of arriving in Pittsburgh I knew for sure.
It may have been futile to hold on tos this box for so long, but in March I dug it out of a drawer. Now seeing the plus sign on the stick, we were faced with the sudden need to make a whole series of choices. No, not the choices of the Pro-choice people, but rather where I would go for obstetrical appointments and where we would have this baby. Only a week or two before, Randy's employer cancelled our American insurance, so suddenly cost rather than just convenience and level of care was a factor. We knew that if there were any way to have this baby in China safely, the maximum cost would be a fraction of what it would be in Hong Kong or the US. While we knew that the average Chinese hospital would not be our choice, we wanted at least to investigate some of the "VIP" services some of the hospitals offer foreigners and rich Chinese, or some of the private hospitals inside of China.
I went for a confirmation test at a hospital associated with Beijing University, called Bei Da Yiyuan. I had heard of one foreigner, a Filipino woman married to a British man, that had her son there and was very pleased wih her experience. She had described the VIP delivery room as "like a hotel." I loved how often I would encoutner that simile in the following weeks when I would hear from people about their experiences in a variety of Chinese and HK hospitals. The hospital also provided her an English interpreter. I was hoping to be pleasantly surprised by the VIP services at Bei Da.
My only previous experience at a Chinese hospital was when I had to go through a battery of tests for my residency permit. I had to be inspected for diseases of the mouth, drugs, HIV. It was a chaotic place, not unlike Penn Station in New York. There was little privacy, and no soap or even soap dispensers in the bathroom. I told Randy that day I never wanted to step foot in another Chinese hospital.
But in March of this year we went to Bei Da and found our way to the VIP floor. Normally I really don't like to exercise in a obvious way any sort privilege our foreigness brings. However, I was more than happy to escape the chaos of the regular hospital waiting area, again the closest American experience I have is Penn Station in New York. Hundreds of people were milling about, some of them connected to IV's even, most watching a board waiting for their number to be called. Ren shan ren hai; there were people everywhere.
Even at the VIP department we were somewhat lost. The nurse assigned to English-speaking clients was less than happy to see us. She had to walk us step-by-step through the whole process rather than hang out at a desk doing nothing. Her English was less than impressive. I envied the few Japanese patients that were ahead of me as their nurses seemed to be much more helpful, or at least pleasant. I had to buy a VIP card for 100 RMB, then take a number for the gynocology "department" which was really just a room with a desk and an exam table. After waiting more than an hour, I was permitted to see the doctor to tell her what I wanted. The doctor and the nurse asked me how I felt (nauseau, soreness) and I described in English my list of symptoms. They were somewhat surprised that I was there already, almost not believing I could know so soon. They never weighed me or took my blood pressure. They didn't even enquire about my history. She wrote some instructions and I proceeded back to the cashier to pre-pay for the test. I waited again, and then I was summoned again to the doctor. I was given 2 cups and steered to the bathroom.
Usually, when a pregnancy confirmation test is needed in the US (and HK), blood is drawn. While the urine test can give a positive or negative result, the blood test can provide the HCG level. This number in and of itself is useless, unless it is ridiculously high early in pregnancy (indicating perhaps a molar pregnancy). It is also useful if miscarriage is threatened, and day-to-day levels can be monitored to see if they are increasing at the proper rate. The step with just the urine test in the US has been replaced by the home test, so the HCG level in the blood can be a very important test.
However, at Bei Da VIP clinic I simply provided my own samples for them to test. Weeks later, in Hong Kong, my doctor would laugh at the futility of their basically repeating the home test as he drew my blood.
As I waited for the results, which at this point I already knew what they would be, Randy and I discussed how we could proceed. One option was to try to do everything at Bei Da. Another was to do as much pre-natal at Bei Da as possible because it was inexpensive and then go to a private hospital in Guangzhou (HK-style but Chinese cost) that an American friend recommended. Or pre-natal at Bai Da and delivery in the US. Or (what was seeming more and more inevitable) go to HK (HK is all-or-nothing). Only Asian options would guarentee that Randy would be present for delivery, something we regret not happening with Maeve. However, Bei Da was looking less and less like an option for anything as we sat and waited.
I was summoned back into the doctor's room with the English speaking nurse. The doctor started talking and the nurse translated for me that I was pregnant. Then she asked me, "Do you need this baby?"
What an odd question, I thought. Did she confuse the English words "want" and "need?" I remember hearing other kids' parents telling them that they had their wants and needs confused when the kids told them they needed some outrageuosly priced thing. Was she really asking me if I wanted this baby? Would I admit that at the age of 35 I was so human that, yes, I think I need this baby. Not just want, but need. I think Randy does, and I especially know that Myles does. But she probably really meant "want" and that in turn really meant that the doctor was ready to schedule me for an abortion if my answer was no.
I just told them yes, this baby was wanted. The doctor wrote something in a booklet I was supposed to bring with me everytime I returned to the hospital. The hospitals (and my dentist here) do not maintain records. Every patient is responsible for keeping track of their own medical records in these little booklets. There would be no appointments, no referrals to a recommended OB with privileges at the hospital. I knew it couldn't be just like the US, but I didn't realize it would be like this. The doctor wrote out some notes in my booklet and gave me a box of folic acid "for the baby's brain." The nurse told me to come back in about three weeks for an ultrasound, though later I would wonder if she really was supposed to say three months. When I did return, there was much confusion about my being there so soon, and even after paying the 100 RMB VIP charge and the ultrasound charge (another few hundred RMB), she said they were too busy to see me, and that they might not be able to see anything anyway, so could I come back the following week?
Bei Da was soon crossed off my list for anything unless there was an emergency. I made a quick visit to another "highly recommended" hospital in Shenzhen before deciding that Shenzhen was not an option at all. At this other hospital, I walked up a few flights of stairs to the OB department. Without an elevator for patients' use, I can't imagine this hospital would be much fun to rush into if I were already in labor. I was about to make my way to the reception desk when I realized the sign (which was also in English) pointing to the delivery room showed that the "Pain-free abortion clinic" was in the same direction. I turned around and walked out. What if their English-interpreter confused English words and I ended up in the wrong room?
That afternoon I called my primary care doctor in Hong Kong, hoping that I wasn't too late to get the ball rolling there.
Continued tomorrow or when I can get online again......
It may have been futile to hold on tos this box for so long, but in March I dug it out of a drawer. Now seeing the plus sign on the stick, we were faced with the sudden need to make a whole series of choices. No, not the choices of the Pro-choice people, but rather where I would go for obstetrical appointments and where we would have this baby. Only a week or two before, Randy's employer cancelled our American insurance, so suddenly cost rather than just convenience and level of care was a factor. We knew that if there were any way to have this baby in China safely, the maximum cost would be a fraction of what it would be in Hong Kong or the US. While we knew that the average Chinese hospital would not be our choice, we wanted at least to investigate some of the "VIP" services some of the hospitals offer foreigners and rich Chinese, or some of the private hospitals inside of China.
I went for a confirmation test at a hospital associated with Beijing University, called Bei Da Yiyuan. I had heard of one foreigner, a Filipino woman married to a British man, that had her son there and was very pleased wih her experience. She had described the VIP delivery room as "like a hotel." I loved how often I would encoutner that simile in the following weeks when I would hear from people about their experiences in a variety of Chinese and HK hospitals. The hospital also provided her an English interpreter. I was hoping to be pleasantly surprised by the VIP services at Bei Da.
My only previous experience at a Chinese hospital was when I had to go through a battery of tests for my residency permit. I had to be inspected for diseases of the mouth, drugs, HIV. It was a chaotic place, not unlike Penn Station in New York. There was little privacy, and no soap or even soap dispensers in the bathroom. I told Randy that day I never wanted to step foot in another Chinese hospital.
But in March of this year we went to Bei Da and found our way to the VIP floor. Normally I really don't like to exercise in a obvious way any sort privilege our foreigness brings. However, I was more than happy to escape the chaos of the regular hospital waiting area, again the closest American experience I have is Penn Station in New York. Hundreds of people were milling about, some of them connected to IV's even, most watching a board waiting for their number to be called. Ren shan ren hai; there were people everywhere.
Even at the VIP department we were somewhat lost. The nurse assigned to English-speaking clients was less than happy to see us. She had to walk us step-by-step through the whole process rather than hang out at a desk doing nothing. Her English was less than impressive. I envied the few Japanese patients that were ahead of me as their nurses seemed to be much more helpful, or at least pleasant. I had to buy a VIP card for 100 RMB, then take a number for the gynocology "department" which was really just a room with a desk and an exam table. After waiting more than an hour, I was permitted to see the doctor to tell her what I wanted. The doctor and the nurse asked me how I felt (nauseau, soreness) and I described in English my list of symptoms. They were somewhat surprised that I was there already, almost not believing I could know so soon. They never weighed me or took my blood pressure. They didn't even enquire about my history. She wrote some instructions and I proceeded back to the cashier to pre-pay for the test. I waited again, and then I was summoned again to the doctor. I was given 2 cups and steered to the bathroom.
Usually, when a pregnancy confirmation test is needed in the US (and HK), blood is drawn. While the urine test can give a positive or negative result, the blood test can provide the HCG level. This number in and of itself is useless, unless it is ridiculously high early in pregnancy (indicating perhaps a molar pregnancy). It is also useful if miscarriage is threatened, and day-to-day levels can be monitored to see if they are increasing at the proper rate. The step with just the urine test in the US has been replaced by the home test, so the HCG level in the blood can be a very important test.
However, at Bei Da VIP clinic I simply provided my own samples for them to test. Weeks later, in Hong Kong, my doctor would laugh at the futility of their basically repeating the home test as he drew my blood.
As I waited for the results, which at this point I already knew what they would be, Randy and I discussed how we could proceed. One option was to try to do everything at Bei Da. Another was to do as much pre-natal at Bei Da as possible because it was inexpensive and then go to a private hospital in Guangzhou (HK-style but Chinese cost) that an American friend recommended. Or pre-natal at Bai Da and delivery in the US. Or (what was seeming more and more inevitable) go to HK (HK is all-or-nothing). Only Asian options would guarentee that Randy would be present for delivery, something we regret not happening with Maeve. However, Bei Da was looking less and less like an option for anything as we sat and waited.
I was summoned back into the doctor's room with the English speaking nurse. The doctor started talking and the nurse translated for me that I was pregnant. Then she asked me, "Do you need this baby?"
What an odd question, I thought. Did she confuse the English words "want" and "need?" I remember hearing other kids' parents telling them that they had their wants and needs confused when the kids told them they needed some outrageuosly priced thing. Was she really asking me if I wanted this baby? Would I admit that at the age of 35 I was so human that, yes, I think I need this baby. Not just want, but need. I think Randy does, and I especially know that Myles does. But she probably really meant "want" and that in turn really meant that the doctor was ready to schedule me for an abortion if my answer was no.
I just told them yes, this baby was wanted. The doctor wrote something in a booklet I was supposed to bring with me everytime I returned to the hospital. The hospitals (and my dentist here) do not maintain records. Every patient is responsible for keeping track of their own medical records in these little booklets. There would be no appointments, no referrals to a recommended OB with privileges at the hospital. I knew it couldn't be just like the US, but I didn't realize it would be like this. The doctor wrote out some notes in my booklet and gave me a box of folic acid "for the baby's brain." The nurse told me to come back in about three weeks for an ultrasound, though later I would wonder if she really was supposed to say three months. When I did return, there was much confusion about my being there so soon, and even after paying the 100 RMB VIP charge and the ultrasound charge (another few hundred RMB), she said they were too busy to see me, and that they might not be able to see anything anyway, so could I come back the following week?
Bei Da was soon crossed off my list for anything unless there was an emergency. I made a quick visit to another "highly recommended" hospital in Shenzhen before deciding that Shenzhen was not an option at all. At this other hospital, I walked up a few flights of stairs to the OB department. Without an elevator for patients' use, I can't imagine this hospital would be much fun to rush into if I were already in labor. I was about to make my way to the reception desk when I realized the sign (which was also in English) pointing to the delivery room showed that the "Pain-free abortion clinic" was in the same direction. I turned around and walked out. What if their English-interpreter confused English words and I ended up in the wrong room?
That afternoon I called my primary care doctor in Hong Kong, hoping that I wasn't too late to get the ball rolling there.
Continued tomorrow or when I can get online again......
Comments
One question- I've had 3 babies at 2 different hospitals in Chicagoland, but I've never had blood drawn to confirm I was pregnant. Just urine. And I don't recall anyone I know mentioning that they had blood drawn, either.
Any ideas on the ratio of blood vs. urine testing?
Good luck, Jen, I'll be praying for you and your family.
chris
And that's a fascinating description of Chinese hospitals. Of course, having spent about half my life in India, I'm used to the "two-tier" health-care system. Next-to-nothing for the poor, and near world-class for the rich (though that's changing now, basically as upward mobility increases).
What I find fascinating is that my Indian family and friends (all upper middle class) generally find the idea of being in a hospital in the US to be somewhat scary: "they won't treat you if you don't have insurance!" or "you'll spend hours in an ER!" or "do you know the doctors there don't make home visits?" or "they are not familiar with tropical diseases" or "they are so uptight about paperwork!"
A few years ago, my brother (who travels to the US several times a year) fell sick near the end of his trip and changed his flights so he could go back to Delhi early. "I wouldn't trust them here at all." Turns out he had dengue fever -- a (unfortunately) common monsoon malady in India, but probably unheard of in the US.
[Granted, if any of my circle went down the road to the municipal hospital that caters to the aam admi, the common man, they'd flee to the US if necessary ...]
And, my best friend from college, who lives in Guangzhou, was involved in a horrific gas explosion accident a few years ago. He got amazing treatment at a special burns unit in Guangzhou and survived (a miracle too, I'm sure. He had burns on 82% of his body), after 3 months in intensive care, at a fraction of what similar care would cost in the US.
It sounds like the "rich-tier" hospitals in China are probably not quite as well organized as in India. However, with the growing economy and the large ex-pat presence, it seems that you should be able to find decent and adequate care.
At least, I'm confident it won't be like another buddy of mine, whose first child was born in a convent in Khartoum, Sudan! :)
Rest assured of my periodic prayers for y'all.
Gashwin--I mention in my post today that other Chinese cities have better equipped high-end hospitals than Shenzhen, at least for maternity services. The market in Shenzhen just isn't there because most foreigners and mainlanders with moeny go to Hong Kong. There are aspects of regular Chinese hospital care which are remarkable--I think that since they aren't trying to push you out the door, they will take time to let you heal in the hospital. Maternity stays at Chinese hospitals are usually a week. My friend had her eardrum replaced and stayed in hospital for a week and a half. However, medicine is not a highly-paid field in China, and sometimes you get what you pay for. And staph is a huge problem in any hospital in any part of the world, but after you watch a doctor or nurse leave a bathroom without washing their hands, you wonder how bad the staph problem might be here.
Clare-Thanks for the research, but at this point, if we were to go to Korea, we may as well go back to the US. Our reason for wanting to remain close is so Randy can be there and be helpful. And at least one Catholic hospital in HK was scratched off our list because it didn't jive with our ideals.
And the no knowledge of tropical diseases---this was almost a huge problem for us. When Myles and I returned from our first trip to China, we were on a beach vacation in North Carolina. He spiked an incredibly high fever one morning, so high and so quickly he went into seisures and fell unconcious, vomitting all his tylenol. When I told the ER dr we were in China only a week ago, he had such a look of nervousness. At a beach hospital they normally only deal with vacationers' broken bones and sunstroke. What on earth was I bringing into his ER?
I could see him at his computer and on the phone through the course of that day, checking Myles symptoms with tropical diseases he had only ever read about.
"Pro"
"step foot"
"foreigness"
"IV's"
"gynocology"
"which at this point I already knew what they would be"
"Her English was less than impressive."
Glass houses, etc.
This is a blog. I am sure that Jen, like most moms, is doing her best at "blogging on the run" and fitting it in among her many other duties. The rest of us are simply grateful that she she does it so frequently and so well.
I'm sorry, but if you had to pay to read this, I will refund your money.
Had I gone to some other hospital, like Second People's Hopspital, I would not have assumed that they were able to speak English, and I would have relied on my own Mandarin or taken someone with me. However, since Bei Da Yiyuan advertises as part of their VIP "package" English-translator services (as well as Japanese), I was obviously disappointed with that of that service, for which I paid EXTRA. If I went to some regular local hospital I would not have expected anyone to speak English.
You are clearly unfamiliar with my blog, something that is generally only read by a few people related to me by blood or by marriage (and oddly enough, occassionaly by writers for the Atlantic and the South China Morning Post). I am not the typical expat-land type--
I study Mandarin, I have no hired help, I attend church services at a Chinese church, I am disappointed when people answer my Chinese questions in better English than I speak---I am the oppposite of the ethnocentric American you want to accuse me of being.
I generally offer a viability US at around 8-10 weeks, that confirms a pregnancy much more than any lab test would.
I know of a few midwives who will fly in to other countries and attend births at home - these midwives generally work with missionary families. Is that something that might interest you? and thanks to clare for the referral. I am way behind in my email and my blogging these days but some day I hope to get back up to speed.