Question for women who have had a baby in Singapore

[kday]

Hello,
I'm new to this but really hope someone can help.
It looks like we will be relocating to Singapore in the Summer and my third child is due in late October.
I had my first two girls in London, the first via emergency c-section and the second a "VBAC" (vaginal birth after c-section). The hospital here was really supportive of VBAC and I really want to try it again with baby no. 3. Does anyone know if ob-gyns/hospitals in Singapore are in favour of these, or is it "once a c-section always a c-section", like it used to be here?
Many thanks for any help you can give.

[regina12]

They are likely to be conservative in their approach as but will be likely to support your wishes if they can. There is a number of western expat obstetricians there if that is your preference. I would thoroughly recommend Dr TC Chang however - universally known as "TC". He used to practice out of the Thompson Medical Centre.

In the first instance contact the Mother and Child Centre, set up by western midwives to help women like you. //www.motherandchild.com.sg/. They will advise after discussing your needs and are lovely.

good luck.

[laptopwieldingharpy]

yes to TC Chang

Shirin Jacob (camden medical/gleneagles) is )contrary to all you may hear) a real earth mother when it comes to obstetrics. she works with a lovely british doula.

Definitely contact the doulas through mother and child, I know 2 personally, beautiful women, having themselves experienced birth in the UK and Singapore.

[kday]

Many thanks, regina12 and laptop. That's so helpful (and quite a relief!). I'll contact Mother and Child and look to see if I can use "TC", too.

[regina12]

[www.expatgynaecology.com/]

There - I've even found you a picture of him. He's so lovely!

[regina12]

//www.expatgynaecology.com/

sorry is that better?

[papooshka]

Another popular gynae is Paul Tseng who practices at Thompson Medical Centre. I had a VBAC here in Singapore.

Mother and Child are fab and theres also Parentlink who are a similar company.

[Lollypolly]

Paul Tseng delivered my overdue, large and breech baby by section at 41+ weeks - I did lots of research on the web and chose him because he has a reputation for less intervention than other docs. He's lovely too.

Mother and Child is expensive ($50 for a hv consultation) but there is no postnatal checking or support here as a matter of course apart from your 6 week check. Personally I prefer www.nmsg-singapore.com and their Mamma Wellness group...

[rumbletum]

Paul Tseng delivered my dc3 at Thompson Medical Centre. Agree with lollypolly, lovely man, positive experience all round.

[kday]

Thanks so much for all your advice. Unfortunately none of these doctors/clinics are included in my husband's work insurance policy and the ones that are don't seem to get a very good wrap online for sensitivity/willingness to assist with different birth options. Is it outrageously expensive to pay for the birth ourselves or am I mad to think about that as an option? Any more help you can give would be great.

[rumbletum]

I don't know how much it would cost now if you were to pay for the birth yourself. I had my dc3 there in 2005 so prices would be v different now. All the best for your move!

[regina12]

Perhaps you could call the clinics/practitioner you like, explain your situation and ask the prices and options? If you forgo the hotel-like surroundings of, for eg Gleneagles, then hospital prices are cheaper (Thomson, where TC Chang and Paul Tseng prefer to deliver is not luxurious (or wasn't when I was there). KK women's hospital is state/government and if the doctors were to deliver you there (and both aforementioned I think, do) the the cost would be different. The cost of the hospital stay is distinct from the cost of the obstetric care and delivery and there is a price list (for hospital stay and for obstetric care and delivery) so you can see if it is possible within your budget. There are budget options, relatively speaking but you can only find out what they are by asking.

[kday]

Many thanks. I have no idea how it works there so that's really helpful. I'd put in a call/emailed but worried that I wouldn't have a response until Monday! I can definitely do without luxury - I just want the chance to do a VBAC.

[papooshka]

Try Mary Rauff at NUH....she is meant to be fantastic, and also as she practices at NUH its much cheaper. One of my friends had her for 2 babies and raved both times.

[laptopwieldingharpy]

Public hospitals are very good. I had very good ante natal screening at KKK for baby heart defect, very sensitive and caring.

There is no reason they would not listen to your wishes.

Talk to the doulas at Parentlink (PM if you want names), they are very knowledgeable and its a fee well spent for someone in your position (new to sg and pg)

good luck

[LadyPenelope]

TC Chang delivered my ds with VBAC at Thomson. VBAC was what I wanted after an Emercency C section first time around (which was not in SG.) He was great - extremely supportive and he was also very happy to have a doula there. She has since left SG but she was tremendous and I'm sure a key reason why my ds was eventually born with CS.

We were fortunate to be covered under insurance for almost all the costs, but IIRC, there were packages available so you would know the costs ahead of time. It may even be asking your husband's company to consider paying the costs even if not covered by insurance. (Depends on your overall package but if the insurance ultimately covers maternity but you're not covered now because you've not been in scheme for the 1 or 2 year waiting period, it worth thinking about.)

I'm not sure about the public hospitals and their thoughts on VBAC.

[LadyPenelope]

that should say a key reason why my ds was eventually born without CS.

[regina12]

It is different to the UK. Care is obstetrician-led rather than midwife-led. You will see your doctor on each visit and he will provide all care and attend the birth. The system is more like that in America than in the Uk, (I've had babies in all three countries). Their midwives are similar (I would say) to American Obstetric nurses and not as highly trained as our midwives, hence the market for centres like the Mother and Child mentioned and for doulas, which provide things (services, but also childbirth culture) we are used to from the NHS.

State care, as someone said above, is very very good though you might find it culturally different (eg they are far more inclined to take the baby away and assume you need all the rest you can get. Just say if that is not what you want though and they will comply). The doctors mentioned above are well used to dealing with expats and tend to have trained and worked in the west so they understand us culturally. Those doctors who trained in Singapore will be excellent medical practitioners but their birth culture might differ - only a little though- You have insurance though so there is no reason to assume the doctors listed on it are not very good.

I don't know the reason for the limited list but if you ask you might find it is simply limited to those who practise at a cheaper hospital. If that is the case, you might be able to pay the doctor of your choice from insurance and have him/her deliver at your insurance company's choice of hospital, or you might decide to pay hospital fees yourself and deliver at your doctor's usual hospital.

Until you check with your insurance company the reasons for the list of preferred doctors and if there is any flexibility in it; and you check the options with your preferred doctors too, you cannot know what your choices are. I notice from the link I added TC Chang is already booked up for the Summer months so do ring. You might be pleasantly surprised and they are used to anxious mothers, new to their system. Remember that as it is a private system you get more of a voice and choice - it isn't quite such a set system as birth in our NHS.

If you run the names on your insurance list names past the midwives at Motherand Child or Parentline, it is likely they will know them. Singapore is a small island!

The cost of birth is not astronomical if you are on a comfortable expat package though there should be no need to pay as your insurance company is unlikely to use inadequate doctors.

I am sure your experience will be good.

[Merlion]

I'm due to have my second here in a couple of weeks and am under Dr Kek at Mt Elizabeth. She is and has always been incredibly reassuring and understanding. DS was fairly straightforward VB and I am hoping this one will be too so can't give you any advice re VBAC but she was sympathetic to my birth plans. We don't get covered from my or DH's insurance so are paying for everything. Yes, it's pretty expensive but we don't have any choice!

Regina I visited a friend who delivered at Thomson under TC recently and not luxurious?! It was more like a hotel suite (think tv,dvd player, music system)! When I had DS it was one of the busiest days of the year (08/08/08) so for Chinese very lucky and my room at Mt E wasn't nearly as nice but that may be been down to there having been 15 babies delivered by ELCS before DS decided to arrive .

[Merlion]

A couple more things - I spent a lot of time at Mother & Child after I'd had DS but friends who didn't or were unable to bf said that they didn't feel particularly comfortable there IYSWIM.

Other friends have also recommended CHI at Rochester Park - they have a twice weekly Well Baby Clinic that is $15 a time.

[regina12]

Merlion, Maybe my luxury-ometer is awry! - I just seem to recall Gleneagles being just like a 5 star hotel, and Thomson seeming less so and no different to the (admittedly brand new) NHS hospital in which I had had a previous birth. But TC preferred to deliver at Thomson - though he was willing to go to Gleneagles if I had been very keen, but I wasn't bothered

Or maybe Thomson has had an uplift since my time!

[Merlion]

might just be me Regina - the last time I went to an NHS hospital was to visit my Grandma last year and it was truly dreadful in the way that she was treated but that might just be a difference between maternity and other types of wards.

[kday]

Many thanks, everyone. I've got an appointment with Dr TC Chang when we land in Singapore!

[Merlion]

Great news and good luck!

[Lollypolly]

Thomson has been renovated - it was nearly complete when I had DD2 there in 2008 and I had the choice between a new room or an old room. Be aware that there are different levels of rooms and on the hospital tours you get to choose which one you want (and how much you are going to pay!). In the shared rooms (4 beds), no babies were allowed except for feeding. It's a cultural thing and allows mums to rest. For this reason I chose a private room and had to keep asking the nursery nurses to leave baby with me. You might want to splash out on a private room if you want your baby in there with you....

[AngelaJ68]

I've been living in the US and in France and I delivered my first child abroad. But when it comes to a good gynecologist and obstetrician, there is no one as good as Dr Shirin Jacob in any of those countries. The moment you enter her clinic, you know that you are in the right place. The scent, the flowers, the magazines, and the friendly staff - everything transforms this much dreaded trip to the doctor into such a great experience.
Dr Jacob has a healing smile and her focus and complete attention on the person are unmatched. She does not just go for an exam, but she gently and kindly takes your history and looks at you as a human being and as a whole. You will have the most amazing experience with this woman. You will learn how to have a happy pregnancy, how to eat well to ensure the best for your baby and yourself, how to lower your stress and to find your comfort zones. The lessons you learn during this time will stay with you for the rest of your life. She has changed my life and the lives of so many of my friends who saw her- we all lost weight, learned how to take care of our bodies, re-energized our marriages. Definitely go to her.