Giving birth in developing countries... or not(29 Posts)
So we hear that our expat friends in Nepal have a baby due in June.
They looked round the maternity facilities at the Western hospital in Kathmandu and were not impressed - I quote: 'the tables were clean but the walls and doors weren't'.
She knows that flying longhaul is not recommended in final trimester.
So their plan is to fly to Thailand (couple of hours away) a month before the birth, rent a flat, have the baby in Bangkok, recover for a few weeks, then go either to his family in the UK or to her family in Australia for a bit, then back to Kathmandu.
Please someone tell me they've done this kind of thing and it's worked well for them, because I can't help thinking they're utterly insane but want to be as positive and supportive as possible.
Nowt wrong with Thailand (or Nepal for that matter.)
I was born in Zambia in 1967-my mother's choice.
(The NHS hospital I had my children in had blood on the big lights over the bed,and pubic hairs and shit stains in the toilet.)
I think it's more the travelling and renting aspect MrsB means?
Maybe I'm wrong but I don't think MrsBadger was saying anything wrong with Bangkok. I think she was saying is the whole flying a month before due, renting a flat, then going to the UK or Aus then back to Nepal a bit too much when heavily pg then with a brand enw baby.
But maybe I've misread it?
Is it H?
Tiny babies are easy to travel with.I was on a plane with ds when he was about 8 weeks old.
MrsB,best thing your friend could do is breastfeed.As well as making life much simpler,it will provide very strong protection against any nasties be they in Bangkok,Kathmandu or Grimsby.
Oh yes, to clarify I have no worries at all re giving birth in Bangkok, am sure it'll be fine, it was
a) the assumption that because it wasn't super-clean the hospital in KTM was no good and they had to scour Asia for somewhere 'better' and
b) the lots-of-travelling aspect.
I also have the feeling that the mum-to-be isn't getting a lot of support at the moment and will have zero continuity of care up to the birth and I'm not sure how to help her out on that score.
Agree bfing will make things much simpler though.
first off I think you're a good friend to be concerned and to want some reassurance - and I hope you'll get some from someone with relevant experience. I think there are a lot of questions for your friends to ask - in addition to normal ones about facilities etc - but hopefully they have thought of them - where will her ante-natal care take place? will she have full access to all the records? and be able to take them with her? what language will they be in and will they be understandable by the hospital in Bangkok? will she be understandable by the hospital in Bangkok - communicating with midwives can be stressful at teh best of times - negotiating a language barrier mid-contraction isn;t what I;d call appealing. do they have any friends in Bangkok? wouldn;t it be very lonely for them for several weeks - if it's their first they may have underestimated this - both in terms of needing help and in terms of wanting to share their joy. what's their back-up plan? what happens if she's advised not to fly at all? (she won;t get insurance after a certain stage - can't remember what it is). I might be wrong but I'm not sure there's a great deal of difference (if any) in the stage beyond which you're not meant to fly long-haul and the stage beyond which you're not meant to fly short-haul. Is the hassle really worth the extra fortnight or so, iyswim. They're having a baby. Do they really not want life to stop for a wee while anyway? (hmmm, I seem to have failed utterly on the reassurance front.....I am, however, sure their idea is totally safe. just - maybe like you - not convinced it will make for the most relaxing enjoyable time...)
I spoke to a woman who'd been to a very remote part of India recently who said although the hospital there was Ok, there were some disturbing practices going on like episiotomies being carried out on nearly every woman, so I think your friend is wise to go to Bangkok. Having said that I wanted to just be at home after giving birth, not in a strange place so it wouldn't be my choice, either.
What do other expats do there?
My friend in Indonesia did similar, travelled elsewhere, rented a place and it all worked out fine. But then lots of people she knew had done the same
Most of the expats out there seem to go home - the only ones I know who have given birth out there have been married to Nepalis.
Good to hear that, TheBlonde - this is what I meant, maybe all expats everywhere do it and it's completely normal, just sounds weird to my ears.
And as far as I know they don't know anyone in Bangkok, and I don't think either speak Thai...
Without knowing anything about it, and at the risk of sounding wet, why don't they just go to the UK or Australia in the first place? If they are planning to go there once the baby's born it would save at least one trip, and they'd presumably be closer to one of the families for the duration.
They can't fly longhaul in the last trimester, tamum. Nepal to Thailand is a lot more viable than Nepal to the UK.
Have they checked out the hospital in Bangkok, to see it's ok? I assume there are Western hospitals there?
I thought exactly the same thing (and wish wish wish she was here in the UK!)
I think it's because the father can't get out of the country while the mother is still safe to fly long-haul.
Personally I'd have sent her home to Oz on ahead and joined her later... but I am keeping my mouth shut as I think my main role here is to be positive about what they've decided not pick holes in it.
I considered it after visiting my local NHS maternity unit, and I regreted it not doing it: Fogeting about the horrible midwife, the bath was a disgrace full of droplets of blood, and there were this tiny insects running around as soon as I turned the shower on. In the 2 days I spent there no cleaning took place other than a guy coming to remove the contents of the rubish bins. So... don't asume that developing countries hospitals are less clean just because they are in developing countries. As in every place, there are good and bad hospitals, its just a matter of finding the good ones and avoiding the bad ones.
The reason we decided to stay even when we disliked the hospital was that DH would have hardly time to get to my side if baby decided to come before the due date. Which is not the case with the 2 hour flight to Bangkok if they have several flights a day.
Does she has some friends in Bangkok?, staying on your own for 3 months may be a bit depressing especially during the last weeks when you can't move as freely as before. And it would be good for her to have someone around in case DH is delayed for any reason. If she doesn't have anybody I would recommend having the baby in a place that she has, although that may mean daddy missing the birth
I have been to Katmandu but only visited the turistic places that had not yet being very "westernised". But I suppose that there should be some places that meet her requirements better. Having said that... as a foreigner in Katmandu... aren't you supossed never to stay longer than 6 m? would she need to move out soon after baby is born? as far as I remember they were VERY conscious about the time conditions. And if she has to move out soon anyway perhaps it would be a good idea to consider having the baby in the country/city she would be moving to.
Hope that helps
It's airline dependent isn't it? I flew pretty late, though admittedly only transatlantic.
You sound like a very nice friend MrsB
Thanks for that Chandra - they're both in Nepal on work visas with NGOs so don't have the same residency restrictions as visitors.
The good thing about Bangkok (vs UK or Oz) is she can do the short flight late in her pregnancy, so her DH will go with her when she goes and stay with her the whole time, so no worries about him missing the birth.
Thanks for your reassurance, all of you - I'm feeling a lot better about this than I did when I first heard.
I guess it's because I'm such a stay-at-home that their itinterant lifestyle foxes me even when no babies are involved...
(And do remind me about this in six months when I'm trying to find the contact details for the Bangkok branch of LLL... )
Why don't they fly to Bangkok, stay for a few days then fly to Oz, It's another 9 hours from there but broken up could work.
then they would have some family there for the birth, great hospitals, and maybe free accomodation.
My other idea would be Singapore, much better for hospitals,cleaner and safer in every other aspect and everyone speaks English.
I'm sure they'll sort it out, obviously you've had children and are looking out for them. good on you.
I know a number of expats who've done this sort of thing. When we lived in Indonesia both expats and better-off Indonesians went to Singapore to have their babies. It might be worth your friends thinking about that as an alternatrive to Bangkok. As Singapore is used by expats/Indonesians quite a lot for various medical things the hospitals may well have details available for renting flats short-term etc which might be useful.
Small problem with leaving Thailand a few days after the birth.
The baby cannot travel without passport. This can take a while to sort out - a couple of weeks at a minimum.
The private hospitals in Thailand are good and the staff all speak English.
I know a very reasonable place to stay (short stay apartments) in the Sukhumvit area if she is interested.
When I was in Singapore working as a doula we had loads of clients who flew there from various locations around Asia to have their bubs - from Vietnam, from Indonesia, and others. They would rent a lovely serviced apartment and spend a few weeks hanging out by the pool and shopping, have their baby, and fly home again when bub was a couple of weeks old. It seemed to work out well for most of them. Especially when the Dad would be flexible about work - not so much fun if the Mum to be was on her own and Dad was off working overseas - makes it all more complicated. Often the reason for doing this was not because conditions in the country they were living in were so awful per se but just because they wanted access to things like NICU just "in case". Also access to western style shops for baby things which were not available in the country they were living in. For some they were also looking for a more natural, supportive birth environment - many of the hospitals in developing countries have gone a bit overboard on technology (ironically) and so there is a very high cesarean rate. So it all depends what they are looking for etc. If they want details of a doula in Bangkok I have a good friend who works there as part of a group of midwives. Just one downside - Bangkok is very polluted and massive traffic jams make getting to hospital in a hurry difficult. Most of the hospitals there have a very high rate of medical intervention/cesareans. If Singapore is an option they might want to consider that as an alternative. Not exactly on Nepal's doorstep though I admit.
Agree about the pollution and traffic in Bangkok - I didn't think about the possibility of getting stuck in a traffic jam.
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