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Sunday, 18 September 2016

Knocked up...now what? Choosing a Doctor

So you've confirmed in your own mind that you are pregnant, but how do you find a doctor that you can trust and that speaks enough English to communicate with you effectively, and with some empathy?

Firstly lets go through the basic ways to find a doctor and then I'll give you some of my insights and those I've gleaned from other ladies.

Hospital Choice

There are 3 main hospitals to choose from in Central Bangkok that are most suitable for expats, so this is an easy place to start (but this doesn't mean you can't use the others).

3 main things to think about:

  1. Location
  2. Doctor "style" and Hospital Policy (and willingness to listen to you birth plan)
  3. Cost (for a summary of some of the most popular Labour Packages please click here)


Bangkok traffic can be very bad and if you can't get yourself (or your new born baby) to the hospital in rush hour then think very carefully.

Samitivej (Sukhumvit Soi 49)

Bumrungrad (Sukhumvit Soi 1/3)

BNH (Silom/Sathorn Soi Convent) 

After you have considered location, it is worth considering and reviewing recommendations for each hospital.

Many expats recommend Samitivej, it seems to have developed a superior following, but over time I think people have felt that the service levels and location can make Bumrungrad an excellent alternative. Whilst BNH is quietly recommended for its more personal approach and less stressful environment. I have tried both Samitivej and Bumrungrad, and intend on seeking out advice about BNH.

So for what it is worth here is my brief synopsis of the hospitals in general:

Doctor Choice

Of course you may also wish to consider which specific Doctor you see.

Like myself you may have to go through some trial and error.

The most important factor here is to communicate with your Doctor and confirm they are happy with your pregnancy and birth plan. 
Many Doctors in Thailand do not specialise in Natural birth, or may not prescribe to Western norms. Discuss everything with you Doctor openly and clearly to ensure you are not disappointed close to your delivery date if/when you discover that your Doctor will not agree to your wishes.

Doctors in Thailand are very paternalistic (often with a bad bedside manner). If you do not discuss your wishes with them (and sometimes even if you do) they will revert to their own norm, which does not involve a lot of true informed consent.

Please ladies, always remember to a
sk your Doctor questions!!!
  1. Why do I need that procedure? 
  2. What are the alternatives?
  3. How much will it cost?
  4. If you want a Natural Birth - make this clear early on - ask if they are happy to continue being your doctor if you have a Natural Birth
  5. What is your Doctors view and policy on pain relief (remember gas and air are not allowed in Thailand)
  6. What is your Hospital and Doctor's policy on Birth Partners? Are you allowed a Doula? How many people can be in the delivery room?
  7. You are unlikely to get a fully holistic approach from any Doctor in Thailand but if you want , or don't want, anything specific ask early on
  8. Some things are not routinely practiced here, so ask! (namely - skin to skin, delayed cord clamping, father cutting the cord, natural birth, pain relief)
  9. Some things are routinely practiced that you may not want, so ask! (namely fondal pressure, baby suctioning, cleaning the baby for you, feeding the baby formula for you, sedation after child birth)
Personally I have seen the following and am happy to provide my views:

Dr. Suleewan Ratanachai - Bumrungrad

Services used: Pre TTC tests / Vaginal Ultrasound
Had my pre TTC appointment with Dr Suleewan. She was very nice but I felt that her English was not great and she lacked a little empathy and found it hard to explain some things clearly. She also assisted Dr Anong during a vaginal ultrasound when I lost my second pregnancy, but we did not speak much at that time, but she was purported to be an expert with the Ultrasound equipment.

Dr Kanoknat Boonvisudhi - Samitivej

Services used: Consultant / Vaginal Ultrasound / D&C
She was our Doctor for our first failed pregnancy. She was recommended to me through a friend and she is apparently the only doctor in Thailand to have successfully used gas and air in a delivery (it is a banned drug in Thailand). Many expats mums rave about her and she is understood to be pro Natural Birth if you request this.
She is very friendly and personable and helped to put me at ease with our first pregnancy, she also waived her checkup fees after my first miscarriage. But she wasn't great at explaining everything and her advice was a little wanting for more detail. The only advice she really gave me was to not eat street food and only ride in Saloon cars, avoiding 4x4 cars at all costs, and to think about getting rid of our pet cats. 
But the main reason we did not return to Samitivej for our second pregnancy was because of the nursing staff being less than helpful and the long waits I had to experience between procedures on the day of my misscarriage, and because Samitivej can be very difficult to get to in rush hour.

Dr. Anong Lekagul - Bumrungrad

Services used: Consultant / Abdominal Ultrasound / D&C / post miscarriage embryo testing
We like Dr Anong. She is older and made us feel at ease (she must have seen 'everything' type philosophy). But she may not be everyone's cup of tea. She comes across as a little stern but her experience abroad does mean that she is better at explaining things in English. She is a pragmatist, she doesn't smile a lot and is unlikely to offer floods of warmest sympathy at difficult times, but she gets the job done and commands respect and authority. Our one concern was that she does not seem so adept with modern ultrasound equipment, frequently needing help from the nurses and in the case of our second failed pregnancy she even had to call in Dr Suleewan to help her with a vaginal ultrasound to confirm the miscarriage. But I wouldn't take this away from Dr Anong's skills, we would still highly recommend her for her pragmatic approach and vast years of experience. UPDATE: I have been told that Dr. Anong no longer does births, so she is a consultant only.

Assoc. Prof. Boonsri Chanrachakul - Bumrungrad (now Samitivej)

Services used: Fertility testing
Following our second miscarriage we were referred to Dr BoonSri. He recommended that we had extensive blood tests to confirm if there were any specific problems with either my husband or I. He speaks good English but is not so good at explaining everything. I felt that we paid a lot of money for tests that we never really understood, and following extensive research I am not convinced we needed all of the tests. It is always worth remembering that hospitals in Thailand are profit making organisations and therefore you are routinely offered things that may not be essential.

Assoc. Prof. Dr. Somsri Pitukkijronnakorn - Bumrungrad CURRENTLY USING

Service used: Consultant / Vaginal Ultrasound / some basic blood works
Dr Somri is our current Doctor for our fourth pregnancy. She is very eloquent in English and shows some cultural understanding and empathy. We like her a lot. She is a specialist for High Risk Pregnancies. UPDATE: I have since also received warm feedback from Doula's of Bangkok that she is pro Natural Birth if you request this.

Other feedback I have gleaned for mums and Doulas - for Natural Births consider:

Samtivej - Dr. Yaowaluk (also for VBAC) and Dr. Kankoknat
Bumrungrad - Dr. Nopadol and Dr. Somsri
BNH - Dr. Sorpin and Dr. Chuankamon

First and foremost think about your pregnancy and birth plan and then location - you can and will find a doctor that you are happy with, just remember to be vocal, ask questions and empower your partner to have your back and step in when you can't! 

Technically speaking health care is excellent in Thailand so do not worry.

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