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Wednesday, 18 January 2017

Knocked up....now what? What your Thai Ob/Gyn probably won't tell you

I read this article on HealthyGrades.com today and it made me chuckle...don't get me wrong, it was very useful but it struck me how little information my Thai Ob/Gyn had passed on to me (and made me think "thank god" for google and my insatiable urge to research)

The article lays out 15 clear and useful points and I've added my own interpretations after each one from my experiences in Thailand

1. “There are many forms of prenatal testing available during pregnancy.”
Are there? Really? Who knew? In Thailand they will ultrasound you, ultrasound you some more, and then ultrasound you again (charging you each time, plus extra for 4D which they won't ask you about but assume your consent for) and then they will suggest (more like "tell") you to have a NIPT test and charge you a lot of money for the privilege, and then depending on the results they will charge you again if they think you need an amniocentesis (read my blog on how our NIPT test went). 
That is all assuming you are having a 'normal' pregnancy. If you show even the slightest sign of having fertility problems they will once again use that apparent informed consent to sign you up for a myriad of blood tests (on one occasion they took 17 viles of my blood and charged me over THB25,000 for the privilege), which typically produces a long list of acronyms, which the doctor translates into 2 possible outcomes - everything is normal and we don't know what is wrong with you OR something is wrong with you (at this stage you don't know what, and you won't know what until you get home and googled for dozens of hours) and then they will charge you for more tests.
And of course, one should not forget the importance of checking every 3 months whether you have HIV and Syphilis. I am not exaggerating, I have lost count of the number of times I have seen this appear on my test results, despite having profusely refused to have any more tests for it (after all where the bejeepers do they think I picked up HIV or Syphilis from in 3 months, whilst pregnant?!) 
2. “Your birth plan is not etched in stone.”
Birth plan...what is that? In Thailand women listen to their Ob/Gyn and follow their instructions. If you want to get yourself more informed and involved, I suggest to get yourself a Doula to assist with communcation and your understanding of what is happening.
3. “You should NOT double your food intake just because you are pregnant.”

My weight is taken every visit, but rarely divulged to me. My Doc has recommended that I gain 2kg a month. I've been told to lay off street food, fat, sweets and carbohydrates, to load up on protein, papaya, have 2 eggs per day, chicken livers, fish and calcium rich food.

4. “Remember to exercise and drink water!”

My Doc would faint if I told her I was exercising. I've been told to move as little as possible (I think they are worried the baby will fall out), she has even suggested we get a wheelchair if I need to walk a lot 😂

5. “Don’t postpone dental care.”

That must be a different department and someone else's job as no one has discussed this with me. So despite the money they could make out of this I have not been advised to do anything about my teeth, will they all fall out???
6. “Get your flu vaccine during flu season for a healthy fetus.”
Firstly, what is your definition of flu? Because in Thailand staff seem to be signed off sick with "flu" every other day of the week. This is of course only a light fever and no worse than a mild hangover by our standards! 
As for getting a vaccination for proper flu, quite to the contrary, my husband was diagnosed with Influenza B and no health care professional suggested that I should get vaccinated. Our Doc just screwed her nose up in an attempt to ensure she did not catch any germs from my husband.
7. “Some caffeine is OK during pregnancy.”
Pregnant women seen drinking coffee in Thailand are burnt at the stake. Starbucks will  only sell you decaf if you look pregnant.

8. “Healthy pregnant women can get gestational diabetes, too.”
This has been mentioned in the context of being a "geriatric mother", and my Doc will test me next month.
9. “Remember, a Cesarean section is major surgery.”

They will stick a needle in you and cut your open quicker than entering a LINE promotion. 
Assume C Section first, you may have to beg to have a Natural Birth and check whether your doctor is recommended for Natural Birth. Doula Rassee says "For natural birth we recommend Samitivej (Dr. Yaowaluk and Dr. Kanoknat), Bumrungrad (Dr. Nopadol and Dr. Somsri), and BNH (Dr. Sornpin and Dr. Chuenkamon). (BNH doctors from mama experiences, not my own.)" 

10. “Know the signs of preterm labor.”

Not discussed (yet?)

11. “During labor and delivery, there will be mucus, leakage of fluid, and blood—but it’s usually normal.”

Not discussed (yet?) but see my note on C Sections above, I'm guessing there is a lot less mucus and leakage (but more blood).
12. “If a tear of your vaginal area occurs during delivery, ask your Ob/Gyn exactly where the tear(s) occurred.”
Not discussed (yet?) but I do not expect to have an open dialogue with my doc about this. 
I am quite certain she will do the necessary without even telling me, again, judgement and informed consent are very blurry here (although can be wholly reliant on my husbands interest in this matter so maybe he'll take care of the informed consent for me).
13. “After delivery, your uterus will continue to contract.”
I'll take your word for it
14. “Pregnancy isn’t over after delivering your baby.”
I'll take your word for it
15. “Wait at least 18 to 24 months before your next pregnancy.”
That's a bit presumptuous, let me get past the first one before I decide on whether to have a football team!

Diary of an imperfect mum

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