Miscarriage Support - A Guide to Getting Help in Thailand

Quick reference summary for Miscarriage and Loss Support (all links are live and will take you to a new webpage):

For a more personal explanation of our miscarriage experience please read Miscarriages - How to cope in Thailand

Miscarriages - How to cope in Thailand

This post was the main reason for me starting this blog but its taken me a while to build up the courage to write this.

Knocked up...now what? Chillin

Maybe the Thai's have got something right about this pregnancy lark.

I find myself once again in the early weeks of pregnancy. This is the 4th time and of course there is a lot of trepidation. But this time I am doing things a little differently, I'm doing it Thai style.

My doctor, at the moment, is Dr Somsri (Bumrungrad). She specialises in high risk pregnancies, she is very chilled (for a doctor), she smiles and laughs and talks about her family (even when you would prefer to be talking about your expanding family) but she is lovely and her English is excellent, and she even has a dose of empathy and cultural understanding.

But Thai doctors, and therefore Thai people, can be a bit worrisome and tend to air on the side of caution, with basic advice amounting to "don't move", 'don't think' and forget about having anymore fun.

As with the previous non viable pregnancies I was planning on toughing it out as I meant to go on...this baby has to fit into my regime, not the other way around, and it might as well start now. Especially after having our first scan (6 weeks and 1 day) and finding a good heartbeat, and that for the first time I had some mild morning sickness which is the one thing that has probably made me the happiest for months and months...at last, maybe, hopefully, I am having a normal, healthy pregnancy.

But then it happened.....

That dreaded little drop of blood on the toilet paper (that toilet paper that all us TTC women are now so accustomed to studying in more detail than a mother looking for lice after an outbreak at nursery school). We were about to fly to Singapore the same day for a fun filled (now sober) weekend with friends and I didn't know what to do, less than 24 hours earlier I had seen my babies heartbeat, could it have gone so horribly wrong so quickly????

I called Dr Somsri and her advice was effectively "don't move", 'don't think' and forget about having anymore fun. She doubled my dose of Progesterone, but told me not to worry and scheduled me for a scan in 7 days, she also told me not to fly and that I should move as little as possible and have bed rest, I guess in this type of situation gravity definitely isn't your friend.

I have been finding it hard to focus on work, and to be honest my boss is a prick, plus the nausea and cramping had been genuinely getting a little worse, so for the first time ever it was easy for me to follow doctors orders, and I am currently on a full weeks sick leave doing nothing but lying down and watching TV box sets.

For the first few days I was genuinely worried. I don't know if it was mind over matter but my cramps and nausea were getting much worse, and the cramping was really worrying me. 3 days in and I tried to sit up to type some emails and 30 mins finished me off and gave me every justification I needed to lie back down and finish Season 6 of Game of Thrones. 

I'm now 6 days in to doing not much at all (with 2 days until our next scan) and I am starting to feel less worried, although even a walk to the toilet seems to set off unexpected cramps and once again provides me with all of the justification I need to sit back down on my arse and stretch out with a warm hot water bottle.

I still feel like a fraud though. I've watched most of my friends battle their way through early pregnancy as if it was nothing more than a hangover, seeing them prep themselves for the real shit that happens after 9 months, when they will have no excuses or time to think about themselves. And here I am, lying on the sofa, now working my way through every episode of The Wire (because I missed the hype the first time round).

But, this is my 4th chance, and I don't want to mess this one up. I do want to be able to look back and think that I did anything wrong, I want to start putting my baby first, to get used to the idea that life is no longer about me and instead is about protecting something innocent.

So here I am, being and thinking like a mum for the first time ever. Work is almost out of my mind, the condo is tidier, dinner is prepared on time and I've even made ice cream and baked a cake...this shit is getting real and I want it to keep getting "real".

I want as much "real" as humanly possible, so I'm gonna chill and I'm gonna chill and I'm gonna chill some more, because I'm in Thailand, because I am lucky, because I have worked hard up until now to make some of that luck, and because I can....and because it's how the Thai's do it.

Oh how I laughed

Yesterday I found myself sniggering at what would normally be quite upsetting.

Yet again, oh yes, yet again, I was asked by a Thai colleague if I had "ever thought about having children". It was phrased as if I was almost too old, too past it, too tired to have children now.

Fortunately I was facing away at the time, focussing on making the photocopier work, I say fortunate because it might've been very hard to explain, and stifle, the strange smirk that came over my face. After a moment of brief reflection the usual ache briefly came over me, with the usual tear in my eye, but instead I laughed, laughed out loud, because to be quite frank I am at the end of my tether with ill conceived and tactless dialogues about my apparent inability to bear my husband a child.

I laughed out loud because it was a nervous, but satisfying, reaction. It quickly blew away the tears in my eyes and enabled me to quickly turn to face my attacker. Who looked startled by my reaction. She asked why I was laughing, and I was honest. I told her I was laughing because I had been asked that by Thai people many times. She quickly seemed able to judge that my reaction was not necessarily meant to be warming, and she apologised. I laughed again and told her no need to apologise. I did her the honour of telling her that my husband and I had not had luck so far, so that she could successfully report back to her friends and colleagues with a suitable amount of gossip about the farang.

She bid me the usual Thai niceties, telling me that it will happen when the time is right, and that it has not happened because the time must have been wrong. Yeah, yeah, any woman or man that has suffered a miscarriage has heard that many times. Instead why don't Thai people try to empathise with other peoples feelings, other peoples cultures, listen and learn from other peoples experiences. They carry on blindly believing that their cultural sensitivities are the most pronounced and therefore most rewarding and deserving, and the be quite frank....its laughable.

So from now on I am going to laugh every time a Thai stranger asks why I do not have children.

Buddhism and Miscarriage...am i being judged?

I've been thinking about what my doctors and Thai friends might think about how we (expats) approach miscarriages.

Getting Prepared...POAS

At this stage I had been to the hospital for some stern words about relaxing and taking folic acid but Thailand hadn't really helped me to prepare for anything or given me any real advice of "how to" get pregnant.

So I started to download app after app, full of calendars, hints, tips, recipes, positions, recommendations and statistics and this is where I learnt about Ovulation Tests. It became apparent that one could only get pregnant on a very small handful of days each month and as I didn't have any time to waste I couldn't afford to be second guessing this. I'd spent most of my life thinking that if I missed a bus there was always another one coming along in 5 mins, but I couldn't afford to be so lackadaisical about my dwindling egg supplies...this planning shit had to get real.

If you are TTC then you may already be well ahead of me here, but I once again found myself in a quandary...where could I get Ovulation Tests in Bangkok that I could trust? Given that the pharmaceutical industry here is about as trustworthy and genuine as buying a Mulberry handbag in MBK, I once again headed back to Boots to attempt to buy a brand of Ovulation Test that may be sophisticated enough to tell this old hen when she was laying an egg.

Firstly, it doesn't seem to matter how you pronounce the word "Ovulation" you will find yourself in an awkward and rather public display of pointing, shoulder hunching, graphic gesticulation and embarrasment. 

"Ov..u..lay..tion test ka?"

"Ov..ooo..ay...tion test ka?" 

"O..woo..ay..tion test ka?" ahhhh yes ka "o..woo..ay..tion test, chai ka, have ka". 

Success, at least for a brief moment.

The box they produce from behind the counter looks about as sophisticated as a toddlers doodle pad. It was called 'Baby Sure', was made in Thailand and gave me absolutely no comfort that this would be able to tell me anything more about my eggs than if I was using a divining rod to find them. But there were some English instructions on the back the box and it was the only option they had so I decided to persevere and POATS (Pee on a 'Thai' stick) and hope for the best.

As it happened they are easier to use and understand than a Boots UK branded ovulation test, which was a huge surprise to me, and I'll be honest that I think they are actually better. They have now guided me through many months of egg production, with a few successes, and by comparison my UK sticks just cause me more confusion than certainty whenever I use them.

But are there any other options in Thailand? A friend swears by another, very cheap, Thai Brand called "Check Tru". These are strip style, also contain a pregnancy test, and are about one third of the cost. 

After another false start last month, and our third miscarriage, I have decided to try "Check Tru" for my next ovulation cycle. I plan to test it along with "Baby Sure" and I'll let you know a pee by pee comparison, but for now here is a summary of the only two tests I am aware of in Thailand.

Brand	THB	Type	Style	Ovulation Tests	Pregnancy Tests	Sensitivity of Pregnancy Test
Check Tru	฿270	Ovulation and Pregnancy	Strip	5	1	20ml/U/ml
Baby Sure	฿725	Ovulation	Stick	5	0

Both brands seem to be readily available. "Baby Sure" seems to be the mainstream (excuse the pun) test available in larger outlets like Boots and pharmacies in Central etc, whilst "Check Tru"is available in places more frequented by Thai's, smaller more local pharmacies.

You may find on occasions that pharmacies have run out of tests, but do not despair, there will always be one available in a pharmacy you can get to, just keep asking, persevering and remembering that "v's" are pronounced as "w's" and don't get too embarrassed when you realise you have started shouting the word "owoolation" to the pharmacist.

Happy POASing

Getting Prepared...Getting personal

I think it is normal to worry "If I can have children" whatever age a woman is and it doesn't get any easier with every passing comment from your mother, her next door neighbour, your mother in law, auntie, grandparents or well meaning friend, but in Thailand you have a whole new set of busybodies to deal with.

The Random Stranger

As we were checking out of the small hotel we had hired for our Wedding Party the receptionist (who was about to pop with a baby herself, about 4 foot tall and the same wide) rubbed my stomach and told me (with a smile of course) that I must get pregnant soon. Whilst this wasn't a revelation to me, I know my eggs aren't getting any younger and I'd found my Prince just in the nick of time, I wasn't prepared for a random stranger to be so personal...but prepare yourself ladies because it comes at you from all angles....

The well-meaning work Auntie

All offices in Thailand are full of 3 types of women - young girls with desks full of mirrors and cuddly toys, middle aged women breast pumping milk at their desks and well-meaning Aunty's who spend 50% of the time smiling at you but saying something utterly condescending or two-faced. Beware the later generation also speak much better English than they let on and will forever haunt you if you dare to mutter anything under your breath in retaliation or defence, and I do believe they have la direct line into Buddha himself to report Farangs that deserve damnation and a spell in Naraka. Anyway, moving on, these "old bats" will make it their mission to make you think about being pregnant all of the time, worry about getting pregnant all of the time, worry about getting too old to get pregnant, worry that your husband will make someone prettier, and younger, pregnant...you get the picture. My "old bat" actually started up before I got married. She took it upon her self to give me a little motherly lecture about the birds and the bees before I got married. She explained to me the importance of marriage and how Thai people believe it is important to have a family and that I must try for a baby as soon as I am married, I must stop stressing about work, be healthy, look after my husbands needs and give him a baby, as if I can go to Central Chitlom and buy one off the shelf just as soon as I've saved enough money. She didn't stop there, it was the first thing she spoke to me about after the wedding and is still the first thing she asks me every time we meet (1 year later). I have even told her that I've had two miscarriages and she still smiled at me and told me its my duty to have a baby and that it will happen, apparently she knows I am a good person and she knows good fortune will come to my husband and I (I wonder if this is a direct message from Buddha and the only way to keep me out of Naraka!?!

The Expat Wives Club
I don't want to be too bitchy here because someone reading this blog is likely to be an expat wife themselves, but I do hope you aren't one of the worst stereotypical expat wives out there. I have literally had women from the British Club turn their back on me when I asked if there were social events that I could attend outside of work hours. Also the fact that I do not (yet) know the first thing about any International School Programme, the apparent horrors of live in maids, or the exact floor plan of EmQuartier it would appear that I am not fit to join any of the wives clubs at this precise moment. Anyway, moving on again, whether you are in any of the clubs, or not, you cannot avoid all 'stay at home expat wives', you will have dinners with them, attend drunken annual balls with them etc and for all such events, along with your Spanx, you should always wear body armour to protect yourself against ill judged comments about when are you going to get pregnant? are you trying to get pregnant? Are you trying naturally or going straight to IVF? (after all apparently you can through money at any problem here), will you get a live in maid? will you get a driver? when will you give up work? Fundamentally, when will you become one of us? It's not so much the questions that fill me with dread but often the fear of not measuring up when it's my legitimate time to join yummy mummy clubs. Will my child be wearing the correct attire, and more to the point will I be wearing the correct attire, will I have found the miracle eye cream to at least give the illusion that my child sleeps occasionally and will I have kicked and punched at enough Muaythai bags (noting I haven't kicked at any so far in this life time) to lose enough baby weight to earn my badge of honour as a yummy mummy.

The Estate Agent

They say moving home is meant to be one of the most stressful things you do in life...not as an expat. As an expat, moving home becomes as normal, and as easy, as shopping for groceries. You pick what you like and someone else does all of the hard work packing it up and getting it to your chosen location. I've known women orchestrate a house move whilst 8 months pregnant, a toddler in tow, a husband in another country, and all from the relative calm of a coffee shop eating cake with girlfriends. But there are some very crucial decisions you are forced to make that can cause constant reminders of your TTC journey. The big questions...do you move into a condo with that extra room that 'could' be the nursery, do you consider your commute to work when you are heavily preggers and its 40 degrees outside, have you checked to see if there's a playroom or kiddies pool? Well don't worry because your friendly Thai estate agent will make it her business to know everything about your life, your bank balance, your husband, his bank balance, where and when you go on holiday and last but not least, your childless status. My estate agent, and landlord, made it a point to extol the virtues of the local hospital for emergency childbirth, the nearest University for our future child's education, the best room to use as a nursery and the various complications with choosing a live in nanny, apparently varying from murder (if she is Burmese), work permit (if she is Filipino), lazy (if she is Thai) and of course, sleeping with my husband (if she is a Swedish aupair).

The bottom line, don't put any extra pressure on yourself. Tell all busy bodies only what you want, when you want to, they will be happy with any answer. My responses have varied from "its in the hand of the gods", "we have our pet cats, that's enough for us", "its too hot to start a family in Thailand", "I work too much" to bursting into tears. The Thai's are simply nosey and normally only want to know what their future opportunities for repeat custom (to your mutual benefit) will be. 

Smile through gritted teeth and you'll actually start to enjoy the freedom of telling random strangers about your life, its not very British, but sometimes its just nice to tell someone.

A moment to reflect

I am starting this blog a little round the wrong way, as I am jumping in with my first post when I am 12 months into trying for our first baby. I will go back in time and explain all the other things we have learnt and how we got to where we are now, but this post is about today, what I feel today and what my husband feels today.

Yesterday I was lying on a sunbed on the coast of Sri Lanka when I decided now is the time to start my blog. I told my husband I had done this only after I published the first page on this blog (Who am I?) but he thought it was a great idea and I am so pleased that this holiday has given me the time and space to (a) forget some of the negativity that builds up when you are TTC, (b) put some things into perspective and (c) shag a lot (which is an essential component when TTC).

We are waiting for some test results to come back from the hospital. We know that we can conceive (as we have done twice) but we are waiting to see if there is an underlying reason that I can't carry past 11 weeks, as we have lost 2 babies at 11 weeks (although probably at 9 weeks of development when fetal heartbeat stopped). 

Some will say that we shouldn't get pregnant before we know all the answers to these tests (and, after all, we did pay a small fortune to have the tests taken), but sometimes you have to seize the moment and roll with it. This isn't a honeymoon holiday but we are happy, here and in the moment. We aren't looking at calendars, I'm not pee'ing on ovulation sticks, I'm not tracking my vaginal discharge and most importantly we aren't under pressure. 

If we do conceive on this holiday then we've both decided 'what is the worst that can happen?'. Taking history as our basis I could conceive and there could be 3 outcomes (1) a happy healthy baby, (2) I miscarry again, or worst of all (3) we find out the baby has a genetic problem and have to make a difficult decision together. I am, and always will be, hoping we never have to deal with option 3. I can't get my head around trying for a baby and then finding out that you have to make a decision about that baby's fate before it is born. I can't honestly tell you what decision we would make, I think I know the answer, but I can't say for sure, and I pray that we never, ever, ever have to have that discussion. We know we might need to, after all, my eggs are old(er) than they recommend (not by much though) and we've already had one miscarriage due to Trisomy 21, so there's a chance, but I pray my body will always make that decision for me and never leave it to my, sometimes very confused, head and heart.

So, this holiday has been about relaxing, not pee'ing on sticks, enjoying a guilt free glass of wine and shagging. In fact the only thing I have been doing that remotely suggests we are "planning" a baby is that I religiously take my pre-conception vitamins and force my husband to do the same (I don't really believe in the male version of preconception vitamins, mainly because I think the nights in the pub drinking beer and whiskey and eating chicken wings probably undoes the good, but it makes me chuckle, and feel loved, when he, ever so sweetly, joins in the evening ritual of vitamins before bedtime). Thinking about it, I haven't even done a headstand, or put a pillow under my bum, after shagging. So in my head, if we conceive on this holiday it was because it was meant to be, not because we programmed it, or tried for it, but just because we are a silly, happy, care free husband and wife (for 10 days at least).

It would be incredibly ironic if the holiday that blossomed my TTC blog also blossomed our future baby, so I am not holding out a lot of hope, but the thought has put a twinkle in my eye and a smile on my face...what if seizing the moment, owning your own destiny and just being happy is the answer....how incredible would that be!