8 Lessons Learned About Giving Birth In China

Having a baby in a foreign country can be difficult challenge in most countries, but it’s a extremely difficult challenge in China. I should know, my wife and I had baby #3 out here in Karamay, in the far west of China’s Xinjiang autonomous region a few weeks ago.

Our first two sons were born in Thailand so we were comfortable having a baby in a foreign country. When we found out my wife was pregnant we started looking at how to have a baby in China and what difficulties we might face. We figured it couldn’t be much more difficult than having a baby in Thailand, but boy were we wrong. If we had to do it all over again, I would seriously rethink having a baby in China.

Forgive me if this article is not as coherent as I would like it to be, but I’m in a sleep deprived stupor as I write this. I’m writing to get information out there for parents thinking about having a baby in China because there is not a lot of information out there on the net, particularly about foreign parents giving birth outside of the largest cities.

Prenatal Visits

Stock photo of a Chinese maternity ward. Not representative of the author’s experience.

We confirmed the pregnancy with an ultrasound at the main hospital in a small city. It cost us 120 RMB($20) and my wife was asked if she wanted to have an abortion. This is standard practice. We asked them to date the pregnancy but they don’t seem to do this in the 1st trimester. After confirming the pregnancy, we were told to visit our neighborhood health clinic for prenatal visit.

Lesson Learned #1: Don’t leave the room without them writing down a gestational age for the early ultrasound.

The neighborhood health clinic is the place you visit for checkups on a monthly basis until about week 32. They take your vital signs and give you blood tests. They give advice and make sure the pregnancy is progressing well. They have an ultrasound machine and they gave us one on our second visit that confirmed our due date. While none of the doctors spoke English, we did have a nurse friend at the clinic who speaks English so we managed the visits. The cost of these visits was insignificant.

Visiting the Hospital

Blood tests showed that my wife had an elevated bile acid measurement and we ended up going to the hospital from week 28 on. Her numbers were quite high and the doctors knew that something was wrong but didn’t really know what it all meant. Thanks to the internet, we knew what she had and what needed to be done to have a successful birth. It was hard communicating this to the doctors.

We started running into problems in the hospital early on. With cholestasis, a timely delivery at 37 weeks is the best way to ensure a positive birth. Unfortunately, the hospital couldn’t figure out when 37 weeks was.

We had a pretty good idea of when the baby was due from an early ultrasound. Notice that they don’t date the early ultrasounds but we asked anyway, and they verbally gave us the information. In case you weren’t aware, early ultrasounds are extremely accurate while later ultrasounds can be off my as much as 3 weeks. But the doctors at the hospital started relying on the later ultrasounds which we knew to be inaccurate. The hospital was convinced that our baby was 3 to 4 weeks later than we knew she was. I still don’t know if the large discrepancies were due to operator error or just normal SD but when she came out, her measurements were within 1 week of her gestational age.

Once we dug in our heels we were first sent to the main hospital in our city and, after more dug in heels, we finally were sent to the head of the obstetrics department. He took one look at the heart rate monitor and blood test results and immediately started asking questions. After several questions he told my wife that she needed to give birth ASAP.

Lesson Learned #2: Dig in your heels and demand the health care you need. This is not a time to just go with the flow.

The head of the obstetrics department asked us why we didn’t come earlier to see him, and he brought in his best surgeon to examine my wife. He estimated the baby’s weight within 100 grams of the actual birth weight and said the baby was 36 to 37 weeks, just as we knew it to be. His experience was worth more than the ultrasound.

Lesson Learned #3: Experience is sometimes better to trust than someone relying on technology that they don’t understand the limitations of.

In the Hospital

We were told to prepare 5000 RMB for the hospital expenses. Basically, you take 5000 RMB to the cashier and they put it on an account to draw from. We were put into a special room nearest to the nurse’s station. Normally they keep 3 families in one room, but we got the only private room in the maternity ward.

The surgery went well, and when our baby was born they brought her out to me and I rushed her up to the initial baby/ cleaning station in the maternity ward. I won’t show pictures of it because it would probably make some of your cringe, but I was more concerned at the time about my baby. After cleaning up, they put her under an oxygen hood and our nurse friend watched her while I went down to operating room to wait for my wife to get out of it.

Let me say right here that our surgeon was awesome. I doubt we could find a better surgeon anywhere else and I think he’s one of the best, both in bedside manner, skill and level of caring.

Lesson Learned #4: There are some great doctors in China who are very competent and know what they are doing.

In case you didn’t know it, family is very active in hospitals in China. I was one of the people asked to help push my wife in her gurney from the operating room. Another thing: nurses do not lift patients in China. Our doctor called in some men waiting for their own wives to give birth to help lift my wife from the gurney to the hospital bed, a distance of 6 to 10 feet. Just get a mental picture of this, imagine a woman who just had a c-section and barely covered by a towel being carried by several men, including two strangers to a bed. My wife was so out of it so she accepted my statement that they were workers…..I didn’t volunteer that I didn’t know where they worked.

Lesson Learned #5: Make sure you have people ready to help in the birth process.

After a few minutes in the room a pediatrician came to look at the baby and announced that the baby needed to go to the Neonatal Intensive Care Unit (NICU) for a possible infection. This was scary for us, so I quickly went over to the cashier to set up an account for the baby and they took the baby to the NICU.

After about an hour in the NICU I was called to transport my new baby to another building for an X-ray. It was -5F outside at the time. Picture an American at a very fast walk through subzero weather holding a bundled-up baby with a Chinese nurse walking beside him holding a portable oxygen pillow.

Back in our room we learned just what nurses do in China: they check vital signs, they take blood, they give injections and IVs. They do not clean wounds. I became the person who cleaned up my wife after birth. I drained her catheter. I cleaned the bed after her. I changed her bed tissues. I helped her with her bed pan. Some single Filipina friends visited us in the hospital, and after seeing what we were going through they decided that having a baby wasn’t on their agenda any time soon. It was like free birth control.

Normally, babies are kept with the family in the room and all responsibility for caring for the newborn falls on the family.

Lesson Learned #6: Family is responsible for taking care of the basic needs of hospital patients in China. Without a support network, it’s impossible to take care of your wife and newborn.

This brings up the most irritating part of giving birth in a Chinese hospital: they constantly are asking for things they assume you know you’re already supposed to have. If I wasn’t taking care of my wife’s needs, I was going to stores buying stuff on what seemed like the whims of the nurses. Finally, I reached boiling point and told a teacher at our school to talk the nurses, and if they need something to tell her.

Lesson Learned #7: Have a go between ready to deal with the nurses before you even get into the hospital.

We stayed for 5 days in the hospital and I have no doubt that our nurses were very caring. The conditions were more or less clean, not as sterile as you’d find in the west, but cleaner than some might think. Don’t get me wrong, there were still things that make you cringe, but there were not that common.

I do want to say this about the nurses to clear up any misconceptions: the nurses were caring and knew how to do their job and do it well. They were very competent. It’s just their job duties are different in China than they are in western countries.

The Neonatal Intensive Care Unit

Did I forget the baby in NICU? No, I just wanted to deal with the hospital experience first. Our NICU experience was probably the worst part of all.

They pulled the baby out of our hospital room before my wife had a chance to hold her for the first time. Once in the NICU, they refused to allow us to enter the room to see the baby and refused to bring the baby to the door of the room so we could hold her. This was heartbreaking. A short time after our baby was born the doctor took her away and refused to let us see her or hold her. We didn’t understand what was happening or what was going on. Furthermore, we had no solid information on what was wrong with her.

It took us 4 days to finally get the results of her blood tests and X-ray. The X-ray looked normal, but we were told her blood tests showed signs of infection. They had been treating her with antibiotics through an IV stuck in her head. We could only see her from 20 to 30 feet away. They told us on that day they wanted to keep her for at least 5 days more, maybe up to a few weeks. Talk about frightening.

I looked at the blood test results and decided to see for myself what they really meant. I don’t trust doctors in the US so why should I blindly trust them in a foreign country? After a little internet searching, I realized that one of tests was quite normal for a newborn and that the other test was not supposed to be done on babies in their first 72 hours, since its false positive rate can be quite high. Her blood tests were done at hour 68. After prayer and much thought, I came to the conclusion that our baby was OK.

Lesson Learned #8: Don’t blindly trust your doctors; verify what they are saying to be true.

My wife was leaving the hospital the next day and, after talking it over, it was clear we had to take our baby home with us. Going against the doctors isn’t something you do in the US and is quite taboo in Chinese culture as well. Luckily, I got some good advice from a China veteran who told me that the best thing to say is just “It’s time for our baby to come home.” Say that and nothing more. Keep it simple. It worked.

I still don’t know why the doctor interpreted the test results the way that she did. I have no doubt that she is a caring doctor and is motivated by patient care. I’d like to chalk it up to overabundance of caution. The more cynical might say it was motivated by money or incompetence. I can’t get myself to believe either of those two reasons, so I’m going with overabundance of caution.

Costs

Are you still with me? If so, here is what it costs us to give birth by c-section in a government hospital in a small city in China. For the surgery and 5 days in the hospital, the bill came to 4800 RMB($800). The 5 days in the NICU for the baby cost us 3300 RMB($550).

Conclusion

Needless to say, it was a stressful situation. I wish it would have all been easier, but we learned a lot in the process. I hope this can give someone some information about giving birth in China that we weren’t able to have.