Sunday, July 21, 2013

Pregnant in China

Pregnant in China: prenatal care

Hey all, its Elle Lay. I am expecting another baby. I figured I would write about my experience of being pregnant in China, how we decided where to deliver, and the estimated costs (insurance aside) for it all. 

We are still in the midst of choosing where to deliver. Until February, my family had been utilizing the services of United Family Hospital-Wuxi branch, which staffs a Belgian Doctor every Thursday. Although UFH has been great for treatment of the common cold and medication refills, I have been looking for specialist care for my son, and an OB/gyn  for myself. I heard about Parkway Healthcare Systems in Shanghai through another expat friend and decided to give it a try.

Belle and I braved the February cold with our kids and ventured out on the train and metro to see a pediatrician at Parkway. We both walked away from our appointments satisfied. I felt like I had found what I was looking for in a pediatrician, facility and knowledgable reception staff. 

So, naturally, when I became pregnant, I assumed I would make the monthly, bi-monthly and eventual weekly trek to Shanghai to see an Ob/GYN at Parkway. I liked that they direct bill my insurance provider, and have two American OB's on staff. When I returned to Wuxi from the USA at the beginning of June, I made my first appointment with Dr. Chen At PHS for June 22--a Saturday-- so that my husband could come with me. 

Meanwhile, I had a major meltdown out a week and a half before my scheduled appointment. I woke up and just had this terrible feeling I couldn't shake. I've had multiple losses, so my track record isn't the best. I expect the worst, and felt that maybe I was going to miscarry. So, we found ourselves in the waiting room of the Wuxi Woman's hospital VIP floor. Emily, an English speaking nurse who works on the VIP floor walked me through the visit. They weighed me, took blood, started a composition book for my pregnancy (my medical record, I am guessing) and ultimately ended up doing an ultrasound to confirm viability. The Wuxi Woman's hospital was dark, dingy and half of the halls were without proper flooring and lighting. We rode to the ultrasound floor in an elevator shared with a woman who had literately JUST given birth. There she was lying naked, half covered by a sheet, with her baby is riding along in a bassinet with a nurse. So much for privacy!

When I went for the ultrasound, I was informed that men are not allowed in the room during the consultation. I basically had to put on my big girl panties and face the future of my pregnancy alone. Fighting back tears (okay, I didn't fight em, they were flowing), I laid on the table, let the tech gel me up and waited for the news. Unlike the USA, the screen is not angled towards the patient. Only the tech and nurse get to look. Maybe this is because the Chinese nationals aren't allowed to know the sex of their offspring? I'm speculating there, but none the less, it didn't help my anxiety. Thankfully, Emily spoke up and said, "your baby fine. Alive." They gave me a gestational age a few days older than I expected, no print out of the ultrasound and sent me on my way. We got our fapiao and when all was said and done, total cost was $20 registration, $16 ultrasound, $150 blood work, $8 doctor fee. For peace of mind, it was totally worth it.

When June 22 finally rolled around, we took an 8:30 train from Wuxi to Shanghai main station, then hopped on Metro line 1 to Huangpi street (4th stop). After a 3-4 block walk, we arrived at Parkway for my appointment with Dr. Chen. A nurse escorted us back to triage, my vitals and weight were assessed and she took my history. From there, we went to an exam room where we met Dr. Chen. He asked about my previous losses, medical procedures, and immediately went proactive. My husband and I were impressed with his concern over my previous losses and his efforts to get this baby to full term. He ordered an ultrasound, which we had to wait for, but once inside the room, it was exactly what I was accustomed to at my MFM's office in the USA.  A nice adjustable exam chair, huge television monitor facing me and new ultrasound machines. The tech spent at least 10-15 minutes taking measurements of the fetus, uterine size, cervical length, ovaries, etc. Dr. Chen joined in on the viewing and told us everything looked "perfect".

We scheduled our next appointment for the nuchal translucency test for three weeks later and headed to the checkout area to settle our bill. We had an issue with our policy not being located on our insurers database, so we had to pay up front and submit the claim ourselves. 

This is the only complaint I have about parkway.....the cost.

Wanna have sticker shock?

The bill for consult, ultrasound and progesterone pills was over 4000 rmb. That's $600 US dollars for one appointment. The ultrasound alone was $440. Our insurance policy has a coverage limit of $14,000 usd per pregnancy, so at $600 a visit, I worry that we might reach that limit before we even get to the giving birth part of it all! Parkway does offer a package deal for prenatal visits, in which the patient pays up front for a pre-determined number of visits, keeping the cost per visit lower...actually much lower than what we just paid. The drawback? Our insurance carrier won't pay for services ahead of time. This means that we will need to have an invoice (fapiao) for each visit, detailing the cost and care provided and I will have to send the claim to insurance myself for reimbursement. Also, who's to say I will need all the appointments that the package covers?

Billing and insurance headaches aside, I think we will probably commit to my prenatal and birth at Parkway because I felt most comfortable with the quality of care, cleanliness of the facility, friendliness of the staff (well, except for the receptionist who was more into playing Candy Crush saga on her phone than welcoming us to the clinic) and ease of making appointments. Oh, and.....they ran on time, give or take ten minutes. 

In a pinch, Wuxi women's hospital served its purpose. If any of my pregnant friends had some sort of concern or worry and weren't up for the trek to Parkway, I'd say Wuxi women's would be just fine. It's definitely cheaper, but for me as an American, it pushes me a little out of my comfort zone. 

Here's the contact info:

Wuxi Hospital for Maternal and Child Healthcare
http://www.upmg.us/wx
Huai Shu Alley No.48 
Tel: 051082700410
Direct line to Emily (English speaking nurse on VIP floor): 13951581399


Parkway Inpatient and specialty clinic
3rd floor
170 Danshui Rd
Shanghai (xintandi area) 
24 hour appointment desk: 02164455999

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