# Expats in China - wife is pregnant



## Mike_77 (Apr 24, 2013)

Hi all, it happened, my wife is pregnant.
I dont tell you how happy I am... I am writing here because I am disappointed and need advice!

She is now 1 month pregnant. We are in the process of finding doctors but she is very skeptical and she want to give birth in Russia!
This would be a big problem for me and I dont want to!!!
The options are: China, Russia, Spain (my homecountry).

I would like her at least to TRY China, if there are no complications I dont see any problem. Or at least Spain, in my hometown hospitals are good (better than China or Russia) and for free and we would have at least hour home.
No, she want to go to "her family". WTF? Her family????
Russia means her mother house, DIFFICULT visa for me and unknown hzospital reluability fees and so on.
Without saying that if she decides not for China I will need to leave my job...
I am sooo pissed and deluded... HER FAMILY!?

Thanks for any suggestions


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## Homemaker_Numero_Uno (Jan 18, 2011)

Hong Kong is in China and has some very good world class medical care. I went there routinely for prenatal care and would have delivered there as well except me and HK climate did not get along very well. My Canadian friend delivered there. We both had our first children in 1990. Since then many more babies have been successfully delivered in China  But I think you can easily convince your wife's family to go to HK, and that the care there will be much better, as well as the nutrition available to your wife which is of importance in the prenatal and postnatal periods, particularly if breastfeeding. You should also look at whether you can then get a visa for your child to return to China. I ultimately decided to have my baby in Japan and even with diplomatic postings on our side it took me some time to get an entrance visa/residence permit for him. Much stamping required. If child is born in China, all of this hassle will be greatly diminished, you can just register birth abroad of whatever citizenship (Russia/Spain you desire, or both if possible.) If anything goes wrong, I think maybe the chance of lower cost higher quality care can be had in HK. But not sure what the options are like in Russia, it's a big place! Unless her mom or auntie is an ob-gyn with OR privileges, I would choose HK most definitely. Also keep in mind the prenatal visits required, some doctors don't want to take on deliveries unless they have been able to follow the medical care along the way, otherwise it's too much risk and they can simply refuse to take the patient unless it's an emergency. So without a doctor who can follow along the way, you are going to go to the hospital when in labor, emergency or not, and have an arbitrary doctor, most likely...maybe they are just the ones who have to take the walk-ins. For this reason alone I would highly recommend getting the pregnant person to HK for prenatal visits including the ultrasound, amniotic testing etc that you want while living in China due to needing to know whether pregnancy is high risk. Also make sure you get heavy metal testing, etc. Then have an established relationship with doctor of choice, and go to HK when 35-36 weeks along. After that the airlines are going to refuse travel. Although I managed to fly at 38 weeks + to Japan I don't recommend it. I was young and stupid. If you can send your wife even sooner to HK I would recommend it. Maybe one or some of her relatives from Russia can be enticed to live in HK for a could of months? It is a good place to shop...they could make some profit on the trip. And also eat well. No restrictions on the food in the shops... ;-)


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## john117 (May 20, 2013)

There's a billion or so Chinese people around, proof positive that the Chinese know a thing or two about delivering babies  (congratulations btw)

Ask your company for assistance, then the expat community, and your embassy.


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## Homemaker_Numero_Uno (Jan 18, 2011)

john117 said:


> There's a billion or so Chinese people around, proof positive that the Chinese know a thing or two about delivering babies  (congratulations btw)
> 
> Ask your company for assistance, then the expat community, and your embassy.


My British friend stayed to give birth in Beijing and I visited her. I do not recommend it. The one-child policy is effective because 1) nobody wants to repeat the experience and 2) no respect is given to female reproductive organs in the process of getting out the single authorized baby. Besides that, if you want to have to cook your own dinner in your bathroom in a rice cooker (if you are lucky enough to have a bathroom, which I guarantee will be used by visitors of that patient in the next room or open bay who may or may not be delivering babies or perhaps have infectious diseases) and also supply your own clean linen and blankets... I'd recommend giving birth some other place than mainland China. 

I stupidly was 25 and young and naive and said the same thing as you, ohhhh, they deliver so many babies in China, so of course it will be fine. As an epidemiologist and hospital quality care specialist in risk management, 'going with the flow' in this case is a ridiculous suggestion. Volume counts for nothing. It is a captive audience, there is no need for quality improvement. Repeat customers are not an issue. Take it or leave it breeds nothing but disaster. Anyone who can pay for their prenatal care and delivery already has the best doctors in mainland China and they are not available for the asking through an embassy. Even in diplomatic circumstances, these doctors would not be utilized because they require bribes and special payments. Even then the ante may be upped or care will 'disappear' due to unforeseen circumstances. HK is better equipped and has a longer history of regulation. Many good doctors left before the handover, but the practices they instituted were left behind, there are also more expats in HK and higher expectations and enforcement of standards. 

Obvious you have never been inside a maternity care division in mainland China. Or you would not offer the advice you sketched out. :scratchhead:


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## Mike_77 (Apr 24, 2013)

Thanks guys!
Actually I am pretty positive about the technicalities. There are plenty of options and I am pretty sure that they know how to deliver belabies also in mainland China 

I am more worried about my wife behaviour, not caring much about if, how and when I will be part of this!


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## Homemaker_Numero_Uno (Jan 18, 2011)

http://epress.lib.uts.edu.au/journals/index.php/portal/article/viewFile/1846/2518

Article that compares mainland China and HK in childbirth, as well as HK to other developed countries. A bit outdated but still relevant. 

WHO has some nice statistics, which can more than adequately support your suggestion of Spain. Nothing like a mortality chart with 6x mortality in Russia vs. Spain to help your cause? Unfortunately WHO does not separate out HK, it is averaged in with China, so if you look at separate reports and then the much higher rate for China, you can figure that the mainland rate is much higher than what's reported...whoever in China can afford to travel to HK to give birth, typically does so. 
Cause-specific mortality and morbidity: Maternal mortality ratio - Data by country

Here is Hong Kong separately. Favorable report.
http://www.chp.gov.hk/en/data/4/10/27/113.html

And in the rest of China, any improvement on disaster makes the news (in English) :-(
http://news.xinhuanet.com/english/china/2012-02/23/c_131427844.htm

Losing/changing your job may not be a bad thing...you can definitely pick a healthier place to live. 
https://www.google.com/search?q=hap...0F4mNyATZvoCAAw&ved=0CBwQsAQ&biw=1366&bih=673


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## Duguesclin (Jan 18, 2014)

OP, I do not think the question is so much about China. You could be in the US or in another developed country and your wife may still want to be close to her family. 

Child birth is a very traumatic event, especially for the first one.

I would focus more on the child birth process and her fears/your fears about it. Does she trust you will be a great help if things do not go as planned.

My wife and I did not have our first child in a foreign country, but we had it with not a lot of outside support (meaning family). We took child birth classes together and it was a great help for both of us. 

While child birth is natural, it still a very traumatic event. And the hardest part is not only the birth itself, but afterward as well. Does she trust you will be behind her no matter what? Does your job allow flexibility to be near her if she needs you?


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## Mike_77 (Apr 24, 2013)

I dont know the stats are correct (read meaningful)... based on that giving birth in China, Russia or US is not big difference!
I believe (and hope) it all rwally depends on the situation. Stats gets in all rural China (huge numbers) where I believe a normal hospital is utopy.
Death rate in US is scary!


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## HuggyBear (Aug 4, 2012)

I;d say let her do it in Russia, with her family. If you can, go. It will probably easier for her there because she'll be with her family, be comfortable with the whole language thing, and she'll have her family to be there to care for her (get all the necessary medical supplies, be there everyday), which is important if you absolutely have to work.

Just male sure you have it done in a private hospital. Public or private, you'll still have to deal with the obligatory "bribe" system, so ship along plenty of money, especially if your wife wants to pick a doctor or get a private room.

BTW... The infant mortality rate and the maternal mortality rate in the US are MUCH less "scary" than Russia or China. Otherwise, according to the numbers, Spain is a far better choice all around.


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## Coffee Amore (Dec 15, 2011)

I've lived in Hong Kong. My dad used to work there for a number of years. If I had to pick a hospital in Russia or mainland China or Hong Kong, I'd pick a hospital in Hong Kong any day of the week for the reasons mentioned by Homemaker. 

Since Spain is an option, why not have the baby there? It's your hometown, it's affordable and close to relatives who can help.


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## Mr The Other (Feb 1, 2014)

I too am sympathetic to your wife. Giving birth for the first time is a big deal, doing so in a foreign country even more so.


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## inquizitivemind (Jul 16, 2013)

Speaking from experience here, OP. I just had my baby 3 months ago in a middle eastern country. Here is what I can tell you.

I had my mother come here two weeks before my delivery. I needed her to be here. Why? I knew it was important to her, and it is very comforting to have your mother at your birth. A mother can never be replaced, and if you have a good relationship with her, you will naturally want her there. Just seeing her there calmed me down in an intense pain.

Also, towards the end of my pregnancy, I became more easily frustrated with everyday things. It's normal because you are so stressed from all the weight on your body. Anything that was out of the ordinary bugged me. People speaking in foreign languages drove me CRAZY! 

I can totally understand your wife. Wanting to be home and in the familiar is only natural. Pregnancy can make some women homesick and no doubt your wife will crave some food from her mother.

You should do your part before judging to research how you might be able to be with your wife a couple weeks before and after her birth. Even if it is a pain in the butt to get a visa, it is worth it if your wife will be more comfortable. Remember, as much as this process should involve you both, she will often feel it is only happening to her. You just be supportive and keep her happy. It will pay off in the end.


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## GA HEART (Oct 18, 2011)

Why don't you invite MIL to come down and stay with you about a month out? That way you can be there, she can be there, and everyone is happy?

I had my first baby completely alone (well, my female roommate was there.) Having babies isn't as big of a deal as people make it out to be. But I guess every one is different.


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## Homemaker_Numero_Uno (Jan 18, 2011)

GA HEART said:


> Why don't you invite MIL to come down and stay with you about a month out? That way you can be there, she can be there, and everyone is happy?
> 
> I had my first baby completely alone (well, my female roommate was there.) Having babies isn't as big of a deal as people make it out to be. But I guess every one is different.


If you have a problem like shoulder dystocia and no ready access to an operating room, you do want to have a competently trained physician or midwife available. I suppose language is a huge issue. Can the OP's wife handle English? Can she handle Spanish? Or can she only handle Russian? Ability to follow the caregiver's instructions is a huge bonus in birthing outcomes.


Yes, the stats are indeed relevant. HK vs China vs Russia/US (comparable to China) vs. Spain. Why would I post stats that aren't relative? I'm sure it was a surprise that US has high mortality rate, but also need to look at Stats for mainland China vs. HK. By the way, the stats for mainland China do not really reflect all of the numbers for the rural areas but mostly the bigger hospitals and reporting units in major cities. This is because only the official births are reported, these are the ones that take place in hospitals. So if a newborn dies in rural area, maybe it is reported, maybe not. In the city, probably so. The enforcement of reporting is a bit different. So you can consider the mainland China rate even higher than reported. While HK is even better than Spain, much better than US and Russia. If HK is a viable option, I would also choose that. The odds of getting Russian relatives to visit HK is much higher than getting them to visit mainland China or Spain. The odds of a happy outcome are also much higher.


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## john117 (May 20, 2013)

When you deal with medical expertise in a foreign country there is always the "is this a hospital?" question... If you're used to western medical care things are definitely not as straightforward.

In nearly any country I'm familiar with there are always hospitals for the "elite" and if my own company is an indication that's where we direct our expats in places like China and Eastern Europe. Even in my wife's country somewhere in Central Asia (-istan) they have some top notch facilities with western trained doctors and the latest tech.

If you can find them and afford them that is... Finding them is the hard part.

In the USA we are used to a very high standard of care that is relatively uniform in quality. That's not the case overseas so a lot of homework is required.

Also, it also depends on what the insurance company will cover. If they say China only, HK, Spain, etc.

Personally I would do Spain and not think twice about it...


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## Homemaker_Numero_Uno (Jan 18, 2011)

john117 said:


> When you deal with medical expertise in a foreign country there is always the "is this a hospital?" question... If you're used to western medical care things are definitely not as straightforward.
> 
> In nearly any country I'm familiar with there are always hospitals for the "elite" and if my own company is an indication that's where we direct our expats in places like China and Eastern Europe. Even in my wife's country somewhere in Central Asia (-istan) they have some top notch facilities with western trained doctors and the latest tech.
> 
> ...


Spain is indeed very nice and also inexpensive. But maybe it's not so attractive for the Russians. The human element needs to be considered along with the economics and technology. Otherwise, it's a bust in terms of a viable solution. Finding a Russian translator in HK is probably a lot easier than finding a translator in Spain. The other practicality is visa and paperwork, as well as flying time which can include prenatal visits and ability of father to get to HK for the birth. Pretty much you can get there in about 8 hours from Beijing (for instance) to HK hospital or even a bit less, whereas if delivery is in Spain or Russia the working father needs to vacate his position in order to be there for the birth. And as he pointed out, vacating his position means possible job loss, in which case the insurance doesn't even factor in. It just won't exist. Bribes are probably necessary in Russia and mainland China, whereas in HK likely not. 

If the people involved were all willing, obviously Spain would be a much better option. Also, OP could at least get in line for benefits if job loss happened. Although assistance might not actually be forthcoming... Maybe there are other issues too, such as applying for citizenship, EU citizenship is perhaps easier to process in Spain. But certainly a given in other countries, just more paperwork involved. 

You also have to think, where is a good place to be stranded with the baby and mum (or one or the other) if there are complications? A C-section takes 6 weeks to recover from. Can OP get a job in Spain or is it easier to get a job in Russia (ummm, maybe not) or HK where he already has a work visa? Most businesses in China can find some kind of work or tolerate some work telecommute from HK, but not keen to have already expat go home...especially with a baby, they will just discount him and proceed as if he will never come back, same thing with Russia...Russian wife, going home to Russia, they will say to themselves, well, we have to replace OP, cannot count on him to return. It's the same as actually giving notice. And no unemployment in this case, good luck.


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## GA HEART (Oct 18, 2011)

Of course the healthcare is relavent. I have zero experience with healthcare anywhere except the US, so I was refaining from any kind of input there. I was just commenting on the fact that his wife wants to leave the country to have her baby just so she can be near her mother. To me that sounds a little extreme.


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## LongWalk (Apr 4, 2013)

The air in China is toxic. But the medical care can be good if you find the the right doctor and institution.

In both Russia and China, I should think you need to compensate the physician with bribes or fees to facilitate a higher standard of care.

But the job loss is a major issue.


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## inquizitivemind (Jul 16, 2013)

GA HEART said:


> Of course the healthcare is relavent. I have zero experience with healthcare anywhere except the US, so I was refaining from any kind of input there. I was just commenting on the fact that his wife wants to leave the country to have her baby just so she can be near her mother. To me that sounds a little extreme.


I don't think it's as much as being near her family is it is being in the place of her native language. Any comfort you can seek from feeling normal is much needed throughout pregnancy. Just saying from personal experience, the more normalcy there is to a pregnant woman, the better. I am definitely not having another child overseas. NO WAY.


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## Mike_77 (Apr 24, 2013)

Thank you guys I will give it a thout about being more supportive about my wife inclination.

Anyway I don't see HK as an option. Is still more than 3 hours away from where I live and no way I would find a job there. Also top expensive I guess.

Her mother in China? Guess not.
My wife speaks very good chinese and spanish, no problems for that. Papers for spain are a non issue and her mother would definitly go there.

My wish would be to find a good hospital in China, no matter the price, and don't have any mothers involved... but maybe I am making it too easy.

Thanks again for the helpful insights!


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## GA HEART (Oct 18, 2011)

There's a grandma on both sides! Not likely to have NO grandma involvement.


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## PBear (Nov 16, 2010)

Why would you not want to have mothers involved? For a first child, everyone is often better off if there's someone else besides dad involved in post-natal support of mom. Speaking as a father of two...

C
_Posted via Mobile Device_


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## Homemaker_Numero_Uno (Jan 18, 2011)

Mike_77 said:


> Thank you guys I will give it a thout about being more supportive about my wife inclination.
> 
> Anyway I don't see HK as an option. Is still more than 3 hours away from where I live and no way I would find a job there. Also top expensive I guess.
> 
> ...


If her mother will go to Spain, then go to Spain. It will be easier for you. It will be cheaper. You can take your home leave. Hopefully you work for a Euro compliant company that allows paternity leave. The quality of care is very good. The general environment is more stable.

I don't think it's abnormal for someone to want their mother at the birth. If the relationship is good and the mother is competent and helpful, why should it be otherwise? I think some people don't have this experience and therefore don't understand how it feels to have a loved one who gave birth to you (if not adopted) hold your hand during delivery and wipe your face and know exactly what gives you comfort. Don't give it a second thought about her mother being there. If that's what she wants, don't interfere with them, because you will lose, what's worse, they will consider you a control freak loser. In any case, it will be more fun for you with her mother there, there are so many responsibilities and things to know about when giving birth, otherwise you have to engage a doula and that's just second best, as it's not family and you have to work to form a bond that will be helpful during the birth and after.

HK being 3 hours away is not really much of an issue. You should at least go there and tour a facility and meet a doctor just in case your plans have to change. The world is a very strange place. There is a volcano maybe about to erupt in Iceland...these events and others can decide for you what your viable options actually are. So you need to have a good Plan B and a good Plan C and Plan D. Not just one decision but a toolkit. Also make sure you know a good local doctor because when you come home you need a pediatrician and also in the event of bleeding or miscarriage you don't want someone just yanking out the placenta and damaging chances of having a child later on. You will also want an ultrasound so you can see how many children you are actually dealing with. That could be a game changer, as could the presentation of the placenta/amniotic sac and the umbilical cord. Some mothers do need to be on total bed rest. In that case nobody is going to be flying anywhere later on in pregnancy.


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