Key cultural issues every foreign woman should know to have a safe and comfortable childbirth experience in Vietnam
Having a baby in Vietnam is becoming an increasingly common occurrence among expats from a variety of countries. However, the decision to give birth here rather than in a neighboring city such as Bangkok, or to return home, is not a straightforward one—it involves careful thought regarding a variety of issues, ranging from how to find the highest quality care to a plethora of cultural and bureaucratic considerations. For the majority of prospective parents, finding the right hospital is the most important step in planning for the birth of their child. In Ho Chi Minh City the main maternity hospitals are Hanh Phuc Hospital (www.hanhphuchospital. com), Tu Du Maternity Hospital (tudu. com.vn) and the Saigon International (SI) Maternity Hospital (sihospital. vn). Highly rated obstetrics services and maternity care for foreigners are also provided by Franco-Viet (FV) Hospital, Family Medical Practice and Columbia Asia. Keep in mind that while local public hospitals may offer less in terms of desired services and facilities, top-end international hospitals may occasionally tend towards over-servicing in the area of medical diagnosis and treatment, perhaps in an effort to justify their higher fees, and also to avoid the possibility of litigation. Tu Du is by far the busiest maternity hospital in the city. According to the Deputy Director there, they perform an average of 150 deliveries a day. As with many large public hospitals, it suffers from limited funding which has resulted in inadequate staffing and facilities to cope with overwhelming demands. And while there is wide acknowledgement that under these trying conditions the hospital manages to deliver an efficient level of medical service, the reduced standard of care compared to that offered by the private sector may not be suitable for most foreigners who can afford to pay more.
The VND58 billion Saigon International Maternity Hospital was the city’s first private hospital, and caters mainly for Vietnamese women, including the wives of foreigners. Although some staff, mostly doctors, speak English, the majority of nursing and administrative staff speak Vietnamese only, which can be an insurmountable barrier to non-speakers, unless they have partners, family members or friends to translate. The quality of care at SI may be higher than many local hospitals, yet the cost is much lower than foreign-owned and managed hospitals.
FV Hospital is promoted as the “premier” health facility in Vietnam offering international standard healthcare, which of course strikes a chord with those who would prefer a foreign doctor, or are interested in five-star VIP services. Also, many of the staff speak some French and/or English, including midwives and maternity nurses. However, despite an excellent and progressive approach to pre-natal care and delivery, there have been reports from several parents of an unwillingness to communicate clear information about the condition of babies who are taken away to receive special neo-natal care. This situation is unacceptable to many foreigners, who may need to demand detailed explanation and justification for such action, and the right to veto any non-essential treatment which may separate them from their baby.
Smaller private clinics such as the Family Medical Practice generally provide an excellent standard of medical care with a high level of English, at a premium cost (which of course is much lower than private medical care abroad). And perhaps most importantly, they offer an understanding of Western attitudes and expectations concerning childbirth that is invaluable for many foreigners; because it’s not something that should be left to chance, it is important to meet all key staff as early as possible to ascertain the philosophy of the service provider towards maternal and infant care.
It’s a… Lot of Paperwork!
Despite high levels of training and experience at any hospital, certain cultural differences can present a variety of difficulties to overcome. For example, the World Health Organization recommends that babies should be fed colostrum, the initial yellowish breast milk that contains protein, vitamins, minerals and antibodies to boost infant immune systems, within one hour of birth. However, it is common practice in Vietnam for this ‘dirty’ milk to be discarded and babies to be fed bottles of formula until the mother’s ‘real’ milk comes in. Therefore, it is imperative to insist that breastfeeding be commenced immediately and to forbid the use of bottled formula by nursing staff if the mother wishes to breastfeed exclusively.
When it comes to the birth itself, the principle should be the same. It is essential to ensure that perceptions of what is going to happen in the delivery room are compatible. And the most effective way to guarantee this is the preparation of a birth plan that outlines the parents’ wishes and for it to be discussed with doctors and midwives early in the pregnancy. For instance, unless requested to do otherwise, some hospitals remove babies from their mothers immediately after birth for extensive testing that could easily be delayed to maximize bonding time. If it is not possible to find individuals who are sympathetic and prepared to respect this ‘negotiation’ process, then it is time to explore alternatives. And while such plans are routine in many countries, they are not so common here, so don’t be surprised if it’s a matter you have to raise yourself.
If you opt to give birth in Vietnam, then it is best to ahead to the international hospitals. Nevertheless, you should have to look for medical insurance that covers almost ante-natal care, delivery, and post natal care. And, women who suspect that they might be pregnant ought to get a pregnancy testing kit from nearby pharmacy to do a pregnancy test at home. Even, if the test is negative, you ought to consult MEDICAL experts. Also, you can try simple pregnancy calculator to find out your pregnancy due date, key milestones of your pregnancy process, pregnancy week by week highlights, trimester chart, and graph.
Other requests that can be specified in a birth plan range from preferred pain control methods to positions for laboring, and whether or not a partner can be present for the birth (which some Vietnamese hospitals will not allow). Many Western women are concerned with the high level of medical intervention which is prevalent in Asia, so it is critical to demand that the necessity for procedures is clearly explained and for consent to be gained before they are performed. This particularly applies to unnecessary induction of labor and caesarean section deliveries (which now account for more than a third of all births in Vietnam) if these are things you wish to avoid. The key ingredient for successful planning is to make sure that everyone is aware that the lines of communication must be kept open at all times.
And once you are holding your precious bundle safely in your arms, there are other issues that must be addressed. The children of foreigners born here must apply for a Vietnamese birth certificate before they can register at their own embassy to be granted citizenship. This process involves taking the hospital-issued birth certificate to the Department of Foreign Affairs (with countless copies of your own passports and proof of residency documentation). As children born to foreigners cannot be registered as Vietnamese citizens, you must also take a letter from your own embassy or consulate stating your intention to register your child as a citizen of your own or your partner’s country (with a written Vietnamese translation). After the Vietnamese birth certificate has been issued it must be translated into your own language, and submitted with the above mentioned documents to your embassy.
Choosing to have a baby in this country is a complex, and at times difficult process, but it can be done, and it has the potential to be a hugely enriching experience. The key to success is to do a thorough research, and arm yourself with adequate information (and a comprehensive insurance policy to cover any worst-case scenario situations) before making your decision. Then you must find a health care service that is capable not only of meeting your medical requirements, but also of respecting your wishes and communicating effectively with you throughout your pregnancy, the delivery of your baby and during the post-birth period.