Sunday, May 15, 2016

Delivering a Baby in South Korea

Since giving birth in a foreign country can be scary, I've decided to blog about my experience so other women will have a better idea about what they can expect.

Medipark Versus Hyosung:
I started receiving care first at Medipark, but this was my fifth baby and I wasn't impressed with my Doctor there. I don't know if it was a cultural, or language barrier, but there were a couple of things that she said that made me feel like she was 1. either not a very competent doctor, or 2. that she withheld information because she didn't want to be inconvenienced. An example is when I was barely in my third trimester she told me that the baby was in a transverse position and if (s)he didn't move, I would have to have a c-section. I wasn't too worried since there was still plenty of time and room for the baby to rotate, but I wanted to know all the other options available before we discussed the "C (for C-section)" word. I asked if there were any exercises she knew that could be helpful to encourage the baby to move, or if the baby could be moved by a doctor.

She said that there wasn't anything that could be done. The only yoga moves she knew of were to help a breech baby, and that the baby couldn't be moved. This didn't sound right to me. I went home and after doing research I found the position my baby was in was said to be one of the easiest to change through exercises, or by a Dr. manually moving the baby. This obviously contradicted what I'd been told. I assumed maybe my Dr. just was unaware (which was a little unsettling), or maybe Korea just didn't deal with trying to change the babies position. However, I learned that there were Korean doctors who knew of exercises to encourage a baby to move to a better birthing position, and there were some doctors who could preform ECV's (turning the babies manually before delivery). Needless to say, either my doctor was unaware of this information, or decided to withhold it from me.

I like having natural births by using hypno-birthing. I don't have anything against epidurals, but have issues with being numbed. So, when my Dr. said we'd talk about my being induced when I was 36 weeks, I felt really uncomfortable. She brought up induction and c-sections a lot. I noticed that my appointments always went too smoothly. For a labor and delivery Dr., my appointments were always right on time. There also weren't very many patients waiting. I realized in comparison to my past 4 births this was unusual for a labor and delivery doctor unless most of their births end up scheduled with epidurals where they can hold the patient off from pushing by turning down the meds. this of course is just a theory of course. However, this and a couple of other discussions made me feel like the doctor at Medipark encouraged inductions, epidurals, and c-sections for her convenience sometimes by withholding information that would allow the patient to make another decision. I decided to switch to a doctor my friend had (who had helped her move her breech baby during delivery).

Not everything about my experience at Medipark was bad. In fact, I liked their facility better. The food they serve their patients is also much better I'm sure. Parking was easier, but in the end these were all superficial reasons for me to want to stay.

I switched to Dr. Ku at Hyosung and after meeting her I felt completely relieved and at ease. From my experience she is competent, respectful, and kind. The Hyosung Dr. office is very busy, which is more normal for a labor and delivery doctor who doesn't schedule when their babies are born. That might have meant some of my appointments they were behind, but it was reassuring to see their waiting room packed with Koreans and other people. They always had almost all their couches filled with waiting patients which makes me feel like it is likely because the doctors there are worth the wait. I would have to agree. In fact, when I went to the clinic to request that my referral be switched I had a couple of people tell me they would also choose Hyosung if they were pregnant.

Dr. Ku was also the first doctor I've ever seen who didn't bring up induction. In fact, at my 41 week appointment, I brought it up because my mother-in-law was going to be leaving and I needed to make sure she would not only be here so she could help watch my other kids, but so she could meet her grandchild. There was a Korean holiday coming up that week and my Dr. was planning on leaving then. So, I decided to schedule an induction. I really hoped I'd have a completely natural birth, but I really needed the help and didn't want another unfamiliar doctor delivering my baby.

D-Day The Delivery Experience:
When the day came, I went to the office for an appointment and Dr. Ku checked my cervix and I was dilated at a 4 cm. I'd been have mild pressure every ten minutes or less, but I was able to easily talk through most of it and walk for the most part as well. Still, I hoped to try to go natural. The L&D nurse tried to get me to start on the pitocin right away, but Dr. Ku came in and agreed that I might be able to get things going on my own. After two hours, we decided it wasn't worth the risk of being with another unfamiliar doctor in a foreign country and I decided to start the Pitocin.

Here are pictures of a smaller delivery room we first were in (notice they have the birthing balls there, but they are for shorter Korean women. So, if you are taller than most Koreans and want one, I suggest you bring your own).

The couches pull out and become beds. They are very hard though, so I suggest you bring your own bedding and pillows for you and your husband.

They were pretty busy that day, but as soon as they had a bigger delivery room available they switched us there. They are known to give the bigger nicer rooms to foreigners. The rooms were pretty nice, although they weren't as squeaky clean as I'd like a hospital room to be. Still, they weren't disgusting. I just like hospitals rooms to look sterile and these weren't as sterile looking as I'd like. Here is the bigger delivery room they switched us to:

Here's the bathroom. The toilet had a seat warmer which was really nice:

When we got to the delivery room, one of the nurse asked if I wanted to be shaved, or have an enema. I declined to do either and they didn't push it. When we were checking in, Ms. Ku gave us a bag with kitchen like plastic gloves (the nurses and Dr. use this to check your cervix), tissues, a hand towel (bring your own bigger towel for the shower), a plastic bottle with a straw, a soap bar, and diaper wipes.

Here is a picture of the gown they give you. It doesn't open in the back which makes it nice because you don't have to worry about showing your crack of to everyone. The top opens with buttons which makes breastfeeding easy. They had pockets and told me to put my underwear in there. I didn't understand why. After I had the baby they took them out to put them on for me which was slightly awkward. Mine were gross because I'd leaked on them after my cervical check (sorry if that is TMI). I'd brought mesh bottoms they give to you in the states. They don't have them here in South Korea. Luckily, my sister had a baby recently and mailed me a lot of the supplies she didn't use, so I had a couple of packs. Anyhow, you'll need your own underwear and I'd suggest bringing a lot since you will likely leak). They do provide big postpartum pads, but I was told to not change them unless they were very saturated. It sounds like they had some patients changing them more than they liked. I feel like they gave plenty though so I didn't have a problem. They also provide diapers, but it's not a whole bag, or a couple like they usually give in the U.S. They gave a days worth and then we had to ask the nursery for more. I wish we'd have asked one more time before we left, but we at least had one bag of newborn diapers at home and some old ones a friend had given because her baby had outgrown them so fast. Otherwise we likely would have had to pick some up sooner.

So, after I was checked in, the nurse tried hooking me up to IV's. I asked if I could have a Hepa ring instead. That way I wouldn't be tied to the IV pole and could move more freely and still would have easy access to my veins in case an emergency were to arise. They quickly obliged which was incredibly nice. I later had to be hooked up to the pole when they started the Pitocin, but they didn't even try to keep me hooked up to the fetal stress monitor the whole time. In the states, they always made me wear the monitors for the babies heart and contractions the whole time. Just having the IV pole this time was so much more comfortable and easier! They did make me do a couple of non-stress-tests to see if I was progressing enough where they thought I could have the baby without the Pitocin, and then to make sure the Pitocin drip wasn't overstimulating my uterus.

They started the Pitocin around 1 p.m. and I got up from the non-stress-test 30 minutes to an hour after to get the baby in a better position. If I'd been allowed to stand while they did the test, I'm sure delivery would have been even faster. Around 3:30 I felt like the pressure was so intense my husband worried the Pitocin may be overstimulating my uterus (usually it takes a long time for the Pitocin to kick in for me and it worked way more fast this time). The nurses came in and checked me.

They never let me know how dilated I was and asked if I could push. I was pretty much delirious at this point. I was really confused about why they were asking me to push, and had I been in my normal state of mind I would have declined pushing right away because I didn't have any urge to push at that point. They kept checking my cervix despite me asking them to stop (I don't think I was clear though because from what my husband says I seemed really out of it). Looking back, I think they kept checking because I had a cervical lip that was keeping me from being fully dilated. I could be wrong though, but they kept checking at what seemed to be every 30 seconds.

What added to the confusion for me was there were like five to seven nurses surrounding my bed telling me to push. I was so out of it, I assumed there was something wrong with the baby, or they wouldn't be telling me to push. Remember I was delusional and confused and felt no urge to push at this point, not to mention did I ever think the labor would go so fast. So, I started to push thinking my baby wasn't getting enough oxygen and I struggled to calm down. The nurses had a hard time getting me to breath normally, and finally I heard my husband ask if I was using my hypno-birthing techniques (it is somewhat like meditation) and I admitted no. Really, I needed him to slap me back to reality, but he was too nice to do that and didn't know that my delirium had me believing our baby was in danger. Had there not been so many people surrounding me, and had I heard my husband's calm reassurance more loud and clear I think things would have gone more smoothly, but that isn't really the nurses' fault. I commend them for not shooting me with a tranquilizer. I was just caught off guard. Another thing I didn't like, was that one of the nurses was pushing on my stomach while I was pushing. I told her she was hurting me in between telling the nurse to stop checking my cervix. She finally got it after my husband picked her hand up and said stop. She listened. If I were to deliver there again, I'd ask if I could not be told when to push unless it was necessary for my child's safety, and to not have any nurse push on my stomach and to ask before doing any cervical check. Hindsight is always better though.

Anyhow, I tore a tiny bit for the first time in several births. I am certain I would not have had I been more calm and waited to push at my own pace. Still, it was a very very small tear (1 mm) that was healed completely in less than a week. If you hope to avoid an episiotomy, the doctors seem willing to listen, but I suggest you learn about a second and third degree tear before and decide if there ever is a time an episiotomy would be a good alternative to literally ripping from your vagina to your anus. Luckily, I didn't have to worry about that.

I don't know if it is because I turned down being shaved or the enema, but another odd thing that occurred was the nurses started slathering orange iodine all over my nether region, in between my thighs, etc. They also had sanitized blankets everywhere. Maybe they got it from actors discussing needing hot towels in all the movies? I have no idea. After I delivered my baby, they put my baby on one of those sheets on my stomach and told me I couldn't touch the baby. They actually had the baby on my nightgown as well so I got iodine and who knows what else on it while I waited to hold or touch the baby just laying on my stomach. When they finally let me hold my newborn they suggested I breast feed right then. The Dr. took care of the placenta and couple of stitches before they were ready to wheel me out and take us to our recovery room.

The Recovery Room:
I was given a vitamin, glucose, and more oxytocin to help my uterus contract and go back down through IV's. My husband swears they did this in the States too, but they pump it through a lot faster. We had several problems with my IV including getting air in and having my blood start going up the line (you can see this in the picture). My husband also noticed I was done with one bag and stopped the line. Thank goodness he was there! I had my baby before 4 p.m. and was still tethered to a pole by 10 p.m. All I wanted was a shower! I asked my nurse several times if I could just be unhooked and she said, "No." She had to fix the IV at least three times. It would be dripping normal and then would just stop. The nurse wasn't really on top of things.

Around this 9:00 p.m., I realized that the bathroom we had didn't have a shower. At 10:00 p.m. the next nurse asked if she could unhook me from the glucose (the only remaining bag) that was only half way gone SIX hours later! I was so happy to get unhooked. That is really the biggest annoyance I had. I know that hepa rings have the tendency to get messed up, but I wish the first nurse would have hooked the IV's to another vein directly the first time it showed problems, or at least let me forgo having all the unnecessary glucose since the other bags were gone a couple of hours earlier. At that point, we learned the shower was out in the hall and my husband said I'd want flip flops (which I hadn't brought) if I wanted to shower. He described it as looking like it had been a closet they turned into a shower. I decided to just take a sponge bath out of the sink. Luckily, I'd brought a lot of towels and washcloths and I suggest you do the same.

Another thing that was different was that the nurse told my husband that he needed to massage my uterus after delivery for three hours! He was supposed to massage for ten minutes and then take a five minute break. In the States the nurses will occasionally come in and massage you, but it has never been for ten minutes at a time and never for three hours! My friend had already warned me that they asked her to do this. I did massage my uterus myself a bit, but probably nowhere near the amount they had asked.

Our family came to visit the next morning. We were told that if your baby is rooming with you, you can have visitors whenever. They had no problem with my mother-in-law and other four kids coming and visiting. If you decide to have your baby go to the nursery, I think they have three different times for 30 minutes where you can visit your baby. We had our baby stay in our room with us. After I was taken to the recovery room, they took our newborn for less than two hours to do her first check up and to give her a bath. It wasn't too different from our experience in the states, except we couldn't go with her. They also seemed to respect that we asked that our baby not be given any pacifier or formula.

The nurses didn't come in too often at night. I'd say it was similar to, or even less visits at night here in South Korea than in the U.S. I appreciated this. The next day, they gave us a larger room to move into. Just like with the delivery room, they try to give these bigger rooms to the foreigners. This room also had a shower which was so nice after only being able to sponge bathe the previous night. Here is what the bigger rooms look like:

Bathroom with a shower:

The food at Hyosung was okay. Not horrible and not amazing. They gave meals for both my spouse and I which was nice. Here is what we were fed during our stay. I opted to get "American" food. Here's what dinner the first night was:

Shrimp and rice inside an omelet, soup (which I think was cream of mushroom), oranges, cabbage salad, cookies, and an orange juice. I should let you know, you or your spouse will be in charge of taking the food trays out. They don't have nurses, or anyone else come and pick them up which isn't too big of a hassle, we just didn't know what to do with them for a while. You'll also need to have your own water bottle available. Your spouse, or you will be able to fill it up from filtered water in the hall.

Breakfast: corn flake cereal, milk, a pastry with whipped cream, peaches, and cookies:

Lunch was beef that tasted like meatloaf with rice, cabbage salad, more mushroom soup, cookies, and apples:

Dinner was the same as the previous night:

They also brought a snack the second night. They forgot to the first night, but we never requested it because our friend had brought us stuffed bell peppers so we didn't really need a snack. The snack the second night included a huge bowl of clam chowder, yogurt, and a strawberry cake.

Breakfast the next morning was a slightly spicy crab croissant roll, corn flakes, milk, yogurt, and cookies.

We also had snacks and treats we brought with us. I also brought my own apple juice.

I never use pain killers until the cramping after birth is painful enough to wake me up. An extra strength Tylenol has always done the trick. I didn't need anything at all during my stay, but they gave me a packet with what I assume was an opioid painkiller, a stool softener, and two other pills I don't know what they were for. They also gave me iron and a laxative. I didn't want it so I just put it in my bag in case I changed my mind. I didn't need anything until after I got home anyhow. That's about all I know for pain management.

Overall, I'm very pleased with my experience. In fact, my experience with Dr. Ku was the best I've had yet with an OBGYN. I also like how respected I was. The translator Ms. Ku was also wonderful. There were some things that could have been better, but I am very pleased with my experience and would recommend Hyosung hospital and Dr. Ku for those in Area IV.