Showing posts with label birthing. Show all posts
Showing posts with label birthing. Show all posts

Monday, 1 October 2018

Giving Birth on Base/Post in Korea if You're Non Command Sponsored (Non CSP)

Updated 12 September 2018

If you come to Korea non CSP (Command SPonsored), you can see by the CSP vs non CSP matrix that you don't have access to the same services as those families who come here command sponsored. Usually, if you come to Korea non CSP, you only have access to ER medical services; that means you can't get a regular appointment on base. This means that you can't even give birth on base. However, there are exceptions to the rule. Being pregnant is one of them. If you want to be seen for prenatal appointments on base and/or give birth at a military facility while in Korea, read on.

Get on Tricare Select*
Most bases/posts will have a waiting list to get on Tricare Prime. If you get on Prime, then you have the same medical services as a command sponsored family. However, don't get too excited. Some places have so many people on the waiting lists that they have closed the waiting list. Doesn't make sense to me since people are always coming and going, but that's military intelligence for you.

* Starting January 1, 2019 you will no longer be allowed to switch to Select due to pregnancy. What this means is that if you have Prime, you would need to do one of the following
  • Get a referral to get the birth you want.
  • Pay completely out of pocket (OOP).**
  • Switch during a QLE (qualifying life event, not pregnancy, but for example, a move).
  • Switch during the the annual late fall 90 day open enrollment period.
However, while being pregnant isn't a reason to switch, having a baby is a QLE. So you can switch back after the baby is born.

** Costs vary greatly if you decide to pay out of pocket. A midwife for a homebirth can be 3.5-8mil. A birthing center can be 3-15mil.


Get a Referral
Call Women's Health. Tell them that you're pregnant and they *should* help you get an appointment on base. If that doesn't work, walk into Women's Health and they will help you set up your first appointment. Currently, in Gyeonggi-do and Seoul, only the Brian Allgood Hospital aka the 121 at Yongsan is where you can give birth. You might be able to stork nest i.e. get Tricare to pay for lodging shortly before you give birth. Some other bases/posts may be able to take care of your prenatal care. It's best to ask since things are always changing.

On Base Care for Your Newborn
Your newborn will be able to be seen on base for the first 120 days. Check with the appointment line. Usually the pediatrician will reserve one day a week for appointments for non-CSP newborns. I think at Osan it was Thursday.
 

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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Friday, 1 June 2018

Tricare and Doulas

I talked about Tricare Overseas and home births a few months ago. Unfortunately, Tricare Overseas does not cover home births. Shame on them.

Tricare claims their "primary objectives are to optimize the delivery of health care services in the military's direct care system for all Military Health System (MHS) beneficiaries and attain the highest level of patient satisfaction through the delivery of a world-class health care benefit." How they do that by limiting the choices women to giving birth by not reimbursing women for overseas home births by a midwife is beyond me.

But let's not hold a grudge, let's talk about doulas. According to Tricare, they only cover medically necessary services. They specifically say they will not cover non-medical support during labor and delivery and mention doulas.
Source
Sometimes Tricare Pays for Doulas
Even though Tricare says they don't reimburse for doulas, some women have had doulas covered. Most hospitals and clinics don't break down their bills into super small parts.

For example, while in the hospital, you probably interacted with a few nurses during your stay. However, when you get your bill, it's not likely that you'll be billed for each one. They often get lumped together. Or how about the secretary? You're not likely to see a fee on your bill for talking to her. Another example is your room. You are probably not billed individually for the water, electricity, or sheets that you use. There's probably just a room charge.

Some birthing facilities include doulas in their fees and when they send you their bill, the doula is simply included. Sometimes the doula may be a nurse as well, so it's understandable that Tricare would reimburse families for this fee, especially if they provide medical services during your labor and delivery. Sometimes they're not nurses and Tricare still ends up indirectly covering the cost.

HOW does this happen? Because it's included in the birthing fee.
Some places may even charge the same amount whether or not you use a doula. It's kind of like the room fee. If you take super long showers, you're going to be charged the same amount as someone who doesn't take a shower during their stay.

Bottom Line: Tricare Has Paid for Doulas
Depending on how your birthing facility breaks down their bill, Tricare may end up paying for your doula.


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Thursday, 1 March 2018

7 Natural Birthing Centers in the Seoul Area, Korea

Updated 12 September 2018

Natural Birthing Centers in the Seoul Area
There are a handful of foreign-friendly natural birthing clinics in Seoul. Agitanseun (aka Rosa), GM Cheil, Lee Myung Hwa, Mamas' Birth Center, Medi Flower, and Yeon and Nature. They are also very supportive of you having a doula or birth photographer. Check out the list of breastfeeding counselors, childbirth educators, and doulas and here are birth photographers. Some of the birthing centers may offer free or discounted photos with Korean studios. Medi Flower, for example, works with King Kong in Love.

Prices vary, but if you have Korean national health insurance, they should be 1.5-3 mil for the birth itself and include between 6 hours-3 days of recovery time. If you have interventions, need a C-section, or need special care you may be charged extra. Be sure to ask about prices ahead of time. Remember you can use whatever is left on your GoEun Mom card for the birth.

Home Births
Home births are completely legal in Korea. Here's a list of English speaking doctors and midwives who will do home births. If you speak Korean, you will have more options (and usually pay less than what English speaking doctors and midwives charge). The Korean Midwives Association has a handful of midwives who do home births.

C-sections and Transfers
Simply by giving birth at a birthing center, you will lower your risk for a C-section. Of the natural birthing centers listed below, 3 of them can perform C-sections: GM Cheil, Medi Flower, and Yeon and Nature. Even if you want to avoid a C-section, you should still ask the birthing center what hospital they do transfers to and go there and see what it's like. None of the birthing centers have a NICU. So if your baby needs one, they are going to have to transfer you. Here's an article about NICUs (Neonatal Intensive Care Units) in Korea.

7 Natural Birthing Centers in the Seoul Area
Agitanseun Natural Birth Center (김옥진조산원) Kim Ok Jin (Rosa)
Kim Okjin, Midwife aka "Rosa"
401-1, 3F Saeyang Chungmaru Sang-ga Naeson 2-dong, Uiwang, Gyeonggi-do 
경기도 의왕시 내손2동 401-1 세청마루상가 3F
Telephone: (031) 410-8597
Cell: 010-2447-8231 and 019-447-8231
ojkim80@hanmail.net
Near Indeogwon station

GM Cheil Women's Clinic
896 Gwangmyeong-ro, Gwangmyeong, Gyeonggi-do
Telephone (02) 890-2555
  • A new natural birthing center that opened in early 2016. There's an English speaking midwife named Julia who used to work at Yeon and Nature. GM Cheil is located on three floors. The 7th floor is where check-ups are done. The 8th floor is where the delivery rooms are. The 9th floor is where the recovery rooms and education room is. They offer epidurals and can do C-sections.
  • Prices are about half what Medi Flower and Yeon and Nature charge. Expect to pay about 1.5 mil if you have national health insurance.
  • You can read more about them at this post.  
Lee Myung Hwa (행복한이명화조산원) they used to be Happy Birth
Seonbu-dong 1070-12 Gwangwon Building Office 208, Danwon-Gu, Ansan, Gyeonggi-do
경기도 안산시 단원 선부동 1070-12관원빌딩 208호
Telephone: (031) 410-3573 and 010-2803-3573
  • Lee Myung Hwa is the midwife.
  • They attend home births.
Mamas' Birth Center 
3rd floor, Daesakwanro 60 Yongsan-gu, SeoulTelephone: (02) 797-3573
Danica: 010-7170-1099.
  • Mamas' Birth Center is a natural birthing center. They have experience working with foreigners. They have 5 rooms. Each rooms has a tub. The rooms have great lighting, birthing balls, and birthing stools. They also work with Jinny, a doula who speaks English and Korean. They have birthing education classes. They have double beds (Korean style, so a bit hard).
  • There is no doctor, just midwives. They are not able to perform C-sections, and all pre-natal tests and transfers are done at SCH. 
  • They do home births in Seoul only. 
  • Birth plus 6 hour recovery period: 1 mil. Daily room rate: 250,000. Home births are 1.2 mil and are only done in Seoul. All prices are with Korean National Insurance.  If you don't have KNI, it will be more expensive. People have said a birth plus a 6 hour recovery period is about 3 mil. After that it's 250,000 per day in the room and 10,000 for meals.
Medi Flower
Dr. Hwanwook Chung
2nd Floor of Lotte Castle Medici, 1656-4 Seocho-dong, Seocho-gu, Seoul
Telephone: (02) 548-9400 (Press 9 for English)
Near Kyodae subway station
  • They attend home births.
  • A popular natural birthing center. 
  • About 2.5 mil for a vaginal birth though prices vary depending on insurance.
  • Dr. Chung is the most amazing "labor whisperer". 
  • They are able to perform C-sections. 

Queens Women's Clinic
9-13 Seongjeonggong-won 1-gil, Seobuk-gu, Cheonan, Chuncheongnam-do
041-569-2000
010-2603-8314‬
Waze
  • There's a natural birthing room with a birth tub (for labor and/or birth), birth ball, peanut ball, ropes, and a bar (the latter two are used to hold onto while pushing). 
  • It is Korean style, so you'll be sleeping on the floor.
  • They also have a VIP room. 
  • They can do VBACs and C-sections. 
  • Dr. Seo Gi Won is the doctor. 
  • About half an hour from Camp Humphreys. Very affordable. 
  • They are connected to Dankook Hospital, so they might be able to bill Tricare directly. 

Yeon and Nature 
521 Hakdong-ro (Cheongdam-dong 72-1) Gangnam-gu, Seoul
서울특별시 강남구 학동로521 (청담동72-1)
Telephone: 02-518-1300 or 010-4009-1151
  • Dr. Park's place: opened in late 2014. A natural birthing center that also has epidurals and C-sections available. There are no extra fees to use the birthing pool, every birthing room has pool. Total cost will be around 3-4 mil. This includes the labor and delivery, a 2-night stay, newborn screening, and meals.
  • They have English speaking midwives and doulas. 
  • They do placenta encapsulation and placenta prints for about 300,000 won. 


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Thursday, 1 February 2018

Home Births and Tricare Overseas (Examples from South Korea)

Updated 11 September 2018

Tricare Overseas is not like Tricare stateside. A few women recently had home births in Korea and filed claims with Tricare Standard (now Select). After a year of going back and forth, with Tricare asking for more and more documentation and these women being reassured that Tricare would reimburse them, Tricare finally issued their response: they wouldn't cover it. None of it was covered. These women were about $8,000 out of pocket. The home births took place with staff from MediFlower.

Switching to Tricare Select for Pregnancy
Starting January 1, 2019 you will no longer be allowed to switch to Select due to pregnancy. What this means is that if you have Prime, you would need to do one of the following
  • Get a referral to get the birth you want.
  • Pay completely out of pocket (OOP).*
  • Switch during a QLE (qualifying life event, not pregnancy, but for example, a move).
  • Switch during the the annual late fall 90 day open enrollment period.
However, while being pregnant isn't a reason to switch, having a baby is a QLE. So you can switch back after the baby is born.

* Costs vary greatly if you decide to pay out of pocket. A midwife for a homebirth can be 3.5-8mil. A birthing center can be 3-15mil.

What Kind of Labor and Delivery is Covered?
On Tricare's website it states that labor and delivery are covered. On that page, they also say . . .

Facility/Provider
Usually, your TRICARE plan determines the type of birthing facility you will use (military or civilian, office-based or freestanding, etc.). You also have different options for the type of provider who delivers your baby (obstetrician, Family practice provider and or Certified nurse midwife, etc.). These types of decisions will be made by you and your provider during your prenatal visits. 

However, there is no mention of home births, just certified nurse midwives. All midwives in Korea are CNMs.


What about Home Births?
Tricare Standard (now Select) actually does mention home births. The December 2015 Tricare Maternity Care Fact Sheet talks about choosing to deliver at home and what the cost shares are. 
Source
Contacting Tricare on Facebook and the Tricare Overseas Hotline
That sounds promising, doesn't it? Don't get your hopes up. I contacted them on Facebook since the Tricare Overseas hotline kept saying home births should be fine when I talked to a representation after pressing 3 (for claims).

Source

Calling Tricare Overseas, Again
About a week later, I called the Tricare Overseas hotline, again. This time instead of calling about claims, I pressed 2 (for referrals and authorizations). I said it looks like home births are covered but women in Korea are repeatedly getting denied. They put me on hold and came back and said home births are considered home health care and home health care is not covered overseas. I couldn't believe it, but sure enough, you can find the information on Tricare's site as well. How in the world they consider home birth to be the same as an illness or injury is beyond me, but that's Tricare for you!

Source
The funny part is that they're wrong. (I know, you're shocked that Tricare is wrong). Home births are not home care. So why aren't home births being covered? It's because of the midwives.


Are Korean Midwives Covered?
The midwives they went through also work at a birthing center in Seoul. Tricare Overseas will cover births at that birthing center (MediFlower), but won't cover home births. Tricare says they cover midwife services if they're state licensed and certified by the American Midwifery Certification Board.

Korean midwife do not fulfill those requirements, so why is Tricare reimbursing patients who give birth at the birthing center but not those who give birth at home? When women give birth at the birthing center, a doctor is put down on the invoice since there is always a doctor on call. The midwife is then put down as a nurse. The same is not true for home births: the midwife is simply put down.

Source

Bottom Line: Tricare is Not Covering Home Births in Korea
It's not fair to women to be told that home births are covered and then to find out they're stuck paying the full bill. Had these women known, they may have gone to birthing centers or chosen a less expensive midwife.


Tricare's Convoluted Stance on Home Birth Overseas
On Tricare's website it states that labor and delivery are covered. However, there is no mention of home births, just certified nurse midwives (CNM). All midwives in Korea are CNMs. Tricare claims that home births overseas fall under home health care and therefore don't cover them. Home birth really isn't home care. If Tricare doesn't want to cover home births overseas, that's up to them, however, they should update their maternity section and specifically list home births.

If You Still Want to Have a Home Birth, Read This:
If you're going to have a home birth in Korea, here's a list of providers. You might also want to consider reading The Essential Homebirth Guide as well as getting some birthing supplies together.

I personally believe that women should allow to choose where they give birth as long as they are able to do so safely. Hopefully Tricare will change. I just wouldn't hold my breath. Since Tricare isn't covering home births overseas, you have three options.
  1. Choose a cheaper midwife. MediFlower is great, don't get me wrong, but they're also more than double what other birthing centers charge for people with Tricare.
  2. Choose to give birth wherever you want and pay out of pocket. Don't bother filing a claim.
  3. Go to the USA and find a CNM who will do home births.  

Tips for Dealing with Tricare or any Medical Insurance Company
This medical hack below has lots of tips to help you out. Many times the people dealing with claims are paid minimum wage and have no medical background. They're simply checking boxes. If a claim is denied, it's usually because certain boxes aren't check. The last thing you want to do is have someone with no medical background making decisions about your health coverage! So follow these tips below if your claims are denied. (This will not work for home births in Korea since they don't fulfill Tricare Overseas requirements).


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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Friday, 29 December 2017

Giving Birth at Pyeongtaek St. Mary's: Emergency C-section

It's been a year since I woke up from an emergency C-section at Pyeongtaek St. Mary's. As I mentioned in my other post I had planned on a peaceful home birth with Danica and Jinny from Mama's Birth Center. I had written about my birthing experience on one of my private blogs but since I recently made that blog public, I decided to publish it here as well.

My first birth was at Agitanseun Natural Birth Center (김옥진조산원) Kim Ok Jin (Rosa) at her old location in Ansan. Since then I had gotten involved in the natural birthing community and become a childbirth educator, postpartum doula, breastfeeding counselor, Dunstan Baby Language Educator, and La Leche League Leader. I felt confident in my abilities to give birth naturally and had planned on a home birth.

Unfortunately, it ended up with an emergency C-section. For those who say I shouldn't have attempted a home birth, I totally disgree. Had I been in the hospital during labor, I'm sure I would have had a much shorter labor before they did major abdominal surgery that left me with a 5.5 inch scar from the C-section. Labor is beneficial for both the mom and the baby.

I had a lot of difficulties coming to terms with it, especially since I 100% believe that the interventions led to the C-section, with pitocin most likely being the cause of it. It turned into a horrific nightmare. Yes, the baby's heart rate was at 90 when I was transferred to the hospital, but it then dropped to 60 while there. My midwife refused to give me pitocin because it can increase or decrease a baby's heart rate. I believe that had they not given me pitocin, I could have had a vaginal birth.  The information has been copied from my other blog, Stay Inside Baby!

Transferred to Pyeongtaek St. Mary's
Around 7pm her heart rate dropped to 90 (the norm is 120-180) so they transferred me to Pyeongtaek St. Mary's. I was only 4cm dilated but it felt like I was in transition.To make it worse the baby had just gone up a station. I had asked if I could wait an hour, but they said no. My neighbor came over and helped frantically pack a bag to go to the hospital.

I think going in they wanted me to get a C-section. I was given an epidural, oxygen, pitocin, antibiotics (since I had a cough and runny nose), fluids, and a catheter. I had an EKG test and multiple NSTs. I was not allowed to eat or drink anything. I was allowed to move but with IVs in both my arms plus a catheter, movement was very limited.

My doula and midwife came with, but the doctor quickly kicked them out. Luckily, Mary the nurse was on call that night and she was familiar with my case. My doctor, Dr. Lee was also there, but he didn't perform the C-section. 

I am fully convinced that them hooking me up to pitocin caused her heart rate to drop. My midwife had pitocin and refused to give it to my. Why? Because it can cause a baby's heart rate to drop or go up dramatically. Had I not been given pitocin, I probably would have been able to have a vaginal birth.

They bullied my husband into signing the papers by saying the baby could end up dead. The reason the baby's heart rate was dropping was due to pitocin and all the stress they were putting me through. They should have taken me off pitocin. I wish I had had advocates for me there, but they had kicked my midwife and doula out. This was my second birth and I had planned it well, yet all the interventions got out of hand, as they usually do.

Frantic Birth Plan
When I realised the baby was going to be born soon, I started telling them what I wanted and didn't want. I didn't have a birth plan because I hadn't planned on giving birth in a hospital. I was told that immediately after the birth I would be able to hold her and breastfeed her, so I said no formula. True to their word, they did not give her formula: they gave her sugar water. I wasn't able to hold her for 13 hours, not because she wasn't ok, but because I was unconscious and had IVs in my arm. I said delayed cord clamping, but that didn't happen either. They didn't bath her, but they sure scrubbed all the vernix off her.

Emergency C-section
Her heart rate dropped to 60 (the norm is 120-180) and then they gave me a spinal and took me to the OR. In the OR they gave me something in my IV that made me unconscious. My husband was not allowed in. She was born on her due date at 11:39pm. They briefly stopped the drip that kept me unconscious. I remember seeing the coiled cord in the bucket before I saw her. They didn't do delayed cord clamping like I had asked. Her APGARs were 8 and 9. She had a flat head on top which makes me think she was brow presenting which would explain the small measurements and failure to progress.

Recovery
Afterwards I was unable to move or open my eyes for about 5 hours. I could hear what was going on around me though. I was flat on my back for 8 hours in order to prevent a spinal headache. When I woke up I had short-term amnesia. I thought I was in Peru with my ex. I left Peru almost 6 years ago. 13 hours after the C-section they took the catheter out and I was able to walk. Contrast that to my first birth where I walked out of the birthing center 8 hours after giving birth.

I was given antacids, antibiotics, and pain killer pills three times a day. I really don't think they helped. I ended up with 2 ketoralac shots 8 hours apart on the second day because the pain was so bad.

I was alone so I had to do everything myself, like bus my food trays four times a day and walk to the nursery. The food was decent. I got three meals plus a snack. I was able to choose between Korean food and Western food. I decided to go with Korean food since I knew that the cooks could cook Korean food. I certainly didn't eat everything. I didn't really like the food, so my daughter and husband got some. There wasn't much fruit. I think I got fruit once or twice, so my husband brought me some.

Amazing Nurses
I really didn't enjoy my recovery time at Pyeongtaek St. Mary's. However, the nurses and international clinic were amazing. Mary and Luna helped me fight against some of the policies and worked with me even though they might not have agreed with what I wanted. They helped me breastfeed without taking the class, breastfeed on demand, got the baby into my room, got me discharged early, and allowed visitors outside of visiting hours. 


Not Being Allowed to Hold the Baby
I still hadn't held my daughter. I was told that it was hospital policy that while I had an IV in my arm I couldn't hold her. They wanted to keep me on morphine, fluids, and antiobiotics for 1 day and then do 2 more days of antibiotics for my upper respiratory infection (aka the common cold).

Meaning that if I followed what they wanted, I would be able to hold her on the 4th day. I'd be free to look at her through the windows though. I told them to stop the morphine and fluids and that I didn't want antibiotics. I'm not sure if you've ever been suddenly taken off IV painkillers and given Motrin instead, but let me save you the trouble about imagining what it's like and tell you that headache medicine does not help when they've put a 5.5 inch incision into your lower stomach. It just doesn't work. They took all the IVs and catheter out and then I was taken to the nursery.

Being Told I Wasn't Allowed to Breastfeed
I was shown the baby through the glass and when I asked to breastfeed her, remember, it's been a little over 13 hours and all she's had was sugar water, I was told no. Why? I'm glad you asked! I had to take a class before I was allowed to breastfeed. Thankfully, Mary was there and told them that this was my second child, I'd breastfed my first until she was 4, I actually teach breastfeeding classes, and I was one of two La Leche League Leaders in Korea. After about 10 minutes of arguing how I was able to breastfeed, they finally "permitted" me to hold her.

Let me just tell you that the "class" they teach must be pretty crappy. All women were given nipple shields and they all used them, they "cut" their breasts instead of used C or U holds, and they were leaning forward.

Where Babies Can Stay
You had two choices about where the baby would stay: the nursery or your room. You couldn't take the baby to your room and then put them back in the nursery. Since it took me about 15 minutes to walk 10 feet (remember Motrin to recover from a C-section), I could barely take care of myself, so she stayed in the nursery. The first night she was in the nursery and my husband spent the night with me. The second night she was in the nursery and my husband was at home. The third night, we finally got her in my room and my husband spent the night with me.

If they're in the nursery, you're "allowed" to feed them 5 times a day for 30 minutes each. Five. They actually listed 6 times on the information sheet in the nursery, but I was told it's really 5. This is only for breastfeeding moms. So if you breastfeed, you get to spend a total of 2.5 hours a day with your baby. Yeah, that's healthy. If you aren't breastfeeding and would like to hold your baby, you either take your baby to your room or wait until you get home. Lovely.

Now, in order for a baby to be healthy and a mom not to lose her milk supply, a baby should eat a minimum of 8-12 times a day. Let's do the math. . . 12 divided by 5 means they're letting you feed the baby less than half of what is required for a baby to thrive. Thriving isn't just about nutrition, it's about touch. 2.5 hours a day with their moms, definitely not a healthy environment. Now let me just explain that all these rules are for normal, healthy babies. They're not in the NICU, they're not sick, they're totally health.

Of course, they could supplement the baby with formula or breastmilk in the bottle, but if you're trying to breastfeed, bottle feeding just isn't helping. Yet another reason why their breastfeeding "class" is crap.

I was pumping. My husband brought my pump since their pump "wasn't working" Fantastic, right? On Friday, I decided that I'd had enough and told them I wanted to be called every time she was hungry. They called me about every hour. It was horrible. It was hard enough walking to the bathroom, now I had to go downstairs (in the elevator, but still) about every hour. Thankfully, I knew my husband was coming that night and we were going to get her into our room. 

Having the Baby in Your Room
The third night (Friday) we finally got the baby to our room. No easy task. We had to sign a few papers, all in Korean, no idea what we signed. And even then they didn't want to hand our own child over to us.

We had to keep the room at a minimum of 26 degrees (78.8 F), but they preferred 28 degrees (82.4 F). We had to fill out a paper saying how often she peed, pooped, and ate. That paper was checked by a nurse at night and in the morning.

My Husband's Accommodations
No pillows or blankets are given for dads. Just a gym mat. We asked and again were told that it was against hospital policy. I was sweating so I gave him my blanket.

Dads are only allowed 30 minutes a day with their babies and that's from 8-8:30pm. Moms aren't allowed in during that time. There are no exceptions. My husband decided to keep working while I was in the hospital because then he could get 14 days off in a row. Plus, why waste days when I was in the hospital? And someone had to take care of my first child.

He missed the birth, but saw her through the glass before I got to see her because they knocked me unconscious. I got to hold her, but he didn't. He never got to bond with her during those first two days. He was about ten feet away, looking at me when I breastfed, but was told it was "against hospital policy" for him to hold his own child.

Trying to Leave the Hospital
When went in on a Wednesday night and were told 5 days, which meant that we were supposed to leave on Sunday since they counted Wednesday as day 1. Then we were told if we left on a Sunday, we would be charge 50% more since the accounting staff wasn't working and they weren't sure of the exact charges. What they'd do is overcharge us and then on Monday we would come back and sort everything out.

I'd had quite enough of the hospital policies, so decided to try to leave early. On Thursday, we asked to leave early. They said no. Imagine that. Even though both of us were perfectly healthy. On Friday, in the morning, after we got the baby into our room, we then informed them that we were leaving the next day. They tried to talk us out of it. Got a nurse, a doctor, acted very concerned. We politely insisted.

Saturday morning around 7am, I was given the ok. It took them about 4 hours to finally discharge us. We had to pay and get meds, which consisted of antacid, pain killers (yea Motrin, totally not enough), and antibiotics for my upper respiratory infection (common cold). But we finally left 2.5 days after arriving.

Interventions
A c-section is major abdominal surgery. They are necessary at times, but when 33% of women given birth are given them, you know they're taking advantage of the situation. Interventions are the #1 reason why I tell people to pick a good place to give birth. Here's what was done to us in the 2.5 days we stayed. There might have been more, but this is what I can think of now.

In Labor
  • Epidural
  • Oxygen
  • Pitocin
  • Antibiotics
  • Fluids
  • Catheter
  • EKG test
  • Multiple NSTs
  • Not allowed to eat or drink anything
The Birth
  • Being knocked unconscious for the C-section
  • Immediate cord clamping
  • Rubbing off the vernix
After the Birth
  • 5 hours being unconscious
  • Amnesia
  • 13 hours flat on my back
  • Baby being given sugar water 
  • Baby in the nursery
  • Being told I wasn't allowed to breastfeed
  • Only being able to hold the baby five times a day for 30 minute at a time 
  • Antacids, antibiotics, and pain killer pills twice a day 
  • 2 ketoralac shots
  • Husband not allowed to hold the baby until day 3
Complications Afterwards
11 days after the baby was born, my left breast was super hot and painful. I had no energy, just wanted to sleep and had a slight fever. I went to the ER at Osan AB and was told my WBC (white blood cell count) was 19,000 and the norm is supposed to be about  4,500-11,000. They did loads of tests: blood, urine, breastmilk, nose mucus, ultrasound on my breasts, temperature checks, blood pressure, and possibly more but I can't remember.

I was diagnosed with mastitis, which I fully believe was due to Pyeongtaek St. Mary's only allowing me to breastfeed 5 times a day.

The doctor originally wanted me to put me on meds, but I was allergic. His number two choice was to stop breastfeeding for 2-3 days while they dripped antibiotics into me. No thanks. Stopping is the worst thing you can do. They admitted me and the baby overnight and gave me antibiotics. My husband stayed with me the first night because I was still recovering from my C-section. They decided on day 2 that I should stay another night. We hadn't wanted to since that would mean missing the baby's appointment to get her passport, but my WBC was still high, so the baby and I stayed another night. My husband wasn't able to stay because we didn't have anyone to take care of my daughter. I left on the 3rd day. The next day they called me and told me I had a mild case of MRSA that I had caught while at the hospital (since I didn't have it when I went in) but that I wouldn't need treatment.

Final Thoughts
Although I loved the prenatal care I got there I would not recommend birthing there. Here's a list of places around Korea and here are 6 birthing centers in and around Seoul.

I know some people say that all that matters is that you have a healthy baby, but I don't believe that at all so please don't say that to me. I planned for a peaceful home birth and ended up with everything I didn't want plus complications afterwards. With all the difficulties we had with miscarriages, this complicated pregnancy, and a nightmare birth, we have decided that we are done with having kids.



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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Thursday, 28 December 2017

Home Birth with Danica and Jinny from Mama's Birth Center

It's been a year since my second child was born. I had written about my birthing experience on one of my private blogs but since I recently made that blog public, I decided to publish it here as well. My first birth was at Agitanseun Natural Birth Center (김옥진조산원) Kim Ok Jin (Rosa) at her old location in Ansan. Since then I had gotten involved in the natural birthing community and become a childbirth educator, postpartum doula, breastfeeding counselor, Dunstan Baby Language Educator, and La Leche League Leader. I felt confident in my abilities to give birth naturally and had planned on a home birth. Unfortunately, it ended up with an emergency C-section. I had a lot of difficulties coming to terms with it, especially since I 100% believe that the interventions led to the C-section, with pitocin most likely being the cause of it. Below you can find out more about my experience with laboring at home with Jinny and Danica. The information has been copied from my other blog, Stay Inside Baby!

Labouring at Home with Danica and Jinny from Mama's Birth Center
I mentioned before that I was having a home birth. My midwife came to check out my house a few weeks before and I showed her my birthing box that I had prepared. Then she dropped off a bag full of supplies as well as oxygen.

I'd been having contractions for the past two nights. My husband and I had just gone to the pharmacy to get some cough medicine. I was having minor contractions but thought nothing of it. He went back to work and about 20 minutes later my water broke. I called him and told him and he asked if I was kidding since I had just told him to go to work. I then cancelled my doctor's appointment that I was supposed to go to. While on the phone I had sent kakao messages to my Jinny my doula and Danica my midwife. I texted my neighbor and asked her to pick up my daughter from daycare.

The midwife and doula arrived around noon and I was only 2cm dilated but it felt like I was further along. The contractions picked up in intensive pretty quickly and all I wanted to do was stay in the bathtub. It was comfortable and I didn't have to worry about peeing myself. The baby was sunny-side up so labor was much more intense than my first. Being in labor with a sunny side up baby is a lot more intense than being on pitocin with no painkillers. I spent a lot of the labor straddling the toilet in reverse and in the tub.

My husband was not that helpful to be honest. He went in the bedroom and was watching The Simpsons. My doula did pull him out of the bedroom and got him to help while I was on the birthing ball. She took photos so he does have proof that he helped. However, he said he didn't think he was needed since I had a midwife and doula. I don't think he really knew what to do. (He should have paid more attention in the birthing class).

We tried to flip the baby by side lying and hanging my leg off the couch. It just wasn't working. My midwife kept checking the station, dilation, and heart rate and things weren't looking good.

Transferred to Pyeongtaek St. Mary's
Around 7pm her heart rate dropped to 90 (the norm is 120-180) so they transferred me to Pyeongtaek St. Mary's. I was only 4cm dilated but it felt like I was in transition.To make it worse the baby had just gone up a station. I had asked if I could wait an hour, but they said no. My neighbor came over and helped frantically pack a bag to go to the hospital.

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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Wednesday, 1 November 2017

Common Tests and Interventions Done Prenatally, During Labor and Birth, and Postpartum in Korea

 The Mayo Guide to a Healthy Pregnancy
Buy from Amazon
While your caregiver will offer all these tests and interventions, it's up to you to accept them. They don't typically ask you if you want them However, you can ALWAYS have a choice and can opt out and say no. Even if you say no, your doctor is not likely to "fire" you or refuse you care. More often than not, they'll just think you're weird.

You might also be interested in reading the following:

Tests and Interventions Done Prenatally in General
  • Ultrasounds, weight, and blood pressure are done at every doctor's visit.
  • Being told not to gain too much weight or even go on a diet if you're overweight.  
  • No medicine offered to help with morning sickness.   
  • Flu shot.
First Trimester
  • Monthly visits until about 28 weeks.
  • Blood and urine tests during the first visit to test for things such as protein in your urine, thyroid function, liver function, Hep B, titers for immunities to childhood disease, blood type, and HCG level. 
  • Pap smear during the first visit to test for abnormalities and STDs.
  • Chorionic villus sampling (CVS) done between 10-13 weeks if you're over 35 or high risk.
  • 4D ultrasound done around 12 weeks as part of the Nuchal Translucency (NT) test.
  • First trimester screening around 12 weeks which involves the NT test and blood test to test for chromosomal abnormalities.
Second Trimester
  • Monthly visits until about 28 weeks.
  • Amniocentesis done between 15-20 weeks if you're over 35 or high risk.
  • Triple or Quad test done between 15-20 weeks to test for chromosomal abnormalities.  
  • Flu shot during winter.
  • Gestational diabetes (GDM) test done between 24-28 weeks. 
Third Trimester
  • Visits every two weeks between about 28-36 weeks.
  • Weekly visits from 36 weeks until you give birth.
  • Rhogam shot given around 28 weeks to Rh- moms.
  • Blood test to check for anemia and cholesterol levels done between 28-32 weeks.
  • Internal ultrasound / exam to check cervical length done between 28-32 weeks.  
  • Urine tests done between 28-36 weeks to check for protein in your urine.  
  • DTaP shot after 32 weeks.
  • Non-Stress Test done around 36 weeks.
  • Group B Strep (GBS) test done around 36 weeks.
  • X-Ray done around 36 weeks to rule out tuberculous. Not as commonly done as before.
  • EKG done around 36 weeks to check for abnormalities that might interfere with medicine given during birth.  
  • Induction at 41w3d.
Tests and Interventions Done During Labor and Birth
  • Induction done after 12 hours of water breaking if 36+ weeks.
  • Vaginal exam upon admittance and then every hour.
  • Monitoring blood pressure and temperature.
  • Fetal monitoring for 15-20 minutes every hour using a belt strapped across the mom's belly.
  • Enemas.
  • Shaving of pubic hair.
  • IVs for fluids, antibiotics, and/or glucose. 
  • No food or drink during labor.
  • Birthing on your back.
  • Episiotomies (an incision made from the vaginal wall). 
  • Pitocin.
  • Coached pushing aka purple pushing.
  • Immediate clamping of the umbilical cord.
  • Pitocin and massage to birth the placenta.
  • "Emergency" C-sections. The rate for Korea is about 33%, which is the same as the USA.  
  • Rhogam shot given up to 72 hours after given birth if the mom is Rh negative.

Tests and Interventions Done Postpartum
  • Suctioning the baby's airway after birth.
  • Washing the baby with soap and water.
  • Taking the baby away immediately to be weighed and measured.
  • Taking the baby to the nursery.
  • NICU: Seeing your baby twice a day for 20 minutes. Info about NICUs in Korea. 
  • Feeding the baby formula and/or sugar water.
  • Erythromycin Eye Ointment.
  • Vitamin K shot. 
  • Hepatitis B shot.
  • PKU test done between 3-4 days old.
  • Bacille Calmette-Guerin (BCG) shot for TB given around 2 weeks.
  • Staying 3 days (if a vaginal birth) - 5 days (if a C-section).
  • Check-up at 6 weeks for the mom.
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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Monday, 3 April 2017

Miscarriage, Pregnancy Loss, Neonatal Death, and Infant Loss Support in Korea

 Beyond Tears: Living after losing a child
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Updated 23 March 2018

Losing a child is something no parent should ever have to go through. There are technical names for the losses depending on when they occurred, however, the result is the same: the baby is gone.

Many women suffer from miscarriages and some do not even know they were pregnant. A baby is usually considered stillborn if the loss happens after 20 weeks and if it happens before then it's considered a miscarriage. A very early miscarriage (before 5 weeks) is usually considered a chemical pregnancy. Neonatal death is when a baby dies within the first 28 days of life. Infant death is between 28-364 days.

Time legally allowed off work
This is from Live in Korea.

image source

What to do
There are places to seek out help and talk to people who have been through the same experience, trained volunteers, as well as professional counselors and social workers. There are also a number of books written on this topic.

Depending on how old the baby was, many families find that photos or memory boxes (here's a list of what you can add to your memory box) can be very comforting. Others create certificates of life for their child that they lost in utero, such as the ones available at Bears of Hope, Grief Watch, and Memorial for the Unborn.


Support in Korea, both online and in person


Online Support in Korea (these do not deal with loss specifically)

Counselors and Social Workers in Korea


Online support, not specifically for Korea
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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Tuesday, 9 August 2016

New Birthing Center in Seoul, Korea

http://www.gmcheil.co.kr/en.htmlNatural birthing has changed a lot in Korea in the past five years. Nowadays you will find natural birthing clinics (that usually have a C-section rate of 10% and below), women's clinics, and even major hospitals that offer things such as birthing tubs, rooming-in, and freedom of movement. Many places have doctors, midwives, nurses, and staff who speak English. Here's a list of some popular places to give birth in Korea. Doctors are starting to recognise the importance of doulas and allowing women to make choices about their birth.

In the spring of this year, another natural birthing center opened up in Gwangmyeong, which is in the western area of Seoul. GM Cheil Women's Clinic located right outside exit 3 of Gwangmyeong Sageori station at 896 Gwangmyeong-ro, Gwangmyeong, in Gyeonggi-do (phone is (02) 890-2555 and the fax is (02) 890-2554) have three floors dedicated to helping women get the birth they want, whether that be a hands-off birth or a C-section. They are very accommodating to women who want to use doulas.

While the doctors are not fluent in English, they have studied abroad and are able to understand. Julia, a midwife who used to work at Yeon and Nature, speaks English and has experience working with foreigners. They also have an IBCLC who can help with breastfeeding. Unfortunately, they do not attend home births now, but hopefully they will in the future. Here's a list of English speaking doctors and midwives who will do home births.

In June I got the chance to visit GM Cheil and was given a tour by Julia. When I walked in on the 7th floor I was struck by how peaceful it was. The area is bright and open. The check-in area, doctors' offices, and the IBCLC's office are all here.

The 8th floor is where the delivery rooms are located. GM Cheil only has private rooms and are equipped with birthing tubs, toilets, birthing balls, a birthing stool, a queen sized bed, a table and chair, a bassinet, necessary toiletries and for mom and baby. They also have peanut balls that are available upon request. All rooms have floor to ceiling windows with thick drapes, the ability to dim the lights, and control the temperature. While they don't have a NICU, they do have one incubator available so if there are minor issues you don't have to worry about being transferred to a hospital. The education center, where yoga and birthing classes take place, is also located on this floor.

After delivery, many women choose to move to the 9th floor for recovery. Rooms on this floor are also private and each room has two twin beds: one for the mom and one for her partner. These rooms are also equipped with toilets and showers, a small table and padded stool, a foot stool for breastfeeding, a breastfeeding pillow, and necessary toiletries for mom and baby. They provide a small gift bag for moms afterwards which consists of a baby outfit and a placenta print. There is also a small shampoo room here. GM Cheil is always thinking about how important the little things are, such as having a place to wash your hair after giving birth. They have a small room with a salon chair. After giving birth it allows the mom a chance to feel pampered as her partner washes her hair.

I took photos but they don't do justice to how amazing GM Cheil. You can check out their website or visit and ask for a tour. Prices vary according to what type of insurance you have, but you can expect to pay about what you would pay at Mamas' Birth Center or half of what Medi Flower and Yeon and Nature charge.

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Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


Tuesday, 15 December 2015

2016: Upcoming Events and Resources

Updated 28 September 2016

I am currently only offering breastfeeding support in the Osan area. Please see this post to find people who work in the birthing field, such as birth doulas, breastfeeding counselors, childbirth educators, Dunstan Baby Language educators, HypnoBirthing® practitioners, IBCLCs, infant massage instructors, nutritionists, postpartum doulas, placenta encapsulation specialists, pre and post-natal massage therapists, and pre and post-natal yoga instructors. Feel free to contact me with any questions.

Upcoming Events
Baby Fairs

La Leche League: a breastfeeding support group.

Milky Mamas Meetings: a breastfeeding support group.
    • Seoul: 4th Thursday of every month at the Yongsan Family Health Centre on the 3rd floor in a brand new building right next to the Hannam Dong Jumin Centre (한남동 주민 센터) from 11am-1pm. More info can be found at MMKorea Nursing Support. You can also contact Melanie, Leila, or Sheila.


    Support
    Breastfeeding Support
    • I offer breastfeeding support that can be done in person, on the phone, or via Skype. I can help with latch, positioning, knowing whether your baby is hungry or getting enough milk, and common breastfeeding problems.

    Resources
    Tender Embrace Birthing contains a number of resources such as . . .


    About Me
    I've been involved in the birthing field since early 2013. I am certified as a childbirth educator, postpartum doula, breastfeeding counselor, and Dunstan Baby Language Educator. Check out my about me to learn more about my training and experience.You can also see what people have said about my blog and services.


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    Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


    Wednesday, 9 December 2015

    Childbirth All or Nothing: BBC Documentary 2015

    This documentary follows four women and the different choices they make to birth their babies. It focuses on extremes, hence the name "All or Nothing". From a home birth with a midwife, a home birth in water, an unassisted birth aka a free birth, and a planned C-section you'll see why they made the choices they made. Other topics discussed are . . .
    You can watch the full 50 minute documentary on YouTube and read more about it at In Pursuit of Midwifery. You might also be interested in The Business of Being Born. There's also a sequel, called More Business of Being Born, which has four parts.
    1. Part 1: Down on the Farm
    2. Part 2: Special Deliveries
    3. Part 3: Explore Your Options
    4. Part 4: The VBAC Dilemma
    Two other good films are: Orgasmic Birth and Organic Birth and Organic Birth. 
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    Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


    Monday, 7 December 2015

    Doctors and Midwives Who Will Do Home Births in Korea

    Updated 23 September 2017

    Home births aren't that common in Korea and only a few doctors and midwives who do them speak English. If you're going to have a home birth, read the information in The Essential Homebirth Guide. It will definitely help you and your partner out.

     The Essential Homebirth Guide
    Buy from Amazon
    The Korean Midwives Association has a handful of midwives who usually don't speak English, but are willing to do home births and travel. Below you can find a list of doctors and midwives that speak English. They are all in Seoul and Gyeonggi-do, however, they may be willing to travel. Here is more information about birthing centers and hospitals in Korea.

    Some places accept Korean health insurance. I also wrote an extensive article on Tricare. Keep in mind that Tricare does not cover home births overseas.You will be paying completely out of pocket if you have Tricare and want to have a home birth in Korea.

    Kim Ok Jin (Rosa) Agitanseun Natural Birth Center (김옥진조산원)
    Kim Okjin, Midwife aka "Rosa"
    401-1, 3F Saeyang Chungmaru Sang-ga Naeson 2-dong, Uiwang, Gyeonggi-do 
    경기도 의왕시 내손2동 401-1 세청마루상가 3F
    Telephone: (031) 410-8597
    Cell: 010-2447-8231 and 019-447-8231
    ojkim80@hanmail.net
    Near Indeogwon station
    • Expect to pay about 3.5 mil for a home birth.

    Lee Myung Hwa (행복한이명화조산원) they used to be Happy Birth
    Seonbu-dong 1070-12 Gwangwon Building Office 208, Danwon-Gu, Ansan, Gyeonggi-do
    경기도 안산시 단원 선부동 1070-12관원빌딩 208호
    Telephone: (031) 410-3573 and 010-2803-3573
    • Lee Myung Hwa is the midwife.

    Mamas' Birth Center 
    3rd floor, Daesakwanro 60 Yongsan-gu, SeoulTelephone: (02) 797-3573
    Danica: 010-7170-1099.
    • They also work with Jinny, a doula who speaks English and Korean.
    • They do home births in Seoul only.  Home births are 1.2 mil and are only done in Seoul. All prices are with Korean National Insurance.  If you don't have KNI, it will be more expensive. Expect to pay about 3 mil.

    Medi Flower
    Dr. Hwanwook Chung
    2nd Floor of Lotte Castle Medici, 1656-4 Seocho-dong, Seocho-gu, Seoul
    Telephone: (02) 548-9400 (Press 9 for English)
    Near Kyodae subway station
    • They attend home births. Expect to pay about 3.5 mil if you have Korean insurance or about 8 mil if you don't.This is the most expensive home birth option available.
    • Dr. Chung is the most amazing "labor whisperer". 
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    Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.


    Tuesday, 20 October 2015

    Recommended Books

    Here's a list of all the books I've recommended.
     What to expect when you're expecting
    Buy from Amazon

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