Shop around for that special delivery

With the coming of the economic downturn, more hospitals have developed so-called baby or maternity packages, so that customers have a better idea of what the final price of delivery might be. Usually three packages are offered: for normal delivery, normal delivery with an epidural, and caesarian section delivery. The quoted price usually includes the delivery team and necessary medications, and a limited length of stay.

Bangkok Nursing Home’s Dr Boonlert Triam-amornwooth advises that a couple choose a package that’s financially manageable, and that they carefully check to see what’s included, although they usually don’t vary much. Complications requiring extra treatment and medication, though, will increase the cost. "Patients sometimes pay more than the package, but most births are standard," says Dr Boonlert. Even if the delivery is normal, though, extra costs may be incurred. For instance, a baby with jaundice may need to be kept under observation for a third night, and normal packages usually include only a two-night stay; this will add to the bill.

Dr Boonlert also notes that while cheaper packages suggest the quality of facilities and care might be lower than elsewhere, even an expensive package won’t guarantee that a birth will go smoothly.

But price is just one of the many factors to consider when choosing a hospital to have your baby at. "People should not choose their hospital based on the package – the benefits of the package are only financial," says Samitivej Hospital’s Dr Yaowaluk. You should like the hospital; take a walk through the wards to get a feel for the place. And ask questions on the issues that matter to you; the warmth of the staff and their willingness to help you are important in gauging the level of care you’ll be given.

Another important factors will be choosing a doctor you trust. "The patient should try to find a doctor they feel confident and satisfied with, and who can answer the questions they have," says Dr Boonlert. For many, where their doctor works will be the decisive factor in choosing the hospital.

Sound out the facilities and availability of staff, too. "Check that your doctor is on call all of the time in case of an emergency and make sure that the operating room can be opened very quickly," suggests Dr Boonlert. "Ensure that an anaesthetiologist will be available at all time, and that after delivery, a paediatrician will be on call."

Prospective parents may also want to check on the hospital’s rate of Caesarian sections. The standard rate in the US for 1995 was just over 20 per cent. Your doctor’s individual attitude that is very relevant, so try to find out your doctor’s personal rate.

Another important statistic is the rate of administration of epidural anesthesia, which is thought by some to increase the length of labour, the likelihood of a caesarean section or the need to use forceps. As well, ask how many high risk births a hospital deals with, and how many sick infants they care for. It might be difficult to interpret the statistics, but knowing that a hospital keeps careful records can be an indication of their professionalism.

If breastfeeding is important to you, choose a UN-designated baby-friendly hospital. These are hospitals that support breastfeeding (for more information, see http://www.who.dk/who%2Deuro/about/babies.htm#ten. In Thailand, Samitivej Hospital and all public hospitals except university teaching hospitals are designated baby-friendly). Also find out the percentage of mothers who have successfully breastfed their infants at that hospital.

And in a town with traffic problems like Bangkok, proximity to the hospital is another consideration. "It may come down to choosing which hospital is convenient to your residence, in order to avoid traffic problems," says Dr Boonlert.

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