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Birth Plan Fee

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mom to be
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Birth Plan Fee

Postby mom to be » Fri, 27 Feb 2009 5:53 pm

Hi, I would like to check with all the mothers if anybody encounter the same experience as mine.

I need to pay extra S$300 to my gyne. Otherwise, she wont except any birth plan. Should I pay her or is it illegal for her to charge me birth plan fee? Other gyne will they charge such service and how much?

Im 34 weeks pregnant now and in need of answer badly. My gyne is Dr. Heng from east shore hospital. Thanks!

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lainy
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Postby lainy » Mon, 02 Mar 2009 5:47 pm

she did what?? i must say that nothing surprises me anymore! my OB is utterly uninterested in my birth plan - i am 34 w as well...and is not very conforting to know this now....
seriously why is it such big deal? what exactly is she charging you for? the fact that you wish/don't wish painrelief and you would like to inform her now??
absolutely insane. i really don't think it is legal...
lainy

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Postby batgirl_cdn » Wed, 04 Mar 2009 9:28 am

It is completely unacceptable for an ob-gyn to charge a fee for a birth plan. Also, if your ob-gyn isn't interested in your birth plan, change doctors, even in late stage of pregnancy. They aren't the kind of person you want at your birth. Remember, they are working for you! You pay their fees.

A doc isn't even needed for birth unless there is a serious complication, which is very rare. Stand your ground and be firm about your wishes. Remember that your husband must ensure that nurses and docs stick to the birth plan providing that it doesn't harm mother or baby in the event of emergency.

You need to educate yourself about what constitutes an emergency and what the consequences are to accepting some interventions commonly done by medical staff. Ask the doc questions about why they want something done, don't accept his/her word straight away, because they often recommend things only to speed labour for them, which can make a stressful and complicated birth for mother and baby.

If anyone is interested, Dr. Lai Fon Min at Camden, and Dr. Paul Tseng at Thomson, are the best docs in Singapore to go to for respecting wishes about birth. You won't have to struggle much with them because they believe that women can give birth without intervention if all is going well.

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Postby mom to be » Mon, 09 Mar 2009 5:32 pm

Hi All,

Thank you for the reply. I wish to change doctor but now I'm 35 weeks and my husband suggest me to stick with the same doctor as she got my full record of pregnancy history.

Just wondering if anyone here are using the same gyne as mine, Dr. Heng Tun Lan, then maybe can share her birth experience and cost :???:

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Postby batgirl_cdn » Thu, 12 Mar 2009 9:39 am

Why can't you just bring your medical record to a new doctor? I've heard of one lady here in Singapore changing her doc during labour because her doc wouldn't do a vaginal breech birth. She switched to a doc who did and the birth went just fine - baby perfect, no c-section needed.

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Postby viajera » Thu, 12 Mar 2009 11:28 am

i agree with batgirl_cdn. a friend of mine arrived in singapore when she was 32+ weeks pregnant. it's really no problem seeing a new doctor even at this late stage if your pregnancy has been normal.

equally important, and they are linked, is the hospital where you wish to give birth. the nursing staff and facilities will also be important factors in your birthing experience. come to think of it, i didn't see my doctor much during my stay in the hospital-- probably half an hour during the delivery and 5-min checks the days after.

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Not to late to switch

Postby playfulmom » Mon, 11 May 2009 11:50 am

My friend had a birth plan and her doctor (at TMC) was ignoring it too. Finally at 39 weeks, the doctor said she was being too pushy about trying to go naturally and MADE her swtich doctors over to Paul Tseng.
Can you believe it?
So, no 35 weeks is not too late at all.
By the way, my friend had a natural birth in the end.

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Postby sabs » Mon, 11 May 2009 1:32 pm

i didn't pay for the birth plan and i didn't know about birth plans. My gyn Dr. Motoko Yeo wanted me to think about my birth wishes and she gave me an example of an birth plan.

She was great.


And i was in the same week like u because we moved to singapore in the 6 pregnancy month and then i looked for a month or longer for the right gyn for me.

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Re: Not to late to switch

Postby batgirl_cdn » Mon, 11 May 2009 11:44 pm

playfulmom wrote:My friend had a birth plan and her doctor (at TMC) was ignoring it too. Finally at 39 weeks, the doctor said she was being too pushy about trying to go naturally and MADE her swtich doctors over to Paul Tseng.
Can you believe it?
So, no 35 weeks is not too late at all.
By the way, my friend had a natural birth in the end.


I'm 36 weeks and have just changed docs. Some women have changed in labour! If you aren't happy with your doc or he/she won't respect your wishes, please don't be afraid to change.

Some docs are really in the Dark Ages here in Singapore. I'm so glad that your friend switched and had the natural birth she wanted. It is really worth fighting for!

In my first birth (not in Singapore) the doc ignored some parts of my birth plan. I said no episiotomy and she did one with the excuse that the baby's heart rate was dropping, even though I was already tearing to make way for the baby! My son was completely alert and responsive moments after birth, so where was the distress that necessitated the episiotomy? How was I in a position to argue with her when I was in the middle of birthing my baby and focused inwards on the task? I feel she abused her power in a vulnerable situation. She also cut the umbilical cord before it stopped pulsing and nurses wouldn't give a blanket for the baby while he was resting on me because they just wanted to take him away as soon as possible to do their usual procedures. If you don't have a birth plan and dad (and mom if capable) don't stay firm, then hospital staff will just do what is convenient for them. They need to have more respect for the people who are paying their fees and trusting their bodies and precious birth experience to.

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Doctor fees and procedures

Postby playfulmom » Fri, 15 May 2009 9:25 am

Batgirl, thanks for bringing up this great topic.

There are not enough mechanisms in Singapore to protect health care consumers. Women are often not given all their options, or given incomplete information so they can be rushed into a decision.

The government has done a decent job of creating transparency in fees, especially at hospitals. But doctors are always keen to "up-sell" to unnecessary procedures and give dodgy reasons for why their advice makes sense.

Moms, make sure you or a partner (husband, doula or friend) research es anything new that your doctor advices. Look for key terms like "evidence-based practice" or "medically necessary".

Do not rely on Singapore-based medical information because you will be drawing from a small % of the medical data available to you. Use sites from the US, Canada, Europe and Australia where the government/insurance is more active about monitoring not only doctor's fees but their decisions (i.e. questioning their actions).
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Postby batgirl_cdn » Fri, 15 May 2009 11:17 am

I agree playful mom, but I'd even say it goes beyond Singapore. Women everywhere in the world using highly medicalized birth facilities are treated as high-risk as default and interventions are done that parents can't complain or get justice for unless the baby dies as a result. If the baby is healthy then no one wants to listen about the unnecessary frightening or traumatic experience that mom and baby had. Many parents feel convinced after that they needed to go through such a bad experience to get their healthy baby in the end, which is so sad.

If parents don't know what procedures are typically done for a hospital birth from entry to hospital to exit from hospital they should ask to be walked through step by step. Do the research after and ask why things are done! There is absolutely nothing wrong with making a birth plan that tells hospital staff what procedures you will accept and what procedures you won't. Doulas in Singapore are in a tough spot because they can be ejected from the mothers room if the staff get upset that she is interfering, so it is up to dads or other family members who are birth companions to stand up for mom's right to not undergo some procedures. Of course you need to be flexible in the rare event of emergency to baby or mother. The problem is, this is sometimes abused by docs - as in the episiotomy given to me. Doc claimed fetal distress but there was none, the doc simply wanted the birth to go more quickly.

The worst thing mom can do is just turn up at the hospital and hand herself over to the "medical professionals" for the birth. If you feel there is nothing wrong with this, just beware, because you can very well open yourself up to a traumatic experience that leaves you wondering after, "What if...". You can only give birth to your baby once, so why not try to make it as gentle and wonderful as possible, with as few people meddling in the experience as possible. Remember, the majority of women are fully capable of birthing their babies without interventions! Women have been doing this since the beginning of time!

This link is a good start. It contains further links to useful articles that delve into some of the topics for consideration. Interactive Birth Plan at childbirth.org - http://www.childbirth.org/interactive/ibirthplan.html When we made our birth plan we also included our wishes about routine vitamin k for the baby, as well as initial immunizations. In Singapore some hospitals are still trying to shave and give enemas to mothers, so that could go into the birth plan as well.

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Who will be your advocate in the hospital?

Postby playfulmom » Fri, 15 May 2009 11:44 am

Thanks for the link and I totally agree.

Yes I have been shocked to hear about doulas being forced out of hospital rooms in Singapore so that doctors could convince their patient to get induced or have a C-section. Ladies, when you are too stressed/ tired/ drugged to know what to do make sure you have a strong advocate standing by...

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Postby cbavasi » Fri, 15 May 2009 11:56 am

Also be sure to check the hospital policy on who is allowed in the delivery room. At Gleneagles my mother was only allowed in the room until I needed to push and then was made to leave. She actually should not have been in the room at all but she pled a good case with the nursing staff and was allowed to remain.

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Postby batgirl_cdn » Fri, 15 May 2009 12:24 pm

cbabavasi, that is another new bit of info for me too! I can't believe they have rules about who can be in the delivery room with you. Was your husband still there with you, or were they expecting you to birth your baby with no companion but the nurses and doc?

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Postby cbavasi » Fri, 15 May 2009 1:34 pm

My husband was there and you are allowed to have a doula but the hospital policy was that only one family member could be with you in the birthing room. This was in 2007 - so maybe the rules have changed - but best to check what the policy is for the hospital you choose to deliver at.


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