Maternity Care In Thailand: What The Options Are And How To Decide On A Birth Plan
Wherever you live, access to good quality care during pregnancy and labour is important. If you are living abroad, particularly if you are not yet fluent in the language of your new home, finding the right plan can be stressful, and you may encounter cultural differences. We recommend that you start the process of choosing your doctor and birth plan as early as possible.
The Thai healthcare system is modern and ranks amongst the best in Asia. There are three tiers: public hospitals, premium clinics and private hospitals. The state-run public system offers universal healthcare to all Thai nationals. In addition, if you are working in Thailand or have become a permanent resident, you are legally obliged to pay into the national insurance scheme. This grants you free access to healthcare in your area. If you wish to use a different hospital to the local one, or you need to be transferred, you will have to pay extra.
As a result, it is a good idea to have private health insurance, alongside the national scheme. Expats who are neither working in Thailand nor permanent residents are not covered by the national scheme and must take out private cover. Public hospitals in Thailand are generally considered to be good, and Thai life expectancy has increased since their introduction. However, waiting times are long, and it may be difficult to find English-speaking staff. In rural areas, the public system is often worse than in the cities.
Premium clinics are part of the public healthcare system, but they charge additional fees. They offer a higher degree of care and have shorter waiting times. Staff working in these are more likely to speak English.
Private hospitals in Thailand are often state-of-the-art, and, in major cities, you will find hospitals that cater specifically to expats. Most expats giving birth in Thailand choose to use a private hospital.
When it comes to maternity cover, health insurance policies vary. You should check with your insurer to find out what services and which hospitals they cover. If you are planning to have children but are not yet pregnant, you may find it useful to take out specific Maternity Insurance. This will help to make sure you can access the services you want. You should consult a local insurance broker for help with this. Note, though, that you cannot claim on Maternity Insurance unless you have had it for at least a year before you become pregnant. If you are already pregnant, you may find you have to pay out of pocket for prenatal care. You should also make sure you have insurance in place for your child once they are born.
Private hospitals offer childbirth packages, which you can find details about on hospital websites. Visit your chosen hospital in person, in order to look at the facilities and talk to the staff. You can usually make an appointment for this. Packages cover normal delivery services, in a standard private room. They do not cover any complications that may arise during the delivery. You should also check who will be allowed into the delivery room with you and whether they can stay overnight. While most hospitals will let your partner be present at the birth, they generally will not let your children attend too.
Always make sure you know exactly what is covered and what is excluded (note that things like your meals may not be included), before you purchase a childbirth package. It is not unusual for new parents to find they face additional charges. At time of writing, packages for natural childbirth start at around 27,000 baht ($870/£670) in public hospitals, while they can cost up to around 95,000 baht ($3050 /£2500) in private hospitals. Packages for Caesarean sections cost between 55,000 ($1770/£2455) and 130,000 baht ($4180/£3360).
In Thailand, many women are advised strongly to give birth by Caesarean section. If you do not want this, and there is no good medical reason for it, look for a doctor who belongs to the Childbirth and Breastfeeding Foundation of Thailand, an organisation that supports natural childbirth. Home deliveries are rare outside of remote rural areas, and you will struggle to find a midwife or doctor who will attend one. In addition, most health insurers will not cover this.
In most cases, birth is medicalised. If you want a drug-free natural birth, equipment, such as a birthing pool or birthing balls, or another alternative approach, you will have limited options, as only one or two hospitals offer these.
Childbirth packages do not cover antenatal care, and, in some rural areas, public hospitals have only limited services. In the public sector, you are unlikely to be able to see the same doctor every time. You should check hospital websites to see what antenatal services they offer and which doctor is right for you. Friends and colleagues may be able to offer recommendations. Look for a doctor who makes you feel comfortable and is used to dealing with expats. Check that they are happy for you to ask questions, too. Respect for authority is culturally important in Thailand, and some doctors are uncomfortable with questions.
You can expect regular appointments for routine check-ups, necessary tests and ultrasounds. Many doctors in Thailand will perform an ultrasound every time they see you, so you will have a good sense of your baby’s development. If you are using a public hospital, expect monthly check-ups for the first seven months, then fewer thereafter. In the private sector, the number of appointments is something for you to decide with your doctor. Your insurance package should cover these, but some tests may attract an extra fee. Antenatal classes are less common in Thailand than in the UK or the USA, but some private hospitals run them. If you want a class in English, a private hospital is probably your only option.
After your baby is born, you should see your doctor for a post-birth check-up to make sure that you are healing properly and that your baby is doing well. In some hospitals, your childbirth package may cover this. Your baby’s healthcare plan should include regular check-ups thereafter, along with vaccinations. The exact details will vary according to which hospital you have chosen, but you should expect around seven check-ups in your baby’s first year, and three in the second.
Vaccination against tuberculosis is mandatory; all other vaccinations are not. Thai doctors follow the schedule for vaccinations recommended by the American Academy of Paediatrics. In addition to standard vaccines against Polio, diphtheria, whooping cough, tetanus and MMR, babies in Thailand are vaccinated against Japanese B Encephalitis. Your hospital may offer you a vaccination package that reduces the costs, but a course of vaccinations for your child, up to the age of four, costs around 20,000 baht ($643/£518).
Bangkok Mothers and Babies International is a volunteer organisation supporting mothers and babies, set up by the Childbirth and Breastfeeding Association of Thailand. You can visit their website here.
The Childbirth and Breastfeeding Association of Thailand website (in Thai) can be found here.
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