Expats opt for freebirth

Pregnant foreigners living in Thailand face a lack of options for giving birth. There are no midwifes in Thailand, there are no birth centers. Giving birth in a hospital is natural for people in Thailand.

Expat women, a bit more critical, with more options to educate themselves using online resources are less likely to just go with what everyone else is doing, just because everyone else is doing it and without questioning it.

The alternative that is available is to give birth at home, but without having the assistance and reassurance of a midwife or another professional birth attendant and more foreign women chose this alternative to avoid the routine hospital procedures that hinder the natural birth process and that so often lead to c-sections via the known cascade of interventions.

Not accepting to submit to major abdominal surgery and the stressful environment of a hospital was a mother in Bangkok who expected twins. She gave birth at home to both babies without any assistance.

A Phuket expat recently invited an aspiring lay midwife from Australia to attend her birth at home, despite the logistics involved of having someone from overseas stay in Thailand for at least 4 weeks. When giving birth naturally you do not induce labor and can therefore not predict an exact birth date.

Foreign couples in other areas of Thailand have posted in online forums used by expats, searching for midwifes, without success. The reports of c-sections accumulate.

A Krabi woman, originally from Australia where natural births and homebirths are still considered an option, was left traumatized after receiving an unexpected and unplanned c-section at Bangkok Phuket Hospital, one of the common excuses ‘failure to progress’ was given by the doctor but the doubts will remain with this women for the rest of her life. Was it more convenient for the doctor to get the birth over and done with instead of waiting many more hours? Do the doctor and the hospital too quickly suggest that a c-section is needed and could there be financial motivations?

There are no midwifes in Thailand, only obstetric nurses working in hospitals. A birth at home with a midwife is not an option. There are no birth centers in Phuket. Birth in a hospital or a birth at home without a professional birth attendant (unassisted birth) are the only options available.

A reply to my 2008 enquiry from the Thai Nursing Council:

Kindly refer to your e-mail dated April 10. request homebirth service from a midwife. According to information provided by representative of Thailand Nursing Council in Phuket, there is no service provide there. Several hospitals are available at Phuket.

C-sections in Thailand

In Thailand, Dr. Stephen Atwood of the maternal and child-health section of UNICEF’s regional office, says, “I’ve seen statistics from Bangkok General Hospital that suggest the national rate is as high as 65% of all births.” (The actual figure is unknown — the Thai Ministry of Public Health told TIME that it does not keep statistics.)

In Thailand, the pleas of natural-birth advocates do not find a large audience. “It’s like pushing a stone uphill,” says veteran campaigner Dr. Tanit Habanananda of the Childbirth and Breastfeeding Foundation of Thailand. “We’re frustrated. It’s very easy to get a C-section in Thailand. We have some colleagues at hospitals trying to change things but it’s very hard.” His spouse, Dr. Melanie Habanananda, adds: “If you use the term ‘natural birth’ here, people think it means you have to go sit in a paddy field to have your baby.” Cesareans, she says, “have become very fashionable, especially among middle-class women” A third of the babies at Bangkok’s private Samitivej Hospital, for instance, are delivered by C-sections, even though its birth unit was set up by Dr. Tanit Habanananda specifically to promote natural childbirth. (Those babies are also almost entirely born to Thai mothers. The foreign women who make up a large portion of Samitivej’s admissions prefer to try for natural birth, says Dr Boonsaeng Wuttihpan, head of Samitivej’s birth unit, who adds that the hospital remains very committed to promoting nonsurgical delivery.)