Why a famous obstetrician is not necessarily the best for you

Last week, I was at a dinner function where a charming lady engaged me in conversation about the birth of her young granddaughter.  ‘The private hospital was excellent,’ she said.  ‘And the obstetrician was really famous.’

This is a line, almost word for word, that I have heard often since I have become visibly pregnant.  In fact, it is the third time I have heard this comment about exactly the same hospital and the same medical practitioner.  And the really weird thing is that despite the obstetrician being supposedly famous, no-one can actually remember his/her name without furtive resort to text messaging the patient.  Nor were all the birth experiences what I would term especially positive (although the individuals involved might never admit to this).

I have now started to get a bit cheeky.  After people tell me what a wonderful experience their daughter/wife/sister/cousin had with their famous (and therefore expensive) doctor at the private (and exclusive) hospital, I then ask about the birth itself.  ‘Was it a natural birth,’ I ask.  ‘Well, no she opted for a caesarean,’ is the usual reply.  ‘But the room was luxurious and the food was fabulous.’

I find this unquestioning acceptance of inevitable intervention somewhat bizarre.  Surely a trusting relationship with one’s practitioner, and the experience of a stress-free birth free from as little intervention as possible should be primary motivations for child birth?  Yet here in Taiwan when I tell people that, barring a serious medical contingency, I want a natural birth without resort from pain relief (just like that experienced with my son) they look at me like I am nuts.  ‘Wouldn’t you rather have a famous practitioner?’ I can almost hear them thinking.  ‘Surely it is dangerous to seek to let nature take its course seeking a natural delivery rather than to trust someone qualified to take charge?’ 

I am not suggesting that famous practitioners are in any way negligent or bad.  The fact that they have a good reputation means that they have appropriate qualifications, dedication to their job and are far from being some shonky back-yard operator.  But what I am surprised about is the general lack of knowledge amongst women about some of the more invasive practices used in many Taiwanese maternity hospitals, especially the more high-end establishments.  I thought at first this was a communication issue because Chinese was not my native langauge and I am finding I need to assertively drag information out of my obstetrician.  But from speaking with Taiwanese mothers the common theme seems to be ‘lack of respect’, and a sense of disempowerment because they didn’t know what was happening (or going to happen) during the birth itself.  Is it any wonder many Taiwanese women stop after having only one child?

While not all births Taiwan are traumatic, the translation of an article in Common Health Magazine 2003 (Taiwanese Women: Why Aren’t You Angry) gives a picture of some of the out-dated and interventionist practices still commonly used — don’t read if squeamish.  I understand from speaking with doula and childhood educator Angela Chang that some of the medical practices are still in use, although some are gradually being phased out or at least not administered without permission.  I find it odd that on the one hand Taiwanese are so reliant on traditional medical practices postpartum (e.g. the practice of one months’ confinement post birth is almost mandatory), yet so rigidly clinical in the lead up to and during the birth itself.  For example, it is next to impossible to find ante-natal yoga/relaxation classes, let alone merging of complementary health care such as using acupuncture or Chinese medicine to prepare for birth.  And most birth classes are run by pharmaceutical or other medical companies, so are hardly impartial.  (A key exception is the informative English-language birthing classes that Angela runs at Parents’ Place.)

We are currently in the process of changing our birthing arrangements to deliver at a birth center instead of a private hospital.  We visited the birth center recently, and were impressed by the calm and friendly atmosphere — and the freedom of choice of delivery.  I casually mentioned our thinking to one or two society ladies when they asked about my hospital arrangements; they were quite shocked that I would even think of changing, especially as the birth center is out in the suburbs while the private hospital is centrally located (and expensive).  So I think from now on I will just tell them I am still going with the private hospital, while quietly go ahead and doing what my husband and I believe is best for us and our baby.

What do you think about the medical practices in Taiwan’s maternity hospitals?

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About taiwanxifu

‘Taiwanxifu’ (pronounced ‘shee foo’) means ‘Taiwan daughter-in-law’ in Chinese and has been my nickname ever since I married my Taiwanese husband, Sam. I love sampling Taiwanese food, even local specialties such as stinky tofu, pigs blood cake and Taipei beef noodle soup with offal. But there are many other options on the menu. Promise!
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11 Responses to Why a famous obstetrician is not necessarily the best for you

  1. a. says:

    Well, at least there’s hope since you’ve found a place on par with your beliefs, great for you! This whole “famous obstetrician” sounds like it’s a way to have more “face” and bragging rights, sad way of thinking.

    • taiwanxifu says:

      I hadn’t thought about this issue in terms of face, but I think you’re right. There seems to be quite a lot of status attached to where you actually go to give birth. With many families only choosing to have one child, they tend to put an even higher premium on the type of medical care during pregnancy.

      But I also saw similar patterns in Australia. While midwife programs tended to offer supportive and positive outcomes for mothers, many women chose to pay a fortune to see private obstetricians. There are many reasons for this, in part a desire to ensure the best quality care that money can buy. But paying more money doesn’t necessarily mean a better outcome: the relationship with your medical practitioner, especially finding someone who will listen, is crucial.

  2. taiwanxifu says:

    Comment provided by Traditional Chinese Medicine practitioner, Claire.

    “Unfortunately,Western medicine is also a model way in Taiwan, plus a lot of parents like to chose the [right time] for their unborn baby so for they will have a good life after they are born. That’s why more then 50% women choose to have caesarian section. Also, most of the doctor won’t have enough time to wait for labor (from stage 1 to stage 2 could take a long long time), they are too busy to see more patients in their clinics, that’s why if you book for a caesarian is much easier for them to control their time. Most of doctors ask nurse to call them at the last minute so they can make it just on time (to take the baby out and clean the placenta).

    I have to say Chinese medicine is used more in CHINA, not in Taiwan. This is because we don’t have (or i don’t think) any hospital where Chinese medicine is used to diagnose and treat patients.”

  3. daiyuflower says:

    Thank you for posting the link to such an informative (and disturbing) article about childbirth in Taiwan. I’m glad that you are choosing a birth experience that you are most comfortable with. I did want to say that I noticed your use of the phrase “natural birth,” and wanted to point out that I think many women often prefer the term “unmedicated birth” instead because in a sense, no matter how the baby is born, bringing a child into the world is still the most “natural” of experiences :) I really enjoy your posts and hope the best for you and the baby!

    • taiwanxifu says:

      Thank you for your comment. I will use the ‘unmedicated birth’ term in future.

      • taiwanxifu says:

        I should also add that I didn’t mean to sound too preachy about having an ‘unmedicated birth’. In part this came about unexpectedly (although the support of Mr Taiwanxifu and my doula helped). I did ask for some pain relief early on, but the hospital was having a busy night and the doctor (and midwives) forgot. In the end I figured I might as well keep going because I found that the breathing was working and I was able to manage. I am confident that with positive support and encouragement, I can have a good experience this time around as well … even though there are indications the baby will be big!

  4. daiyuflower says:

    I didn’t think you were being preachy at all :) I hope I myself did not sound preachy! I think that the practices you described in Taiwan and that are described in the magazine article are overly clinical and medicated, and I hope that women in Taiwan soon start demanding more control over the process. I just wanted to *gently* point out that using the term “natural” implies that some people have “unnatural” births and no one really likes that word associated with their child 😉

    • taiwanxifu says:

      No, I didn’t think you were preachy so let’s agree neither of us were! I was just conscious that some women are harsh on themselves because the birth experience they wanted didn’t turn out as planned. Sometimes unexpected things do happen, although being in a supportive environment really helps achieve optimal outcomes.

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  6. Seayin says:

    Natural birth is what is termed in the UK as a vaginal birth. A C-section would be called a C-Section (say, rather than ‘unnatural’ birth). I am currently considering which one to try as I endured an emergency C-Section with my first child 3 years ago and hated the recovery.

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