SO you're an expat mother-to-be and you want to have your lucky Dragon baby in Shanghai in the auspicious Year of the Dragon. What are your options? Margaret Ferté explains.

The doctor can only see you in three months' time," the nurse at a local hospital said, reminding me that 2012 is the auspicious Chinese Lunar Year of the Dragon. Like many of my expat friends, I unknowingly got myself caught in the long baobao (Dragon baby) frenzy.

So what do I do now? Do I return home to deliver my baby? What are my options in Shanghai? How much does it cost?

These are questions a number of expat women are asking this year. Whether or not this is an auspicious year, expat moms-to-be are off to a competitive start.

"Sadly, I haven't found a Chinese hospital that is willing to take me. I am now considering going home for the birth. I wasn't aware that Chinese women book their deliveries in advance," says 29-year-old American Natalie Green.

When she was 10 weeks' along, Green tried to make her next appointment and was told the hospital was full.

Like most expat women, I was shocked by the excessive cost of giving birth at international hospitals in Shanghai. Unless you have very deep pockets or your insurance covers 100 percent of all maternity expenses, it will be very difficult to pay for it by yourself. With such high prices, expat mothers can expect excellent quality of medical care and service and, very important, a medical culture that they are familiar with.

Unfortunately, not all of us fall into that category.

Some have insurance that places a limit on maternity expenses. Some don't have. For a lot of expats, where we go largely depends on whether we have insurance or not.

Heather Turner, a 30-year-old American housewife, had no insurance and going local was the only affordable option for her. But "one of the Chinese hospitals turned me away last October because I was too far along. In the States, you never get turned away," says Turner.

She was seven months pregnant then.

After further search, she finally found a Chinese hospital to take her in. However, she was overwhelmed by the cultural differences.

"Everything was unclean. The toilets smelled and there wasn't any soap, and there was so much noise around. It was not a comforting place," Turner recalls of the hospital.

She and her husband were shocked by the "no-husband policy" in the birthing room. "So 1950s!" And she wanted a natural birth but the hospital insisted on performing a C-section if labor is longer than 24 hours.

"I felt I would not be in control at local hospitals," Turner says. "They were very pushy about having to do every procedure and test ... Doctors don't like it when you question authority. They are not used to explaining or educating their patients."

There was no communication at all about why a particular test was called for or what her options were. In the end, Turner decided to have a home birth in Shanghai. "The biggest turn-off for me was the lack of a peaceful environment. It was too much to handle."

Fortunately, one of her friends who used to work as a midwife in the States helped her with the delivery.

Turner spent no money on her home delivery.

Instead, she used a method widely discussed among the expat mothers now - Hypnobirthing (The Morgan Method).

All went well and she delivered a beautiful, healthy baby girl, Della.

Of course, other expat women feel okay with Chinese hospitals and are satisfied with the care.

Local hospitals who want foreign patients are aware of some negative feedback and are constantly trying to improve to provide better service.

Apart from differences in medical culture and environment, there's also the language barrier.

For 36-year-old Malaysian Beth Chan, it wasn't a problem. "My doctor's English was very limited but it didn't bother me since I'm fluent in Mandarin."

So what am I going to do?

Home delivery in Shanghai? Not me, for sure. Going local? No thank you. It's my third birth and my first in China. I fall into the category of expat women with limited maternity coverage. How can we enjoy a level of care similar to that back home without breaking the bank?

Some women choose prenatal packages and pay separately for the birth. But for many of us, signing up for a prenatal package may not be an option for various reasons - we may return home over holidays, we don't need all the tests in the package and we want to save the bulk of our budget for childbirth, and so on.

When I looked into the prices of individual prenatal tests, I was shocked to find out that, even for medical providers in the same category, there is a huge price discrepancy.

Take for example, Level II ultrasound, among international hospitals and clinics, for the same test, the price ranges from 800 yuan (US$126) to 4,185 yuan. Sticker shock.

Let's take another example, for a non-invasive, abdominal surface-only scanned test, the price ranges from 20 yuan to 1,766 yuan.

Most international hospitals and clinics don't provide much flexibility to mix and match the package according to your needs.

I found my solution at Raffles Medical, which offers three prenatal packages at 3,600 yuan and 6,280 yuan and a variety of tests that you can add.

Apart from Raffles Medical, there are also VIP sections at local hospitals, which fill the gap between pricey international hospitals and budget local hospitals. Doctors and staff speak good English, by Chinese standards.

They have better a bedside manner and are used to handling the concerns, questions and expectations of expat patients.

Most expat women prefer to deliver their babies naturally, me included, and the doctors and midwives are willing to work with us.

Deniz Connan, a 40-year-old Australian, delivered at the VIP ward of Shanghai East Hospital which cost 30,000 yuan had a "very positive" experience.

"The staff was kind and attentive and the facilities were very modern and clean. We felt we received good medical care for an affordable price."

Green, who was turned off by local hospitals and finally went back to the US to deliver, offers some advice:

"If you go local, you need to be prepared to sometimes publicly discuss your body and your health, and you need to be aware that people will be anxious and cutting in line. I would advise all expat women to bring a translator if they need one, and be very persistent about booking appointments and delivery as early as possible. And try to be open-minded!"

Housewife Ruth Pater, 38, from the United States, advises women to educate themselves very well "to be more in control." If complications arise, turn to international hospitals for second opinion before returning home. "For international hospitals, customers are paying for the trust and confidence," she says.

Pater delivered her babies at the VIP section of Peace Maternity back in 2004 and 2006; it cost 16,800 yuan and 22,000 yuan respectively. Today, it costs at least 31,000 yuan to deliver there.

Frenchwoman Sonja Hurez, 33, urges women to get as much information possible on various options available. "Trust yourself and your gut feelings. Make sure everything is checked when you see your doctor. If you feel something is not right, make sure you get someone to listen to you."

Whether you will have a Dragon boy or girl remains a mystery in China since hospitals are not allowed to disclose the gender, even to an expatriate. Obviously, some people find out.

Prospective mothers need to be informed about the various facilities available in Shanghai. Visit the hospital, the rooms, the toilets, find out about birthing policies, talk to staff, get a feel for the environment and, talk to other mothers.

There's still space available for delivery of your Dragon Baby. No need to pack your bags, but be quick.


Margaret Ferte is a consultant with Expatmedicare (www.expatmedicare.com), which specializes in international health insurance. Their service is free of charge.


Popular Hospitals Among Expat Mothers

Raffles Medical (Prenatal care only)

Add: Level 2, 1801 Hongmei Rd, Innov Tower

Tel: 6197-2311


Shanghai Family United

(www.ufh.com.cn/en/)

Add: 1139, Xianxia Rd

Tel: 2216-3900 ext 1700


Parkway Health Clinic

(www.parkwayhealth.cn)

Add: 2-3/F, 170 Danshui Rd

Tel: 6385-9383 ext 638


American-Sino OB/GYN/Pediatrics Services

(www.americanobgyn.com)

Add: 3/F, 800 Huashan Rd

Tel: 6210-2299


Worldpath Clinic International

(www.worldpathclinic.com)

Add: 5/F, Blk C, No. 3, 777 Century Ave, Pudong

Tel: 2020-7850


Shanghai East International Medical Center

(www.seimc.com.cn)

Add: 150 Jimo Rd (551 Pudong Rd S.), Pudong

Tel: 5879-9999 ext 2660

Changning Maternity and Infant Health Hospital

A: 773 Wuyi Rd

Tel: 6228-8686 ext 1125


International Peace Maternity and Child Health Hospital

(www.ipmch.com.cn)

Add: 13/F, 910 Hengshan Rd

Tel: 6447-0399


Shanghai Changning District Central Hospital

Add: 4/F, 1111 Xianxia Rd (next to Shanghai Family United Hospital)

Tel: 6290-9911 ext 1333



Shanghai Red House Maternity and Infant Hospital

Add: 566 Fangxie Rd

Tel: 3318-9900 ext 8256



Shanghai East Hospital

(www.easthospital.cn)

Address: 150 Jimo Rd, Pudong (VIP section on 3rd floor)

Tel: 5882-2171



Shanghai No. 1 Hospital of Maternal and Child Health

Add: 391 Yaohua Rd (VIP section on 2nd floor)

Tel: 6870-6550