Having a baby in Kazakhstan Part 1: Prenatal care

The difficulty with not speaking Russian or Kazakh is that meanings are lost in translation. I am fortunate that my OBGYN speaks English (and has worked for the World Heath Org.) and as such I do not need a translator. Even still, none of the nurses speak English (which will be addressed later), and even though some of the signs on the various doors in the hospital have an English translation, I do not think it means, what they think it means. This room for example is called the "Sanitary room". Now I have not been in this room (I am not sure I want to), but I am sure that it is not the only room in the hospital that would be considered sanitary.

Another favorite room of mine is called "Control room". I would LOVE to see what is in there (many conspiracy theories come into play), but unfortunately the door has never been open. Only high level security must be allowed in.  These intensely labeled doors, long with the "insane asylum" green walls, and the lack of light do not make for a cuddly prenatal experience.  Instead it becomes a cut throat, every man for himself, don't mess with the mamma bear situation.

As I mentioned before, my OBGYN is the cream of the crop here (in fact the way we were put in contact was with some major strings pulled. We know a guy, who knew a guy at the ministry of health who gave her a call. Yes, I am her only client). When Brett and I went for our initial visit and were shown around the hospital by our physician we were impressed not only with her, but with the respect she received. Part of me felt uncomfortable as we were shown (paraded) around the hospital. I was brought into a laboring woman's room so I could see what was offered. I apologized and felt so invasive, but her sweet little heart gave me a big smile and said hello (she was told we were American, as part of the explanation as to why I should be allowed in). We were then taken into an empty labor room, and both Brett and I were pleased. On the walls were posters of support potations for partners to help the woman in labor, as well as a nice large tub, birthing ball, and other equipment that might not be as readily available at some hospitals in the States.

My physician is also unique in that I actually get to make appointments. Typically, prenatal care here the woman come at 8:00, 9:00 or whenever and are seen on a first come basis (hypothetically). These woman sit for hours. There is nowhere to check in, and so they sit in a darkened hallway (the lights are never all turned on--see below) and wait. Part of me screams with injustices as I go in and out of my appointments, but ironically when I have to sit and wait (ex. to get my blood work) with everyone else, it is remarkable how quickly I shout inside, "I should not have to wait..."

Did I mention that the hospital is a "Cash Only" business? You pay in cash before you can be seen, or receive test results. I have told Brett how much cash we need to have on hand when I go into labor. Hate to get all the way there and not have enough to be allowed to deliver. :)

 HIPAA would totally freak out here. A door is locked? No problem, unlock it with the key left in the door. Nothing is electronic. My paperwork is in a paper file which new information is added to via glue stick. I am given a little book (in Russian) in which my stats and appointment info is copied (in case anything happens to the hospital copy), also in Russian. This little book is apparently also required to be checked in during labor.  It is remarkable that paperwork is not mixed together. This desk below had about 5 different women's files out at the same time. Due to the difficult waiting situation it is also common for women just to walk in and start asking questions.

Unlike the US where most of your appointments are in the 3rd trimester, here they are in the 1st. This is due to the fact that few have check up's (when they are pregnant it may be the first time they have come to a doctor), as well as the lack of cross training. There is a physician who gives pap smears, one who does breast exams, the "general physician" who checks for TB by pounding on your back. You also receive a dental examination and eye examination (again, these are not done routinely otherwise).

Aluminium Pinard Stethoscope

While they do give sonograms (there is only one screen and it is faced away from you), they do not use fetal dopplers with a regular visit. I have only heard this baby's heart beat twice this pregnancy. Instead they use a Pinard Stethoscope (see below), which works for the OB, but I have missed hearing my sound of the heart beat.

So far we have felt comfortable in our care. I think key factors for this include that our doctor speaks English and that this is our third pregnancy.  I have many other stories that I would love to chat with any of you about next time I see you. :)

Part 2 to come in about three weeks. But who's counting?