On Choosing Not to Medevac for Delivery

It has been six weeks since little D entered this world, and oh my goodness, I forgot how time consuming newborns are! If I'm not breast feeding, changing a poopy diaper or rocking him to sleep, I am doing something toddler related with my older kid or attempting to get a solid hour of shut eye. The past couple of weeks have gotten better, though, as Baby D is waking less at night and I am no longer a walking zombie during the day.  Laundry is getting done, I am back to taking work assignments from clients again, and our part-time nanny is awesome.  In other words, things are starting to return to normal. 

But all that aside, I wanted to write about a decision I struggled with while pregnant with D, and that many pregnant women in the FS struggle with when they find out they're pregnant: To medevac for delivery or not to medevac for delivery?

As I said earlier on this blog, S and I originally moved to Turkey with the intention of timing our second pregnancy so that I could deliver back in the States during language training for his second post.  That way we would already be living in D.C. and we wouldn't have to worry about medevacing. Well, you know what they say about life and plans.

When I found out I was pregnant last summer, I immediately started discussing my deliver options with S and we went back and forth about what we thought was best for me, for E, for the baby, and for us as a family.  Should I uproot E  for 3 months to go back to the States?  That would mean pulling him out of school, taking him away from his daddy, and taking him away from his friends and his routine.  Was it worth it?  Would I receive better medical care in the States compared to Turkey? Would I be able to have a normal delivery since doctors in Turkey prefer (and sometimes convince their patients to have) c-sections?  Will I feel comfortable with the language barrier if I chose to deliver here?  If I went back to the States, would I stay with my parents?  Should I put E in a new preschool? Would S be able to make it in time for the birth?  Would I be able to fly back to Turkey by myself with a newborn and a 3-year old without losing my sanity?

All these questions (and more!) swam through my head daily.  In the end, after some push back from the powers-that-be in Ankara, I chose to stay in Adana to have D.  I even signed a waiver from the Embassy acknowledging that it was preferable for all pregnant women to fly back to the US, but in the end, I still chose to stay in Turkey.  It is a decision I do not regret.  

Here's why:

Prenatal care/My Doctor

The prenatal care in Adana was fabulous.  I was lucky to have found a doctor who spoke English and who sincerely believed that c-section rates in Turkey were through the roof, and natural/normal delivery was not such a crazy idea after all.  I met with my OB once a month and he ran ultrasounds, monitored my blood pressure, prescribed vitamins and iron supplements (which I didn't take because I opted to take the same ones I took while pregnant with E--thank goodness for Amazon!) and kept track of the baby's growth so accurately that he was able to predict D's weight within a gram before his birth.  And not once did he try to convince me that D was too big to be delivered naturally, which I have heard other doctors say, even in the States.  And yes, D was a big boy.  My doctor knew what I wanted and he was going to be damn sure I got it, barring any emergencies.  He was never late for appointments, never rushed me if I had questions or concerns, and always had a calm, cool, and collected demeanor. He made me feel comfortable from day one, and that was most important to me. 

The hospital

My doctor worked out of a new, private chain hospital that has locations throughout major cities in Turkey.  It is a state-of-the-art facility, and the staff was unbelievably friendly every time I showed up for a visit.  I paid close attention to how things were handled--did nurses use gloves, did equipment get sanitized correctly, were things disposed of properly, and the answer was always yes.  Not once did I feel someone was slacking on the job when it came to cleanliness.  In fact, this was probably one of the more cleaner hospitals I've ever been in.  It was even nicer than the hospital in Brooklyn where I gave birth to E.  To be fair though, that hospital was about 100 years old and had been worn down over the years but still...The hospital also employed several translators who were called upon any time I needed.  They usually showed up within minutes of being called, and always maintained a high level of professionalism. Someone from the med unit in Ankara even came down to inspect the hospital to ensure that it was up to US standards, and it was given a thumbs up.  (I still had to sign that dang waiver, though).  After my second doctor's visit, I was comfortable with the hospital, the staff, and I trusted my doctor. But I still curious about delivery.  

The labor & delivery room

When it got close to my due date, but still not past the date at which I could change my mind and high-tail it back to the US, I asked my doctor for a tour of the delivery room.  He happily obliged and called up a translator to walk us through the area (my doctor had another delivery to get to, so he wasn't able to go with us). However, the head nurse on the delivery floor was there during our tour, so we directed all our questions to her.  I could see right away that things were done differently here. For instance there was only ONE labor room and only ONE (separate) delivery room.  Since most births occur in the operating room for c-sections, one of each room was all that was needed.  I didn't have to worry about having another woman labor at the same time as me, because chances are, I was going to be the only one.  And I was.  The labor room was your standard hospital room--a bed, a couch, numerous machines and monitors and inspirational quotes with butterflies and flowers pasted on the walls.  And this is where things get different--I didn't deliver in the same room where I labored.  When I had E, I labored in one room and when time came for me to push, they pulled off the bottom of the bed, pulled out the stirrups and said push.  This bed was just your normal, everyday hospital bed.  The delivery room was across the hall, and instead of a bed, there was a chair. It was a big. hospital-grade chair specifically designed for childbirth.  It looked weird and awkward when I first saw it, but then I realized birthing while sitting up is actually preferred and is easier than lying on your back, so I was okay with it.  My only concern was how I was going to get from the labor room to the delivery room and up into that chair.  The nurse explained their process and again, it all sounded okay to me, albeit different.  So I trusted the process and stuck with my gut--I was going to deliver in Turkey.  And I did.

In the end, I am happy with my decision.  We got to keep the family together.  We didn't have to disrupt everyone else's life, especially E's, which was my top concern, and it was never a question as to whether S would make it in time for the delivery.  Baby D's medical care before, during and after the delivery was also of top concern, and after all is said and done, I have no complaints.  The nurses post-delivery were attentive and helpful.  A lactation consultant was dispatched to my room every two hours to assist me and make sure the baby was latching properly.  She showed up a little too often for my taste, as this was not my first baby and I quickly remembered how the whole breast feeding thing worked, but she was nice and I new she was just doing her job, so I couldn't get too upset. 

My doctor checked in on me at regular intervals following the birth and monitored my healing very closely.  Instead of seeing me at 6-weeks post delivery like is custom in the US, he requested to see me after one week, and again after 3 more weeks.  And after he was satisfied with the progress of my healing, he insisted that I call his mobile number if I wanted to see him again or had any discomfort after 6 weeks. 

Our room was comfortable and large, with a separate sitting area for guests and a couch if S decided he wanted to stay the night.  Seeing that we had another kid at home to take care of, he obviously didn't stay.  But still, the option was there.  D got to be in the room with me the entire time.  He was only taken away when they needed to run tests.  Oh, and the food was amazing!  Hospital food is supposed to suck right?  Well, not here.  I was showered with snacks, juices and gourmet style lunches and dinners, as well as Turkish style breakfasts with cheese, tomatoes, olives and bread. S and I were even presented with a gourmet meal on my last night, complete with silver domed dishes loaded with steak and potatoes, a delicious salad and amazing dessert. The best part is that there is a stylist on staff that will come in and do your hair and makeup, as well as a professional photographer who will take a few photos for you. And yes, all this is covered by insurance.  Since I gave birth on a Sunday (when the stylist was off duty) and we checked out on a Monday, I decided to forgo the pampering so as to not delay our departure.  As fabulous as things were in the hospital, you just want to be home, ya know?  

Anyway, I realize some women have no choice when it comes to medevacing.  Lots of posts just don't have the medical facilities or experienced staff that meet the standards of the US, and they must go back to the States for safety's sake.  I totally understand that.  We are lucky that the medical facilities at our post were up to US standards, and we are grateful that we could stay.  I had an amazing experience here, and if I had it to do all over again, I would not have done anything differently. 

Plus, because of D, we will always carry a little piece of Turkey with us forever.

Early morning snuggles with my boys

Baby D - 1 Month

E playing with his little bro.