I decided to write this post for those expats and OFWs  (Overseas Foreign Workers) who are pregnant and thinking delivering here in Singapore for the first time instead of going back to their home country to give birth. I will share with you my experience. I just delivered last 9 May 2018 to a bouncy baby boy, our 3rd baby boy, in KK Women’s and Children’s Hospital here in Singapore.

My first two boys were delivered in the Philippines. Initially, when we learned that I was pregnant with our first baby, we did have thoughts of me, delivering here in Singapore. However, since I didn’t know much OB-Gynae doctors here in Singapore, I asked the referral department to assign me to any OB doctor. I was assigned to a senior female OB consultant. After a few sessions with her, I was dismayed that she didn’t seem as caring and attentive enough which brought a wave of panic for me as a new pregnant mommy. I didn’t want to go doctor-hopping so I decided to give birth instead in the Philippines. Being a doctor myself, I get to enjoy the perks of giving birth in the Philippines without it being cost-constrainting and I get to avail some government discount as well since I am paying dutifully my government monthly dues. Plus my family gets to be with me when I give birth and will be able to take care of me during my recovery. So, I was pretty happy with our decision to deliver in the Philippines. For my second pregnancy, we decided to do the same thing even if I really liked the OB doctor who does my prenatal checks in Singapore. So, I had my scheduled caesarean section for baby #2 in the Philippines.

When we found out that I was pregnant for the 3rd time, the logistics of us, 4 going home to the Philippines before my 34 weeks pregnancy (since this the allowed weeks of gestation for a pregnant woman to ride a plane) and again my eldest & hubby going back to Singapore for school & work until they come back again for my schedule caesarean delivery and going back again to Singapore, then back again to Iloilo to fetch me & baby #3 back to Singapore, seems very taxing, confusing and notably expensive. All the back and forth travelling doesn’t seem practical at all, so we seriously thought of having me deliver baby #3 in Singapore once I clarify with my company my maternity benefits and if we can afford the maternity hospitalisation bill in Singapore, considering I will be delivering baby via caesarean section.. Being a foreigner and in a non-Permanent Resident Visa, I need to make sure that we won’t be buried with hospital bills we can’t afford since we don’t get any subsidy. I clarified my maternity benefits from my company that I will be paying only 10% of my maternity bill and the rest will be paid by my company. My baby’s bill, which is often not as expensive as the mother, will be footed by us. But I can still claim the expenses incurred from the company once we have made the baby as my dependent.

So as far as the regular prenatal check-up goes, the schedule follows as the recommended prenatal schedules:

• Weeks 4 to 28: 1 prenatal visit a month
• Weeks 28 to 36: 1 prenatal visit every 2 weeks
• Weeks 36 to 40: 1 prenatal visit every week

There would be scheduled ultrasound scans in between these prenatal check up and an Oral Glucose Tolerance Test on Week 24 to 28 to check for Gestational Diabetes. I also did the First Trimester Screening For Down’s Syndrome with all my 3 babies.

I liked my Obstetrician too for baby #3. She is Dr. Kazila Bhutia. She has a MBBS (LHMC, Delhi), MD (O&G), MRCOG (London,UK), and FAMS (O&G, Singapore). I like her friendly and caring approach to her patients. I like that she always have a smile on her face. She takes the time to answer my questions and my concerns. She explains to me well, giving me options and offers helpful advice.

My last prenatal check-up with her was last 4 May 2018. I was asked to do an ultrasound scan first to check my amniotic fluid and to know baby’s estimated weight. Baby’s weight was 2.9 kg and my amniotic fluid was adequate. I saw Dr. Kazila shortly after that. She explained that she scheduled the caesarean delivery on our chosen date, 9 May 2018, at 9:45 AM. Since my previous caesarean incision was midline, she will do the same incision. She would have preferred the Pfannestial Incision or Bikini Cut (actually me too, aesthetic-wise) because it is less painful and has reduced incidence of wound infection. She reiterated that now, even if it emergency CS, they still do Pfannestial incision but she didn’t want to create two scars for me so she will follow the previous incision. She said I didn’t need to be admitted a day before the surgery. I just have to fast 12 midnight before the operation and come early in the morning to be prepared before the surgery. I was, then instructed to go to the nurse for further instructions. In the nurses’ room, I was given an appointment on 6 May 2018 for a pre-admission assessment before my actual hospitalisation to ensure that I am fit for surgery on the 9 May 2018. The nurse also instructed me to go to Billing for Financial Counselling so I would have an idea how much is the estimated cost of my caesarean delivery as well as baby’s hospital stay.

In the Billing Department, the kind lady gave me the estimated cost for both normal & caesarean delivery for non-residents. (I will add in MediSave for those PRs who are reading this as well)

Class A1 (single-bedded) Packages *

Initial Deposit                                            $4,526          $7,055

Class B1 (four-bedded) Packages*

Initial Deposit                                            $3,841          $6,573

*Correct as of 23 Feb 2017

Under my company, I am privileged to get the Class A1 Room. So my estimated cost is: $11, 455. And if complex, it can go up to $13, 746.

For my baby, the estimated cost is $2,245. And if complex, it can go up to $2,694.

I have to admit, one of my apprehensions for giving birth in Singapore is the cost. I heard horror stories of foreigner patients  who accumulated expensive hospital bills due to complications of their condition and they have to reach out to the public for financial help. I may be shouldering 10% of my maternity bills but still if complications does occur, that 10% can still be a lot.

On 6 May 2018, heavily pregnant  at 58.9 kg, I headed to KK Hospital for my Pre-Admission Assessment. We never had that in the Philippines. When I got there, the staff took my height and weight. Then a nurse asked me a series of questions in her checklist. Then I was transferred in another room to have my some blood test taken. Lastly, I was seen by a doctor who asked a few questions and auscultated my lungs  & heart since I told him that I been suffering from Upper Respiratory Tract Infection the past 2 weeks. But I assured him I am significantly better. I was cleared and ready for my caesarean section on the 9 May 2018.

I got a call from KK Hospital on 8 May 2018 for my instructions before my surgery. The staff advised me to fast from 12 midnight including water. I will have to head to the hospital by 6:30AM at the Day Surgery at Basement 1 across the Taxi Stand and make sure that we don’t bring a lot of stuff because there won’t be any space for secure storage in the operating theatre. My husband will be joining me inside the operating theatre and no room won’t be provided for us until they finish the surgery.

So at 5:45 AM, my hubby and I kissed our two sleeping boys, took a cab and headed to KK Hospital with our 2 bags and small pink trolley. We headed to Day Surgery. We arrived a little before 6:30 AM so we waited a few minutes before they officially open. We did the routine registration then we were ushered into a sliding door where I have to be prepared before proceeding to the operating theatre. The regular questions and safety checked were done by the nurse. Then a doctor came to me, asked me a few questions and told me that they will give me a solution to keep my gastric fluids down for the surgery. Then a nurse would bring you to a room for a shave if you haven’t done your own at home or did your Brazilian wax.

Once we are done will the pre-surgery prep, a staff from the Operating Theatre fetched us and brought us to Level 2 where the Operating Theatre is. I was asked to wear a blue hospital gown then a pink robe with a head cap and a cover for my shoes. They ushered me to a room where patients wait for their surgery. The staff would give us a heavy blanket to warm us as we wait. They brought my hubby in the same room with me wearing an outfit that looks like an astronauts suit but thinner in material. The staff told me that I will come in first, the staff will prepare me and once the surgery started, they will asked my husband to come in but no photograph is allowed inside the surgery room. Then the pretty young anaesthesiologist with a nice pink Crocs sandals came in to speak to me and my husband. She did the routine questions. She told me of the plans for anaesthesia. She said that she will do a spinal anaesthesia but in cases that it is difficult for them to insert the spinal anaesthesia, they will do general anaesthesia. I told her that my first delivery was via general anaesthesia because the anesthesiologist have trouble in inserting the spinal anaesthesia during my emergency CS. My second delivery was a successful spinal anaesthesia  but I was sedated until the time, baby came out and I get to kiss him groggily. She was nice and clear in giving me the needed information as well as the risks that may occur.

The hospital staff lead me to Operating Room 3. She chatted with me for awhile and learned that this is my 3rd baby. She noted that my room is so appropriate because I will have my surgery in Room 3. When I went in and they lay me down the bed, a wave of panic and fear set in. The big operating light overhead scared me and the cold room enveloped me into chills even before the anaesthesiologist administered the anaesthesia. It was sinking in that this is my first time giving birth in Singapore and my anxieties are going a bit haywire. I said a little prayer to calm my nerves. I was greeted by Dr. Kazila when she went in the operating room. I felt a little bit better seeing her in the room. Then they inserted the IV on  my left hand. The young pretty anaesthesiologist asked me to sit down with both my legs dangling one side of operating bed. I need to relax, shoulder down and my neck bend down. She told me she will be inserting the lidocaine anaesthesia to numb the pain for spinal insertion. It was a bit painful but tolerable. I just have to meditate a bit and concentrate on a peaceful place so I wouldn’t feel the pain. Then she inserted the spinal anaesthesia. She said I was doing great. I was surprised she didn’t have a hard time in administering the anaesthesia because in my second CS, they did have difficulty in inserting the spinal anaesthesia because of some blockage in my spinal cord, the anaesthesiologist have to go a bit higher on my spinal column. Then they asked me to lie back down and I felt my legs getting really heavy. The anaesthesiologist tested a block of ice pack for sensation on  my face, chest up to my abdomen to see if the anaesthesia is working. It was indeed working because I noted the difference and they started inserting the urinary catheter and placed the screen near my neck to cover the operating site. I did fear I may feel them opening me up and it is scary thought. The anaesthesiologist did tell me when baby is coming out, I would feel a bit of pressure on my abdomen because the doctors will try to push baby out.

My hubby was brought in and was placed on my left side  near my head so he won’t get to see the operation. He asked me if I felt anything. I said I don’t feel anything, just a few tugs and pull in my abdominal region. Then the anaesthesiologist said, “Oh, we see the baby head already.” Then I felt a light pressure near my xiphoid process, then  I heard a sweetest sound, a tiny cry from our baby. Then they called my husband to look at the baby. I heard our baby crying faintly in the background and I let out a tear in my left eye. I was so glad I was fully awake during the procedure. I was overwhelmed with joy just hearing my baby cry. I couldn’t wait to hold him. Then later, a Filipino nurse came over  to bring me the baby.  They want my baby latch on my breast to facilitate production of my milk while  the doctors stitch me back up. My baby was perfect and beautiful. I smell his head full of thick hair and kiss his soft cheeks. He still doesn’t know how to latch properly but in time, I know he will be an expert.

Dr. Kazila told me that they are done and congratulated me.  I was then brought to an area  where I will be monitored before I will be transferred to my room. I was joined by my husband and they brought baby Zeke in to latch on to me. My vital signs were normal so soon, I was transferred to my room.

Credit: www.kkh.com.sg

In my room, I was attached to a calf pump on both my legs which acts like a bp cuff that inflates & deflates every few minutes to prevent Deep Venous Thrombosis. They brought in baby Zeke in the room soon after and was placed beside me. Soon, the effects of the anesthesia as well as the postpartum hormones came rushing in. I was nauseous and vomited on my pink hospital gown. Then I felt super hot that I want to tear off the hospital gown. To top it all, I felt really sweaty and trapped with a compression stockings on and the calf pump on. I vomited several times and the nurses gave me some anti-emetic medications for my vomiting. By evening time, the symptoms wore off except for the slight itchiness of my skin maybe from the anaesthesia or because I am not used to not bathing in the evening. By dinner time, I got to eat porridge and drink some juice.

You get to choose your meals in KK Hospital with variety of options, from Halal, Western to Vegetarian choices. Nurses were nice and attentive. They come in speedy everytime I press the the call button. They helped me when baby would cry at night and encourage me to swaddle baby instead of always making him sleep beside me. They also encouraged me to breastfeed the baby instead of supplementing. They arranged a lactation nurse to see me which has been very helpful and taught me techniques to get a good latch from baby.

• My hubby and I were surprised when a staff came in with a big knapsack and said, You just delivered here?” and she, then, left the bag in our chair. We saw inside lots of freebie stuff from brands and companies given to the hospital for mommies & babies to try out. We love it! There were swaddle blankets, nursing breastpads, storage bottles, bathing & skincare sets for baby, laundry solution for baby’s clothes, magazines, discount vouchers, etc. We were so happy with the stuff we got. Also during lunch, we got a little congratulations cake from from the hospital. So sweet, isn’t it?

By Day 2, I was rushing to have my IV, my catheter and calf pump removed. I felt icky and strapped in the bed. I wanted to freshen up so I wouldn’t feel sickly, dirty and sweaty. By noontime, my IV, catheter and calf pump was removed. I get to changed to my own pajamas and I felt much better. I find the pink hospital gown heavy and too warm for me. In the afternoon, I received visitors and I feel much better in facing visitors by Day 2 without me feeling nauseous and gross. I also got to see my two older boys who came to visit in the afternoon. Oh, they adore their new baby brother.

I was expecting to go home by Day 3 on 11 May 2018 but I was told that 3 days as CS patients means 3 days post-op, so the operating day is not included in the 3 days. Plus they need to give me my last Clexane injection on 12 May. Gosh, the Clexane injection which is for prevention of Deep Venous Thrombosis was injected in my abdomen and it is the most painful thing I ever felt. And to think I have high tolerance to pain but it was really bad. I didn’t like it at all.

By 12 May 2018 Saturday, after clearance from Dr. Kazila and the paediatrician, we are ready to go home by lunch time. But I get to enjoy their Mother’s Day lunch special  before  we go off. It was a Hawaiian Chicken with mashed potatoes and a tart with a Happy Mother’s Day greeting plus a flower with a note. So nice!

We asked how we will settle payment and the nurse told us that the bill will be mailed to us in 2 weeks. We can pay in any AXS kiosk. We were surprised that we can just leave the hospital without payment from us.

Overall, my experience in giving birth in Singapore was a positive one. I am happy with the service I have received in KK Hospital. I am also happy that prayers for me and baby has came through that I had a smooth delivery and baby Zeke had no complications.

Thank you everyone for those who were praying for us and for those who wishes us well… Signing off now because I am going to breast-feed my little one.

P.S. In case you are wondering how much bill we incurred, we still haven’t got the bill, hehe