What? You’re Telling Me I Can’t Get an Epidural?!

For those mamas soon-to-deliver in Bangkok, I thought I’d shed some light on a recent rumor that’s going around about hospitals changing their policies on epidurals, and in some cases, the inability to get epidurals at all.  With an impending delivery on the way myself, you better believe I wanted to get to the bottom of what is really happening before Baby Girl Braunohler makes her debut in May.  I heard everything from – “women haven’t been able to get epidurals” to “more women are choosing c-sections” to “once you have an epidural, the anesthesiologist stays in the room with you the entire time through delivery, and you now pay based on the amount of time you are in labor with an epidural (instead of a set fee for having an epidural).”  I held out until 7cm to get an epidural when I was in labor with Logan, but I can tell you that I would not have wanted to know what the final 3cm + pitocin + pushing and final delivery would have felt like without it.  So, yes, when the time comes, I better be able to get an epidural if I want one.

According to my OB,  sixteen years ago, a women in labor at Samitivej Hospital died of an amniotic fluid embolism, a very rare condition that is almost always fatal.  The anesthesiologist who had administered her epidural was able to reach her in about one minute, however her rapidly deteriorating situation could not be reversed and she died quickly.  Last month, the judge rendered a decision on the case (yes, after 16 years!) and found the medical team to be at fault for not attending to the woman sooner.  As a result, all anesthesiologists in the city went on strike — and if you happened to deliver on that unlucky day or two last month, an epidural would have been very difficult to come by.  Because of the decision, hospitals quickly realized they needed to “take care of their own,” and each one restructured their policies and protocol for anesthesiologists working in labor and maternity wards.  As I will be delivering at Bumrungrad, the hospital has now hired an anesthesiologist to be present in the labor and maternity ward at all times.  In the event that you have an epidural and then have to deliver via c-section, you will be taken to the operating room and handled by a second anesthesiologist for the c-section.   This means that you will pay double the doctor’s fees for anesthesia, since the delivery will require two anesthesiologists instead of one.  I understand from other mothers that have/are delivering at Samitivej, if you are administered an epidural, the anesthesiologist must remain with you in the room through delivery.  You will then pay anesthesiologist fees based on the length of time you were in labor with an epidural instead of a set price for having an epidural.  I’m not sure about BNH or other hospitals in town, but if you know, please do share.

I hope this clears up some confusion surrounding why hospitals’ policies and pricing are changing.  One less thing to worry about during labor and delivery certainly makes for a more calm mama!

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