Are you thinking about having a baby in Thailand? How exciting! I’m happy you came across my blog! In this post, I will share my personal birth story in Koh Samui, Thailand, with you.
Foreigner Giving Birth in Thailand
Actually, we were totally happy as a family of three. But life in Thailand as a family is just so much more carefree than having kids in Germany. And so we decided to have a second one. When I got pregnant with Ruby during the COVID pandemic, it was clear that we would have the baby in Thailand and not fly back to Germany for the birth. What is it like to have a baby in Thailand? How can parents prepare for the delivery? What can they expect and what not? I have compiled everything worth knowing and my experiences with giving birth in Thailand as a foreigner.
Prenatal Checkups and Screenings
At the beginning of the pregnancy, we lived on the small island of Koh Tao. Since all services were heavily down during COVID and there was no midwife on the island, I only had one option: the General Hospital. Unfortunately, the medical equipment there is so outdated that the doctor detected pregnancy at 6 weeks but no heartbeat at 8 weeks. So he then declared Ruby dead with a high probability.
You can hardly say anything worse to an expectant mother, can you? I wanted to be on the safe side and took the speedboat over to Koh Samui. A friend had recommended Dr. Rapheephan. And here she gave me an immediate all-clear: Ruby’s heart was beating strongly, and the development was age-appropriate. Relief!
Since I felt so comfortable with Dr. Rapheephan, I also had further screenings done there. Later, I changed to Bangkokhospital Samui because they had a combination offer.
We had the following screenings done:
- regular Ultrasounds 2D/3D
- Screening for Down Syndrome
- small and large glucose tolerance test
- swabs, blood tests (honestly, I can’t remember the names of the routine lab tests)
I was used to a clear plan for all screenings in Germany. My gynecologist didn’t even question which tests I would have (except, of course, the optional self-pay screenings). Here in Thailand, I had a hard time keeping track of everything. Since our travel health insurance didn’t cover anything, we were complete self-payers (check out the best health insurance for Digital Nomads here). The doctors only told me what could be next, on request.
My tip: Actively ask what’s next (and how much it costs). Then, do your own research and find out whether the test makes sense in your eyes or not.
The Choice of the Birth Clinic
In Thailand, foreigners are free to choose where they have their babies. There is a lot of competition. And since the Thais love price packages of any kind, you can compare them. For us, it was important that the doctors had a good reputation, that the staff could speak a little English, that the technology was modern, and that the facilities for emergency care of newborns were available.
My tip: Ask around, gather experience, make visit appointments, and get to know the hospitals. In large hospitals, there are usually extra departments for foreigners with English-speaking staff.
We heard many good things about Bangkok Hospital Samui and decided on the Baby Delivery Package “Cesarean Section” with a Standard Room. Our first daughter was born by c-section in Germany because of a breech presentation. In Thailand, this means that every birth after a cesarean section may not take place naturally either.
In August 2021, the price was around 69,000 Thai Baht, provided you had at least 3 or 4 checkups at the hospital. However, it was a bit more expensive because there was an English-speaking resident with the surgery.
Our Doctor was Dr. Siwaporn Peerananrangsee, a very warm and calm person with perfect English.
Packing the Hospital Bag for Giving Birth in Thailand
We knew in advance that Bangkokhospital is well equipped. As a welcome gift, there was a backpack with baby bottles, baby clothes, nursing pads, wet wipes, and cleaning materials for the baby (cotton pads, saline, eye drops). Therefore, I did not need much more.
This is what I took with me:
- 3 sets of comfy clothes for me
- 5 comfortable panties
- Hygiene items
- Smartphone, including charger and headphones
- 1 set of newborn clothes
- healthy snacks such as nuts, granola bars, and dried fruit
My tip to men: Bring your wife something personal so she’s not so alone. My husband framed a picture of himself and our daughter and got a big bouquet of flowers. I always looked at this altar when I was feeling anxious or overwhelmed.
The Day of Birth
Fortunately, the pregnancy went without any problems, and Ruby could see the light of day on August 18. Unfortunately, the doctor advised me to stay overnight in the hospital one night earlier to monitor my health. And so, my last night without a baby was almost sleepless. Every 4 hours, a nurse came into the room and checked my vitals. If something like this is suggested to you, ask if it is absolutely necessary, and if not, refuse it!
The following day, a nurse came in around 6 am to shave and give me an enema. After that, it was a matter of waiting until I was finally wheeled into the OR at 9 am, sober. Due to the COVID-19 pandemic, my husband was not allowed to be there for the surgery. He took our big daughter to school and didn’t get to the hospital until around 10 am.
Twenty minutes after I arrived in the OR, Ruby was already there. The resident stood at my head during the entire procedure and gave me a good talk. That helped a lot as a husband substitute.
My tip: Be sure to tell the staff immediately if you are not feeling well in any way. For example, I had a slight feeling of nausea at the beginning. The doctor immediately gave me anti-nausea medication.
After the baby was shown to me and I was allowed to kiss her, I was put into a twilight sleep. So, I didn’t hear anything about the stitching and work afterward. Around 10 am, I was allowed to go back to my room and see my husband. About 30 minutes later, Ruby was brought to us.
The Hospital Stay after Delivery
I had to stay in the hospital for three nights after the birth, which was so good! Because I was the only mother with a child in the entire ward and enjoyed everyone’s attention. Someone came to my aid immediately whenever I hit the “nurse alert” button. I could have Ruby swaddled at any time (especially great when you can’t get up right after surgery yet), and even at night, they took her. Only for breastfeeding every few hours, she was brought to me and put on. However, from night two on, as the highness from the meds slowly wore off, I had such cravings that I didn’t want to give Ruby away for that long.
My tip: Don’t be shy and ask for painkillers. You don’t have to suffer when giving birth in Thailand. A nurse even told me at the end that a mother before me had been given morphine. If I had known that earlier…
I have heard from many families that the men stayed overnight in the room – sometimes even with the other kids. However, that was out of the question for us. After all, it is enough if one of us sleeps badly.
Birth Certificate and Embassy Affairs
In Thailand, citizenship is based on blood. So if both parents are foreigners, the child born in Thailand will not get Thai citizenship. Only if at least one parent is Thai can one apply for it. In our case, after giving birth, a nurse took care of the paperwork, ordered the Thai birth certificate, and handed it over to us on the last day. An English translation was provided free of charge.
Since we wanted to fly to Europe a few months later, we used these documents to apply for a German passport for Ruby at the German Embassy in Bangkok. But theoretically, the Thai birth certificate is still a sufficient identity document in Thailand for a long time. We even saw parents with 3 or 4-year-olds who exclusively used the birth certificates for their children for domestic flights.
Good to know
- We decided to store stem cells from the placenta and umbilical cord blood so that Ruby or other family members would have a better chance of being cured of various diseases. We had to plan, pay, and arrange this procedure a few weeks before the birth. Our partner is the company Medeze in Bangkok. Very interesting for anyone who believes in science and has a little money to spare!
- Prepare yourself during pregnancy for strange-sounding advice (at least for Westerners). For example, doctors advised me to eat 12 (!) eggs a day to keep my blood levels healthy. In practice, I then committed to 6 a day. That was difficult enough.
- In Thailand, there is little room for privacy for pregnant women. Periodically, my belly was patted, and people guessed whether it would be a boy or a girl. I didn’t mind at all. And you know what? 99 percent of the people even thought correctly – it was a girl.
- If your baby has regular Western measurements, it is enormous by Thai standards! And you will be told that at every opportunity – whether before or after giving birth. Don’t take it personally. I have to say, I was a bit annoyed to hear all the time what a giant my little baby (3,600 gr. birth weight) was.
Baby Delivery Options: Why Thailand Encourages C-Sections
Thailand, like many countries, has its own reasons for the relatively high rates of cesarean sections (C-sections) in its healthcare system. The encouragement of C-sections over vaginal births is not attributed to a single cause but rather a combination of medical, cultural, and systemic factors.
Firstly, there is a global trend towards the medicalization of childbirth, where labor and delivery are increasingly managed within a medical framework, often leading to a higher reliance on surgical interventions like C-sections. This trend is partly driven by perceptions of C-sections as being a ‘safer’ option, reducing the risk of complications that might arise during natural childbirth. The perception that C-sections are easier, safer, and more controllable contributes to their preference among both healthcare providers and expectant mothers.
Additionally, private healthcare facilities, which are popular among expatriates and wealthier Thais, tend to offer more personalized and comfortable childbirth experiences. These facilities often promote planned C-sections, which allow for scheduling convenience and predictability. The ability to choose the baby’s birth date and make preparations beforehand are cited as advantages, along with a more controlled delivery experience.
It’s important to note that while C-sections can be life-saving in certain medical situations, the World Health Organization suggests that C-section rates higher than 10-15% are not associated with reductions in maternal and newborn mortality rates. The trend towards higher rates of C-sections, therefore, raises questions about the necessity of such interventions in cases where they might not be medically required.
In short, we can say that the encouragement of C-sections in Thailand is influenced by a mix of medical practices, cultural preferences, and the availability of advanced healthcare services, particularly in private hospitals.
Home Birth in Thailand – The Role of Midwives and Doulas
Traditionally, midwifery was the norm, but the landscape has shifted towards hospital births due to government initiatives aimed at improving healthcare and reducing infant mortality rates since the 1970s. This shift has led to a strong reliance on medical systems and a decline in home birth practices, with licensed midwives mainly operating within hospital settings or in remote areas.
For foreign midwives wishing to practice in Thailand, the challenges are significant. They must navigate through rigorous certification processes, including passing exams in formal Thai, which presents an additional layer of difficulty. This, coupled with regulatory barriers for non-Thai citizens in the medical field, limits the availability of licensed foreign midwives in the country.
In Thailand, doulas give great support during childbirth, even in hospitals. They are there for moms and dads all the way, offering emotional, physical, and info help. They teach about childbirth, how to relax, get partners ready, and help after the baby is born. Having a doula around can make giving birth in Thailand smoother and less stressful, even with hospital rules.
While home births may not be widely advocated in Thailand due to infrastructural and continuity of care concerns, they are possible. I personally know of many women in Koh Phangan who gave birth at home with the support of a dedicated doula.
Statistics Around Child Birth in Thailand
According to the World Fact Book, the birth rate in Thailand is around 13 babies per 1000 people. Maternal deaths are not very common, but when they happen, they’re often due to bleeding, infections, high blood pressure during pregnancy, complications with the amniotic fluid, and other reasons.
Almost all Thai women giving birth (97%) have professional medical help, which is a lot higher than in other places in the region, where it’s about half that rate. Thai women are more likely to get prenatal care at least four times during their pregnancy (74%) compared to other Southeast Asian women (43%), and they’re also more likely to use birth control (81%).
Child deaths before age five have gone down to 14 per 1000 births from 28 in just six years. The rate of babies who die in their first year has also dropped from 20 per 1000 births to around 16 in less than a decade.
Traditional Thai Pregnancy Beliefs and Abortion Laws
In Thailand, pregnancy is tied to some unique beliefs. According to several sources, people think a soul flies into the womb to start life. When a woman’s period stops and she craves sour food, it’s believed she’s pregnant. She should tell her partner, then her mother, and her mother-in-law. Infertility is thought to be a lack of balance, which some believe can be fixed with acupressure.
Buddhists view abortion as a serious act because it prevents rebirth and takes a life. But since January 2021, Thailand has allowed abortions within the first 12 weeks. Other legal reasons for an abortion include risks to the mother’s health, severe potential health problems for the baby, or pregnancies caused by sexual offenses. Before this law, many women sought unsafe ways to end pregnancies.
There’s also a scary ghost in Thai stories called Krasue that targets pregnant women, trying to harm them or their unborn children. This spirit is part of the folklore explaining some illnesses that pregnant women face, especially in rural areas.
Conclusion to Giving Birth in Thailand
I found giving birth in Thailand much more pleasant than the delivery in Germany. Of course, there is always pain after a C-section. But at no time did I feel that I was not in good hands or treated worse as a farang. The postpartum period in Thailand was especially lovely. The healing process was much faster with lots of sun and the proximity to the sea. So, if you have the chance, go for it!
Let me know how your experiences were in the comments! Do you have any questions? I’m here to help!