Having a Baby in Shanghai: Complete Guide

Shanghai Living

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Things to consider when having a baby in Shanghai

First things first: Maternity insurance

Expecting a baby is daunting for every new mother, and living in a city far from home adds to the stress. But rest assured, giving birth in Shanghai is a well-worn path and there is plenty of expertise on hand.

International hospitals in Shanghai deliver high quality patient care , even if the style may differ from what you’re used to back home. Many expats arrive here with health insurance as part of their package, but as international insurance packages differ widely, it’s a good idea to check your policy before you get pregnant to avoid being blindsided by any unanticipated costs of having a baby here.

If your coverage is limited or you are uninsured, it is important to note that you need to obtain health insurance and/or specifically add maternity coverage BEFORE you become pregnant. In the insurance industry, it is a standard requirement that this coverage is obtained a minimum of 10-12 months before you deliver your baby (not before you become pregnant).

Hospital choice

Your insurance coverage will likely greatly impact your choice of hospital and therefore provider. International insurance should be accepted at international hospitals but always double-check with the individual hospital’s billing department if you have any questions about coverage. It is also worth looking into whether you have to purchase a prenatal package through the hospital or whether they allow you to purchase tests à la carte.

Liaise with your insurer and the hospital to determine whether direct billing is an option, or if upfront payment is required. If you have an un-expected pregnancy, with no maternity coverage, it is recommended to insure the baby from birth.

The international maternity hospitals include American Sino, ParkwayHealth, Shanghai United Family Hospital, Worldpath and newcomer Redleaf Maternity Hospital, all of which are located in Puxi, and Shanghai East International Medical Center, which is located in Pudong. Raffles Medical is a popular Singaporean clinic that provides affordable prenatal care, but no delivery services. Popular local hospitals in Puxi include Changning Maternity Hospital and Peace Maternity Hospital. In Pudong, Shanghai First Maternity Hospital and Shanghai East Maternity Hospital attract many expats for their excellent VIP sections. If you intend to give birth at a local hospital, this will need to be pre-booked well in advance; if not, you may have trouble being accepted as a patient as there may not be space available.

Currently, the only hospitals performing water births are Changning Maternity and Redleaf hospitals. For those who want to experience a home birth, it’s important to note that they are technically allowed, but they cannot be attended by medical personnel. Obtaining a birth certificate will also be an issue as birth certificates can only be issued by hospitals. If you have your heart set on a home birth, it may be worth considering returning to your home country to give birth.

Key criteria for choosing a birthing hospital:

A strong medical team that follows evidence-based international medical protocols, such as those by the American College of Pediatrics and OBGYN, and provides a strong emphasis on a non-invasive birth. “In Shanghai, C-sections account for 60-75% of deliveries in local hospitals, compared with 30-40% at international hospitals.

Discuss medical intervention with your doctor, and provide a birth planbeforehand.

An on-site neonatal intensive care unit (NICU), so that both parents and baby can remain together if the baby requires intensive care. Be aware that babies may still be transferred to a specialist pediatric hospital, like the Children’s Hospital of Fudan university, for any major complications.

A complete continuum of care, including prenatal classes, knowledgeable and caring midwives, board-certified obstetricians and pediatricians. And breastfeeding support staff.

Giving birth at a local Chinese hospital

There are 3, 600 maternity beds in hospitals across the city equipped to manage up to 250, 000 births every year, according to the Shanghai Health and Family Planning Commission. However, given that Shanghai’s family planning regulations changed in March 2014, allowing couples to have a second child if either of them were an only child, the city is preparing for a baby boom. An extra 20,000 to 30,000 newborns are expected per year between 2014-16, with an estimated 200, 000 babies to be born annually in the city. A record 239, 600 babies were born in Shanghai in 2012, the auspicious Year of the Dragon.

According to Gerald Ang, General Manager of Raffles Medical Shanghai, which provides prenatal and antenatal care for patients delivering at local hospitals, the number one tip for those planning to deliver at a local hospital is to book early.-Maternity services are in heavy demand in Shanghai, especially the VIP wards of the well-regarded hospitals.

Those delivering at local hospitals, in the VIP wing or regular ward, should expect vast cultural differences and limited English-language support. C-sections are common and breastfeeding support may be minimal. Typically, private rooms at Chinese hospitals have a small sofa, intended for an ayi or your mother-in-law, not your husband.

Check out our handy guide to international maternity hospitals in Shanghai:

international Maternity Hospitals in Shanghai

Redleaf Hospital

Offers gynecology, obstetrics, newborn care, pediatrics and postpartum recovery services that adhere to the highest international standards. 105 beds and 178 on-site parking spaces.

No. of deliveries: 74 (since Redleaf’s official opening in July 2013)   C-section rate: The vast majority of clients choose vaginal delivery. Cost: Prenatal Package price: RMB 23,000;Natural Delivery: RMB 73,000; C-section: RMB 110,000 Prenatal packages: Includes check-ups from 12 weeks; initial & follow-up consultations; 15+ types of lab tests, 3 types of ultrasound tests, fetal non-stress tests, and Down Syndrome screening tests. Can choose individual services from the package. Pain relief: Yes, epidural and other pain relief are available. Midwife present: Yes. Water births: Yes. NICU: Newborn Special Care Nursery is available on site; for intensive care, newborns will be transferred to Children’s Hospital of Fudan University. Prenatal classes: Prenatal classes available on-site in English and Chinese. Breastfeeding support: Yes.

Contact: 1209 Middle Huaihai Road, Xuhui District; 6196 3333 (24-hour)

Parkway Health

International team of over 80 qualified doctors and specialists offering premium medical services, including family medicine, pediatrics, obstetrics, and gynecology.

No. of deliveries: 300   C-section rate: 40% Cost: Prenatal: between RMB 15,000 and RMB 25,000; Natural Delivery: RMB 60,000; C-section: RMB 98,000. Prenatal packages: Available from 12 or 16 weeks. Includes blood tests, ultrasounds, genetic screenings and doctor consultations. Can choose individual services from the package. Pain relief: Epidural (locally manufactured) available; not included in the delivery package. Midwife present: A midwife is always present during labor. Water births: No. NICU: The birthing center is equipped with an incubator for pre-term babies with no other complications, and a Neonatalogist is on site. For major complications, newborns are transferred to Fudan Hospital’s NICU. Prenatal classes: Prenatal classes available on-site in English. Breastfeeding support: Yes.

Contact: 3F, 170 Danshui Lu, Huangpu District; 6445 5999 (24-hour)

Shanghai East International Medical Center

A US-China joint venture providing a full range of world-class services including family medicine, pediatrics, obstetrics, gynecology, and on-site 24-hour emergency service.

No. of deliveries: Between 70-80   C-section rate: Less than 33% Cost: “Prenatal Care from 12 weeks RMB 25,000/ from 24 weeks RMB 15,000; Normal Vaginal Delivery – RMB 62,000; Operative Vaginal Delivery – RMB 72,000; C-Section: RMB 86,000Prenatal packages: Available for mothers in the 1st or 2nd trimester. Packages start at 12 and 24 weeks and cover all consultations and check-ups until birth. Individual services available up to 24 weeks. Pain relief: Epidural (locally manufactured) and on-call support from an anesthesiologist. Midwife present: Yes. Water births: Not licensed to perform water births, but a bathtub is available. NICU: No NICU, but have a partnership with Shanghai Children’s Medical Center for emergencies (fees may apply). Prenatal classes: CPR and First Aid, Antenatal Classes, and Pilates available in English and Chinese. Breastfeeding support: Yes.

Contact: 150 Jimo Lu, Pudong District (1F, 12F); 5879 9999 (24-hour)

Shanghai United Family Hospital

Medical hospital offering a wide range of medical services with international standard treatment. Offers an English-speaking emergency department operating 24/7.

No. of deliveries: 85   C-section rate: 30% Cost: Please check website for details. Prenatal packages: Yes. Please check website for details. Pain relief: Natural pain relief, Entonox, epidural all available. Midwife present: Yes. Water births: Available by patient providing equipment. NICU: Yes. Prenatal classes: Both Chinese and English classes are available. Breastfeeding support: Yes. Daily lactation consulting services, midwife clinic for breastfeeding. LLL meeting on-site.

Contact: 1139 Xianxia Lu, Changning District; 4008 919191 (24-hour)

American-Sino OB, GYN, Pediatrics Services

Providing a comprehensive array of on-site services for women and children, including obstetrics, gynecology, and pediatrics, by certified specialists from overseas and China.

No. of deliveries: 1200   C-section rate: 40% Cost: 850 Prenatal packages: Prenatal Care RMB 20,000; Normal Vaginal Delivery – RMB 45,000; C-Section: RMB 70,000 Pain relief: Painless services available. Midwife present: Yes. Water births: Opening at the end of 2014 in cooperation with ASOG International Hospital. NICU: NICU will be available on site in ASOG International Hospital; emergencies currently transferred to other hospitals. Prenatal classes: Will soon provide bilingual lectures, prenatal yoga, postnatal pilates and more. Breastfeeding support: Yes, ASOG offers professional breastfeeding support.

Contact: 3/F, Block 6, Clove Apt Bldg, 800 Huashan Lu; 6210 2299

Choosing a provider

This is a very personal decision. Talking to friends or asking questions on local forums is a great way to find out other people’s experiences with different doctors. Above all, you should make sure that your feelings and philosophy about childbirth match those of your practioner’s. It’s a good idea to take some time researching childbirth and labor methods to help you decide how you feel about interventions, medication, and other relevant issues. The patient-doctor relationship needs to be a trusting one so your birth can be a positive experience.

Tara, a young mother-of-two, recently had a planned C-section in an international hospital and felt that the care she received was much better than that of her first birth back home in the United States. Tara said, “After the birth, I had a sudden onset of pneumonia in the middle of the night that was handled flawlessly by the nursing staff and doctors. I also received essential help from the amazing lactation consultant provided by the hospital. I hope to deliver my next baby in China.”

Make sure you are informed and educated about your birth and your choices. Different practitioners may have different approaches to procedures, so it is often best to outline your wishes in a written birth plan that can be discussed with your doctor or midwife. For instance, if you wish to deliver in a squatting position, check in advance that your doctor is comfortable with attending this type of delivery. Likewise with a VBAC (Vaginal Birth after Cesarean). It is much easier to switch doctors early on in your pregnancy should you find yourself uncomfortable with your originally assigned practitioner.

In Shanghai, the C-section rate ranges anywhere from 60-75% in local hospitals to 30-40% at international hospitals. Sometimes interventions are used because it is common practice as opposed to being absolutely necessary. If you are adamantly against having a C-section, a telling sign would be to find out your doctor’s individual C-section rate. Good communication with your doctor is essential throughout your pregnancy.

Asking your caregiver the right questions in your early visits is vital to selecting a provider that is right for you. Vanessa discovered in the last weeks of her pregnancy that the local hospital where she planned to deliver would not allow her husband or any other person in the delivery room. At that point, it was too late to consider another hospital. First-time mom Brittany had a completely different experience giving birth in another local hospital. “Overall, the doctors were very accommodating to our unconventional requests. Actually, I personally wanted to give up and just have a C-section after the first day, but the doctors on staff encouraged me to push through and have the natural delivery that I had hoped for.”

Labor support

Having the right support around you during labor and delivery makes a world of difference. That support can come from husbands, partners, or perhaps a close friend. Many women in Shanghai also choose to hire a doula, a non-clinical caregiver who offers emotional and physical support during labor, delivery and postpartum. Oftentimes a doula is hired by parents who are looking for a more natural style of birth.

According to Alison Nantz of Shanghai Doulas, “In our experience, our clients are generally less likely to be offered C-sections or highly medicalized births if their doctors know they have hired a doula. The act of hiring a doula tends to suggest to the caregivers that these couples are more committed to a non-medicalized birth, although this is not always the case.” The benefits of a doula are obviously multiplied here in Shanghai where language and culture can be an issue. Having assisted at hospitals all around the city, doulas generally have a good idea of how each hospital works. The doula does not take the place of a husband or labor companion. When asked about how partners can feel more involved in the birth, Nantz says, “We make sure we involve partners as appropriate to their comfort levels, and we work as a team to support the mother-to-be.”

Prenatal Support Prenatal classes

Most international hospitals host prenatal childbirth classes that provide information about pregnancy and childbirth, and address the physical, psychological and emotional challenges that a family may face during pregnancy, childbirth and postpartum. Check whether classes are included in the hospital’s prenatal package. The second trimester is an ideal time to attend.

Yoga is hugely popular among expectant moms, with programs offered across the city. Many of the yoga studios offering prenatal yoga also offer post-natal, baby, and “mom and me” yoga classes.

Create a network of support – The importance of having a strong network of support during pregnancy can’t be underestimated. Making friendships during that time will give mothers connections with others who will be going through similar challenges and milestones at the same time. Establish regular coffee mornings and playgroups, which provide ongoing opportunities for socializing for both mothers and children.

Many mothers have found invaluable support from the forum Shanghai mamas, which offers opportunities to connect, ask advice, share stories and experiences, and meet a diverse community of families and friends.

Childbirth classes

The second trimester is a great time to start looking at prenatal or childbirth classes. Some hospitals will provide these free of charge, while others have an additional fee. It is best to check with your hospital to see if it is included in your package or if it is a separate cost. All childbirth classes are not created equal. Different hospitals have different approaches to teaching about labor management and childbirth. Childbirth classes should include information about the stages of labor and the different pain medication that is available at the facility.

A popular trend in Western countries, Hypnobirthing has been gaining popularity and prominence among expats here in Shanghai. The Hypnobirthing philosophy functions on the premise that most labor-related pain is a result of fear and tension, which can be diminished with the use of deep relaxation. Fear during labor activates our primal fight-or-flight mechanism, causing stress hormones that force blood to the arms and legs, which depletes blood flow to the uterus, creating uterine pain and hindering the labor process.

The Hypnobirthing method is not just for those who are focused on natural childbirth. One mother, Tiffany, used Hypnobirthing on her fourth birth and although she ended up having an epidural, she confided that by using the Hypnobirthing methods for relaxation, she achieved the best sleep that she’d ever had in the last months of her pregnancy.

There do not appear to be any Lamaze or Bradley method childbirth classes available in Shanghai.

Prenatal exercise

According to Victor Rowse, a Shanghai fitness expert, the best prenatal exercises are any types of exercise which challenge the muscular system. They offer the most benefits in preparing your body for the physical demands of labor and supporting the increase in bodyweight. This could mean climbing hills, lifting weights, or even just lifting your own bodyweight. Doing squats, lunges, step-ups, running and jumping exercises are all perfectly fine for pregnant women.

Many women use yoga to strengthen their bodies in preparation for labor. Shanghai has a number of excellent studios around the city which offer prenatal yoga classes. Studies have suggested that prenatal yoga can improve sleep, reduce stress and anxiety, increase the strength, flexibility and endurance of muscles needed for childbirth and decrease lower back pain, nausea, headaches and shortness of breath.

Lactation guidance

Whether to breastfeed or formula feed is a very personal decision. Every new mom must take into account her work and family situation and decide what will work best for her and her infant. Recent scandals surrounding the quality of formula milk in China have made new mothers more vigilant about where they source their baby formula. If you choose to formula feed or supplement with formula, there are a number of reputable foreign and local brands to be found here.

Don’t worry if you’re set on breastfeeding and it does not go smoothly from the very beginning. It’s a learned skill and for many, it does get easier. Rachel, a mom-of-three confided, “With my first baby, the hospital nurses wanted to give him formula because my son was having trouble nursing. Luckily, skin-to-skin contact while nursing immediately solved the issue and my little guy nursed like a champ from then on.”

In many cases, encouragement and a little information goes a long way with breastfeeding. For mothers who are having issues or expectant mothers who have questions regarding breastfeeding, the Le Leche League of Shanghai meets monthly in Puxi (English) and Pudong (Chinese). They offer free mother-to-mother breastfeeding help and information through monthly meetings, email and telephone.

If your baby is not gaining weight, has sudden weight loss, or is having latching problems, it may be worth getting in touch with a lactaction consultant like Melanie Ham of LunaBelle Lactation. If you are returning to work but wish to continue breastfeeding, you may also wish to get guidance in how to manage both.

Mothers groups

The first few months as a new mother can be emotionally tough, especially going from working full time to full-time mom! A sense of community and good friendships can do wonders for your emotional state as you embrace the challenges of parenthood. Lucky for you, Shanghai is the smallest big city you will ever live in; the truth of that can be found in the great community resources available here.

There are several online resources that are specifically helpful to those who are pregnant or about to become new mommies. Bumps&Babes contains a wealth of information about pregnancy and parenthood. With a panel of international experts who contribute online articles about hot topics, sign up for their weekly newsletters to keep you in the know about pregnancy and parenthood events and classes.

Shanghai Mamas is a private forum for mothers (and fathers too!) to exchange ideas, get help, make new friends and ask questions about life and parenthood in Shanghai. They organize weekly coffee mornings and get-togethers around the city, providing chances for you to get out and meet others in similar circumstances.

Struggling to cope

Even with all these great support systems, some new mothers still struggle. Naturally occurring hormone changes immediately after birth, as well as lack of sleep, lead many women to feel overwhelmed and depressed. While it is normal to have a bit of an adjustment phase with a new baby, there is a big difference between a little “baby blues” and postpartum depression. Signs that you may need immediate help include not being engaged with your infant or having feelings of harming yourself or your baby. It is important to realize as well that postpartum depression can occur up to a year after the birth of your baby.

For women suffering from postpartum depression, the Shanghai Community Center or the Shanghai International Mental Health Association are great places to get counseling help. While neither conduct any classes or sessions specific to postpartum depression, they do have trained counselors and clinical psychologists who can help you navigate through the difficult time. For emergency situations, Lifeline Shanghai is an English-speaking hotline that provides free, confidential, and anonymous emotional support via telephone 10am to 10pm, 365 days a year.

Hopefully, this guide will give you an overview of the options available to you in Shanghai, as you prepare for this amazing, albeit slightly nerve-wracking, journey into parenthood. In the end, the most important thing is a healthy baby and a healthy mother. Congratulations and best wishes for your pregnancy and birth!

Registering Your Baby in China

If you have lived here for a while you will know that administrative tasks in China require both time and possession of the right documents; registering a newborn baby is no different. What’s more, it needs to happen within a month of the baby’s birth, or you will incur a fine, so it helps to be organised.

To save you time researching what needs to be done, Bumps & Babes has collected information from each individual embassy or consulate on registration procedures. Can’t find your country’s information? Let us know and we will be happy to help you out!

Question 1: The child was born in China and his (her) parents are foreigners. How do I apply for the child’s visa?

Answer: Within one month after the child was born, his (her) father or mother should bring the child’s birth certificate and the parents’ ID certificates to the Exit-Entry Administration Bureau of Shanghai to register and apply for the relevant visa.

Question 2: The foreign child born in Shanghai is not able to obtain his (her) passport within one month. What should be done?

Answer: Within one month after the child was born, his (her) father or mother should bring the child’s birth certificate, parents’ ID certificates and the receipt of the embassy (consulate) to the Exit-Entry Administration Bureau of Shanghai to register. He (she) must apply for the relevant visa as soon as he (she) gets the passport.

Question 3: The child was born in China and his (her) father (mother) is a foreigner and mother (father) is a Chinese. He (she) has obtained the foreign passport from the foreign embassy (consulate). How do we go through the procedure for exit?

Answer: According to China’s Law of Nationalities, if the child was born in mainland China and one of the parents is a Chinese national, the child will have Chinese nationality. Exit-Entry Administration won’t issue him (her) with a visa even if the child has obtained a foreign passport. The child’s parents should bring the birth certificate of the child and their own ID certificates to the Exit-Entry Administration Bureau of Shanghai to go through nationality confirmation then apply for exit.

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