I have returned to the topic of pregnancy and postpartum care/beliefs! While trying to organize my thoughts on this topic, I realized I should start at the beginning with prenatal care. So here are some similarities and differences between the two as I have experienced it. (Note: our first two children were born in Ulaanbaatar, and I am currently ~39 weeks pregnant with our third while we are in the US.)

Cost:

Healthcare costs vary widely around the world. In Mongolia, there is a mix of socialized healthcare and private healthcare. For the most part, we used private healthcare at a large independent hospital, although our kids’ vaccinations were done through the local micro district clinics. We did have insurance, but by and large, we always had to pay upfront and submit receipts for reimbursement. Even so, we were able to pay out of pocket because costs were much lower than in the US–even at the expensive hospital.

The hospital where we received prenatal care offered several packages that covered care, starting from x-weeks to delivery. All told, our prenatal package cost somewhere in the ballpark of $1200 US. When it came time for delivery, we had a second package that covered all costs through labor, delivery, and postnatal recovery in the hospital. That package cost about the same, depending on which labor/delivery/recovery room(s) you selected. With our first, we opted for the suite that included labor, delivery, and recovery in the same room. With our second, I decided to go the cheaper route of labor, then moving to delivery, then recovering in a separate, smaller room. Both options provided great care just at different price points. All told, our out of pocket costs (that were reimbursed by our insurance) were less than what an American patient would normally pay for deductibles.

Somehow, we are fortunate enough to qualify for state health insurance, which means, at least so far, that all of our healthcare costs in this pregnancy have been covered. However, if they weren’t, we would be facing much higher bills. According to WebMd, prenatal care usually averages around $2000 US, but labor and delivery can cost anywhere from $4000 US to $45000 US. If you have any kind of risks in pregnancy or any emergencies in delivery, costs will add up from various tests and procedures.

What is Included:

In both Mongolia, and the US, I’ve had monthly visits that led to bi-weekly visits, and ended in weekly check-ups in the last month and a half of the pregnancy. One major difference I’ve experienced is in the number and type of prenatal tests given.

Ultrasound vs doppler: in Mongolia (and throughout most of Asia), regular ultrasounds are normal. I had one for every monthly appointment, and it was definitely a highlight to see our babies grow over the course of the pregnancy. In the US, ultrasounds are performed fewer times, usually only two or three in a healthy pregnancy. The rest of the time, the baby’s growth and health is monitored by doppler to hear the heartbeat and measuring the size of the uterus to approximate growth. Because I am of “advanced maternal age” at 35, I have had more ultrasounds than the average American mom because of potential risk of birth defects, etc. (So far, baby girl has been healthy and on track in every way.)

In the US, I’ve had the gestational diabetes blood sugar test, some blood tests, and a number of urinalysis tests, and that’s been about it. In Mongolia, I had all of these tests, but I was also referred to a nephrologist when an ultrasound showed unusual swelling in one of my kidneys. (I was fine, and I’m still not sure what happened there other than pregnancy does weird stuff to your body.) I was also referred to a nutritionist, which wasn’t an option that was covered during this pregnancy in the US. In the last couple of months of pregnancy in Mongolia, I had regular non-stress tests (NST) to monitor fetal activity leading up to delivery. In the last few weeks, I’ve been doing NST appointments several times a week due to possible complications from contracting Covid-19. Otherwise, I’m not sure if this is normal in the US.

Something that I’ve experienced as an option stateside is physical therapy to deal with hip and back pain. I’m honestly not sure if physical therapy is a common enough option in Mongolian healthcare or if I just wasn’t referred to it because it wasn’t a big enough issue in past pregnancies. Chiropractic care, massage, acupressure, and acupuncture are all common enough, but I don’t know about other forms of physical therapy.

Takeaway:

These are the similarities and differences between prenatal care in Mongolia versus the US. Overall, I found my experiences fairly comparable, although significantly less expensive in UB. What do you think? Would you be willing to go through a pregnancy in a different country? I’m curious about your thoughts and questions!