Davao’s hospitals
I have a Japanese friend who’s married to a Filipina, and she recently gave birth to a healthy baby girl. My friend, Naoki, has been in Davao for about 6 months now, and got to love the city so much he made a Japanese-language website about it. However, recently, he had a truly disappointing and disheartening experience with our medical services.
When Naoki’s wife was still pregnant, other Japanese nationals living in Davao quietly warned him of a tendency among would-be mothers married to Japanese men to undergo Caesarian section at childbirth. And according to rumor, it isn’t voluntary.
I’m a guy and far removed from birthing concerns, but isn’t it true that parents are forewarned of the necessity of Caesarian section? Naoki’s daughter was born a couple of weeks ago via C-section. He was not informed of the reason why, even up to now.
My friend was so frustrated over this, especially over the fact that the hospital has not made any efforts to apprise him of the overall situation.
Davao, in case this is not clear to those in the medical field, is positioning for global competitiveness. In the information technology industry, our city is exerting all effort to become an investment destination. In tourism, the movers and shakers of this industry have been going full blast in promotions and similar activities. Real estate developers are also in on the action, gearing up for the city’s potential to become a retirees’ haven.
Why are there murmurings going around that our hospitals are trying to make an extra buck (or in this case, lapad) off of our foreigner residents? The Japanese will not say this outright to their Filipino friends, but I know enough about them to know if there’s something wrong.
May 3rd, 2007 at 4:24 pm
Blogie, thanks for blogging this. Sunlight is a great disinfectant, as I say frequently. Exposure through the blogoshpere can create change and help Davao City.
I just wish the hospital’s name and doctor’s name would appear. Your friend is owed an explanation. Why should the hospital and doctor enjoy anonymity? In fact, they owe us all an explanation.
May 3rd, 2007 at 4:30 pm
Hi Nick. Sorry but it was my friend’s wish that I do not include the name of the doctor. He is indeed owed an explanation, especially when they kept his baby in the hospital’s nursery for longer than seemingly necessary — again, without an explanation. So how can you blame Naoki for feeling that he’s being had?
Nick, this is a serious matter. Once I have more information — hard information — I will blog again about this. And next time, I will definitely include names.
May 4th, 2007 at 12:20 am
Hi Blog!! Great blog!
Emergency Cesarean section is sometimes warranted if the baby shows signs of distress in the middle of labor (slowing heartbeat especially after contractions), if labor does not seem to be progressing (the cervix is not dilating or the baby isn’t descending after several hours), or if the mother’s health is in danger (i.e. patients with preeclampsia who develop convulsions). The doctor IS obligated to tell either the patient or her next of kin why the C-section was done especially if they ask for the information. In an absolute emergency, a doctor may do a C-section to save either the baby’s or the mother’s life, but afterwards he/she certainly should tell the father WHY he did it.
I hope that your friend DID ask the doctor why the C-section was done and why the baby was kept in the nursery. From my experience with the Philippine health care system, many patients and families (especially the less-educated) feel that asking questions implies lack of trust in the doctors/nurses. “Dyahe” is the sentiment that a lot of us hide behind. Many in my profession only divulge information when they are asked point blank. Your friend should assert his right to information, if his wife will not.
May 4th, 2007 at 12:27 am
Hello Che. Yes, the father did assert his wish to know why the C-section was done and why the baby was kept in hospital. Unfortunately, I wasn’t there to interpret for him, so I guess he wasn’t able to insist enough. But, he’s pretty OK in English, so I’m sure the hospital staff understood what he was trying to say. He was told, however, that the report would be given him upon discharge of the baby. Weird no? Couldn’t they have printed it out? But at discharge, no report.
May 4th, 2007 at 6:25 am
Nice points, though, Che, about “dyahe” and the feeling of lack of respect. It is prevalent. I see it a lot.
May 4th, 2007 at 7:23 am
Isn’t it SOP for the patient and family to be asked if they agree for the patient to be operated on? If this is so and they weren’t told about the procedure then they can always sue the hospital. They better do.
May 4th, 2007 at 11:24 am
I remember when I was doing training in one of the hospitals in Davao emergency CS is performed when a vaginal delivery would put the baby’s or mother’s life at risk, although in the last decade it has been performed upon request. And usually the attending OB will inform the mother and her husband or immediate family members the reason why they are doing such surgery.
The complications might be a fetal distress or maternal distress. Here in Canada if your first-born was delivered through CS, the 2nd and your next babies will be delivered through cesarean section as well.
Those doctors should have a valid reason why your friend had an emergency CS not just because they wanted to charge more from your friend.
I have your friend and the baby is in good health after the surgery.
May 4th, 2007 at 11:55 am
Ayeza, even in the Philippines and in Japan, succeeding births after CS will be carried out under CS. That’s why my friend was saying, his and his wife’s lifestyles have been altered forever.
Sue? Hmmm… Tricky business, that.
May 4th, 2007 at 4:51 pm
VBAC - vaginal birth after C-section - is attempted in many cases if the doctor feels that it is safe. It isn’t limited to the West; it’s also done in PGH (less so). It also depends on the kind of CS done.
Going back to the initial problem - now that his wife has been discharged, I’m sure she has a postpartum appointment scheduled with the doctor. Naoki should take that opportunity to press the doctor for a reason for the C-section. A CS is the doctor’s call, not the hospital’s. In the same vein, when their child goes to his first pediatrician appointment, he can ask the doctor why the baby was in the nursery longer than expected. I can’t stress enough - ASK THE DOCTORS.
Dito sa US, baliktad naman. Because insurance companies pay for hospital stays, you’re allowed to stay only 48 hours after a normal vaginal delivery and 72 hours after an uncomplicated CS. Then they hustle you out. How ironic.
Abaniko has a point - informed consent should be obtained whenever surgery is performed. (in emergency cases, consent can be obtained from next of kin) I’m pretty sure we used to have people sign consents before we delivered babies in PGH - maybe blanket consents (delivery + C-section if warranted) that patients just signed and didn’t read. (we all do that anyway)
I guess without knowing all the details, we can speculate about your friend’s case till the cows come home. I do hope that when you have more hard information, you tell us all what really went down
May 4th, 2007 at 6:41 pm
Thanks for you input, guys! Yes, I’ll try to update this after and if I’m able to gather more info.
You know, I just hope I’m wrong about this…
May 5th, 2007 at 6:27 pm
Type your comment here.
Hi blogie,
I’ve been in medical field for more than 15 yrs in the Philippines,in a
govt hospital,there’s never been a
case that a C-section was done without explaining the reason to
the immediate family members,even to
those who are most illiterate,we have
to find ways to make them compre-
hend everything.Im now practicing
in U.S and I believe its just a case
of “lost in translation”.Assuming that the C-Section was done in a Private hospital.Patients diagnosis
will always indicate the factor,Like
C-Section secondary to Fetal Distress or CS sec to Placenta Previa
so on and so forth.
May 6th, 2007 at 12:34 am
The husband should have been appraised of the mother and the baby’s situation before any operation (or after, if an emergency CS was done). I don’t think it’s not an option for the doctor but rather a must.
@Che
Nice to see you here…