Sunday, January 5, 2014

Preparing for Child Birth in Costa Rica and actually enjoying doctor appointments

Let me start by reminding you, we are having our 3rd child within the next few weeks - so this is not our first rodeo. However, this is our first childbirth in Costa Rica and thus far, we have been pleasantly happy with our experience in the doctors office and laboratory. 5 years ago, when I was pregnant for the first time, I was given a book, What to Expect When you are Expecting. I studied it day and night because, as new mothers know, the first baby is exciting and scary and nothing can prepare you for the actual childbirth better than this book. I read the book to my mother and my husband and we followed it, religiously, step by step. I didn't even ask questions at my doctors appointments, because the book already prepared me. This was a good thing, because my doctor in Texas kept such a busy schedule, I barely got 5 minutes with him after waiting sometimes an hour just to see him! He was always in such a hurry and I was too nervous to ask questions. I felt like a cow being herded through his office, coincidentally which was full of many other cows like me. His staff was always changing and he did not own a 3D or 4D ultrasound, only a sonogram - which meant more exciting physical exams. I would sit in the waiting room, for what seemed like forever, then I would go with someone who would weigh me and send me to the bathroom to leave urine, after which I was left in another waiting room to wait another 15 - 20 minutes. Then a different assistant would come in and take my blood pressure and tell me to change into the backless buttless gown and wait for the doctor. More waiting. The doctor would finally arrive gloved up, do the exam and asked if I needed anything, all with a hurried disposition and no eye contact. Then he would send me to the sonogram room to listen to the baby heartbeat. By the end of the appointment, I was usually hungry and tired with no knowledge of what just happened in the 2 hours I was shuffled through his office maze. My wallet sure felt the pain too! By the second child, I had to get a sitter because the torture of all the waiting was agonizing for my young son and torturous for me! 
Now that I am in Costa Rica, I have had a completely different experience. My doctor does not have any receptionists, nurses or assistants, or a big fancy waiting room. He has a small air conditioned waiting room, of which I am usually the only patient waiting, never for more than 5 minutes. When he opens the door, I go into his office with a pleasant personal greeting and he looks me in my eyes while asking how I feel. We sit and chat and if my husband and 2 kids are there, he visits with all of us, along with his daughter, our translator. We step into the examining area attached to his office where I slip into a robe and he and my kids take my weight and blood pressure. They have so much fun playing doctor and he humors them the entire visit. By this time, we have only been at the doctor office for a total of 15 minutes. He has his own 4D ultrasound and we are able to see the baby and her heartbeat with each visit without waiting. I remember in Texas, the 4D ultrasound was over $300 and once we even drove 3 hours to Austin because there was a special for $40, 1 disk and 5 pictures. Here, I get 1 disk and a photo with every doctor visit. Since the technology is first hand in Dr. Rojas' office, there is no need for physical examinations either. He answers the phone, sets the appointment, works the ultrasound machine and delivers the baby. Not only am I amazed at how well I am being treated, I actually enjoy my doctors visits. I already feel like part of the family and he and his family have embraced my family. We greet each other with hugs and cheeky kisses and he and his daughters know the names of our children. 
Upon leaving, we pay a minimal fee for our service, which includes the 4D ultrasound pics & disc and if I need a lab workup, he sends me, at my leisure to the lab, if not today, tomorrow or the next, no hurry. With my past experiences, I plan to be the first person at the lab so as not to wait. Promptly, at 7am, I arrive and I am usually back home within 15 minutes. The lab never costs much and they usually have my results within a few hours. If I need something from the pharmacy, I walk in and get it. There is never any waiting and, we found, at Don Juan pharmacy, there is always an English speaking pharmacist who is very knowledgable.
About 2 months ago, a few days after my son attended a field trip, we all ended up with congestion and fever. We sent an email to my doctor, which he answered within the hour and my husband was back from the pharmacy with meds for all of us shortly after. In the states, I would have had to make separate doctor visits for both children, they never saw them at a single appointment, plus a different doctor appointment for me, after which we could drop the prescriptions off at the pharmacy to wait a few hours before receiving the medication. Sick visits were over $50 each on our insurance plan and, depending on our deductible, being sick meant about $300. Here, it cost us the price of some antibiotic for 3 people, around $27 and no hassle. 
Now, maybe they do not have drive-throughs and maybe my doctor does not have as many patients as one would expect, sitting in a large waiting room, but I like walking in and receiving prompt, good service with eye contact and pleasantries. I know the technology is top-notch and my treatment has been personalized and thorough. I enjoy the family friendly attitudes of our care-givers. My pocket book enjoys the break in prices and my family enjoys more time with me and less time waiting for me to get back from the doctor. So every time I hear people complain about how expensive things are getting in Costa Rica, I am amazed. The things that really matter are not so expensive - healthy, fresh food and good health care. TV's and fast food are expensive. We have even been able to find good resale shops for some of our baby gear. I look forward to having our 3rd, and last child in Costa Rica and I hear great things about CIMA, the hospital where we have chosen to have the baby.
We are working everyday on our Spanish and growing excited about the experience of having a child in a foreign country and raising our family in Atenas, Costa Rica. The more we learn about health care here, the more information I will post because it is important to know you have options when it comes to quality healthcare. I encourage anyone who is interested in learning more, know that you do not have to be treated badly just because of your insurance and that there are so many options outside of your town or country. So think outside the box, and next time you need a procedure done or some dental work, give Costa Rica a try and turn it into a medical holiday. I know not every person can just up and fly away, and it is not encouraged to go have your baby in a foreign country for ulterior purposes, but we can educate ourselves better about healthcare options and not be forced into feeling like cattle. As I said before, this is our 3rd child and I still reference my book,  What to Expect When you are Expecting, and now I am noticing the differences between pregnancy in the States vs. pregnancy in Costa Rica. There is a section of the book that advises you not to be outside in the heat and not to walk on rough terrain or uphill. Obviously, this book was written for the sheltered mothers, because I see pregnant woman daily, including myself, walking uphill in the heat on rough terrain and I have never felt better. Yes, I had to take a 2 month break now that I am almost due, but just the thought of not being able to walk around town just because you are pregnant makes me laugh. Since I never walked around town in Texas, it did not bother me, but in Atenas, Costa Rica, we spend much of our time outdoors, pregnant or not. 


  1. A very pleasing article to read especially if you have a baby coming soon. I will love to visit the place someday. The visit will be much easier now that Visa assistance is very abundant these days.

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