Oh, baby

Dissatisfaction with Bulgaria’s state healthcare drives expectant mothers to the private sector or even abroad.

By Gabriel Hershman

It should be one of the happiest days of a woman’s life. But all too often the experience of giving birth is marred by the rudeness and carelessness of staff in some Bulgarian hospitals. One mother we spoke to said she was made to feel “like an animal” during her stay in a state maternity ward.

My Bulgarian wife was so wary of her country’s state-run hospital care that she decided to give birth in Portugal – our residence at the time – in spite of communication difficulties and that intangible feeling of cosiness that comes from being near your extended family in your own country.

She shared a room with one other mother in a Lisbon hospital. Admittedly, it was a stiflingly hot day (with no air conditioning) but, apart from a brief onset of panic the first night after the birth when nurses seemed to be incommunicado, the entire experience was relatively serene. The food was fit for consumption and the “accommodation” was comfortable, so much so that I once flaked out on the other bed, exhausted, when the other mother had departed!

Maybe my wife and daughter were discharged a little early after her caesarean (four days) but the treatment, if not exactly punctilious, at least didn’t make you feel like cattle. A charming final touch – and here I was very impressed at the largesse of the Portuguese state – was that departing mothers were given a basket with baby cosmetics and a little guide book!

Unhappy birthday
My wife’s best friend, on the other hand, gave birth at Sofia’s First City hospital last year. Her account, we warn you, is much less complimentary.

“I had a caesarean. Yet when I arrived at the hospital nobody told me what would happen. They put me on the gynaecological chair for check-ups without telling me what they were going to do. They performed a clyster and then inserted the catheter to collect all liquids.”

She was in pain and started getting strange contractions. “I complained but nobody paid any attention. I lay like that for the next two hours begging to be allowed to sit.”

Even after the birth her treatment was still poor. “My contractions continued, yet not before the evening of the same day (her son had been born at 11:15am) did someone discover that the catheter hasn’t been properly fixed, so explaining my discomfort.”

Staff "advised" her to get a bandage from the nearest pharmacy. “My doctor (to whom I’d paid 400 leva) hadn't told me that I’d need to buy a bandage myself! So I was reduced to walking from room to room in the hospital begging for a bandage. In the end I found one. But I was told I’d have to buy the next one myself!”

Post-natal conditions were no better. “The babies were in a separate ward. So every day at certain times the mothers had to queue in front of the ward to breastfeed their babies. Nobody offered guidance about the process. I felt like an animal on a conveyor belt. There was no sensitivity or any guidance from the staff whatsoever.”

Nightmarish stories like this may not be typical, just as in Britain tabloid stories of people languishing on NHS trolleys for 24 hours may mask many satisfied customers.

Indeed, another mother – who gave birth at Sofia’s Maichin dom Hospital – related a more favourable picture of a state maternity ward, albeit with reservations: “They had a very professional team. But the beds were too low and many facilities needed adjustment. The first couple of days were really tough. I lacked help and I couldn’t get to the food area. I suppose I could have screamed and protested but I didn’t.” 

Yes, in terms of post-natal care, she was satisfied. “They examined the baby every couple of hours, checking its weight and overseeing breastfeeding. They certainly showed you how to take care of the baby.”

Another mother who’s now given birth three times at the same hospital (then known as the Tina Kirkova Hospital of Obstetrics and Gynaecology, now renamed to Sveta Sofia First Hospital of Obstetrics and Gynaecology) also related a better experience. 

She found the ward reasonably clean and comfortable. All rooms (both pre-delivery and post-delivery) were shared by two to three women but single rooms could also be booked.

“The labour room was somewhat old-fashioned but the staff was helpful. You didn’t have to beg for pain-killers and they would talk to me, although I cannot guarantee their fluency in other languages, which may be a problem for expats.”

After delivery, she was left on a stretcher for two hours or so near the delivery room before being taken off to the ward. But she claimed that they checked on her regularly. Then she was taken to a room together with her newborn. She has one gripe. “There were few instructions on nursing. Had it not been for my mother, a gynaecologist, I might have missed a few important details about breast-feeding the first time round.”

The private option
Another option is giving birth at a private hospital, such as the recently opened state-of-the-art Tokuda Hospital in Sofia. At Tokuda the birth itself is free, provided you have paid Bulgarian national health insurance, of course. Another mother relates her experience:

“I first went there about a month before my daughter was born and it wasn't a problem to arrange the birth. I had to choose a 'team' of doctors (this is common in most Bulgarian maternity hospitals) so I just picked a name from the list (a woman, I didn't want a male doctor) and paid 500 leva for that. I was overdue nine days so in the last week I went every day, which was nice because I felt they were in control of the situation.” 

She also paid for a pristine private room but you could share with three others if you didn't want to pay: “The midwife came from time to time to see if I needed anything and in about the last hour the doctor was with me non-stop. They wheel you off to the delivery room for the birth itself. That was the only disturbing part as in the UK I'd been in the same room throughout and being suddenly wheeled down the corridor and moved onto a rather strange bed actually stopped my labour for a few minutes. But in the end it was fine. A very sweet touch was that a CD was playing something like George Benson in the delivery suite and as soon as the baby popped out they put on a CD with 'Happy Birthday'!”

We stayed in three days, I chose to have them take my daughter at night and bring her in at three-hourly intervals, which is the way they do it here. I must say this was far preferable to having a screaming baby non-stop by your side as it was in the UK and no one to even give you five minutes rest while you have a nap or take a bath. My family could visit any time because I was in a private room. In fact, my son spent a whole day with me. The food was quite good and they took special care to come up with a vegetarian menu for me. All in all, it was a very positive experience.”

No doubt, all expectant mothers would like to know that one day the standard of care in the state sector would obviate the need to go private. Nobody seriously expects a complimentary basket of cosmetics in Bulgaria. But mothers and babies are entitled to be treated with due care and respect.