the cost of being pregnant in Kyrgyzstan

When I was back in the states in June, I had a check-up at my mom’s doctor’s office. A few weeks later, my mom emailed me to tell me that the bill from the appointment had arrived, and it was nearly $3000.

Three thousand dollars.

Not anywhere close to what I was expecting. Being the kind and generous and endlessly loving mother that she is, I’m (thankfully) off the hook from paying it. Let’s just say that after that, Farrell and I were adamant; any prenatal care would be done in Bishkek until I got back to the US.

I was lucky that one of my closest friends in Bishkek (and my former housemate) went through her first pregnancy in Bishkek about six months before I did, so I mostly just copied her and knew a bit about what to expect from doctors. I went to Neomed for most of my prenatal care; it’s clean and has relatively up-to-date equipment and English translators. It’s considered expensive to the typical Bishkeker (or, at least, my former Russian teacher would always give me a hard time about how rich I must be to be able to go to Neomed), but I could hardly contain how giddy I was to pay such ridiculously low prices for medical care.

Overall, the care was fine, though a bit over-dramatic at times. I was told more than once that I was at risk of suddenly miscarrying, which I think was wildly inaccurate. A pattern emerged of me going to an appointment at Neomed, being told some piece of news and prescribed a half-dozen medications for reasons I didn’t understand, coming home and spending time researching and translating what I was told and prescribed, figuring out something could be horribly wrong, sobbing hysterically, calling my midwife in the states and being told that the news is bullshit, the medications are unnecessary, and I’m fine. All is well until four weeks later and the cycle repeats.

The most frustrating aspect of receiving medical care was the language barrier. Eventually I had to really throw a fit and insist that there be a translator in the room with me after one appointment in particular where I could only understand the ultrasound technician’s calm and soothing voice repeating “хорошо” (good), only to find out that she suspected I was going through preterm labor (I wasn’t). It was only during my very last appointment when Irina, the translator I worked with most (but also the most stubborn), and I talked about my Russian skills and she finally understood that even though I could have a pretty decent conversation about my family and my favorite foods in Russian, I didn’t know how to say “blood pressure,” “miscarriage,” or other medical terms.

Also frustrating was the confusion of having doctors and caregivers spread all over the world. The tests I got at my mom’s doctor’s office in Pennsylvania had some troubling results, which the receptionists said I could talk to the doctor about “at my next appointment” (considering I was in Bishkek, this wasn’t going to happen). My midwife is fantastic and we communicated really well while I was away, but she’s not trained to interpret lab results like that. My doctors at Neomed interpreted the results in a way that even I could tell was completely wrong, and prescribed a diet of green tea and watery rice porridge, herbal tea (with ingredients that aren’t safe for pregnant women), and a round of antibiotics that have been banned in the US for almost 20 years for being recognized as a carcinogen. For that episode, I made an appointment with an American doctor who works at a state-run training clinic in Bishkek. While the facilities were much less flashy and as well-equipped as Neomed, being able to sit face-to-face with an American doctor, who could look at both my English and Russian medical reports and translate it all into plain English I could understand, was so valuable. But it meant I had five caregivers on two continents in total.

Going to the American doctor in Bishkek really convinced me that I had to take a lot of Neomed’s advice with a grain of salt, and after wasting a few too many som on prescriptions I later found out were unnecessary (or even dangerous), I promised to not buy any prescriptions until after I researched what they were.

And with that explanation, let’s break down my costs for prenatal care in Bishkek:
– 4/18 appointment: 450 som (just an ultrasound)
– 5/2 appointment: 1860 som
– Prescriptions (folic acid, iodine, magnesium, sedatives) = about 700 som (a high estimate)
– 5/3 appointment: 1720 som
– 5/14 appointment: 950 som
– 6/1 tests: 152 som
– 6/1 appointment: 674.50 som
– 7/5 appointment: ~800 som
– 7/25 appointment: 152 som
– 7/26 appointment: 456 som
– 7/31 appointment: 1140 som
– Prescriptions (herbal tea, probiotics, and something to induce labor that I didn’t take): ~550 som
– Antibiotics (that I had to research for myself): 28 som (for a full course!)
– 8/1 appointment: 655.50 som
– 8/6 appointment: 902.50 som
– Prescriptions (iron supplements): ~180 som
– 8/16 tests: 152 som
– 8/17 appointment: 1121 som
– 8/25 appointment with American doctor: 500 som (the training clinic works off of donations, so that’s how much I decided to give)
– 9/19 tests: 120 som
– 9/20 appointment: ~900 som
– Prescription (pregnancy support belt): 420 som
– 10/18 tests: 504 som
– 10/19 appointment: 1369 som
– 10/30 appointment: 855 som
——
Total = 17311.50 som, or $366.39

Less than $400 for about seven months of prenatal care. Even better, Neomed gave me an automatic discount since I was going to them for all three trimesters (which is why most of the numbers aren’t rounded). Other costs are harder to estimate, like paying for the cabs I took to get to my appointments instead of marshrutkas (because 99% of the time, my belly wasn’t big enough to earn me a seat and I didn’t feel like standing). Still, all of this pales in comparison to the one appointment I had in the US back in June, or my midwife’s fees ($3750).

Some people have asked, why not just deliver the baby in Kyrgyzstan too? I did consider it at first, and I’m planning to write another post all about that. There were a lot of personal, medical, and cultural considerations that went into my decision to fly back to the US to give birth. Turns out, giving birth is kind of a big deal, or so I hear.