CONTRIBUTED BY ALEXIS BRIDLEY
Alexis is contributing a series of posts about prenatal care, Labor & Delivery, and postnatal care at 121 -the Brian Allgood Army Community Hospital (BAACH) – in Yongsan, Korea. This is the first post in that installment. Over the next few weeks you can also read about her perspectives on prenatal care and labor & delivery at this facility.
Monday: We are pregnant!
Tuesday: Babe. We got orders…to Yongsan, Korea…in 5 months.
Did you hear all those brakes screeching or was that just in my head!? Being pregnant is the most exciting, nerve-wracking rollercoaster of your life. Add Uncle Sam’s plan for a trans-pacific move to your already crazy hormones and well, it’s enough to send anyone into a downward spiral. Here is my journey of prenatal, delivery and postnatal care in Korea!
I arrived at Yongsan 28-weeks pregnant with twins. Prior to coming, I was seen by a civilian provider as I was living too far from a military facility. I had my provider print all records prior to my flight so that I was able to provide the physicians at 121 with my prenatal care thus far. Once I arrived, I immediately went to the Tricare office at 121 to get enrolled in Tricare Overseas. Being large and in charge at 28-weeks pregnant with twins, I wasn’t required to take a blood test to confirm pregnancy, nor was I required to have an appointment with my Primary Care Provider (PCP) to get a referral to OBGYN. So straight up to OB is where I went to schedule my first appointment.
There are several (four or five depending on the time of the year) OBGYNs at 121, as well as a midwife. From my experience, you can “request” a provider for your appointments; however, whoever is on-call when you go into labor is your delivering physician. So, my advice is to see as many providers as possible so that you have at least some familiarity with all of them… then cross your fingers, wish on a star that your favorite OB is on-call when your little one decides it’s time!
When I arrived at 28 weeks, I saw the midwife (first available appointment) and was identified as high-risk (due to having multiples). I was scheduled for an ultrasound at 121 the next day to check on the babies and make sure everything was still looking good since my last appointment in the states was at 26-weeks. While most pregnancies are monitored monthly at this point, I had been monitored twice a month since the first sonogram showed twins. Unfortunately, the results of my ultrasound suggested a significant weight discrepancy between the twins, so I earned a referral to Samsung Medical Center for additional care/observation.
I was actually pretty thankful I had a referral to Samsung for additional care, as it is not uncommon for twins to be delivered early. I was informed that anyone who went into labor prior to 36 weeks (twins or singletons) was transferred to an outside facility (whoever had available Labor & Delivery/NICU beds available) for delivery, as 121 is not equipped for neonatal care. Even if the babies were born after 36 weeks but had preemie issues, they would be transferred to Samsung. My care at Samsung was exceptional. I was seen in the International Clinic twice a month (5 different appointments). I also had additional ultrasounds and non-stress tests (NST) at most of those appointments. I had a birth plan written with the OB should I go into labor prior to 36 weeks and deliver at Samsung. To say I felt confident with wherever I was going to give birth was an understatement.
My prenatal care at 121 was also exceptional. After the ultrasound suggested the weight discrepancy, I had NSTs twice a week to closely monitor the babies’ heart rates and fluid levels. The non-stress tests were completed in the WICU (Women and Infant Care Unit) so I quickly became friends with the nursing staff- most of whom I LOVED! The NSTs are done in the observation room where one would go to monitor early labor prior to admittance for delivery. I was able to make appointments for NSTs at pretty much any time during the day and they were scheduled right there at the nurses desk. No need to call the appointment line – score 1 for WICU!
My medical appointments were often brief, but I always felt my questions and concerns were answered. Had I not been high-risk, I would have been seen at 28 weeks, 32 weeks, 36 weeks, then weekly starting at 38 weeks. At my 36 week appointment, we scheduled an induction date for 38 weeks. For a singleton, this definitely would not have been scheduled so far out; however, seeing as I needed two pediatricians (and pediatric teams) as well as two OBGYNs during delivery, they wanted to have me on the books so everyone could prepare.
I also completed the admission packet at this time so that I didn’t have to fill out paperwork in the middle of contractions (which was really nice). I met with anesthesiology to complete paperwork for an epidural. This paperwork could have been completed at a later date if I wanted to go au natural; however with twins, I didn’t want to risk delivering Baby A without complications and then having to be completely sedated should an emergency delivery be needed for Baby B… plus I’m just not brave enough to deliver two babies without pain medication!
At around 38 weeks, they also provide a tour of the WICU if you request. The WICU is a tiny unit on the 2nd floor, directly next to the OBGYN offices. The main door is locked so that those who shouldn’t be on the unit are NOT on the unit. They have one NST/observation room with two beds. They have 3 labor rooms, where you would stay during labor and delivery. Afterward, you are moved into a recovery room. There is one individual room and three rooms with two beds. I say rooms with two beds because they REALLY try hard not to have you share a room. They do have a tiny nursery, but you are encouraged to keep the baby in your room.
When I was pregnant, there was not a labor and delivery class offered at 121. A friend was able to find an English speaking L&D class at a local hospital. I found an online course through BabyCenter that I felt was pretty comprehensive. I believe they are now offering a class monthly – my guess is this is likely to change frequently depending on certified individuals stationed in the area. When I delivered there was also an awesome lactation consultant available (who has since PCSd) before, during and after my delivery. She was solely volunteer based – another position that is filled when a qualified individual is stationed at Yongsan and willing/able to volunteer their services.
Stay tuned – next week I’ll talk about my experience with labor and delivery at 121.
Have you received prenatal care at 121? What were your experiences? If you have anything to add to this conversation, please don’t hesitate to do so in the comments – we’d love to hear your perspective – or answer your questions!