In Some Places

When we found out we were expecting in November of our second year in Kyrgyzstan, our plan for the next year was to move back to South Korea – which had been the plan regardless. After getting position offers from the school in Korea, we decided to tell them I was pregnant even though I was less than two months along (just to be nice and considerate). When we informed the school in Korea, they told us that they thought it was not a good time for relocation and rescinded our offers. Bah.

So there we were, in a Central Asian country many of our family members couldn’t pronounce, expecting our first child.

I had some experience navigating the medical system in Kyrgyzstan over the year we’d lived there. The previous Spring, I had a very irritated eye for weeks. The first doctor I visited informed me that it was a particle in my eye and I would immediately need surgery. Terrified, I sought a second opinion. The second doctor thought it was allergies. After not clearing up, I tried again. The third doctor suggested I see the dentist. The fourth suspected sinus problems and wanted me to schedule sinusitis surgery. I waited it out and it cleared up on its own. With this experience in the back of my mind, I was not enthused about the prospect of prenatal care.

Yet, there we were. They scheduled my first appointment for when I was five weeks pregnant. I decided to go to a large private clinic that offers translation services, Neomed. Our first few minutes there, the translator apparently decided that my husband spoke enough Russian to understand and she left the room. Sure, my husband speaks conversational Russian, but he doesn’t know words like “pregnant”, nonetheless, “cervix” or “embryo” or “heartbeat” or “prenatal vitamins”. There is a pretty particular vocabulary that comes with being pregnant and it’s hard enough to keep up with in English, yet here they were rattling these words off in Russian.

We couldn’t convince the translator that Ryan didn’t understand, so we nodded along and insisted on calling the translator back two or three times, but she would just leave and leave again.

That first appointment I cried in the ultrasound when they saw the blob (it was too early to see the baby) because it measured two weeks behind what size it should be. Turns out the ultrasound technician measures the size of the baby, and the doctor considers time after your last period, which is a difference of two weeks, so little blog was right on schedule. The first of many unnecessary tears.

The medical system was distinctly Soviet. The first ultrasound where we could see the baby, I had to ask for a picture to be printed off. The ultrasound lady just took measurements and sent us on our way without any sentimentality. And at each appointment, no matter how many times we tried to convince her otherwise, the translator insisted my husband understood Russian. At the same time, we were still charged for translating services (double the price of the appointment, though the price of medical care in Kyrgyzstan was still ridiculously low compared to the US, even with the extra “translator” fee).

I was prescribed four different medicines and had to do meticulous research to make sure I was taking things that were okay for me and the baby. I was especially nervous after having read or talked to other pregnant women who had been prescribed things that are known carcinogens or are very clearly not ok for pregnant women. When I expressed concern or questions, the doctor’s main response was always “Все нормально” – everything is normal. Not helpful when, at the same time as assuring you everything is normal, they are prescribing crazy medicines and taking daunting notes for your medical records.

I was also once chided for mentioning that I had consulted a recommended procedure with a doctor I knew in the US. The Kyrgyz doctor said I should not be talking to any American doctors. Eek. 

After severe, severe morning sickness I went in and they suggested I get an IV with something in it. I can’t remember what it was, but I had the name at the time. I was hooked up to the IV while frantically googling what they were trying to put in me. Reading what it was (derived from cow blood – I’m a vegetarian) and reading that it has no relation to morning sickness, I quickly apologized in Russian to the nurse and asked her to take the IV out, then rushed away.

They didn’t have any of the most recent morning sickness medicines, not even Unisom, in the country, so I just stuck it out all seven months I was there. My coworkers became very used to the sound of me retching in the staff restroom.

I put up with all of this at this clinic because we hadn’t found any complications with my pregnancy, they seemed to be following the general schedule of what appointments and tests should happen at different stages of pregnancy. I was so run down with exhaustion and morning sickness that I couldn’t fathom trying to find a different doctor.

At our 20 week ultrasound, we got to find out the gender of our baby. The ultrasound tech told us everything was normal, the refrain as usual. She happily said “девушка” – “girl” – but I made my husband clarify a few times that she was saying we have a girl, not talking about me as a girl or asking us if we want a girl. She confirmed – girl!

We went home after that ultrasound and I set to translating the summaries of the ultrasound, an arduous task that I got in the habit of doing because of the lack of real translator (despite our payments). I mostly used the Google Translate app to hover it over the document and translate the words, but often had to google the meaning of words after, especially with detailed lab results. This time, at the very bottom of the ultrasound report, it read, in Russian, “threatened miscarriage.”

I freaked out. HOW did they let us leave without saying anything, if they saw a threatened miscarriage on the ultrasound?? What did they see? Despite trying, I couldn’t find anything else in the ultrasound report that seemed to be wrong. I called crying, and the front desk informed me that I would definitely need to come in to get prescription drugs. I made an appointment for a few days later. But then I seethed. What was even wrong? What if I hadn’t translated their document? Would they have called me? Exactly what kind of medication would I need?

I finally reached out to a friend and decided to go to a different medical clinic for family medicine – Eldik. It was decidedly not as fancy as the other clinic, but did have an American doctor in residence. I skipped my appointment at the other clinic to head to the new one.

My new doctor went over the copious records that I had. She commented on the amazing amount of lab tests they had done, and I realized that I had been taken for a run for my money. They ran every test they could. After reviewing records, I explained what I found translated on the last ultrasound report. The doctor said they tell this to almost every woman, sometimes at every ultrasound. Whether it’s for liability, or to try to get you to come in and spend more money on more appointments or more medicine, we weren’t really sure. But she assured me that if I came back home and showed the report to any American doctor, they would have no idea what the issue was. Everything, she said, looked great.

It was hard to shake the feeling that something was wrong, but I was assured that everything was ok by the new doctor. She explained that although she was a little out of practice, she could keep up with the labs and requirements and get me to the seven month mark, at which point I would be flying home. The first time she pulled out the doppler and celebrated with me as we heard the heartbeat, I cried. Not because I could hear my baby’s heartbeat, but because I had a doctor who I could understand and who gave me some time and space at these medical appointments to understand and enjoy what was happening. I cried because I could understand her telling me what clothing to remove and what to keep on, and it was just comfortable to be in a space with a shared language and culture around pregnancy. 

Although I continued to see that doctor, there were no ultrasound machines or labs, so any other tests had to be done out of the office. Instead of the normal gestational diabetes test, I had to eat two Twix bars and then go in to get my blood drawn (the only test they offer takes ALL DAY, so we had to trick them by telling them I hadn’t eaten anything). I had to get my blood drawn one hour after eating the Twix. So after downing two Twix bars for breakfast I walked to the lab to find it had permanently closed. I frantically walked back home and biked to another lab to have my blood drawn, hoping I wouldn’t have to eat Twix for breakfast again.

At one of my last Kyrgyz ultrasounds, we got a great shot of my baby’s face. I asked for a picture and the tech said “you can’t see anything in the pictures!  The baby is too big.” I pushed Ryan to ask again and again for a picture and finally the technician hesitantly printed it off. She just didn’t understand why we wanted it. So, we have a picture of baby as a small bean, and a picture of her face. We don’t have any pictures from in between, none of those beautiful profiles shots of baby, because we forgot to ask at those appointments.

I also did have a final ultrasound at my new doctor’s office; they had recently gotten a machine and were hosting a training for local techs. The trainer spoke English, and they offered a free ultrasound in exchange for a pregnant belly to train with. It was the first time I could understand what the tech was saying. Here’s an arm; here’s a leg. There’s the placenta. I was mesmerized as I watched on the screen finally knowing what was what in my seven-months-pregnant belly.

Then came the flight to the US. You can’t fly after 35 weeks; I flew at 31 to make sure I would make it. I also brought our dog with us on the plane, but she was too heavy in her bag for me to carry. So I used a stroller to stroll the dog through the airport. I flew from Bishkek to Istanbul then Istanbul to Chicago, completing 20 hours of travel with my big belly and my dog, and hanging out with family in northern Indiana for a week before my dad drove me to our home in Colorado.

My first US appointment was a breath of fresh air. Trying to explain some of my copious medical records (translated from Russian to English) was a little difficult, but it was so nice to communicate with up-to-date providers. They insisted on one last ultrasound (anyone concerned about how many ultrasounds I had this pregnancy? I think it was 9; seemed like a lot to me.)

In the ultrasound they thought they saw signs of clubfoot because my baby’s feet were turned in, but noted that they don’t usually do these ultrasounds this late. I couldn’t help but think that, even with so many ultrasounds, that it was inevitable that something was missed in Bishkek. They also thought baby blob was nearly 8 pounds at 36 weeks, totally freaking me out as I was hoping to have an unmedicated vaginal birth. So, I left that ultrasound just as worried as I had all my Kyrgyz ultrasounds.

Our baby Anika was born in Denver, CO USA at 39 weeks exactly, weighing 7 lb 3 oz and with slightly turned in feet from being crammed, but no clubfoot. I had the exact birth experience I wanted, but I know this was in large part due to the fact that I felt safe in the hospital environment and trusted my providers.

Pregnancy was nothing like I expected it would be. It was nausea and puking, fear and worry, wonder and excitement and anticipation and anxiety. Pregnancy in Kyrgyzstan widened my eyes to how important access to modern, trustworthy medical care is. How lucky I am to have the literacy and resources to read about things and make decisions and advocate for myself. How shitty it is that other women don’t have access to those same things. How, even in the US, ultrasounds were completely wrong.

In my case, location didn’t end up mattering so much. Pregnancy in Kyrgyzstan was a collection of stories that, at first stressful, are now funny and entertaining because everything was ok. Yet if there had been complications, I would have had to leave the country to get quality care. The problems with corruption and bribery are rampant in Kyrgyzstan, and although it is a beautiful country with kind people, when it comes to dealing with serious medical issues, if you want good care you have to LEAVE THE COUNTRY. That is mind-boggling to me, considering how many people cannot afford it. We are grateful to have had a healthy pregnancy and birth, but it was quite the journey.