NINE MONTHS AND BEYOND

by Ani Ivanova

Despite the wide choice you have to select your Bulgarian gynaecologist carefully

Before the democratic changes in 1989, women in Bulgaria had antenatal examinations in their regional clinic and gave birth in the regional hospital without having the right to choose their obstetrician or midwife. Since then, everything has changed – even the conditions in the hospitals of the still unreformed healthcare system.

If you now have to choose an obstetrician while you are in Bulgaria, you have a very wide choice. The great number of doctors who are specialists in this area (they study for over seven years) is a direct result of the fact that Bulgaria has four medical colleges: in Sofia, Plovdiv, Varna and Pleven. This is why the choice of a doctor may take a long time – unless you have the recommendations of friends or colleagues. The easiest way to find information about the nearest hospitals, clinics and specialised surgeries is from the Internet. You will notice that private health centres win patients with their modern equipment (3D and 4D ultrasound scanners) and flexible working hours. Prices vary but they are several times lower than what you will have to pay in the West. For those with health insurance, that is for those who pay such in Bulgaria, examinations (but not laboratory tests and medicines) are paid by the National Health Insurance Fund, or NZOK. However, to avail of this you have to go to a state clinic or a clinic that works with the NZOK.

If you need specialised medical help, such as infertility treatment or artificial insemination, you should turn to the clinics that provide it. Several hospitals in this country offer in vitro fertilisation. Their clients include couples from Bulgaria, where infertility affects about half a million people, and foreigners, who are attracted by the good specialists, the modern diagnostic and treatment equipment and the low price of about 2,000 leva for the overall in vitro procedure. EIBank gives loans for the treatment of infertility (operations, in vitro fertilisation, male sterility treatment and the freezing of umbilical cord stem cells when the baby is born) on a joint programme with the I Want A Baby Foundation. One of the conditions to get the money is to be a permanent resident of Bulgaria.

The choice of a hospital where to give birth to your child again depends on where you live and whether you want special care. Most specialised obstetrics and gynaecological centres have delivery rooms with perfect conditions and equipment. Most polyclinics, even the state ones, have the so-called VIP maternity wards, where pregnant women can give birth and care for their newborn children, often in the company of their husbands. There, the conditions are a little better than in the ordinary wards and include a separate room, meals and a rehabilitation therapist. All these are paid extra. In some hospitals, such as the Sheynovo Hospital in Sofia, you will have to pay an additional amount if you want to choose the doctor who will deliver your baby or perform a scheduled Caesarean section. In others, such as Selena in Plovdiv, this is included in the overall price you have to pay. Prices vary a lot and can reach 2,000 leva, depending on the extra services. In one of Sofia's hospitals, Sveta Sofia, you can even give birth underwater.

According to Bulgarian law, mothers can take 45 days maternity leave before childbirth and a year afterwards and receive 90 percent of their salary. From the beginning of this year, fathers can also take up to 15 days paid leave.

When the one-year paid leave is over and you have to return to work, you face the problem of finding someone to look after the baby. The reason is that in Bulgaria there is no such profession as a "baby minder". The people who take up this job are very different and often totally unsuitable. For this reason as well as for the tradition that parents should be always available to help – something you must have noticed if you have Bulgarian in-laws – a lot of people prefer asking one of their close relatives to do the job. The authorities have taken this unwritten rule into account and now mothers can hire the baby's grandmother and grandfather as a child minder. They are paid the minimal salary, which is 240 leva per month at present, until the baby reaches 3 years of age.

If you have slightly older children, you are probably considering a suitable kindergarten. Because of the limited number of such institutions and the chaotic enrolment procedure, finding a place for your child in a nursery school in Sofia is as difficult as winning the lottery. A solution to this problem is the private day nurseries, children's clubs and centres, where the conditions are usually better, classes are smaller and teachers are a little more motivated.

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