As an expat in the Philippines, you will have a number of choices when it comes to giving birth. You can choose to have your baby at home, in a public hospital, or in a private hospital.If you are covered under the Filipino national health insurance scheme, PhilHealth, then this will cover your prenatal care and the delivery. However, public healthcare is undeniably overstretched. Alarming photos in the local Filipino press show mothers having to share not only the same ward but the same bed. For this reason, many expats choose to give birth in the private sector.
Read on to learn more about your options.
How to decide on a birth plan
A birth plan is a list of what you would like to have happen during labour and afterwards. It is written so that your doctor knows what your wishes and expectations are. When writing your birth plan, you may want to consider the following questions:
• Where do you want to give birth?
• Who do you want to have with you (e.g. your partner)?
• What kind of birth do you want (e.g. vaginal birth or a Caesarian)?
• Do you need any birthing aids?
• Do you want pain relief, and if so, what kind?
• What kind of birthing environment would you prefer?
You will likely be restricted to giving birth in hospital, as the Department of Health has been discouraging home births, in an attempt to reduce the infant and maternal mortality rate. In 2018, the infant mortality rate in the Philippines was about 22.5 deaths per 1,000 live births. In 2013, the Department of Health implemented the ‘No Home Birthing Policy’, which requires mothers to give birth in hospitals or registered birthing facilities. Fines and imprisonment of Filipino mothers have been reported. These draconian measures, which some commentators say are an infringement of women’s rights, have been introduced to address unacceptably high mortality rates and a reliance on ‘hilots’ (untrained birth personnel).
In general, expats in the Philippines choose hospitals, such as St. Luke’s and Makati Medical Centre, due to the higher levels of care.
There is an emphasis on C-sections in Filipino hospitals (with a commensurate level of expense), so if you do not wish to give birth via this method, unless it is medically necessary, you must make this very clear. Do not let yourself be talked into having a C-section because you are a foreigner and will be expected to pay more. Some expats choose a clinic, with a hospital as a backup plan, as clinics are more amenable to conventional births.
Maternity care in the Philippines
Once it has been established that you are pregnant, your doctor will schedule a series of appointments for you, including for medical tests, such as ultrasounds and scans. As your pregnancy advances, these sessions will become more frequent.
Medical care in the country is generally of a high standard, both in the public and the private sector. Many Filipino doctors have trained in the States and speak English. However, facilities and equipment in public hospitals may not be at the level that you are used to in the West. Using a public hospital will mean that your treatment costs will be substantially less.
Some average costs in the private sector (if you don’t have insurance) are:
• Prenatal GP visit: ₱700 to ₱1250 per month (US$14 to US$25)
• Prenatal ultrasound: ₱1150 to ₱4000 (US$22 to US$78)
• Birth and delivery: ₱15,000 to ₱100,000 (US$294 to US$1960)
• C-section: ₱80,000 to ₱170,000 (US$ 1568 to US$3332)
Costs will be cheaper in the public sector. Delivery under PhilHealth can be free. Otherwise, you are likely to find yourself paying around ₱2000 to ₱24,000 (US$39 to US$470), depending on the nature of the delivery and whether there are any complications.
PhilHealth offers a Maternity Benefits Package. Whether you are eligible for this will depend on your employment status and your level of contributions. If you are, you will be entitled to ₱6,500 (US$127) if you give birth in a hospital. If you give birth in a non-hospital facility, you will receive ₱8,000 (US$157). Philhealth also gives benefits to mothers who have a C-section birth – you will receive a fixed amount of ₱19,000 (US$373). This will only apply to your first four normal birth deliveries. PhilHealth will also cover complicated vaginal delivery at ₱9,700 (US$190); breech extraction at ₱12,120 (US$238); and vaginal birth after C-section (VBAC) at ₱12,120.
You will need to bring with you:
• Hospital admission form
• OB admission slip
• Your birth certificate
• Maternity benefit form, if applicable
• Photo ID for both you and your partner
• Marriage certificate (if applicable)
• PhilHealth or HMO Claim Forms
• Your own night clothes and baby supplies
You can expect to spend one or two days in the hospital, unless you have had a C-section, in which case you will be discharged a little later.
You will then need to make a series of postnatal appointments. Ask your GP about the vaccination rota. You may be able to have your child vaccinated for free if you have a local community clinic, but otherwise you will have to pay for each vaccination.
If you are intending to claim under PhilHealth, you will need to take the following to a Philhealth office within 60 days of being discharged from the hospital:
• Latest copy of your PhilHealth Member Data Record (MDR)
• PhilHealth Claim Form 1 (CF1), filled out and signed by your employer; you can get this at Philhealth branches, the birth hospital or healthcare facility, or your employer
• Proof of premium payment; employees will need to submit the certificate of premium payments with OR numbers
• PhilHealth ID and a valid ID
• Claim Form 2 (CF2), filled out by your doctor or health care provider; the hospital usually provides this form
• Marriage certificates
Paid maternity leave is available to all working mothers and has recently been extended from 60 days to 105 days. You will have the option of extending this for 30 days without pay. Under the new law, employees who are solo parents will also be granted an additional 15 days of paid maternity leave.
Will the baby be a Filipino citizen?
Your baby will only be eligible for Filipino citizenship if either you or their other parent is a Filipino citizen.