Thanks for your thoughtful reply!

1. I would have to disagree on the cost issue, though. A higher-end obstetrician these days charges around HUF 10 000 per visit, and HUF 100 000 for the birth itself. So if you start attending prenatal care when you’re in your first month, you’ll end up paying about a total of HUF 200-250 000 for the pregnancy and birth of your baby if you have the Hungarian health insurance. By contrast, both Rózsakert and First Med charge a flat rate for prenatal care that’s 200-300 000, and does not include the cost of Telki, which is about HUF 600 000 for a vaginal birth, but they charge fee-for-service, which means it’ll be more if you want an epidural or end up having a C-section, or needing any extra procedures. Yes, if you have private insurance, their packages are very nice, and you may not “see” the actual cost. You may also be correct in your assessment if you do not have the Hungarian health insurance, because I actually don’t know what the Hungarian system charges for lab tests and other procedures you need during pregnancy. I do know, however, that at a state hospital, the cost of a vaginal birth is HUF 80 000, and the cost of a C-section is about HUF 130 000. So for an uncomplicated pregnancy and birth, you can expect to pay a total of about HUF 300 000 if you designate a doctor and have your baby at a Hungarian state hospital if you do not have the Hungarian health insurance and pay everything out of pocket. Which is still a great deal less than the HUF 800 000 – 1 000 000 you would spend at a private clinic and Telki.

2. I know Telki has lots of doctors who work there who speak other languages. My experience, though, suggests that when you show up at Telki, at first your doctor will not be there, and you’ll be attended by the nurse and doctor on duty, and they may very well not speak English. Your doctor is likely to only be called to the hospital once you are in active labor, approaching full dilation. And after your birth, you’ll still have 3-5 days at the hospital, during which time again you’ll be attended by the regular staff, and it’s about 50-50 who speaks English and who doesn’t.

3. I agree that the doctor’s person makes a huge difference in how medicated the birth ends up being. Some doctors simply use interventions more readily and more often than others. However, all doctors are constrained by the hospital policies and by the policies of the head doctor in particular at that hospital. So your doctor can always be overruled by the head doctor if there is a question about your care. And at that point, it comes down to the professional philosophy of the head doctor at that hospital, and you don’t always know that in advance. Some hospitals simply have a reputation for being more interventionist than others. Yes, you’re right, that even at the most interventionist hospital it’s possible to end up lucky with the right doctor and the right kind of quick and uncomplicated birth. My point is only that your chances are higher at a hospital that is known for being non-interventionist.

I’d also like to address your point about episiotomies. Several large studies have now indicated that episiotomies actually increase the chance of a 3rd or 4th degree tear – precisely the type of bad tear they were meant to avoid. The WHO has actually contraindicated routine episiotomies since 1997, and yet in Hungary, they are still performed routinely, even at the most non-interventionist hospitals.

I’m glad you found the blog informative! I don’t know where any of the ob/gyns who practice at Telki received their education, but here is a page that lists who currently works there: http://www.telkihospital.hu/szuleszet-1

At a quick glance, none of them were trained outside the country, and not all of them speak English at more than an intermediate level.

I would recommend that you schedule appointments with a few of them after you arrive here in Hungary, and choose the one that is the best match for you, based on your birth plan and what you consider important.

Hope this helps!