Wednesday, December 8, 2010

Childbirth in IMSS - Mexico's Social Insurance Health Care System

The new IMSS hospital where my son was born
Over the past week and an a half, I haven't been posting much, because exactly a week ago my second son was born!  (I'm finally getting back into the rhythm of day to day life again, so I think my posts should be a little more on track again.)  This is, precisely, the event that I'm going to write about today.

In my last post, 2 days ago, I  wrote about the variety in Mexico's health care, and the difference between private health care, and the cheaper options whether public, charity or just inexpensive private services.  I mentioned the Mexican Institute for Social Security (IMSS) which is a government-run system funded primarily by deductions from workers' checks; the same workers who get the deductions have access to the service.  A small number of people also pay an annual insurance fee, which works just like any private insurance, but is cheaper.

It was in a hospital from IMSS where my son was born.  The hospital is brand new, offering long-awaited specialized services to the IMSS system for Playa del Carmen, which so far had only been a family health care clinic (see picture.)  The new hospital is very well organized, looks nice, has plenty of seating in the waiting areas (this contrasts to the old clinic, where people waiting usually have to stand up.)  The seats are also shiny stainless steel and relatively comfortable; I sat on one for 12 hours, and felt fine.

A lot of Mexicans, especially from Mexico City it seems, have a very negative impression of IMSS, and there are some of horror stories kicking around; I even found a few on the internet for Cancun. 

The service we had in the new hospital, however, was amazing, with no complaints.

We didn't just trust luck, however, or pick IMSS just because it was cheaper for us; we investigated just like we would private health care service.  When we found out my wife was pregnant, we began doing our research and investigated several private hospitals.  The least expensive option was about $1500 dollars for a natural birth, or $1800 for a c-section.  Since from what I understand about 60% percent of births in Mexico end up being c-sections, we decided to count on this expense.

Partway through the pregnancy we got work coverage through IMSS, and we investigated to find out that they do cover childbirth for those covered through work even if they were covered only after the pregnancy started.  So we began to consider this as option.  With all the negative opinions out there about IMSS, we decided to get some first hand stories.

The IMSS Family Health Clinic
My first boss in Cuernavaca had already told us that both his children were born in IMSS, and the service was excellent for childbirth.  But this was 15-20 years ago in a city a couple thousand kilometers away.  At the time, our brand-new IMSS hospital here in Playa had not yet opened, and the clinic didn't handle childbirth; this was only done in Cancun.

So, we set to work looking for neighbors who had recently had babies and asking them if they had been born in IMSS.  We found about 3 or 4, and all of them had the same story; excellent service, no problems.

We continued our investigation and found only two downsides.  One is that you get the doctor who happens to be there at the moment; no matter who your doctor is, or even if you have a specific time programmed, you wouldn't know who the doctor will be, and even if you did, there would simply be no choice in the matter.  Since all feedback had been positive, we weren't too concerned about this fact.

The other was that the father cannot be in the delivery room.  I believe that this is important; but when it came right down to it, my wife and I sat down one evening and realized that this was our only real hesitation; so we asked ourselves, "Is this worth $2000 dollars?"

Our answer was "No."  As important as this, we know that many mothers have had their children without their husband at their side, including her with our first son.  We decided to have our baby in IMSS.

The only third difficulty was the fact that it had to be in Cancun, about 45 minutes away; IMSS offers an ambulance service from Playa, but we did some calculation and realized that even 2 taxis and a hotel room would total about $150 dollars at the most.  Several neighbors had offered us rides or to lend us their cars as well.

This issue, however, sorted itself out; we knew the new hospital would be opening around the same time the baby was born.  When it finally opened, we went for a few check ups and tried out the emergency room services (that's where people go in for child birth); everything was great, and the service was good.  (This contrasts to the family clinic, where the receptionists always talk to you like you've done something wrong and you're wasting their time; the doctors, even there, however, are usually helpful.) 3 days before the baby was born, our neighbor, who works there, informed us that the first 2 deliveries had taken place the night before; everything was set to have our baby in the new IMSS hospital a 10 minute taxi ride away from our house.

The night before the baby was born, my wife had been feeling intense contractions for almost 20 hours, and she was admitted to the hospital at 8 pm.

  • At 9 pm the doctor informed me that they would be giving her an injection to help ease the pain since her tolerance for the pain was lower than normal.
  • At 11:30 pm, the doctor gave me another update, telling me everything was going well - slowly but well.
  • Until about 4 am I had been  fairly calm, knowing that during the night shift, news was only given if there was some complication.  No news was good news.  I had read about 100 pages of The Lord of the Rings in the waiting room, waiting for any announcement. I started getting nervous, excited etc., certain that my child had been born.  I went out for a few short walks, getting some coffee at the nearby all-night convenience store.
  • At 6 am, I started getting phone calls from my parents and in-laws wondering why there wasn't any news yet.  I had to explain the system to them.  Needless to say, the phone calls made me more anxious to get the news.
  • At 8 am, the day shift finally arrived, and the nurse finally had news!  The baby had been born at 6:40 am.  Both the mother and baby were fine, and were in recovery.  Since everything had gone well, my wife and the baby would be released at around 1 pm.  I went home to rest.  I slept for only about half an hour, and took a shower, shaved, made a lot of phone calls.
  • At 12:30 pm went back to the hospital with my 3 year old son and my mother-in-law.  I entered to help my wife change, hold my baby for the first time and take care of the documentation.  The couple I work for were kind enough to come and pick us up at the hospital, and were waiting for us in the waiting room.

The Baby's First Picture - In the Waiting Room
On the way home, my wife said it had been a hard, long labour, but the service had, again, been excellent.  The whole night either the doctor or the nurse was with her.  At one point the nurse put on music, and was very supportive during the most difficult parts.  She said that they treated her even better than where our first son was born, which is a reputable hospital in Mexico City specialized in childbirth.  She said she couldn't have been happier with the service!

Perhaps the most difficult part was the bureaucracy we had to go through in the family clinic in the earlier stages of the pregnancy; but that belongs to another post, where I'll complain about all my encounters with Mexican bureaucracy at the same time.

I don't doubt that other patients in other places, with other services have had their bad experiences.  But for us, the service was excellent.  We made the right decision in choosing the IMSS hospital for our childbirth.


  1. I like the IMSS too. I am Canadian - it reminds me of the health system in Canada. It's even faster. You can get an appointment with a specialist in less than a month. That's impossible in Canada.

    One of the reasons why IMSS has a bad reputation, is because they can only compare to their private health care, wich is absolutely amazing and affordable. This is just my opinion of course. I could see a gyno today if I wanted to for less than 40$, and it will be BETTER than anything I ever had in Canada.

    I did half of my pregnancy in Mexico and the other half in Canada. Back in Canada, I felt like I was in the Flinstones. The gyno in Canada doesn't have the ultra sound machine. That blew my mind completely that I had to wait for months to have an ultra sound (in Canada).

    IMSS is like health care in Canada, expect much faster, but it's a nightmare in administration and paperwork. (that;s true for anything here in Mexico)

  2. I agree with your comments; haven't experienced much health care in Canada, but I know the waiting is horrible, and many people complain about the impersonal treatment.

    I think the "competition" of a very affordable private system helps keep IMSS on track. If only they could fix up the administration side of it ...

    The only thing I'd point about what you said is that we've found in the private system here, not all the doctors who have all the fanciest equipment are good. One doctor started cancelling all our appointments when we told her that we couldn't afford childbirth with her, and that's considering that we were still paying her a higher-than-average amount for the appointments! (To me this said she's in it only for the big money). But we've only had 2 cases like this, and they've really been exceptions. Most of the doctors we've had here - private or IMSS - have been really concerned about taking care of us.

  3. I'm going to Cancun in 2 weeks and will be 32 weeks pregnant. Everything is going well and my OBGYN said she thinks it is fine to go. However I'm 42 so I'm considered "high risk" so there is a remote chance that I could go into labor early. I have insurance that will cover about 80-90% of the fees. I've been told to research a private facility. But I too read that many deliveries end up inc-section (I wonder if they do this on purpose so to make more money?). I didn't have a c-section with my son so I can't imagine needed one a second time. I don't speak Spanish either. Since we will be staying in Cancun do you have any recommendations for me? Or where to go to get some?

  4. Two weeks - I guess that's right about now. If you're not in the hospital yet, my only unqualified advice is to let your doctor know that you prefer natural birth (if that's the case.) A number of Mexican women I've talked to actually prefer c-sections; even if they haven't had a baby yet, there seems to be the impression that it's easier, nicer, better, etc. I suspect that this preference also contributes a lot to the higher rates of c-sections there. So simply letting your doctor know you what your preference might make a difference. (I can't say for sure, but I suspect that especially the private facilities respond to patient's preferences quite readily.)

  5. question where you not aloud to go hold your son right after the birth or was it your choice to leave and come back .... nervous

  6. In the public hospitals, the father can't be there at delivery time, and so I couldn't hold my son immediately. The baby was left right beside my wife, though, and she held him. I would've loved to have been there.