Children in Mexico have immunization scars on their arms that look like the ones the boomers have. When I would get together with other moms and toddlers, some of their children would have the recently-made red welt on their arms.  In contrast, our son was born in Mexico, has a full regimen of shots and does NOT have that scar — ultimately not for cosmetic reasons, but for immunity and health reasons.

I don’t know much about vaccines, but I know that they can be made from live, killed, or modified versions of the disease causing agent. Since I had already grown to deeply distrust IMSS and the national medical system in Mexico due to some bad experiences, I found a private pediatrician in our town that was well-thought of and famous for not giving lots of prescriptions and medicines, especially antibiotics, which tend to be frighteningly overused in Mexico.

You see, seeing that scar on childrens’ arms had gotten me to thinking.  My parents had that scar, but I didn’t. I wondered if it was because we no longer vaccinated for that in the US. I could imagine three different reasons for discontinuing a particular vaccine. Reason number one might have been that whichever disease it protected against was so uncommon it was considered “eradicated.”  Reason number two might have been that a new vaccine had been developed. Reason number three might have been that the vaccine was later determined to cause more risk than benefit. The pediatrician I found helped us to make informed decisions about which vaccines were right for our son.

It has been a couple of years since we did our son’s vaccination series and I am not a doctor, nor a medical professional, so double check all of this info for yourself.  If memory serves, that scar is caused by the tuberculosis vaccine. Our doctor told us that the vaccine does not produce immunity and is only useful to help protect people in high risk situations, such as children who live with a family member who has active tuberculosis. Since no one in our family had tuberculosis, we did not give him that vaccine. Our doctor said that having it can even cause a false positive test for the disease.  Another vaccine I was worried about was the polio vaccine. I don’t remember as many details about that one, but by conversing with this doctor I felt safe giving the vaccine we gave.  Not that everything from the US is better, but this doctor administered the same vaccines that are given in the US. This had the added advantage for us, that if we were to return to the US (where no one seems to know one thing about Mexico), the schools would be satisfied with the shots our son had had.

The shots were expensive — hundreds of U.S. dollars, but I never regretted a single cent. An unplanned benefit of taking our son to this pediatrician when he was healthy was that, when our son was ill, we could call our pediatrician at any time day or night and he would help us without making us bring our son in.  This doctor, like many in Mexico, still serves the parents directly and the relationship with the doctor has been soothing to our nerves. Imagine the difference between heading out to the emergency room at 2:00 am with a baby who is throwing up bile and calling the pediatrician who knows him, getting told over the phone what to buy at the 24 hour pharmacy, and giving it to the child 30 minutes later. Of course, this same sleepy pediatrician didn’t just give us a medicine’s name over the phone and hang up. We talked about the symptoms, then he told us warning signs that might indicate more sever problems, and he followed up.

I was also impressed by his use of lab tests, rather than simple symptoms. One time, this saved our son from being unnecessarily medicated. One time I saw blood in his stool. A friend’s baby had just been diagnosed with amoebas (from blood in his stool) and was taking harsh medicine for it. My doctor ordered lab tests of the stool sample and it turned out to be an extremely acidic stomach. The doctor quickly figured out that I’d recently added Oreos back into my diet! Since I was nursing, the Oreos were effecting my son. That was a simple, safe fix and my son was spared a regimen of harsh medications.

Another friend’s daughter was always on antibiotics for this and that. In contrast, our son never needed them. Our pediatrician always found ways to help him to heal quickly and naturally. He is a standard M.D., not naturopathic, it’s just that he is very smart about how he does things.

When you live in Mexico, see if you can find a pediatrician in your town with a strong reputation. Even if you are “retired in Mexico” and don’t need a pediatrician, I think these anecdotes can give you some ideas of what to look for for yourselves!

*** THIS BLOG POST WAS NOT WRITTEN BY A MEDICAL PROFESSIONAL. DO NOT MAKE ANY DECISIONS BASED ON THE INFORMATION CONTAINED HERE. FIND A DOCTOR AND ASK HIM/HER FOR GUIDANCE.***

I also want to say right up front, that my experiences in Mexico cannot be compared to those that I might have had in the US. I’ve only been pregnant once and I was nowhere near the US during this experience. Despite being quite “American” in lots of ways, I know nothing about pregnancy and delivery in the US.

What I learned in Mexico is that a lot of women who say they want a natural childbirth experience end up with caesarean deliveries. The more I learned about the situation, the more I came to view childbearing as a feminist issue. It appears that when childbirth is guided by women, with men in active support roles, births tended to be bonding, positive experiences for family units. On the other hand, when the birth process is in the hands of doctors, it becomes a medical procedure and women’s physical strength and emotional experience is negated.

It’s too bad we aren’t in Europe. There are some places in Europe where the labour and delivery wards are designed to make women and their partners comfortable and to assist in a relaxed, natural delivery. They have cushions of different sizes, areas for stretching and hanging, accessible warm water showers, and dedicated staff. There are even beautiful water delivery options! Alas, that is not for us, but we can still have great labour experiences, if we take charge of our own options and surround ourselves with caring, knowledgeable people.

To find a doctor who is committed to natural childbirth, ask people about their doctors and delivery experiences. You have to compare stories. There were some doctors in our town who were well thought of, but most of the women that I talked to about their deliveries had caesareans…. Ask doctors what percentage of their deliveries are natural. WHO says that 20% of deliveries should end in caesarean. If the doctor says 80% of his/her deliveries are caesareans, you have not yet found your doctor.

In our town, La Lega de La Leche was a good source of information on local doctors and their tendencies, but there isn’t a group in every town. Another good source of information was our pre-natal class. We attended free trial sessions of two different classes to see which one we preferred. The one we chose really stood out to us. The instructor included the partners (mostly fathers, but other “coaches” were also made completely welcome. The instructor’s objective was to give the mother full support during labour and delivery), rather than focusing only on the women – she even had a special form for fathers to complete while registering.

By learning the stages of labour and pre-labour you and your partner are better prepared to set yourselves up for success and have a natural delivery – even with a caesarean liking doctor. This class also included a small percentage of partners who chose home delivery. We were not considering delivering our baby at home, but that showed that it was a community of people who were dedicated to natural childbirth.

A strong indication of a doctor’s commitment to natural childbirth is if they charge the same no matter what kind of birth it is. The doctor I most preferred in our town was known to be committed to natural childbirth and she had only one fee – no matter which way the delivery occurred. Doctors who charge more for a caesarean are more likely to deliver that way. It’s a racket, really. They show you two prices, one for natural childbirth and one for caesarean. They tell you that there is “no reason” you shouldn’t have a natural delivery. You like the lower cost of the natural delivery, so you feel like you are getting a deal. What you don’t know is that by delivering caesarean, not only do they earn more money the process is more under their control. They don’t have to wait around for natural processes to unfold. They don’t have to put in the hours of helping you relax, walk around, sit in a hot shower, etc, etc.

On the flip side, just by not doing these things, they make it more likely that you won’t be able to deliver naturally. (This is really a key point that first-time moms rarely take into consideration – and doctors bank on it – literally.) Before we had our son, we heard lots of stories from other moms and I observed that even when parents were clear with their doctors that they “wanted” a natural childbirth there would always be “something” and they’d end up with a caesarean (and convinced that they needed it, so don’t let that be an indicator for you).

I think it’s important to mention that at first our pre-natal class appeared to be overly expensive given our earnings and our usual spending habits in Mexico. I asked my husband to attend the free trial visit to the class before I would even tell him how much it would cost! In the end, we both thought it was worth every peso. I was shocked when my husband – who normally won’t even spring for pollo rostizado if we can make scrambled eggs at home, said so to his family and friends. It was lovely to hear him telling his BROTHER all about the stages of labour and how to help his wife during delivery. Both of us strongly advise first time parents to take a pre-natal class together (called clase psicoprofilactico in Spanish) – and the more committed to couples and to natural childbirth the better. This class got us started on the path of parenthood as a united pair. Friends and family commented on how we were unusually relaxed as newbie parents. Not to mention that we had a dream delivery with our son, that is a sacred memory to both of us.

Here is the kind of story you are looking for when you are researching doctors. One of my friends delivered her baby before I did and she chose the same doctor I preferred. She told me that during transition (that’s when it hurts the most and most women end up getting an epidural, even if they didn’t “plan” one in their original birth plan) she asked for an epidural and the doctor told her, she would not give one because the baby would be born before it could even take effect. In the moment, my friend felt angry. After delivery she said she wanted to give the doctor a big kiss and hug for saying, “no.” She and her baby were both more alert and ready to begin nursing than they would have been if she had gotten an epidural – not to mention that an epidural would have greatly slowed the process down, reduced my friend’s experience of the actual delivery, and introduced unnecessary risk. She had her next two babies with this same doctor.

Maybe you can turn this into a question for doctors you are “interviewing.” Something like, is there ever a point during labour that you would refuse a mother pain relief?

In my case, the first doctor we went with was highly recommended by a friend, so I was convinced that he was just the greatest gynaecologist in the world. Luckily for us, he chose to blatantly lie to us so that he could begin to steer us toward a caesarean. If he had been less bold, he might have kept us as clients. As it turns out, we had already started our prenatal class and when I told the teacher what my doctor had told us, she told me to get a second opinion. When I got the second opinion, his lie was exposed and we never went to see him again.

The short of it is that I had asked my doctor about a condition I thought I might have. He used that little bit of fear that I had to tell me that I needed a caesarean. He even had my husband look at my cervix through a special instrument so he could “see” how much I needed a caesarean. When I got the second opinion I was told that my cervix was completely normal and healthy looking. This other doctor probably knew that to any regular guy, like my husband, a normal cervix looks terrible. He literally banked on freaking my husband out. This is so unethical it makes my stomach ache! It is also not that uncommon. In a different context, I heard our prenatal class instructor say that doctors commonly manipulate the fathers into pushing for the caesareans by scaring them about the “consequences” of not getting one. This is why it is so important that each expectant mother have a birth coach that attends the classes with her and can support her during labour.

You might also ask around and see if there are any professionally trained midwives or doulas in your town. Una “partera” can mean a lot of things in Mexico, so do your research well, but there is potential there for a lovely delivery experience. Even if you talk to a midwife or doula, but don’t choose to deliver with her, she will likely know which doctors in town are committed to childbirth, which ones ‘ride the fence’ and which ones have earned the nickname “Dr. C-Section.”

Once you find the right person, it will be lovely.

I’m so very glad I delivered in Mexico because our family had a beautiful natural birth and my husband was involved in every stage. He was my hero all of the way through, providing pain relief with acupressure, coaching, encouraging, and caring for me. He will never forget seeing his son born. Also, Mexico is a wonderful place to have little children.

Click here to see a description of the e-book by the author of this website that talks honestly about expat life and health care in Mexico.

Every body wants to know about the famous pharmacies here in Mexico — especially those of retirement age. Can you really get your medicine over the counter at a fraction of the cost? The answer is yes… and no. …

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Living or retiring in Mexico, if you don’t feel comfortable taking all of the risk for payment of your health services through private coverage, you could opt to pay for a formal health care insurance plan that would cover you in case of unforeseen, large expenses. These plans are sold by insurance agents and paid to large companies such as ING or Mapfre.

Click here to see a description of the e-book that talks honestly about expat life and health care in Mexico.

Retired people will know that when you are over 64 you can no longer qualify for coverage. It’s the same in Mexico. If you are under 64, here is a basic outline of formal healthcare insurance in Mexico.

There are two plan types, which are generally sold as seperate policies. The first is “Gastos Medicos Mayores” (Major Medical Expenses) and the other is “Gastos Medicos Menores” (Minor Medical Expenses).

Gastos Medicos Mayores

“Mayores” is for the big stuff like accidents and long term sicknesses. …

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Gastos Medicos Menores

“Menores” is for the yearly stuff such as doctor’s visits, preventative health, lab tests, etc. …

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My personal wish for everyone who comes to live or retire in Mexico is that they don’t have to use IMSS. I had IMSS as a “benefit” when I worked as a regular, full-time employee (this is called nomina) at a language school in Cuernavaca.  

All IMSS personnel and facilities are serving about 5 times as many people as they should  be expected to serve. Under these conditions, even professional, kind people cannot give good care. You will hear that the best doctors work for IMSS, which I don’t doubt is true, but because of the under staffing and underfunding and Mexican version of the good-old-boy network, those doctors end up serving their acquaintances and clients who know them through their part-time private practices.

Click here to see a description of the e-book that  talks honestly about expat life and health care in Mexico.

I was quite under-joyed with my so-called benefits. For retired people from the U.S. and Canada, the reality of IMSS is quite shocking; even dangerous.

If you want to, stop reading right here. I don’ t have anything good to say about IMSS — especially not for retired people, who may actually need to use the service. In fact, you may not even qualify for it. See Mexico Connect to read about the exclusions.

If you feel the need to read the bad news, let me start by telling you about how IMSS almost killed my husband.

IMSS Almost Killed my Husband

When my husband broke his arm he was brought to the IMSS emergency room where they set his shattered bone without anesthetic and then put him in intensive care with no blanket. When I got there he was shivering from shock and there were no blankets available, but they lied about it and said that “the laundry would come in the afternoon.”

I stood there in the center of the circular intensive care bay and scanned the open-ended cubicles surrounding me. Each patient had a different type of blanket. None of them seemed institutional. They were crocheted, fuzzy — all looked distinctly brought from home. Just coming down from shock myself (I had just come from the scene of the accident were the police didn’t bother to tell me how my husband was, but I could see the state of the vehicles that had been involved in the accident.) I went out to the street and around the block to a public phone (there are none inside) and called a friend who lived nearby and asked her to bring a blanket that she didn’t care if she didn’t get it back.

The light in the bathroom on the intensive care floor was out and my husband had to leave the door cracked to pee. His shoes had been removed by the ambulance staff, so he stood on the floor, sticky from pee, in his socks. I could smell the reek of urine from outside. No soap nor paper were provided.

Two beds were crammed into each cubicle designed for one. The lady next to him had the tubing for her bag of blood draping over him.

After a day, he was transfered to normal care where no pillows were provided to elevate his arm. Once a day a doctor would come and say that they were waiting for the swelling to go down on his arm in order to pin and cast his shattered arm bones, but they continued to leave his arm down by his side. (No, I didn’t figure out that we had to elevate it because I was running around getting soap, toilette paper, and clothes for my husband and a lawyer to help us get through the attacks by the insurance company and the public assistance people who were saying that they were there for our protection, but getting belligerent. I learned later, from the lawyer that they were posturing for bribes.)

No food was given to him because he was “going into surgery” but the surgery wasn’t even scheduled yet. I have no idea what would have happened because the insurance of the person who caused the accident finally kicked in and my husband was transfered to a private hospital where he was immediately prepped for surgery and I cried spontaneous tears of relief.

My IMSS Clinic

The line to enroll at and do other paperwork at my clinic is usually long. A 30 minute wait is normal. You’ll see elderly people standing there on their swollen feet.

Once you get inside, there is one row of plastic chairs along the wall, facing the little reception desks for each little doctor’s office. The plastic chairs are full, and people who can’t get a seat stand up. The receptionists are grumpy.

The floors are so dirty it looks like — I can’t think of another place where I’ve ever seen floors so dirty. You can see black dirt caked thick wherever people’s feet don’t keep it thin. …

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I have more horror stories than these, but I think that is enough to make it clear that I would not recommend living or retiring in Mexico if IMSS were to be your only source of health care services.

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A Personal Anectdote

Without getting into details, I’ll tell you one of my experiences with a dishonest doctor so that you’ll know what to watch out for when you live or retire in Mexico.

I got a referral for a doctor from a fellow expatriate from the U.S. The doctor charged a moderate amount on the pay scale (300 pesos per visit) and was a gentle, friendly person.

The author of this website has prepared an e-book that honestly talks about expat life in Mexico.

At first I was very pleased with this doctor, but eventually came to a crucial cross-roads with him. I asked him for information about a condition that I thought I might have. He used that opening to withhold information from me about tests available from local laborartories and to recommend that he perform an expensive, invasive, and unnecessary surgery on me. …

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Professionalism in Their Offices

In addition to the huge difference in the morals exhibited by these two doctors, there was a difference in the professionalism demonstrated by their receptionists. The former doctor’s receptionists would make appointments for times such as 6:30 and 7:00, but when I got to the office, I would wait until 9:00 p.m. to see the doctor. If it was because he was regularly detained, why did they not use my phone number which they had in their appointment book to call me and ask me if I’d like to arrive later or reschedule my appointment?  As a retired person, I’m sure you don’t want to sit and get flat-butt in a waiting room for hours.

At the honest doctor’s office I wait….

The rest of this section has been moved to Mexico: The Trick is Living Here (Second Edition).

When you live or retire in Mexico, get referrals from friends and acquaintances, but be your own advocate. It may be necessary to switch doctors in order to get the kind of care you deserve.

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Private Hospitals

Click here to see a description of the e-book that honestly talks about expat life and health care in Mexico.

Savvy retired people will be asking, where do these private doctors treat their patients in emergencies? The answer is that there is an extensive system of private hospitals at which private doctors provide services. Just like doctors, the hospitals vary in cost, quality, and variety of services provided.

At first, these hospitals will strike the recently retired in Mexico as more like clinics. They are generally small, often converted buildings with jury-rigged ramps, etc. Each hospital hires it’s own receptionists, nursing staff, and cleaning staff. They also own the equipment there, such as X-ray machines and other things that most of us take for granted will be at hospitals.

One of the reasons Mexicans give for having IMSS insurance is that the large IMSS hospitals in Mexico city are better equipped than private hospitals. They reason that, if they are at a hospital, they want to be sure that the necessary equipment will be available on location.

If you have a special condition, such as diabetes, it would be smart to list all of the hospital equipment that you may need….

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As you move toward your goal of retirement in Mexico, it’s helpful to

understand the health care “system.” I put “system” in quotes because it’s not as systematic as in the U.S. and definitely not as systematic as in Canada, which has its advantages and disadvantages.

Click here to see a description of an e-book that honestly talks about expat life in Mexico.

—-

“Julia Taylor writes about living in Mexico… with the definite knowledge of an insider. She shows us a side of the Mexican people and their belief systems that you would never find out about, unless like her, you really get to know the people.

“If you want real insights into Mexico, its people, and how to live like a Mexican, this is a must read.”

Suzanne Marie Bandick www.suzannemariebandick.com

Author of: Only in Mexico, You Say? The Humorous Side of Living in Mexico

I’ll start by describing the basics of how people who live in Mexico access health care services and branch from there into specific topics. You can decide how you might fit into the picture once you retire in Mexico. Having a general picture of how it all works will help you to make a smooth transition and to take advantage of the advantages while softening your exposure to the disadvantages.
Mexico has two different types of health care, which are referred to as private (particular) and public (seguro).  You can decide which you want to participate in when you live or retire in Mexico.

Private vs. Public Health Care in Mexico

Public

There are three major groups in the public health care system. They are IMSS (Instituto Mexicano del Seguro Social or Mexican Social Security Institute) which is available to many people working at private institutions as well as immigrants to Mexico—including retired people, ISSSTE (Instituto de Seguridad y Servicio Sociales de los Trabajadores or Security and Social Services Institute for Workers) which is available to employees who work for the state and other public institutions, and seguro popular, for all those not covered under IMSS.  These services are organized on a national level and most employers who provide benefits—as they are legally required to—pay into IMSS for their employees. Beneficiaries can receive their services without paying anything in addition to what their employer pays on their behalf. Retirees who opt into IMSS pay for their own coverage.  Seguro popular is available for retirees, and provides services on a sliding scale.

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Private Doctors

Private health care in Mexico can be terrible or it can be wonderful. It depends on what you make of it. When you retire in Mexico you could have the kind of personalized, professional care that you can only dream of in Canada or at your HMO in the U.S.

On a service for service basis, the cost of care in Mexico is much lower than in the U.S. That’s the good news. The bad news is that you have to pay for it out of pocket (unless you opt to pay for health insurance), which can be quite expensive if you are earning in pesos.

Private health care in Mexico isn’t a formal system at all. Doctors….

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Finding a Doctor You Can Communicate with in English

Due to their common experiences, other expatriates are generally the best people to ask for referrals. Of course, when you first live or retire in Mexico, you might not know anyone, so you could start with the yellow pages under “medicos” (and there are tons; over 60 pages in the Cuernavaca yellow pages!). Those who speak English list that in their advertisement. Another good option is to see if there is a Newcomers club in your town and ask them for a referral. You can also put a post up on an expatriate forum such as Expat Focus. Once you find a professional, honest doctor then they can become an excellent resource for referrals to specialists in other fields.

If you don’t like the first doctor you find, try another. I’ve gone to some doctors based on referrals and felt like they were just stringing me along to get me to come back and pay them more money. I’ve also found a couple of doctors who are professional, helpful, and give help over the phone without charging.

I don’t think that it’s necessarily true that more expensive doctors are always better, but so far I’ve had better experiences with the doctors that charge more. One of my favorite doctors is also an expatriate from the United States (and she charges on the higher end of the scale).

The Cost of Private Doctors in Mexico

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Note: There are also private hospitals in Mexico, which work differently than those in the U.S. and Canada.

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