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In Varna, Maichen Dom provides excellent prenatal and birthing services. I gave birth there in 2014, and was very pleased with my experience.

Prices in this guide are an estimate. Maichen Dom in Varna is a private hospital, and is at the top of these estimates. Public hospitals may be a bit lower, but they are often in worse repair and do not offer as many extra services.

Pregnancy

Doctor's Appointments:

In Bulgaria, pregnant women are expected to attend a prenatal exam once a month for the first seven months of pregnancy, and once every other week for the last two weeks. These appointments are generally brief. You will be weighed and measured. You may listen to the baby's heartbeat or have an ultrasound. (A note on ultrasounds: I had one every month, to measure the growth of the baby, and that was the normal procedure for checkups. You should educate yourself about the possible risks of ultrasounds, and let your doctor know if you do not want frequent ultrasounds.)

During these appointments you should be prepared to talk about any issues you are experiencing. Also, be aware that Bulgarian doctors tend to put off talking about the birthing process until the 8th month. However, if you let your doctor know that you are not covered with Bulgarian insurance and so you will have to plan your finances accordingly, they will usually be more willing to discuss the different options you have for birth sooner in your pregnancy.

Special Testing/Procedures:

Most facilities will offer biochemical prenatal screening twice during your pregnancy, as well as check your hormone levels if you have any issues. 4D ultrasounds are also an option, if you are interested.

Cost:

Check-up: 15-30 bgn

Check-up w/ ultrasound: 25-40 bgn

4-D Ultrasound: 90-100 bgn

Biochemical prenatal tests: 20-50 bgn

Prenatal Vitamins: 15-30 bgn for 30 days

Doulas:

Doulas are becoming more popular in Bulgaria, but they are still not common. If you intend to have a doula at your birth, you should find a doula and talk about it with your doctor early in your pregnancy. Many Bulgarian doctors would prefer to not have a doula at your birth, and there may be an extra cost for them to attend. However, many Bulgarian doulas are great sources of information about Bulgarian hospitals and basic birthing information. If you cannot find a prenatal class in English, you may want to hire a doula for some private lessons in your seventh or eighth month.

Doulas cost around 175-250 bgn to attend your birth, and 20-40 bgn for a one-on-one class.

Birth

Hospital Stay:

After a vaginal birth, you should expect to stay in the hospital for at least 3 nights. After a Caesarean section, the minimum stay is 5 nights. Standard rooms are generally 2-4 women. Private rooms are usually available, but must be reserved in advance.

You should bring at least two nightgowns, slippers, and toiletries. Some hospitals provide sanitary pads for the mother and diapers for the baby while others require you to bring your own. You should ask your doctor about this.

Every hospital has different rules regarding how much time the babies spend with their mothers during your stay. If you are in a shared room, you may not be able to have your baby sleep in with you. If you want to spend more time with your baby, you may have to request a private, VIP room.

It is worth noting that visiting hours are generally quite short, for 1-2 hours a day, and your significant other and family will not be allowed to visit outside of these hours. If you want your significant other with you and the baby during those first few days, you should consider booking him (or her) into the room with you, for an additional fee.

Birth Plans:

While it doesn't hurt to write up a birth plan, they are not common in Bulgaria. You should keep it general and to one page. Also, be sure to get it translated into Bulgarian.

Pain Management:

The walking epidural is the most common type of pain management offered in Bulgaria for vaginal birth. Generally, the anaesthesia will wear off slightly before the active phase of labour, so you can feel when to push, and then be administered in a stronger dose after delivery.

For Caesarean births, you may be offered general anaesthesia or a full epidural.

Nitrous Oxide is not offered in Bulgaria.

Some hospitals will allow you to use a TENS machine if you bring it yourself.

Water birthing is available in Plovdiv, Varna, and Sofia. However, it is uncommon and most women simply use the tub for pain management and give birth outside of the tub.

Maichen Dom, in Varna, has a very nice active birthing room with an exercise ball, mats, a whirlpool tub, and birthing stools.

Natural pain management methods can also be used, such as massage, breathing, and hypno-birthing, however, to successfully use these methods you may want to have your partner or a birth coach with you.

Manipulations:

Many Bulgarian doctors still practice episiotomies as general procedure. If you would like to avoid one, let both your doctor and the doctor (and nurses) on duty during your birth know.

Forceps and vacuums are used, but only in emergency situations. Most doctors try for more natural manipulations first.

Costs:

Vaginal Birth: 700-800 bgn

Caesarean Birth: 1000-1500 bgn

Epidural: 150-200 bgn

Having the Father Attend the Birth: 80-120 bgn

Per Night in Shared Room: 60-90 bgn

Per Night in VIP Room: 30-40 bgn

Per Night to have your partner in the room with you (only in VIP rooms): 20-30 bgn

Newborn care: 130-160 bgn

Choosing Your Birth Team (as opposed to the oncall team): 100-150 bgn

Choosing Your Date of Birth on a Holiday: 100-150 bgn

Most Bulgarian hospitals do not accept payment plans, and require payment when you check out.

Child Care:

If your child is a Bulgarian citizen, they get the benefit of free healthcare. Your doctor will visit you at home within 24 hours of your release from the hospital, and you baby will attend checkups every month. Vaccines are free, but any prescriptions are not.

However, if your baby is not a Bulgarian citizen, you will pay around 450 bgn for the same level of care for the first year, and 300 bgn for the second year.

Overall, if you find a doctor you trust, and tour your birthing center early in your pregnancy, you can expect a safe, modern birth experience without leaving Bulgaria.