Here’s everything you need to know about what to expect!
So, you’re pregnant? Congratulations, mama-to-be! If you’re a first-time mum or are new to Hong Kong, deciding where to give birth is important and can be difficult to decide, especially if you don’t know what is involved. And then sometimes, the decision gets made for you, given the prohibitive costs of private hospitals here! If you have opted to deliver at a public hospital in Hong Kong, we’re here to help. So we’ve enlisted midwife Rosie Adams, from Annerley (OT&P), to guide you through the process and these are her top tips.
Editor’s note: Please note that due to the spread of the novel coronavirus in Hong Kong, public hospitals are currently not allowing husbands and birth partners to participate in the birth or visit the mother and baby in the hospital. These rules will be revised after the outbreak has been contained.
How to register for delivery at a public hospital
Upon confirmation of your pregnancy, you will be provided with a letter from your midwife/GP/obstetrician. With this letter, you will be able to register with the public maternity system in Hong Kong. At the earliest opportunity, call your nearest Maternal and Child Health Centre (MCHC). These are external clinics associated with some of the public hospitals. You could also call the hospital directly to make your first appointment to book in. All hospitals work within catchment areas; therefore you will have a designated public hospital based on your address. However, if you have a preference for an alternative public hospital outside your catchment area, then there may be the option of registering with them, depending on their capacity (look below for our list of public hospitals, including reviews by Sassy Mamas who have given birth in them). In this case, it would be wise to call your chosen hospital directly to enquire about their availability.
Documents required for registration
Once you have made your booking appointment (there is usually around a 4-week waiting time for this), then you can gather the required paperwork. To register, you will require your confirmation of pregnancy letter, your Hong Kong ID card, a proof of address letter (i.e. bank statement or phone bill), copies of any recent blood tests or scans you may have had done privately or overseas and (if you are married) a copy of your partner’s Hong Kong ID card.
What to expect from the public system throughout your pregnancy
Throughout your pregnancy in the public system, you will be seen by both midwives and doctors. These appointments may be at either an MCHC or in the hospital itself. Some public hospitals also provide two ultrasound scans – one at 12 weeks and another at 20 weeks. However, these are not provided by all hospitals. Your hospital will advise you to have these scans done privately if they do not offer them.
Editor’s note: Quite often, many expats who choose to deliver at a public hospital opt to supplement their maternity care with a package at a midwives’ clinic (such as Annerley’s Nexus Public or Best of Both) or with a private obstetrician who can cover scans and tests leading up to the birth.
Many hospitals offer tours of the maternity ward and some also provide basic antenatal classes (check if these are in English before signing up) covering things such as pain relief options and positions for labour and breastfeeding. It’s a good idea to talk to your midwife at your first appointment about the hospital tour and classes if you are interested in joining, as they tend to get booked up relatively quickly. Some public hospitals also provide a birth plan template for you to complete prior to delivery (if not, you can download Sassy Mama’s birth plan template here).
Labour and giving birth at a public hospital
Upon arriving at the hospital for delivery of your baby, if you are found to be less than four centimetres dilated, you will be admitted to the antenatal (or pre-labour) ward until you reach active labour. In this ward, partners are only allowed to be with you during visiting hours, which are typically an hour at lunchtime and two hours in the evening. The ward is also shared with usually six to eight beds in one room. Once you are transferred to a delivery room, your partner will then be able to join you for the remainder of the labour and delivery. However, some public hospitals do differ in practices and processes, therefore it is advised to discuss this with your midwife during one of your antenatal check-ups to gain an understanding of your chosen hospital’s policy.
In the public system in Hong Kong, midwives conduct the majority of deliveries, with doctors on call to deliver should a medical need arise. Once you reach the delivery room, the care is usually one-to-one with your allocated midwife, with other midwives and doctors on hand for assistance. The majority of public hospitals in Hong Kong are also teaching hospitals, so it is likely that you will be asked if you consent to having midwifery or medical students present to witness your delivery.
Once you have delivered your baby, you then usually remain in your delivery room for around an hour and a half before being transferred to the postnatal ward, which is similar in set-up to the antenatal ward. Partners are again limited to visiting hours here and you will be in a shared ward. You should expect to stay for around 36 hours following a normal delivery and for at least 48 hours following a Caesarean section. There will be midwives and lactation consultants on hand to assist with breastfeeding, so be sure to ask should you require any help from them during your stay in hospital. Your baby will be checked by a paediatrician before being discharged and you will be asked to return to the MCHC in the first week for your baby to have a weight and jaundice check-up. There are currently no at-home midwife visits provided by the public system in Hong Kong.
Public hospitals in Hong Kong
Now that you understand the process, it’s time to weigh up your options. We love that the government hospital maternity services come at a minimal cost (you can even pay for the delivery with your Octopus card!). Cost aside, most of the public hospitals in Hong Kong are well equipped for any sort of medical emergency. You can find a full the list of HK’s public hospitals and a review of the admission procedures here. These are a few worth considering*.
- Kwong Wah Hospital
- Pamela Youde Nethesole Eastern Hospital
- Princess Margaret Hospital
- Queen Elizabeth Hospital
- Queen Mary Hospital
- United Christian Hospital
However, giving birth at a public hospital in Hong Kong is definitely not for everyone. The language barrier, lack of pampering, the food (yes!) and the strict rules and regulations concerning visitors and birth partners can deter some. So, to help with your decision, we asked a few mums to tell us about their birth experiences at some of the reputed public hospitals here in Hong Kong.
*Editor’s note: Many of the public hospitals are currently geared towards tackling the novel coronavirus outbreak, so obstetric cases may be moved to reduce risk of transmission. Please check with your preferred hospital if they are taking on new obstetric cases.
Public hospital birth experiences
Maura Thompson, mum of two. First delivery at Queen Mary Hospital in 2013, second delivery at Matilda Hospital in 2016.
- The medical care at Queen Mary was great. If I were to change anything it would have been to ask for an epidural earlier as I was wishy-washy on whether I wanted one. Once I decided I did want one, my request came in too late and the anesthesiologist was busy so I wasn’t able to get it.
- I have to say that the strict visiting hours make it hard to feel comfortable when you have to be away from friends and family. But for me, I actually turned this into one of the most positive parts of my stay as it allowed Eve and I to have amazing bonding time together.
- I opted for a public hospital birth after realising that my medical insurance didn’t cover the cost of delivering at a private hospital (and then supplemented the public system care with Annerley’s Best of Both package). We knew we would want another baby at some point so we made changes to our insurance plan ahead of time so it would allow for more coverage the second time around. I have no complaints with either decision.
Elly Liu, mum of one. Delivery at United Christian hospital in 2018.
- I attended classes about what to expect after delivering and how to check if the baby is hungry or full. I did all the checkups they provided before giving birth. They also taught me how to breastfeed after delivery and what exercises I should do to recover better.
- I’d say the facilities are very good there and the fees are great. However, overall the experience was average. I was feeling really unwell after giving birth and it was really hard for me to move, but they only provide basic care and comfort services which I personally think was not enough.
Jess Mizzi, mum of one. Delivery at Queen Mary Hospital in 2018.
- I’m not going to lie, I didn’t have the best experience at Queen Mary. I laboured at home for 12 hours before getting to the hospital at 7am. I practised Hypnobirthing as I knew that getting an epidural was so highly dependent on the availability of an anaesthetist. Unfortunately, that meant the staff didn’t really take me seriously. No one checked how far along I was until I screamed out and they realised I was ready to push. They told me “we’re a bit busy today, you’re going to have to wait a while”! My son was having none of that and was born within two hours of me arriving at the hospital.
- I think the most important thing any parents preparing for delivery in the public system should do is arm themselves with as much information as possible (the team at Annerley do a fantastic workshop on this). The food is going to be terrible, so pack your own and be warned, you will get no sleep in the post-natal ward. Most importantly, unless you make a fuss you won’t get much attention (take note, anyone doing Hypnobirthing or CalmBirth). That said, I chose to go to the public hospital because of the medical care and it was good, as expected, and the pregnancy and delivery were without complications.
Anita Balagopalan, mum of two. First delivery at a hospital in India in 2013, second at Queen Mary Hospital in 2015.
- My first delivery was a disaster. As a result of neglect and a lot of conflicting instructions at the hospital in India, I ended up with a third-degree tear, being unable to breastfeed, falling down and cutting my face after an epidural and some of my daughter’s (and mine) medical needs being overlooked. In comparison, the medical care at Queen Mary was outstanding! I didn’t get an epidural (though I had been harping about it for two hours), but active labour happened in such a flash, it wasn’t missed either. I didn’t have a birth plan but verbally instructed the staff that I wanted plenty of skin to skin contact immediately. That was done and most of my requests were listened to (except the epidural, of course!). The staff dealt with my panic about breastfeeding very gently and it ended up being so easy and natural.
Tarana Desai Shah, mum of one. Delivery at Queen Mary Hospital in 2013.
- Queen Mary Hospital has given me my second life. This is no exaggeration – my experience of the hospital pre and post-delivery has been nothing short of gold standard. I had a very smooth pregnancy and had planned to deliver at a very prestigious private hospital. But an emergency at 36 weeks saw me transferred to QMH. The doctors were experienced enough to deal with an “Aortic Dissection“ (even though they had not come across a case like mine in decades) as they patiently explained to us what was wrong with me as a layman. They worked at a fast pace as they planned an emergency C-section, followed by a gruelling 12-hour heart surgery all within 24 hours of my admission. My daughter was initially kept in the NICU for observation. They encouraged breastfeeding as soon as I got back my strength post my heart surgery. The positivity of the staff and constant encouragement around me helped me recuperate faster than I could imagine! I was ready to go home and put this entire ordeal behind me within 11 days of being admitted.
- Of course, the icing on the cake was the fact that giving birth to Isha was cheaper than a meal at one of my favourite Schezwan restaurants in HK! My association and interaction with the hospital didn’t end there. I still continue to be a big fan of the institute as I regularly visit them for my six-monthly checkups, CT scans and medication collection.
- Feel free to read my story in greater detail as I spread the word and make people familiar with Aortic Dissection, which is not only very difficult to detect but can also be fatal.
Anthea Fernandes, mum of two. First delivery at Queen Elizabeth Hospital in 2014, second at Princess Margaret Hospital in 2016.
- Don’t go to a public hospital expecting to be pampered like a Princess. But it will help you get into the groove of motherhood super quickly. The medical care I received in both hospitals was excellent!
- I preferred the Queen Elizabeth Hospital to the Princess Margaret, only because it was less crowded.
Elizabeth Thomas, mum of two. First delivery in 2014 at a hospital in India, second delivery at Queen Elizabeth Hospital in 2019.
- I was allowed to have my husband with me in the labour ward since my second pregnancy was a high-risk one and I went into labour early. They offered me an epidural before I asked for it because I was in so much pain. I was scared because I’d got punctured badly with an epidural during my first delivery, but they explained things well and I agreed and it went smoothly.
- I would say the medical care, the facilities (from the birthing ball to the essential oils they provide!) are all excellent. The food is basic and not all nurses are friendly, but they were all polite and spoke clearly, so these were minor issues. The only time that they didn’t follow what I said was after delivery when I explained that I didn’t have to come for a prenatal check because I had already delivered!
- NICU care was fantastic. It was open almost the entire day and night and the nurses provided me an update every time I visited, even if it was just half an hour earlier! They taught me how to feed my son with a cup and burp him in the incubator – the meds and 10-day stay in the incubator cost around $500.
Editor’s note: This piece was first published on 22, September 2016 by Hulda of Annerley and was updated by the Sassy Mama team, with the help of Rosie Adams on 20, February 2020.