34 weeks and want to change hopsptial & OB, would like to hear some advice

dressuphk

dressuphk

Registered User
Hi ladies, it's my first time pregnant and now 34 weeks. I was planning to go private so have been seeing my OB Dr. Mok at the women's clinic and under her advice we booked a bed in St. Paul hospital when I was 9 week pregnant as she said St. Paul is a very good hospital and has very experienced mid wives.

Things goes fast, my OB is nice, friendly and professional but recently as time gets closer I feel a little uncomfortable about delivery in St. Paul and continue seeing her as my OB.

:butbut:
Things changed when we visited St. Paul hospital around 2 weeks ago, we realized that they will take the baby away from us and we will only see the baby once a day, the bb will be put in a nursery room where only mums can go and feed the baby. -- my husband feel very uncomfortable as he wants to be with the baby, but only if we have a private room will the hospital allow the bb to stay with us. But we do not want private as we JUST realized when we visited the hospital that the OB will charge us more (probably double) if we choose private room. We found it a bit strange and do not want to pay for the double OB charge.

Another thing makes me really uncomfortable is the recent appointments we talked a little about birth plan and etc. When I mentioned that I do not wish to have Episiotomy or want to avoid one, my OB said things I think it is not quite true or reasonable. She said asian women (i am asian) has tighter vagina and would have big risk of tear bla bla:blahblahblah:, and she is very pro episiotomy as I heard from another friend who also use her as OB. But I prefers a natural tear instead of episiotomy.

Yesterday when we saw my OB, we talked a bit about birthing position as I mentioned that I wish to birth squatting -- which utilise gravity -- I am sure a lot of us have read about the advantage of squatting. But she was negative about squatting and said the BEST position is sitting on the bed with incline and have the legs up so she can see what is going on down there -- which is semi-sitting. (honestly I have done lots of research and read lots of books and articles, semi-sitting is not good and the pressure on perineum would get you a worst tear) I was very unhappy but I didn't want to be rude about her opinion and challenge her professional judgement. It seems like that she just didn't respect my birth plan and wanted me to do the delivery in her way, as I can feel that every time when I say something she is trying to persuade me to do it in the way she suggested.

After the appointment yesterday morning, I was really thinking of changing hospital. Our original idea of going private was thinking they would respect our opinion more and provide more personal experience. I talked to my husband about my feeling and decided to book an appointment with Queen Marry. A lot of the friends of mine are going to QMH and I heard good things about them. Especially that QM actually is quite supportive of natural delivery, they do not have incentive to interrupt your delivery with assistance or C-section as they do not earn any money on it anyways.

Do you think I am crazy of making this decision? I mean I am getting very close to EDD. My husband is more tend to stay with St. Paul and the current OB as we already paid a deposit of 10k for st. paul and he think it is nice to have the same OB deliver the baby with us. I hope to hear some advice from you guys as at the moment I feel a bit emotional and also a little disturbed by the whole thing...
 
Sigh. Such is Hong Kong.

I find it amazing that you pay through your nose for a private hospital delivery and they end up being more restrictive than the public hospitals. It's also quite odd that all the literature we read tells us about the benefits of squatting but doctors here seem to regard it as outlandish. There seem to be just a couple or even just one private hospital accomodating of these preferences of the mother and even fewer doctors who are supportive. That said, I knew all this from reading these threads so I was not surprised when the doctor I planned to deliver with at Baptist told me what woudl and would not be accomodated (some of these are hospital policy, some their preferences).

I think you also need to have realistic expectations of the public system. I don't think they're that supportive of squatting delivery either though maybe QMH is an exception. They are also pro-episiotomy - they ask you to sign an agreement - though I think you can resist (though be prepared to insist).

If you are keen on breastfeeding, please check these threads for St Paul's and breastfeeding. At least on that count, QMH will be way better.

By the way, I paid a 6k deposit at Baptist but delivered public in the end (forfeiting the deposit). I was wavering right till the end - one of the things that annoyed me was that I knew that they would bottlefeed my baby formula in Baptist while I was sure they would only cupfeed if thye absolutely had to at the public hospital. I also thought the wards at Baptist was smaller than the United Christian one I had delivered my first baby in. My baby girl made the decision for me by coming early nad requiring an emergency c-sec, which I didn't have the budget for in private. Even though I lost 6k, in all I saved a huge amount of money and got great breastfeeding support. Good luck with your choice!
 
Wow, I thought if you went private you get whatever you want - clearly not... Personally I would be really angry at paying the kind of money you would be expected to pay for a service that is not at all what you want. I think all your requests are absolutely sensible and I still don't understand how uninformed some doctors are about some issues.

Public hospitals abide by the patients charter which gives you the right to refuse any medication, investigation or treatment though as charade says you will need to protest quite strongly.
 
Re Charade: thanks for sharing your experience, it is really nice to know sb. had been in the same situation as me.

Re Aquarian: you don't get what you want in private, I wish I had read more post on Geobaby before I booked but we panicked when I was 9 wks and worried not enough beds this year so put down my deposit with st. paul right away without further research instead based on the OB's words. In private you are more likely to end up in C-secion and assistance. A friend delivered in Matilda she told me the doctor used suction device to get the baby out quicker and her vagina rapture. While the mid wife said it was not necessary - but she didn't have a right to interfere the doc's decision. My friend wanted deliver as natural as possible and wrote that on the birth plan but doc still use suction to speed up -- actually she had a really short delivery.
 
I don't really think that second guessing a doctor's opinion on a friend's delivery is fair. There are all sorts of reasons why a baby may need to come out quickly during a delivery and the doctor is in the best position to make the assessment in the delivery room, while consulting the mother of course. Secondhand accounts always leave out the 'why' a doctor took a particular action.

Regarding Dr. Mok being pro c-section, she is not. The main reason private hospitals have such a high c-section rate is because women request elective c-sections, whereas there are no elective c-sections in the public system. If you do not want one, it will not be any more likely in a private hospital than public. Regarding Dr. mok's position on episiotomy, it is very common. Again, if you insist on not having one, as with the public system, she will not force it. The reason that doctors discuss them is that a natural tear can be much more painful, harder to stitch up and more prone to infection. The flip side to your concern is that some women don't get them and then later wish they had due to complications from a tear. But again, your choice and I've never heard of a forced episiotomy.

All private doctors in HK charge more for private room patients, that's just life. I also know 3 ladies who had 100% natural deliveries, no drugs no epistiotomy with Dr. Mok and she did explain the potential risks etc. in a lot of detail beforehand but ultimately respected their wishes, although the deliveries were at Matilda, which has a slightly more permissive birthing policy. She is quite clinical in how she explains things, but personally I didn't find her to push me towards one course of action over another, it was more of her describing potential implications of what I wanted to make sure that I understood what to expect.

Re: your husband's concern about not being able to see baby while in hospital, going public will not alleviate that issue.

You will be just fine with either hospital, likely a bit more comfortable in a private hospital after delivery, and either way if you have a normal delivery and healthy baby, home with your baby and husband in 2-3 days :)

Will also note that Dr Mok delivered by child, I had some pretty major and unexpected complications and she was excellent in a clinical sense through the whole thing.
 
All I can say is that my first doc asked me during labor if I wanted an epistiotomy (he was a substitue doc who didnt have my birth plan) and as I was taught at annerly refused because of all the tearing issues. At the end, my daughter had meconium aspiration as a result of being inside me for too long (1.5hours too long according to my second doctor). Anyhow, the point is, if it is medically necessary , I.e. Doc thinks it is best, then do it. We are lucky that my daughter survived...she was in critical condition for three days at QMH, after having been delivered at matilda (they didn't have the life saving machine to help resuscitate her left lung that collapsed). I dont intend to scare you here....just want you to be aware that docs know what they are doing, we don't....situations call for different things to be done. At the end the used a suction to get her out and my tear was 9" inches long, took the doctor 45mins to sew me up. All along they were trying to resuscitate my baby.

Another thing is you want to know the doc at the end of the table...no matter how you might look at things differently, at the end of the day, this doc knows your situation the best and can make the best decisions during your labour. Hospital practices...room in/ room out..in the big scheme of things, they are but a few short days compared to the rest of the life you have to bond with your child...

The doctors rate goes with the room rate...common practice everywhere...not much you can do.
 
I think there is a big difference between a doctor telling you *during labour* that your baby is at risk and you need to be cut to speed up the birth vs a doctor telling you you should have one before you're even in labour (and with some fairly bizarre logic). Natural tears heal faster than cuts, so are better unless there's an emergency.

As for visiting hours - I agree visiting hours in public hospitals are rubbish, but surely hubby seeing the baby twice a day (lunch and evening) is better than once a day at st Pauls? Plus my understanding is at public hospitals the mothers are encouraged to room in with the baby unless it's under observation so mum can see baby even when dad can't.

I got the impression from OP that the OB was insisting on doing things her own way (though I might have misunderstood). I think what op is asking for is reasonable
 
Last edited:
I didn't mean my OB is not good, she is a good doctor and should be well respected. I was very happy with her before we get to the birth plan, which is more of our personal experience & feeling.

My husband and I had conversation with our OB twice about some important points in our birth plan (we have not yet shown her the whole thing but just discuss two points episiotomy & labor positions). But we both have the feeling that she said "NO NO" /rejected our idea and insist her own way. It's like "this is not good, that is not good, you should do it this way, you should do that.", but what is the whole point of birth plan? I agree with Aquarian, the OB should not encourage an episiotomy even before my labor - it freaks me out.

Both my husband and I felt very discouraged by the conversation with our OB, we are not hiring her to revise our birth plan. We would rather save the money and go to QM.
 
If you and your husband feel so strongly then I would strongly suggest you change to QM since the whole birthing process is already so stressful in itself no need extra hassle from anyone / anything else. How likely are you to get a spot though? I ask that out of pure curiosity ...no intention of sounding negative ...just no experience with public deliveries that's all...please don't get me wrong...
 
I would agree with other posters, although Dr Mok has never been my doctor, other friends who have had her as their obs have not been pressured into a C-section unless they have elected to have it themselves. About half had a natural delivery and the other half wanted to have a c-section anyway.

In terms of the episiotomy issue, that is personal choice but perhaps she was just telling you in her experience that it might be warranted because of your ethnicity and based on her experience. At the end of the day, when things go wrong, your obs is the one going to be held accountable, not any well meaning friend, mid wife or internet information that you get. That is not to say that you should invalidate any of these resources but that you should weight the information appropriately.

In terms of the charges for a private room, well that is another issue. But did you realise they charge double for not just the doctor's fees but also any pads, gauzes, medication, anything you buy? It's a system problem and I don't think you should put this on your obs (or feel anatgonism towards them because of it).
 
liesliefu, whoever gave you that advice at Annerley SHOULD BE SHOT! I would be ropeable if that had happened to me and my baby, AND although I wouldn't be able to do anything in a legal sense that person would have had a big piece of my mind. Hope everything is okay now with you and the bubs.
 
lesliefu said:
If you and your husband feel so strongly then I would strongly suggest you change to QM since the whole birthing process is already so stressful in itself no need extra hassle from anyone / anything else. How likely are you to get a spot though? I ask that out of pure curiosity ...no intention of sounding negative ...just no experience with public deliveries that's all...please don't get me wrong...
Click to expand...

If the mother has a HKID the public hospital in her catchment area has to make room, so no issue with 'getting a spot'.

However, OP, if you do go the public route you will not know who your doctor is before delivery, and depending on how busy the hospital is at the time there may be little accommodation for your birth plan. If they are less busy there will be more resources to accommodate your particular requests, but you won't know until you get there. My secretary recently delivered in the public system and her birth plan, which was in her file, was set aside entirely during the delivery, neither the OB nor midwives even looked at it as the maternity ward was very busy at the time. Not trying to scare, but you should be aware of how things might go.

I must also say that I am very surprised that Dr. Mok said "no" to natural tearing, not at all how she handled the issue when i discussed it with her (although i am not Asian, i am tiny). She simply gave me the facts, pros and cons of each approach, asked my preference. The squatting issue is actual hospital policy and she may have just been communicating that to you. As others have noted, only a couple hospitals in HK accommodate that position for delivery. Not saying its right, it is just how it goes here.
 
I chose to have an episiotomy. To be honest, it wasn't a big deal. It took a few weeks to heal.
 
mummymoo said:
liesliefu, whoever gave you that advice at Annerley SHOULD BE SHOT! I would be ropeable if that had happened to me and my baby, AND although I wouldn't be able to do anything in a legal sense that person would have had a big piece of my mind. Hope everything is okay now with you and the bubs.
Click to expand...

Thanks mummy moo! All is fine now...she's got delays here and there, but thank god she is with us. On a side note...it tok me three full months to get my babies records from Matikda and I had to go all the way to the top cause they didn't want to release any of it, saying it was "in the system" still! Scary thinking about it inreptrospect...
 
I have taken classes in Annerley but never told to refuse episiotomy though... the Annerley mid wife there did introduce some good methods to minimize tear or episiotomy.

WOW, didn't know labor position is restricted in most of HK hospitals, that's sad...
 
Thanks mummy moo! All is fine now...she's got delays here and there, but thank god she is with us.

Great to hear and god bless....
 
Everything does double or triple in a private room. Even the anesthesiologist fees if you get an epidural (cost of drug doesn't include administering it). It is a HK problem. To avoid any surprises, best to sit down with yr Dr and get a breakdown of all the costs.
 
If you want to avoid or minimize tearing, massaging the perineal area is a must! I wasn't very diligent about doing the perineal massages before birth, but my OB did massage it for me for most of the time I was in the late stages of labor (in the transition & pushing stages). Even though I ended up with a vacuum suction vaginal birth, I was able to avoid an episiotomy completely and I had only 1 single stitch from natural tearing (and I'm a very petite Asian). I was very adamant about not having an episiotomy and my OB was understanding of this. If your OB makes you feel uncomfortable on this subject, I would change doctors. But like others have mentioned, you have no choice in doctors at a public hospital.

If you decide to switch to public hospital, I think you can choose to go home after a 24hr observation period if you had a pretty straightforward uneventful birth (not 100% sure on this). That way, you can maximize the time spent with baby and not worry about having a private room or rooming in. You can have the option hire a midwife to do home visits once you get home to follow up with you and baby.
 
Last edited:
evgreen said:
If you decide to switch to public hospital, I think you can choose to go home after a 24hr observation period if you had a pretty straightforward uneventful birth (not 100% sure on this). That way, you can maximize the time spent with baby and not worry about having a private room or rooming in. You can have the option hire a midwife to do home visits once you get home to follow up with you and baby.
Click to expand...

Actually this is a good third option when considering public vs. private and I know several women who have been very happy delivering in the public system and leaving within a day (you have to sign some forms but they will let you leave without staying 3 days if you have had a normal/ uncomplicated delivery and going home with a private maternity nurse or other full time help, or part time visits from a midwife in their home for the first few weeks.
 
I was home within 36 hours after arriving at the hospital. I didn't have to ask - they asked me if I wanted to go home! They weren't that busy so I don't think that was the reason.
 
You must log in or register to reply here.
Back
Top