details for Public prenatal care and delivery?

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ctrbabe1

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Hi all-

I've been off and on this message board for about 3 years, but as dh and I are ttc our next child, I thought I'd pop back on. We have no health insurance and so will be going through the public/government care 100%. I am an American, but have HKID card, as dh is a HK perm. resident.

I have been reading through all the posts about public care here, but still have a lot of concerns. Can anyone give me a very detailed account of what I can expect for prenatal healthcare and birthing at QM? When do I need to start seeing a doctor, and how often are the checkups? What do they do at the exams? Will they do an ultrasound to determine gender? etc etc etc. DETAILS, please!

For the birth, will my dh be permitted in the delivery room? Will my 3 yo daughter be allowed to come visit in the hospital? Will the doctors and nurses be respectful of my wishes for the birth?

I know the the experience will be NOTHING like what I had in the US (private birthing suite with whirlpool tub where dh and my mom could be with me 24/7) and am apprehensive about the care this time.

Anything you can tell me to calm my fears will be greatly appreciated.

Thanks!
 
Well, just found out today that we are indeed expecting #2, so really, any info you have at all on the public system as far as prenatal care goes, please share!
 
Congratulations Katie! There have been lots of threads on this topic before (to which I have also contributed), so I suggest you try the Search function. However I will reply here to your specific questions:

* Register at the Tsan Yuk whenever you like but before 12wks is best, which is when they do the Downs screening and dating scan. You need to take a referral letter from a doctor confirming that you are pregnant, as the TY do not provide pregnancy tests. I would also recommend that you have a pap smear before registration (if you haven't had one recently), and tell them you have already had one and don't want another one, because they have student doctors keen to practise on you...

* Ultrasound should be provided at 12wks and 20wks, at other times only if a medical need. They are under time pressure to tick the boxes for heart function etc, so don't expect them to look for the gender or even to point out which end is the head, although if you have a kindly doctor who is not in a rush then you might get lucky. I saw a private doctor for that kind of information and reassurance.

* Husbands are definitely permitted in the delivery room. You might hear that they need to have attended antenatal classes, but this is not true - they are just trying to encourage men to become better informed, but will not actually turn away dads who want to attend births. The only problem about husbands attending is if you go to the hospital when you are not in advanced labour, in which case you will be put in the general labour ward which is subject to usual visiting hours. Once you have reached 3-4cm dilation (not an exact science, and it depends on how busy they are), they should transfer you to the delivery suite where your husband can be present. So don't rush to hospital at the first sign of labour!

* Children definitely can't visit your bedside. Not sure what the age limit is. I had the same issue with my 2.5yo a few weeks ago. She came with my mother and husband to the hospital, one of them came to get me and I was able to see her in the waiting room. From there my husband held the baby up in the doorway so she could see the baby. There is a black and yellow striped line beyond which the baby could not be taken without alarm bells going off (we tested it!) because the baby is electronically tagged. Try everything you can to promote a natural birth so that you don't have to stay in the hospital very long - I was able to walk fine immediately after the birth and was out in less than 24hrs, whereas for a C-section I think it's at least 3 days, plus it will be a while before you can walk to the waiting room.

* I found the staff VERY accommodating of my wishes. More so than at my previous visit 2.5yrs ago. So if anyone tells you any stories to the contrary, it may be based on outdated information. They allowed me to walk around without electronic monitoring most of the time, and even provided me with a yoga mat! Do write a birth plan, get it attached to your medical records and take extra copies for the hospital to make sure everyone is aware of your preferences. I found the staff very deferential to my birth plan and they were constantly referring to it. I requested that nobody touch me without asking my permission first (they are not so accustomed to physical boundary issues here!) and they were very respectful of that, for instance, even when the baby's head was emerging. Don't be put off if doctors at the TY say some of your birth plan won't be possible. Doctors usually don't make an appearance until the baby's head is on view - the midwives are in the front line, and they are usually more flexible.

Good luck and let me know if you have any more questions not answered by previous threads!
 
Thanks so much, Jenny. That is wonderful info to have. I will read through the other threads again to see what I missed. If anyone else would like to contribute more info or experiences, I would love to read them!

Thanks again!
 
if you want to hear the good, the bad and the ugly...let me know... i had a nightmare of an experience with my son's birth....

but....
i'm expecting my second and still going back to QMH....
 
Dr Chen at Tsan Yuk is fantastic! he is even better than some of the private doc out there. He never rushes and always listen to you. I hope you get Dr Chen for ultrasound and consultation. He speaks good english too
 
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Carang, yes, I want to know everything. I really want to know what to expect. you can pm me or email me if you don't want to post it all here.

snowball, thanks for the tip! I'll see if I can get him!
 
well...so far with this pregnancy this is how it started....

went to tsan yuk .. got really upset with them as when i phoned to make the appt, i told them that i needed to see the doctor ASAP... when i got there today, it was just for "registration" .... no doctors at all!!! i got upset as i'd put off going to the doctor for almost 2 weeks already because of their backlog. as i said before, i have very high blood pressure and over the past couple of days it's been dangerously high... couldn't take my tablets as i keep vomitting...

anyway, long ans short of it is... i had to go to the A & E dept at QMH... they rushed me through andi was done in 2 hours... had a scan... no heartbeat yet as babes too small still... they gave me a prescription for anti-nausea tablets... going to try them tonight... also have to go back tomorrow for EARLY PREGNANCY ASSESSMENT...

we'll see how it goes... man, the head nurse that i saw at tsan yuk was a complete b*tch and not at all sympathetic... not even an "i'm sorry, but this is the way it is..."

wish i could afford to go private... just not in the cards... now i'm off work

i've had to quit the job that i love as i never know what's going to happen with my health...

i've been referred to the "high risk" team... they seem to be much better and "together" than they were at Tsan Yuk...


i must also say that with my last pregnancy 2 years ago, i never encountered such problems with TYH
 
my birthing experience with my son 18 months ago was TRULY AWFUL.....

i was hospitalised 4-5 times throughout my pregnancy, so i came to know the staff quite well...

the nurses on the ward were fantastic...

but...my birth went something like this...

although i'd been in the hospital for 2 weeks prior to my deliver, because they hadn't bothered to schedule the c-section, they considered it an emergency. they refused to let my husband in for the birth. i was rushed in because my BP had skyrocketed. I tried to explain to them that i would be much calmer if my hubby were allowed to accompany me....NO CAN DO......

finally, once in the operating theatre and the operation was underway, I COULD FEEL IT!!!!!!!!!!!!! it was EXCRUCITATINGLY PAINFUL!!!!!!!!!!!!!!!! the anesthesiologist was very good, tried to up the epi... already frozen to my neck couldn't give me any more, so gave me gas.....IT WAS STILL EXCRUCIATINGLY PAINFUL!!!!!!!!!!!!

finally, finished the operation, wheeled me into the recovery... no one told my hubby that both mother and baby were fine... he was left for over 5.5 hours to wonder what had happened....

and that's just the start....

so, my experience was absolutely horrible....i have had other friends that have given birht public and they were OK... however, my friends that have given birht privately have RAVED about it!

so, from MY EXPERIENCE, the public hospitals get the job done, the private ones do it with as much comfort as possible!
 
hope that doesn't put you off....
but just thought i'd let you know it's not all peaches and cream...
and yet, i'm heading back there for my second!
 
Ladies, It's encouraging to hear positive thoughts on QMH and also appreciated Carang's story. So, thank you.

I've only lived in Hong Kong for 2 weeks. I came to HK with a "pre-existing condition"--pregnancy. I'm now 29 weeks pregnant. I considered private over public care because it just sounded better, but having done a little more research including visiting Tsan Yuk, QMH, Canossa, and a private OB clinic I can't find reasons to spend 40,000hkd for delivery in a private hospital--this is very low considering that I was totally expecting to pay at least 80,000hkd. I asked my private OB in HK to provide reasons why private care is a better choice, but she basically stated that private provides a more "personal" care. I need a doctor to deliver my baby--oh, and help to administer the epidural.

As of yesterday, my health and my baby's health looks great. So, I'm canceling my upcoming appointment with my private OB and taking my chances on Tsan Yuk/QMH and report the good or bad experience later.

BTW, have you seen the views at QMH?! Expectacular!

SyL
 
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