First time and panicking

S

ShatinTang

New member
Hi all. Wife and I live in Shatin, just down the road from the Prince of Wales, so it's our logical choice. Also, we aren't 'high-flying' and haven't got insurance, so it's likely our only choice. Following various posts on this forum, my wife took along her HKID, proof of address and doctor's referral letter and successfully registered today. Unfortunately I couldn't go with her as I was working, and the whole experience has left me panicking a bit because things are not stacking up the way we had expected them to, few answers were forthcoming from PoW and we really have no idea what we are doing. Any advice greatly appreciated.

We went to a local GP (recommended by a colleague), a few weeks back, and he estimated we were about six-and-a-half weeks along. He said we should come back in about four weeks to get a referral letter for a hospital where all our antenatal care stuff would be taken care of. We went back four weeks later (last weekend) and his surgery was closed, so we went across the street to another doctor. That doctor's jaw nearly hit the floor when my wife said she wasn't taking folic acid - the first doctor had completely failed to mention it, and this is our first time! Anyway, we got the referral letter and my wife registered today.

Maybe the first doctor had given us incomplete or misleading information, but we had somehow come to believe that having a scan at 12 weeks was normal. The second doctor practically insisted that we have one, saying such worrying things as "but what if your baby has stopped growing, or has no heartbeat?". So we sort of imagined this would be covered at the hospital. No, they said, scans at 12weeks are not normal. My wife was given a list of private hospitals at which she could get her scan done if she really wanted it. There is some sort of 'free' scan available, but the quota is full and is blocked up for months ahead.

In the end my wife was given an appointment back at the hospital for mid June (at about the 27 week mark) and was told to make an appointment at a local clinic. The clinic, we were told, would be able to answer all our questions.

So, ok, the birth part will cost only a few hundred, I guess. But what most posts don't mention is the cost of the pregnancy itself. How many scans do we need? Do we have to have all of them privately? How do we arrange them and at what points during the pregnancy? How much is it all likely to cost? I am panicking a bit because I won't be able to be there next week for my wife's clinic appointment (more work) and I feel utterly ignorant and uninformed. I am concerned that we have been working on poor information so far, and I feel that the first GP set our expectations off in completely the wrong direction.

What is this appointment at 27 weeks that they have made? Isn't there supposed to be a 20 week scan? What is the scan with the full quota for months in advance and who has been booking up all of those slots? I mean, it can't be the 12 week scan because you'd have to book it before getting pregnant, and although it could be the 20 week scan I don't want to clutch at too many straws. Does it mean we'll have to go private for our 20 week scan as well? How do low-income local families afford all this private scanning? Or do they simply make do without scans?

Is there a checklist of things we need to do during a pregnancy? I work better with checklists.

Also, what is a 'birth plan'?

Thanks.
 
dont know where to start...but first of all, you seem to be in good hands. you've registered for a place in PoW and that ensures that you will have a place to give birth...which is great! :) now, you will have to find (if you decide to do so) a private OBGYN to get your scans done privately, if you believe in the benefits of scans, since public hospitals do not give you as many as the private would and not all of them are necessary (some say). if i recall correctly, i had scans at 12, 20, 28/30, 35...the 20wk is the OSCAR which checks for down syndrome I believe, and was highly recommended for women 35+.

a birth plan is a list of things you would like the hospital / doctor to do or not do during the birth process...say, you'd like to dim the lights whilst you are giving birth...you want an epidural....you will be able to draw up your own birth plan once you read more on this topic - or perhaps take classes. perhaps someone on this forum will be able to point you in the right direction...

dont worry about the folic acid- i never took any for baby #1 as you only take it for the first 3 mths of your pregnancy and I didnt find out i was pregnant till i was 4mths along.

congrats and take a breathe - you'll be fine! the public system is very good in HK.
 
Congratulations! I went to POW but I did all of my antenatal care with Annerley. They provided me with a checklist which guided me thoughout my pregnancy. They do not do scans but they can refer you to a doctor who can do that.

If you have any questions with POW, feel free to PM me. The mums at this forum have been very helpful when I was pregnant & it's time to pay it forward.
 
Thanks, both of you, for the reassuring words. I think as long as I know what I'm supposed to be doing and what I'm responsible for arranging, then I can calm down a bit. It's particularly frustrating hearing only vague translations of incomplete information, second hand. And knowing that I might not get a chance to speak directly to any of these health care professionals is vexing, too. I can see I shall be coming back here with a fair few questions in the coming weeks and months, so thank for your patience and understandig.
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Where I come from (in Europe), regular scans are done around 3 times during pregnancy (if you go to the public system; more often if you have private insurances). No need to do scans more often if everything is going fine.
Around 20 weeks there is a more detailed one where they check that all organs are working, take a look at head, shape, hands, feet, legs, etc...to see that all seems to be in its place..
Before that, but I do not remember if it is around week 12, they do the down syndrome test (blood test and scan to measure something on the baby's neck).
 
I second what others have said. You're registered in the public hospital for a place to give birth and that's one of the biggest things you can check off your list.

Actually, in other countries doctors aren't nearly as "scan-happy" as they are here in Hong Kong. With both of my children I went for a monthly appointment with a private doctor and with my daughter I also went to a monthly appointment in the public hospital. At that point we weren't sure if we were going to give birth in a private hospital or the public hospital but in the end we gave birth in a public hospital--but we needed to be under the care of a private physician if we had decided to go the private route so that he/she could book us into a private hospital.

Anyway, the important scans are usually done on confirmation of pregnancy (internal scan), 12 weeks (if you want it--the OSCAR test), 20 weeks (structural scan of things like the spine, limbs and major organs and their development) and 27 weeks (checking the amniotic fluid level usually as well as just the general condition of the baby).

So, no need to go to a private OBGYN at this point--just attend your prenatal checkups either in the hospital or the maternal health center (if they refer you there) for the remainder of the pregnancy--you usually go once a month until your last month of pregnancy when you go every week unless there are complications or needs for further tests--which will be identified at your regular checkups if they arise. The fee for these checkups if you hold a HKID is usually free unless there are specific tests and then it usually will run you no more than $100 HKD.

The folic acid thing is kind of a well-known thing about being pregnant. Have you or your wife read any information online prior to becoming pregnant or after finding out you were? Most websites such as this one will give you basic advice on what you should be eating and doing at each stage of your pregnancy. It's pretty accurate and if you were even trying to conceive most websites as well as doctors will recommend upping your folic acid intake because the truth is that folic acid is a big deal throughout pregnancy but is the biggest deal in the first crucial weeks of pregnancy when the basic outlay of the spine is developing--folic acid helps to prevent spinal malformities like spina bifida and chiari. So unless you were taking it as you were trying to conceive or getting it in your diet at that time, by the time that most people are able to confirm their pregnancy the "critical period" for folic acid--when it makes the most difference has already passed. It's still important throughout pregnancy, though. But, it's possible your wife was already getting folic acid through her diet (by eating: lentils, beans, peas, citric juices, dark green vegetables...even some breads and cereals are fortified with folic acid)...still a supplement is the best way to go.

So, there is a lot of information out there for free right on the internet--videos you can watch by experts, articles you can read, research you can read--I don't know about you but when I found out I was pregnant I started reading everything I could get my hands on and actually I got very little practical information from my doctor--especially the first time around--I got most of my information from my own research and friends and it served me well.

Anyway, don't sweat it--you're booked for a hospital place. Congratulations too!
 
Just wanted to update on scans at public hospitals. I delivered two babies in the public system at United Christian Hospital in Kwun Tong one in 2010 and my baby girl a month ago.

Earlier, the public system would offer a free OSCAR test/scan at 12 weeks for women over 35 (if you were below 35 you were advised to get it done privately) and a free scan at 20 weeks (called a morphological scan where details of various organs are checked) for all women registered. However, since last year they are offering the 12 week scan free and you have to do the 20 week scan privately if you wish. There is a notice up on this at the clinics and hospitals so I don't think it has anything to do with quota - it's just a policy for everyone.

I chose to do the 12 week scan privately (for reasons even I'm unclear about) and the 20 week scan privately. On the 20 week scan, my baby's kidney showed up as dilated. I took the results of this scan to my next public appointment and they arranged another free scan for me. Thereafter, I had another free scan at 32 weeks to see if the kidney was still dilated (it was). I was also doing private appointments and at my 36 week scan privately, my baby was in breech position. When I did my next public appointment I told them this and they did another brief scan to confirm this before discussing options for delivery with me.

Even with my first baby I had an extra couple of free scans because they felt my baby might be too large. My point is that in the public system, if your pregnancy is very normal they do minimal scans but should there be complications they will not hesitate to offer extra scans.

Unfortunately, yes, you'll have to go private for 20 weeks now unless there is something to indicate to them that they need to offer it to you. However, you can choose not to do it at all. It is kind of expensive. You could save money by doing less private appointments/scans in between though.

Also, a lot of the private doctors reccomended on these forums are the expat friendly ones that tend to be located in Central and are expensive (1000+ for a consultation). However, there are less famous, equally competent doctors on the kowloon side that you could see for basic check-ups and scans (the 20 week scan requires a specialist though). When I was pregnant with my first I saw a doctor who charged 600hkd,scan included.

Why don't you register on the babycentre.com website... they send weekly e-updates on the pregnancy and what you should be looking out for/doing. Then you can do further research on whether you want to do those things.

For folic acid, good to take but don't panic if not. Same with prenatal vitamins. With my first, nausea was so bad didn't take any prenatal vitamins. He was fine. Prenatal vitamins are just insurance in case your diet is not balanced enough. Folic acid is more important but never mind, start now.

My point is that although
 
charade said:
For folic acid, good to take but don't panic if not. Same with prenatal vitamins. With my first, nausea was so bad didn't take any prenatal vitamins. He was fine. Prenatal vitamins are just insurance in case your diet is not balanced enough. Folic acid is more important but never mind, start now.
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Not so sure that prenatal vitamins are just "insurance"--most people don't have a balanced diet even if they eat well. But yes, definitely better to start now.

I also attended private appointments and my private doc (one of the less famous ones that charges $450 HKD with a very well-done 3D and regular scan with printed photos). When I started having problems he suspected I had obstetric cholestasis (a condition where your liver releases bile salts into your bloodstream and you have extreme itching--it can be dangerous for your baby as well). But, he did not have the facilities or contacts to have the very expensive and rare tests done so he wrote me a recommendation for the public hospital and they investigated this for me free-of-charge. That's the plus of having a private doc--he can recommend and refer you to the public hospital as well.
 
Am probably just going to repeat some above but here goes(-:
- Folic acid. Yes, your first doctor should have prescribed or recommended it, BUT, don't panic. Like a previous poster, i was so sick i couldnt stomach it anyway. Of course, best to take it if you can, no doubt
- an early scan is usually only required for dating the babies due date if you are unsure of when your wife's last period was.
-It is very weird for your 2nd gp to 'insist' that early scans are critical to safeguard or monitor the health of the baby. For a number of reasons it's just a very, very weird thing for a GP to say. I'd be looking around for a better GP.
-What is 'normal' and not normal for a schedule of scans really varies from country to country, public to private. If you 'choose' to have the 12 week scan (in combination with maternal blood test) it is because you feel that you would like to know if you are at risk for any issues which may affect the development and/or viability of the baby. It is not essential, but very common to have this scan. I say 'choose' because it's still optional, but most private doctors will just proceed with it and then you face any issues with the results as a consequence of your categorised 'risk' level.
-There is a further scan sometimes/usually (again depending on country, doctor/private/public) after 20 weeks to identify anatomy development and again look at any potential issues with baby development.
- A scan after 30 weeks can sometimes be scheduled to check growth and development.
The fact that the hospital can only fit you in for a scan well after the first trimester, means that you will miss any opportunities to identify any 'issues' early on, in which case you would be in a position to terminate the pregnancy. Many people don't even have scans to really inform such decisions, but like me, just like to see the baby along the way! You need to decide what is best for you. It is really nice to be able to see the baby at least once or twice in utero for peace of mind, an opportunity to 'connect' or even find out the sex if you want. I would definitely recommend paying for it if you can. GOod luck!
 
I am quite new here as my husband and i only found out recently we are expecting a baby!!! I tried to take some preconception vitamins probably one month before conception but on and off. As soon as i found out i am pregant, i switched to the pregancy vitamins but i have been having the worst morning sickness and it goes out through the whole day...so if you are like me, you will probably need to take some vitamins just in case.
 
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