Some Q`s about Public System Antenatal care

S

Shenzhennifer

Registered User
I`ve been looking for this specific information but can`t seem to find it - so forgive me if I`m posting what others have asked in the past.

Assuming that I will be able to continue on with this pregnancy...

We don`t have insurance and so I would be delivering at a public hospital - Princess Margaret, according to my district. And I already have an appointment next month at my local MCHC for the 11 week 1st visit. But I was not able to get much information from the receptionist there, nor from any of the websites. It seems for some appts I would go there, for others, to the hospital.

I`m just wondering how all the antenatal visits go. I know I have to give up 4 hours of my life to wait for my # to be called a dozen times...but how OFTEN do I have to do this? I also plan to go to private Drs sometimes, but I want to know how often I have to go to the public clinic at least at the bare minimum?

What is their u/s schedule? how many - 3? How long is the 18-20 week scan?

Is it worth the hassle? I mean, I don`t have a helper, and these appts are during my son`s naptime. How can he stay in the clinic for 4 hours?...I`m already dreading it:)

Any insights or experience would be great. Thanks.
 
I went to prince of wales for some appointments and delivery. during my appointments I never had to wait for 4 hours, I think the most I was ever there was 2 hours and that included being seen by the doctor and giving blood etc.

When you first go in, you go to the reception desk and they give you a piece of paper, you then go to the nurses station where they check your urine sample (which you bring along). Once this is done, you just wait for number to be called.

I brought my son with me for all of those as I also do not have a helper and he brought his nintendo with him to prevent the boredom. On average I waited 45 minutes for my number to be called.

I did both private and public and as far as I am aware there are 2 scans in the public system. First is at 12 weeks and second towards 20 weeks but I went to my private OB for that one.

As far as the appointments go, I think they are every 4 weeks and then after 36 weeks they are every week, but again I went to Dr doo for those so I am not 100% sure.

I had all of my appointments in the hospital though, none in the clinics so I cannot answer any questions on that I am afraid.

I found the public system fine and giving birth was OK too. I was scheduled for induction a week after my due date and was in hospital for a total of 4 days (after emergency c-section).

All the staff were friendly, polite and professional throughout so would go the public route again if I was ever to have any more (not that I will be planning that!)

If you have any more questions I would be happy to answer if I can.
 
The longest I've had to wait is 2.5 hours all up - quite painful... thankfully I didn't have my daughter with me that time!!
how many appointments - in the beginning it's only once every 6 weeks. Then around 24 weeks or something it goes to once every 4 weeks, and at 32 weeks it goes to once every 2 weeks. You can request to go less frequently though but the doctor needs to approve it... The other thing that you can do is call and cancel your appointment with some lame excuse and they'll give you another appointment 2 weeks later or so instead...

If you're under 35 there's only one scan at 20 weeks.

I think for a non-complicated pregnancy, most of the antenatal check ups are quite boring and not that necessary... they don't really do that much... check your urine, check your BP, check the baby's heart and the size of your uterus... that's about it really...

It's definitely easier to NOT take your kids - but there's always a couple of people who take their kids. Just make sure that you bring things to entertain them. Toys etc... they manage. I took my daughter to my glucose tolerance test at Tsan Yuk and in the wait between blood tests, we went across the road to the park and played. Can't do that in a regular check up though...
 
I delivered at PMH... check ups took about 2 hours I think. And there is one scan around 20 weeks... unless you have complications. any questions, can PM me.. also.. though u can take your son... hope that he will sleep in his stroller the entire time so u don't have to entertain him... very boring in the clinic and a lot of ppl too.
 
1 scan for under 35s? Wow, pretty bare-bones. Great to know that, as I can make my own schedule of scans with private doctors as I like.
Interesting that the check ups are pretty uneventful unless there is a complication. But how can they find out about complications when they don`t do too much to you to find out?:)
My son is not a stroller sleeper anymore, unless he`s truly exhausted and we`re on the move. No, I picture him more throwing a fit after being there for more than an hour... will have to think of something. We`ve been to the clinic before for his vaccinations and it IS very boring there.
Loveask - I will PM you at a later time if my pregnancy advances well, to ask you more details about your experience delivering at PMH.

Also wondering about VBACs in the public system. I heard they try to avoid c-sections in the public hospitals, but does this go for women who`ve previously had c-sections? I`d like to try a VBAC if possible, so how would they treat me? Is that still without complications? Wouldn`t I need to see more the same doctor each time?
 
I am having my antenatal appointment at TKO Hospital. As TKOH doesn't really have full maternity service yet, if I choose to deliver in a public hospital, I would end up delivering at United Christian Hospital at Kung Tong. Probably because of this, the number of people waiting for antenatal appointment are usually not too much, and it usually takes me less than 1 hour of waiting time for each appointment.

As Nicolejoy explained, if you are under 35, you get only 1 scan at week 20 (otherwise, you will also get a Nutchal scan at around week 12 to 14). Other than that, you will get a full blood test (including glucose tolerance test), and they will use a doppler to listen to your baby heart beat on each appointment (don't remember when they started doing this though)

About checking for complications, I guess they assume that you don't have any complication if you don't have any bleeding or pain. Also know that in some other countries, like Canada and Australia, they also do just 1 or 2 scans during the whole pregnancy. The reason you get a scan at each private appointment is because the doctor charges you for that. Not everybody likes that however, as you are still exposing your baby (and yourself) to a small amount of radiation on each scan.... And I think it is kind of unnecessary also.

And about having c-section. I don't think they will force you to try to have a vaginal delivery if they find out that you are not suitable for that (e.g. breech baby, big baby with small pelvis, etc). The doctor should be able to evaluate your situation and offer you the best option.
 
I had opted for a vbac as my first was an emergency c-section and I was very keen for a natural birth second time round.

when I spoke to Dr Doo he just had to check which incision I had on my first as if it is a vertical incision on the womb the hospital will not allow you to have a natural as the chance of rupture is severely high but if it is a transverse incision it should be fine.

When I mentioned this at the hospital they were also supportive. I was booked in for an induction as I went over due by a week and they started me off for a natural delivery. Unfortunately, it did not go to plan and I ended up having an emergency c-section.

It is possible though and the hospital will not force a c-section on you unless it is medically required.
 
Hi Shenzhennifer, you won't need to see the same doctor each time even if you have a particular situation or history that needs to be taken into account. I was worried about the same thing and asked about it when I went for my first appointment at the Prince of Wales as I broke my pelvis and hips years ago so will have to have a c-section and there may be other complications throughout the pregnancy and delivery. They are incredibly thorough. I have to get my full medical report from the hospital I was at in the UK 18 years ago and bring it with me for my next appointment. I will see a different doctor probably but they keep everything well documented and filed.
 
Thanks.
I don`t mind going to private docs for additional scans - I`m not confident with just one:)
Gataloca - in Canada, I believe we get 3, but could be as low as 2. Ultrasound machines don`t use radiation like x-rays do - they use high-frequency soundwaves that are then translated into images. There actually haven`t been any large conclusive studies done indicating that u/s are bad for the baby. But nevertheless many people are still cautious. I`d have less for this pregnancy than for my last, for sure.
AmyH - great to know that you were supported to go ahead with the VBAC, though sorry it didn`t work out as planned. I guess I`ll wait and talk to the doctors to tell them my wishes. My incision is very low and horizontal, so should be ok.
 
Antenatal Check in TKO

Hi Gataloca,
I just went to TKOH to book my first antenatal check.
Would like to hear more from you, if you don't mind.
Is it ok to ask lots of questions at your first visit?
Are the doctors and nurses nice & friendly?
& I'm so glad to hear that the waiting hour will not be too long.
I choose TKOH just because it's near from my place.
Hope I didn't make a wrong choice.

Thanks a lot.

-deasy-
 
Deasy... I'm currently visiting TKOH for checkups. I'm very happy with the public system. For my first check, I registered at the maternal clinic in Hang Hau. I was pleasantly surprised that all the nurses spoke English, although I was the only foreigner there. The doctor was young but very thorough. She asked me about medical history and how my pregnancy was (any bleeding, pain etc) and I gave her detailed replies. It's important that you tell them everything that you can and the doctor is very patient and listens. I had had spotting, a vaginal infection etc and she was attentive to all that, taking a swab to test again for infection although I told her I was cleared in my last test. She did a physical exam and spotted a polyp on my cervix and explained with a chart what it was, why and my options. I had been seeing a private doctor who did not spot the polyp, though to be fair, it could have sprung up in between. She also checked for a heartbeat with a Doppler. I was deemed a complicated case and tranfered to TKO Hospital. If you are a peaceful pregnancy, visits may continue at the maternal clinic.

My next visit was at the hospital. It was again very smooth. The waiting time is not that long - I was done in two hours. Frankly, my private doctor sometimes takes longer. The doctor checked on the polyp and gave me the option of removing it. She removed it so skillfully, it was painless. Again, I introduced my entire medical history to her and she was attentive and patient. In a way, it's a good thing repeating the medical history so you're sure they haven't missed anything though they have it all on their computer. The nurses at the hospital too are very kind.

I had a six week break between appointments so I decided to a private appt in between. Frankly, I was in two minds whether to bother because I was pretty happy with the public system but then I came down with what I suspected was a urinary infection. Both private and public doctors are used to people shuttling between the sustems so just keep them updated about what happened at the other appointment.

I'm happy with TKOH and the public system adn the advantage of it being not one of the big hospitals (like Queen Mary or Queen Elizabeth) is that the waiting time would be less.
 
Hi Charade,

Thanks for your info. I went to TKOH this morning and everything went smoothly except that I didn't meet a doctor but only a nurse instead. Perhaps because I'm just 5-week pregnant? A little confused about that. Did you have the same experience? FYI I haven't planned to visit private doctor yet. Should I?

What about antenatal classes? The nurse gave me a schedule of antenatal classes hold in United Christian Hospital. Unfortunately, they are all in Cantonese. Any suggestions?

Hope you & the baby are well :)
 
Shenzennifer, if you had a previous c-section, the choice to go VBAC or not, is up to you. Weeks before your EDD, the doctor will explain the advantages/disadvantages/risks of the options. I went thru the public route myself and find them very thorough (35 y.o.). Not bad for the HKD700 we paid for 6-day hospital stay!
 
Oh, I think what must have happened is that you just did a registration. My understanding was that they won't even register you before 10 weeks. So I guess they gave you an appointment to see a doctor at around 10 weeks?

I did see a private doctor at about 5 weeks because actually I was being treated for a vaginal infection at the time. And I wanted to confirm that I was indeed pregnant. Then I started having some issues - like bleeding - so again, saw a private doctor. At the time, I was only seeing the private doctor and then decided to switch to public system (at 10 weeks) as I found my insurance only gives very limited cover.

I don't think it's absolutely necessary to see a private doctor beforehand, unless you feel you want to and can afford it. At around six weeks, he could see a heartbeat which was nice. The good thing is they can confirm its not ectopic (where the pregnancy is in the tube). And if you have bleeding like I did, again there's little they can do that early except check on you using a vaginal sonogram... so its more for reassurance that things are fine.

By the way, if you live around TKO, I can recommend a private doc who is much cheaper than the ones in Central that usually get posted on these forums.

I'm wondering about antenatal classes myself. I didn't notice the schedule among the stuff they gave me... but a friend who delivered at United Christian recently informed me that if I want my husband in the labour room we have to do some class there. I have an appointment at TKO Hospital next week so planning to ask the doctor then. Will let you know what I find out. And if you find out anything in the meantime... could you post me a message here, or PM me?

Good luck with your pregnancy too!
 
Hi Shenzheniffer, I gave birth at Prince of Wales shatin but had antenatal checks with a pr445ivate obstetrician. Also at the same time I had milestone tests at POW, eg 5th month scan of baby's devt and pregnancy diabetes testlater. In my last trimester I also had a few tests wtih the POW antenatal clinic. It is correct that you will not see the same doctor each time - sometimes a junior resident but sometimes even the most senior of the consultants, depending on the scheduling. I felt that the private-public antenatal care combination worked best. The waiting time at POW was a nuisance but once we were seen to, the care was good. My delivery experience was good. I planned a natural birth but ended up with an emergency c-section and we were very grateful for the good care. You can search the threads on POW where I have written some of my experiences. Remember that the public hosptials are very busy so as long as you can put up with a no-frills experience (not 5 star hotel like Matilda) you will be fine. I stayed 4 nights after giving birth. Good luck.
 
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