Timeline for first visit (both private and public)?

N

not pizza

Registered User
Hello there

It's our first pregnancy. We've been to the GP on Saturday and got a confirmation of pregnancy + referral to our local Maternal and Child Health Centre (MCHC).
We called the MCHC and various other places. We got our first appt with MCHC for the 14th week, which sounds crazy-late.
We were told to register with our catchment hospital and book ASAP for Down Syndrome tests. Called the catchment area hospital (voicemail), waiting for a reply. I was told to go to the hospital directly (1 hour from home), but the wife these days is KO with morning sickness (6th week).
So I panicked and tried to go private, as well. The same clinic offers OSCAR (90% detection rate, $2550, results available in 2 hours) and safe-T21 (99.1% detection rate, $8000, results available in 3 weeks!) However, it turns out that they will be closed during the period we need the test for (lucky eh), so they encouraged us to ask somewhere else. I called Dr. Belinda Leung in TST (any feedback anyone?) but the nurse said that we should do ultrasounds+consultation *before* OSCAR, and she booked us for that instead, about the same time as when we actually need the Down test, so I am worried that we won't be able to book OSCAR in time after that!
I will call everyone again on Wed, also because their English did not allow me to understand everything they said (par for the course), but I wonder what a "normal" timeline for both public and private is, please.
The books we are reading (both US) don't say when it starts making sense to have an ultrasound. However, they both do stress the importance of having antenatal checks every month, so we are a bit anxious about being left out on a limb for the first three months! The books also mention the importance of interviewing doctors before committing to one, but it seems like people here charge even for the first consultation, which apparently cannot be any earlier than three months into the pregnancy. All this without having seen a list of private doctors near us, which I was hoping the MCHC could give us, together with answers to our various general questions about how things work.
Makes no sense! :tantrum: So far, so frustrating...
Thanks for your help
 
What happened with me was this:
Wk 5 - went to GP, did urine test to confirm pregnancy, she gave me referral letter for public hospital
Wk 6 - saw private OB, had a scan, confirmed baby was looking ok
Wk 7 - went to the public hospital. Filled out some forms, did a urine test, confirmed dates, booked in for downs (nt scan and blood test) in wk 12 and morphology scan at wk 20. They offered me a dr appt sometime around wk 14 but I scheduled it for wk 20 after the scan
Wk11, bit worried that I was showing so early, saw private OB, had another US
Wk 12 - nt scan and blood test at hospital
Wk 16 - check up (with scan) with private OB
Wk 20 - morphology scan and check up at hospital
Wk 23 - check up at mcmh, booked next check up for wk27


Due to placenta issues I'll have another scan (private) at 27wks, and hospital wants to do another at 34wks.

Public hospitals don't do check ups before about 12 weeks because many women will miscarry before then - they want to save their resources. I understand completely about wanting checks before then though. The 'every month' is really only an issue from about wk 20 onwards though.

But be very careful about getting private downs screening. I read a gov report which warned that a lot of private practices that do NT scans are not properly registered/qualified.
 
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first, take a breath....
second, if you are truly concerned and have an issue with the pregnancy, go to any public hospital A & E dept.
that's what i did (very, very high blood pressure---risk for me and baby). they got me onto the high risk team within a week. and i had weekly appts from then on.

otherwise, the first 12 weeks there isn't much that they can do in a normal pregnancy. there is the Down Syndrome test that is usually done around 12 weeks. however, the public hospital only offers this for mums over 35 years of age as the risk is so much greater. you can choose to have this privately if you like.
 
The Downs screening was available for all mums at PMH and also at PWH. I had this at about 12 weeks and this was my first check up at the hospital. After that my visits were monthly and I did my 20 week scan privately as the public hospital was full. If you feel you need a check up before the one at the public hospital just go and see a private OB. Also the MCHC will not advise you on private doctors.
 
not pizza said:
...we are a bit anxious about being left out on a limb for the first three months! The books also mention the importance of interviewing doctors before committing to one, but it seems like people here charge even for the first consultation, which apparently cannot be any earlier than three months into the pregnancy.
Click to expand...

I'm pretty sure that you can see a private doctor within the first 3 months, but yes you will pay a fee. Just call up a private doctor, explain what you want to the nurse/receptionist and book an appointment. When I was in the public system I saw random doctors for one-off appointments a few times. I've always had first scans very early (like 6 weeks), as I could only get pregnant through fertility treatment, I can't imagine having to wait three months! If I were you I'd have a private appointment for peace of mind.
 
m_c their policy re: down's testing at 12 weeks has changed back and forth about 10 times over the past 8 years. when i was having my first almost 8 years ago, everyone got it free of charge... then when i had my second almost 6 years ago, it was only for those mums over 35 or you had to pay for it (about $1000 if memory serves)...

not sure what it is now as it's been so long since i was pregnant...so their policies do change, sometimes with high frequency.

good to know that they offer it to everyone if they so wish to have it.
 
Thank you so much everyone!

Our main concern here is that there is apparently a narrow window for the screening of Down Syndrome (OSCAR/NT scan), 11-14 week according to various sources, and so I'm worried that if we don't book the test in time won't be able to do it at all. OK, we can terminate up to w24 and even so I don't know if we would do it, *but* my wife is at "high" risk (1 in 350, apparently) and it's something we'd like to get off our mind ASAP...
As for policy, MCHC told me "limited numbers, first come first served" over the phone about our hospital (Prince of Wales, Sha Tin) - another reason to hurry.

As for other minor concerns during this first trimester, my wife currently does not have any worrying symptoms apart from severe morning sickness (can't eat anything) and tiredness (can't do anything, lying in bed all day long), so that's kind of OK. Thanks for the suggestion to go to A&E in case of acute or persistent symptoms - knock on wood. I'll also consult my various resources (books, web and you lovely people!) and go to a private OB if anything which is not quite an emergency should pop up.

Also let's see what the public hospital says if and when they call back. I have half-a-mind to just turn up tomorrow with vomiting wife and see what happens.

Still looking for an OB directory/recommendations in the New Territories, since apparently MCHC can't help with that. We live in Sheung Shui (near Shenzhen) and so far I got (Thanks Charade!):
* Dr Yu Kai-man at Union Hospital, Sha Tin (the closest of the bunch so far)
* Dr Jimmy Mak at Baptist Hospital, Kowloon Tong
* Dr Shell Wong at Femina, TST
* Dr Belinda Leung, TST (just off geobaby's directory, first impression from nurse not so good)
I'll give Dr Yu a call in the next few days.

Thanks! :-)
Justin
 
if you do, go to the A & E dept... make sure to tell them that she is pregnant (bring the confirmation from the dr if you have it)... ask them if there is anything they can give her to take the edge off the nausea. i was the same with both of my pregnancies. i actually lost over 20lbs in the first trimesters and didn't show any weight gain until i hit 23 or 24 weeks! during my second pregnancy, i told the drs about it and said that i couldn't eat anything... they gave me a prescription that just took the edge off a little. i still felt nauseous but i could manage to eat a slice of bread or a pce of fruit.
 
I wouldn't wait too long for the hospital to call you, it would probably be easiest just to take wife and sick bag to the maternity ward - plus they'll need to see ID cards and proof of address which obviously can't be done over the phone. They should book you in for the nt scan there and then.

For downs, yes a 35 yr old woman has a higher risk than a 34 yr old women, who in turn has a higher risk than a 33 yr old. It's not that you suddenly become high risk overnight. For what it's worth I started at 1 in 350, and went to 1 in 38,000 after the screening so try not to stress too much.
 
i would not to the mat ward... i would go to a & e....that's how you get on their system quickly. a & e will send you to ob/gyn ward if they think it is necessary.
 
Cool cool, I'll drag her to the hospital tomorrow with paperwork etc, wish us luck!
Last time we've been to A&E we had to wait for 3+ hours (North District Hospital), so I maybe we'll try both depts and see which has the shortest queue :-)
 
i don't think they will just accept you walking into the obstetrics dept unless she has been sent there or is in labour...
 
First time I went to UCH I went straight to the Ob&gyn dept (not the actual maternity ward) to register. I assume it's the same at POW. It was fine, i didn't need to go via A&E. I think the Drs referral letter qualifies as the 'being sent there'.

Edit: Sorry - realise I wrote maternity ward in my previous post: don't go to maternity, go to ob&gyn :)
 
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Utility bills would probably be better than a marriage certificate if you have any. Does your wife not have any in her own name?
 
Unfortunately not! In fact I also don't have any recent utility bills in my name either, I keep almost everything electronic. I'll bring a few random pieces of paper and hope for the best - sounds like we don't really have a choice.
Ah no wait, found a paper water bill, under my name - uhm...
 
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Seems to me like there are two separate issues here:
1. Getting an appointment for Down's Screening in the public system: If you have registered at a public hospital and called/emailed them, they will contact you. I recall for my son I had the same panic but they did call me back and it was arranged. However, that was in 2010 and they weren't providing it free of charge to all women in the system. As of last year (2011), they are offering it free to all eligible women registered for antenatal care in the public system but I guess this means there has been a flood and thus the first-come-first-served. However, since your wife is over 35, she should get priority.
To sort this out, you could try going down to the obstetrics unit you registered at to talk to them again but at least in the case of Prince of Wales, the unit that does the scanning is a separate one so you'd do better to try to call/email/contact them directly.
Just in case, I'd try to make a booking privately. Honestly, Dr Yu is quite busy... not sure you'd get an appointment at short notice (the reason I didn't see him in the end; I needed to make my appointments at shorter notice) but you could explain the situation or see if they can recommend someone else. Being a hospital polyclinic they will have a panel.
Same with Baptist Hospital... you could call the hospital and ask who can fit you in for the one-off procedure.

2. Your wife throwing up and not being able to eat. For this, if you want to go public, I think you'd have to go to the A&E and yes, unless there are other complications, it will be a long wait. A friend with a similar problem waited something akin to 3 hours or more at the end of which they sent her home with some anti-nausea drugs. Another friend ended up being hospitalised for dehydration... not sure how long she had to wait though but obviously her case was considered more serious. So it depends how they assess the case, not necessary she will be whizzed through because she's pregnant. The public hospital I went to (Tseung Kwan O) had a notice up at the obstetrics clinic saying if you need to make an unscheduled appointment, you should go to a private doctor (!) or the A&E... they have too much demand. However, they did once advance my appointment when I called and explained that a private doctor had certified my baby as breech and a quick decision on delivery would have to be taken. So you can try the obstetrics clinic but I suspect in this case they will head you off to A&E.
Honestly, I'd just try to find a private doctor to assess your wife and if she's really in bad shape, a letter from that doctor might speed up the process in the public system.
 
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When you register at the public hospital they will immediately arrange the Down's syndrome screening and your first antenatal appointment for a few weeks later. I registered at 7 weeks (you don't see a doc but just the person at the counter and give them all your documents) and then they gave me the appointment slips. There is no need to keep trying to call the hospital as this will just get you frustrated. As I have said previously go and see a private doctor if you have concerns between now and your first appointment at the public hospital.
 
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