To deliver back home/in USA or not?

H

hkexpat2010

Registered User
Does anyone have experience going back home (and/or to the US) to give birth? We're thinking about traveling back to the US to give birth and are curious to know if others did it and what are some of the pros and cons.

Also, our doc mentioned, the baby may be able to get some kind of residency status in Hong Kong since my husband's mother was from Hong Kong (ie we can prove Chinese blood line). Has anyone had experience with this?

Our doc said it's fine to travel back as long as we go before week 36, airlines just need a dr.s note, and we're double checking that our insurance will cover it without any problems.

Any other issues we're missing or problems people encountered? Any tips or advice would be great!
 
Yes, I had this experience. With my first child (now 3-years-old) I chose to go back to the USA to give birth. At the time, my work allowed me to leave early and come back later after he was born and my husband could get leave time to come be with me. I went back to the States when I was 7-months pregnant and my husband joined me 2 weeks before my due date. I stayed with my mother at her house.

I chose to go back because I'm not a huge fan of the HK maternity system overall and at the time I was younger and wanted to be near my family for my first birth. I also was able to go through a midwife program at the hospital I gave birth at so I didn't have a doctor and was able to give birth "on my own terms" (not with a doctor standing there directing me on what to do and when to do it--like the docs in HK like to do) with my husband present. My husband was my birth coach (we went through a 12-week program to prepare for this) and he was able to catch my son when he came out and cut the umbilical cord, be there for the first bath and baby and my husband were able to room-in with me in recovery. My mother was also able to be there supporting me when my son was born. At the hospital I gave birth at you were literally allowed to have as many people as you wanted attend the birth. I had an excellent midwife who was on board with my beliefs about childbirth and supported me and when I had too much bleeding after my baby was born she saved my life. I had access to a tub of warm water while giving birth to help ease the pain and the hospital was set up like a birthing center so there were a lot of things you could use to make the birth easier--I don't think most hospitals in HK have anything like this.

The down side to going back to the States was that I had to be separated from my husband for a few months. Also, staying with my family after the baby was born tended to be stressful as it wasn't my own home so I didn't feel as relaxed. Also, we didn't have a helper there to help with the baby and my mom was working full-time so it was just me and my husband which was really exhausting--especially because I physically was very weak for many weeks after the birth because of the complications I had. It was wintertime so we couldn't really go outside and enjoy the fresh air because it was just too cold.

Also, we had to pay for the birth out-of-pocket (maternity insurance, unless covered by your employer usually equals out to as much as just paying out-of-pocket anyway) and that ended up being about $8,000 USD and that didn't include the price for airline tickets (and even babies have to have a "ticket" when traveling internationally and the price at the time was about 20-30% of an adult ticket), food and other expenses while we were in the States.

Also, the flight itself to and from the US was pretty brutal--flying when you're 7 or 8 months pregnant isn't very comfortable and especially if you have a long flight. To get to my hometown I was literally traveling for almost 30 hours and in the air flying for about 20 of that. It may be better for those living in a major city. Coming back with a baby on the plane was no picnic either--even though I had my husband's help. I had to pump breastmilk in the restroom on the plane (nasty) and there is nowhere to change a baby's diaper on most American planes so my husband had to change diapers literally on his lap.

This time, I didn't have the choice of returning to the States as my work situation wouldn't allow for it so I gave birth to my daughter in Hong Kong. I planned on going through a private hospital but my doctor bailed out on me when I was 38 weeks pregnant. I gave birth in a public hospital and everything went well--but the reason why it went well was that we were really prepared and stood up for what we wanted when the hospital staff tried to do whatever they wanted with us. I don't think I would have known how to do that if it was my first child, though. And the thing is, public hospitals vary so much from hospital to hospital--some hospital experiences can be great--others can be frightening and it all depends on the hospital and the staff on the particular day you give birth so it's really the luck of the draw, actually. At least in the States, I knew what I was getting myself into--I had taken a tour of the hospital I would give birth and knew the staff well and knew my midwife well so I felt comfortable. Here in HK, I feel like the private hospitals are a money making machine where Mainlanders go to have their kids (maybe Matilda is the exception) and aren't any better than the public hospitals and may even be worse.

So, if I were you and planning to stay in HK to give birth I would just go with the public hospital but definitely be prepared and have someone with you (your husband) to stand up for what you want because my experience is that otherwise you may get walked all over.

Best of luck choosing the right option for you.
 
I was tossing up the same thing when I found out that I was pregnant with my second. Not to the US though - New Zealand (one direct 12 hour flight). Anyway, I eventually weighed up all the pros and cons that I could think of and came to the conclusion that there were way more cons traveling back home.

My personal reasons for not doing it included:

*Flying while heavily pregnant/with a newborn (I wouldn't have left it any later than 32 weeks to return. 36 weeks on a long flight is unthinkable to me - I have enough trouble getting comfortable on the couch and in bed!) So I would have been home for 2 months, waiting around doing nothing while my friends and family were at work. Then, I wanted to allow a good 3 weeks post birth before flying home, in case there were any issues that need to be sorted out. But I would have had to pay extra for a flexible ticket, just in case I had to stay longer for medical reasons. So there is a good 3 months.

*Separation from my husband. He would have used an entire years' leave to be with me for a couple of weeks beforehand and a couple after.

*Huge upheaval for my son and a colossal waste of kindergarten fees!

*Change of season - I would have been going into winter, probably very susceptible to all the colds and bugs. No thanks. But of course that's not an issue from here to the US.

*Frankly I didn't want to have to rely on my family for help. I have a helper here at home and I wanted to make the most of that because I know how hard it was to go it alone the first time around. I can't imagine going through the stresses of having a new baby while being stuck at someone else's house, even if it is your parents. Not for me. I decided it was better to visit my family when the baby is 5-6 months old. Much nicer.

*Cost - I would have had to pay for airline tickets, accommodation, (see above) living expenses and I wouldn't have had any of my baby gear on hand so would have had to source that from somewhere else. The birth would have been covered by the public health system - but this would have been well outweighed by all the other costs.

*Organising passport/visa to get baby home - this would have been a right pain in the A for me. Who knows if you could even do that in only 3 weeks.

Basically my goal is to settle back into normal life ASAP after giving birth. I could not have done that from the other side of the world.

In terms of HK maternity system, I share most of the same concerns as Thanka2. That was the 'push' factor for returning home. However after thinking it over I decided to try to negotiate the system as best I could and push as hard as I could for the birth experience that I wanted (this was not a priority for me with no. 1 but with the benefit of hindsight I realised how important it was to me for the second and probably last time). I ended up scrambling to book a private room in a private hospital (allowing the most freedom), and carefully selecting an OB who supports my wishes, and hiring a private midwife/doula. This does not come cheap (and I have no insurance) but I feel so much calmer knowing I have a plan and everything is in place to help me achieve my intended goals.

Good luck, whatever your decision ends up to be.
 
One other thing consideration to add - I had my child in HK, and we had previously identified a very nice pediatrician here in HK that we have used ever since. He was the one who visited the day of her birth, gave her all her shots, identified jaundice and recommended a course of action, saw her for her first checkups within the next few days, etc. I suppose if you don't care about establishing a relationship with your pediatrician from birth onwards it's not a big deal, but something to consider if you are. Good luck with your choice.

Also, my parents are Chinese so we did get HK residency PR status for our daughter based on this (my husband is not ethnically Chinese and I was born in the US so did not qualify). It is very helpful because we don't have to get her a visa to stay out here.
 
Thanks for the thorough replies! Everyone has given us alot to think about...baby's passport processing time, flying discomfort, etc.

We've recently moved to Hong Kong and my husband travels alot so we're weighing the pros and cons of giving birth here with a very limited support network versus back home surrounded by lots of family. In terms of emotional support, it would be better to go back home, but the logistics of it all seem daunting and we still need to confirm if my husband will be able to be in the US for a few weeks around the time of the birth.

Ssheng- Do you mind sharing what info you had to provide to get your daughter PR status for Hong Kong and was it through the Immigration dept that you applied? My husband talked to them and they said the decision to grant PR status is at the discretion of the officer. Were you able to get any better info? Is the PR status for the lifetime of the child? Are there stipulations like has to live here for a certain amount of time, etc? Sorry to bombard you!

Southside852-If we give birth here, we'll go private- ideally at Matilda.

Thanks again everyone! Any other perspectives would be great!!
 
if possible, why not get your mum and sister, if you have one, to come here instead? i believe their visas would be valid for 3 months. that way, you'd have the support of your mum etc and the comfort of being at home here, where hubby is, no discomfort of travelling or passport processing?
 
I considered going back to Australia to give birth but decided to give birth here (at Matilda.)

Here are some of the reasons I didn't;-
The risk of not getting a doctors certificate to fly if a complication arose. (This must have been a premonition as I was having contractions from 32 weeks and sky high blood pressure)

In Australia you are not able to claim Medicare unless you are a resident for tax purposes, so it would have been as expensive as here. (Many people do claim but it is technically not legal and you risk fines and paying the cost back if you get audited)

Having to live with family for the weeks before and after and not knowing how long that period would be.

As it turned out, my experience at Matilda was fantastic I was happy with my OBGYN here and although my husband had no time off work as expected, he was luckily here for the birth, but not the day after nor my first day home. In the end I feel that I made the right decision to give birth here in HK.

If you do choose to go back to the States I would recommend having a back up plan in HK that you feel comfortable with just in case you can't get a medical certificate for the flight for any reason.
 
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I had both of my kids here and not back home in the US for the same reasons other posters have noted but principally because being with my mom rather than my husband leading up to the birth of our first child wasn't the right choice for me.

My husband is an ABC and initially we thought we wanted to get residency for #1. At the birth registry, they told me (husband wasn't there) that we would need to prove that my husband's mother was not a US citizen at the time he was born in order to qualify.

We have since decided not to do so for a number of reasons but one is the US/China relationship. FYI is a link on dual nationality for HK permanent residents:
http://hongkong.usconsulate.gov/acs_dualnationals.html.
 
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If you are considering giving birth at Matilda then I would give birth there as my American friends have said it's very similar to the US, if not better treatment. I've given birth privately to both sons out of the US - London and in Singapore and haven't regretted it once. I have had very positive experiences at both hospitals and LOVE my OB here in Singapore, more than my US one. Financially it would have been hard to go home because we were not covered in the US so we really didn't even make it an option. My mother arrived 5 days after I gave birth in London and it was honestly really nice to have the time with just my husband and I to get to know the new baby....3 weeks later my mother-in-law came and then after she left, my husband took a week off....it worked out really well and the thought of traveling anywhere but within a 3 block radius of our flat was out of the question.

Those of my friends who have returned to the US, have been away from their families for 4 months and it's really a strain on them esp if they have another child who has to be uprooted from their routines. Yes, there's family there which is invaluable, but home for me now (after 3 moves) is where my husband and other son is. It's so much easier to send my mother and siblings a ticket to come visit us rather then me visit them. There are tons of ex-pats giving birth in Hong Kong every day. I think that most important thing for you will to be is to find a doctor you feel comfortable with it at Matilda.

In the end though, the choice you make will be best for you and your family. There are pros/cons to both and each person can only tell you their own experience. Good luck - everything will work out!
 
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carang said:
if possible, why not get your mum and sister, if you have one, to come here instead? i believe their visas would be valid for 3 months. that way, you'd have the support of your mum etc and the comfort of being at home here, where hubby is, no discomfort of travelling or passport processing?
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This is a good idea if you can handle having your family around when the baby is born and living with you in the same house (unless they're going to stay in a hotel the entire time which is also possible, but expensive).

Let me just tell you my experience a bit. I said that I found living my mom in her house in the States when the baby was born a bit stressful. It was partly because it wasn't my house so I didn't have free reign. For example, breastfeeding was horrible for me--especially the first couple of months--and it was so bad that my breasts hurt so much that even having cloth up against them was unbearable so I was instructed to go braless and shirtless as much as possible by the lactation consultant. Well, this isn't really possible (unless you sit in one room with the door closed all day) in someone else's home where you're a guest and there are also other people coming in and out (for example, my younger sister who still lived at home's boyfriend).

Also, sometimes it was a case of "too many cooks spoil the broth." Dealing with a newborn is tough sometimes and my mom was working so she didn't have time to effectively help us out but she was around enough that I was getting advice from her all the time--which is okay up to a point. She meant well but in the hormonal state I was in it was difficult to have other people observing me as I tried to figure out the first few weeks of being a new parent. It seemed that try as they may to avoid telling me what they thought about the job we were doing, there were still those looks and sometimes opinions. So, that added to the stress. Sometimes, it is better just to be left to your own devices to "sink or swim" for a time and then just have family and friends nearby to call in for "reinforcement" if you really are drowning.

So, this time, my mom and her husband did come to visit us but it was a full month after the baby was born. I think it was better this way as it gave me time to physically be on my feet again and also to wait and see if I was going to have post-partum depression or go through a "crazy phase" and get that out of my system before we had guests. Even though guests may totally come here with the intention to be low-maintenance--at least for me, if I have guests staying with me it's harder to rest because I do feel obligated to be a good host--this is complicated if you're also dealing with hormonal flux and a newborn.

It was just better that my mom came a bit later rather than being here for the birth and leaving or staying the entire time. But, I do think it's important to have help when you have a baby--at least a part-time helper.

That's just my experience.
 
actually, thanka, my mum said to me long before my due date, 'i wont be coming for when the baby is born. You and hubby have been a couple so long that you now need to learn how to be a family. The last thing you need is someone saying.....well, that's not how i would do it!'

a sentiment i greatly appreciated and will probably follow when my own kids have babies.
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i delivered 2 babies in the u.s. (nyc -- ny presbyterian) during the lat 5 years and recently 1 in hk at matilda. i would feel comfortable chosing matilda again in a heartbeat (in most ways, the post-delivery care is much better than in the u.s.) -- other than 1 issue. matilda (and almost every other private hospital in hong kong) is NOT equipped to deal with very sick children at birth. to be fair, many/most hospitals in the u.s. are not equipped with level 4 nicu's, either, though nyp was. if you deliver a very sick child, he/she will be transferred to a queen mary (the local public hospital, which i've heard has excellent nicu care, among the best in asia). that being said, seconds matter in a true emergency (i had to utilize such services in ny), though this happens in such a small number of cases.

the midwives / nurses at matilda were outstanding; very experienced, caring, good teachers and huge supporters of breastfeeding, etc. i was very impressed with my doctor, anesthesiologist, pediatrician, etc., too. try to select a doctor who lives at matilda; then you will be in good shape in case you need an emergency c-section.

there are only 2 other issues with matilda (in my opinion): (1) it is hard to get in; you must apply promptly at 9 weeks pg and even then you are not guaranteed a booking and (2) maybe cost, though my total bill was a lot cheaper than my bills in nyc! it's all relative on that front ...

fyi, matilda prides itself on catering to the expat community -- all of the midwives and nurses are fluent in english (if it is not their first language). i was informed that less than 5% of admissions are to mainland chinese moms. i have friends who have delivered at BOTH matilda and sanitorium/adventist and they recommended matilda hands down (though some said sanitorium is just as good if you can speak cantonese).

good luck ...
 
carang said:
actually, thanka, my mum said to me long before my due date, 'i wont be coming for when the baby is born. You and hubby have been a couple so long that you now need to learn how to be a family. The last thing you need is someone saying.....well, that's not how i would do it!'

a sentiment i greatly appreciated and will probably follow when my own kids have babies.
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That's really great that she took that stance. I'm just saying that if you ask your parents to come over at the time of the birth it can be a blessing and a curse--exactly because it does take some time and work for that family bonding to take place and it's harder with eyes on you--no matter how helpful they are or how much you love them. So, timing can be something to think about--if you need to "play host" to your family as well. So, for us, it was wonderful that my mom could come over a month+ after the baby was born so she got to see the baby in her "newborn" phase but we had also settled down at home together and felt more on our feet. It was great to have her here as I always love to spend time with her and the timing was really good this go around.
 
Thanks for sharing your experiences and thoughts!

Fingers still crossed I'll get into Matilda once people don't put down their deposits. Otherwise, the Dr. said we may not hear until the month before the birth :(

If we do stay in HK, we mentioned to the grandparents that we'd up for visitors a bit after the birth based on info put up here and other friends' input.

Thanks again everyone!
 
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