Warning about Public Hospital 20 wk Scan!

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Shenzhennifer

Registered User
I was so happy to get the last booking for my 20 wk scan at Princess Margaret. Imagine my disappointment when it was performed by a MIDWIFE not the doctor who booked me into her alleged schedule.
I commented on how I had never heard of a midwife doing that level of scan before and this one got totally defensive and spent the next 12 minutes (with my first at a private 20 wk scan it was about 30 minutes) defending herself more than telling me about my baby. In fact, the only reason I know my baby has arms is from a previous scan! She couldn't confirm the sex of my baby (even though private Dr gave me 99% surety), and baby wasn't in a curled up position at that time. She also told me twice that although the scan was 'thorough' it cannot detect all abnormalities, so there's still a chance my baby is not 'ok'.

If I had known this BS would take place, I wouldn't have booked through them, I would have spent the money at a private hospital doing the scan. But now it's too late because you need to book ahead for these lengthy scans. Argh!

I have to say that I have nearly lost all confidence in the public system and am really worried about giving birth there. Will an actual doctor deliver my child? And what will be the calibre of that doctor and accompanying nurses and midwives?

Also, it seems that the public hospitals quite encourage VBACs (cheeeeaper!) and now I'm actually afraid to try for it because of the potential deadly consequences that can result in it. It's one thing to have the same doctor all through your pregnancy who knows what he/she is up against and who has the experience and expertise to prevent a potential tragedy. But now I have to get whichever Joe Blow Doctor who happens to be on duty (their first year as a doctor, perhaps, it will be around Chinese New Year), or perhaps another midwife (while her colleague scalds babies in the bath next door), and maybe they have little or no experience and will do things to me that will actually precipate a demise (like giving labour inducing drugs). And I am at their mercy.

Forgive the rant, but I am REALLY not happy with this system now and there's JACK ALL I can do about it because I'm almost 22 weeks pregnant and of COURSE all private hospitals will be full. And we have no insurance. And it would use a big chunk of our savings to have this child.

NOT LIKING HK AT THE MOMENT.
 
Unfortunately through the public system, you get the doctor who is on duty when you deliver. That really sucks though that you had such a horrible experience. I'm in my second pregnancy and going to deliver public, but going to get my antenatal care with my chosen private doctor so I can get all the important scans with him just so I can get better explanations of my baby. That's weird they would have a midwife do your scan though...usually it should be a qualified technician at least.
 
Shenzhennifer said:
Will an actual doctor deliver my child? And what will be the calibre of that doctor and accompanying nurses and midwives?
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No. If you don't have a complicated birth, the doctor might not even pop in. I know of mums who didn't have the doctor participate in the birth (even at the end) in the public system. You'll be with the midwives most of the time and there is nothing you can do about it.

A lot of mums schedule their ultrasounds with private doctors at that stage even those in the public system. You're lucky to have been given the allocated appt.! I know a mum who didn't! They just sent her away as they were busy on that day. And, they didn't reschedule! They simply couldn't given their caseload!
 
Yes, they have a quota system now. I got the last booking with the doc who saw me at the first trimester screening. I was really happy, but If I knew a midwife was going to do it, I would have gone straight to a private doc. Crazy, this system. My birth will be slightly more complicated since I had a c section last time, and they will try for a vbac. I wanted one before, now I'm scared. This is life or death for me and or my baby. I may be being a tad dramatic, I know, but the stakes are quite high. Kind of like Russian roulette in a dodgy casino.
I'm nearly 22 wks now, quite late to get a booking with a private doc before my 24th week when they stop doing this kind of ultrasound. And way late to get a spot in a private hospital.
 
Just an idea. Why don't you look into being a private patient at the Queen Mary? At least you'll get the same OBGYN and better care? Or try to find an OBGYN who can get into a private hospital. I remember there are many cases of mums who move to HK mid pregnancies and have managed to find a bed at a private hospital.
 
honestly, i can understand you being upset. you didn't get what you were expecting and you weren't happy with the alternative that they provided. that is completely reasonable.

you are being a little overdramatic about the rest of it though. if you think about the numbers of babies that are delivered through the public system, so far as i know (and i could be wrong) there are not so many "problems".

remember that if anything DOES go wrong witht he delivery in a public hospital (at least with matilda) the baby is shipped to a public hospital anyway. the private hospitals are not equipped for very complicated situations (baby-wise).

there are dozens of private OBGYNs out there, maybe you'd be able to find another one just to do the scan?

as for your confidence in the public system, not much i can say to dissuade you.

i do hope that you have another 20 weeks of uneventful pregnancy, though. good luck!
 
Agree with Carang. I had my 20 week scan as a public hospital, and yes, they do not tell much, but usually no comment means that everything is normal. Also your midwife is right about the scan not being able to detect all abnormalities. No test or scan can guarantee that. But if you are really that worried, try calling different doctors to see if there is anyone that could do the scan for you.
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two separate things actually - i would be very upset too if my 20th week scan was done by a midwife. it's a very important scan and a midwife has zero expertise and qualifications for it. i would have gotten the scan done again - either insist on another appointment in the public system or go private.

regarding your delivery - the fact is normal uncomplicated vaginal births are handed to a large extent by midwives here. i have had friends who have delivered at matilda with their gynae coming in and going out. in one case the baby was delivered by the time the gynae arrived. i am not sure going private would help there.
 
I have to say that I was not worried at all when a midwife did my 20 week scan. Personally, I have a lot of faith in midwives as they are often very experienced in what they do. My mother works in the medical profession in the UK (physiotherapist, spent a lot of time in maternity) and says also that midwives are really respected there. In the public system, it seems that it is the midwives that routinely do the 20 week scan, so I trusted mine as she must have seen so many hundred of babies. Also, I believe that they should tell you what abnormalities the scan can and cannot detect.

They don't explain as much, that is what I found lacking. And I don't like having to see only junior doctors every time I go instead of someone with more experience. However I am having an elective c-section and I will meet the surgeon and the anesthetist one week before the operation so I am happier about that.

If I were you, I'd go and get a private scan. You can tell them your concerns and ask them to specifically double-check everything. That is what I did. Not because of my 20 week scan but because the doctors alarmed me by telling me that my baby was too big and they made me come back for scans every three weeks without really explaining the possible issues/problems/implications properly. I went to a lovely doctor in Central who confirmed that everything was completely normal. He said that in the public system, the regular check-ups are done by junior doctors and they aren't that confident. I guess being over-cautious is better than being under-cautious though...
 
Nothing is ever 100%, but you could always get a private doctor to do another scan for you. It shouldn't be a problem. VBACs do need a doctor that has experience though I believe so I would try to get a doctor that supports that because not all doctors will be supportive of it...easier to just do another c-section. Don't give up. If you are really keen on a VBAC, you should go for it!
 
I managed to get a booking with my former obgyn at union who did my son's big scan. He is really lovely and supposedly fit me into his busy schedule bc I told the nurse the problem and how many weeks I am. She said the dr does them before 24 wks and I will be 23 and 5 days at that time. I will still think about whether to go or not, for some expert advice and experience, rather than from some random hk public midwife who may have just passed her assessment last week ( she keep telling me defensively that she passed the assessment and was qualified to Carr out such u/s).

As for my VBAC, really nervous now. I'm ok with the idea of being taken care of midwives and nurses throughout labour if I had a normal situation, but this is different. I just felt like every time I talked to public DRs (3 times) about having a VBAC, they were almost too supportive, like it would be automatically pushed onto me, but not necessarily with experienced and skilled back up medical workers, just whomever will be on duty then.
When I talked to my private doc here who I have seen a few times( he is out of Adventist) he sounded so confident and told me he would never let my labour escalate to a dangerous situation. I called TWAH yesterday and that doctor is booked up until the following month after my due date. Of course.

I just feel unsettled now that I don't really seem to have any options. Yes, I can get another scan from a wicked doctor, and I am sure the baby is fine, but that doesn't change how I now feel about the hospital, system, and how my personal labour might go.

Melodramatic, maybe, but I feel justified: this is my body, my baby and my family, and they are all serious enough for me to be dramatic.
 
if anything, i've found the public hospitals to be overly cautious. at the first sign of any trouble they do what they think is medically necessary. if they think that a c-section is better for you and the baby, then they'll suggest you do that...strongly.

good luck with your decision. as for melodramatic, yes... but many pregnant women are... that doesn't matter. what matters is your comfort with your situation. if you are not comfortable with it and can afford alternate care, then that is probably best for you.
 
Glad to hear that you have an alternative.
Essentially with pregnancy and it's hormones, do whatever gives you a peace of mind.
Takes the edge out of the entire process.
 
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Shenzhennifer, are you certain that you will just have whatever doctor is on duty? This is what I assumed (and what bothered me) about my delivery, but in fact as I am having a cesarian I will know who is doing the delivery (the surgeon and anesthetist) and I will get the chance to meet with them a week before, go over my history and ask them whatever questions I want etc. I did not know that this was the case until I was about 24 or 25 weeks when they set up the appointment for me. Maybe it will be similar for you with a VBAC. And if it isn't, then maybe you could try insisting that you meet with whoever is going to be doing it / on duty that day. Or insisting that a doctor is present. If you kick up enough of a fuss it might work.
 
not, it won't be similar... you can meet your doctor for the c-section because they have scheduled it. they KNOW who the doctor is working that day. for a vaginal birth, there's no way to know when she'll go into labour, so they cannot arrange for her to meet the doctor who will be on call that day.
 
If it is any consolation, I had a VBAC at Matilda and it was the midwives who were there for me with the Dr turning up at the last minute. I had my first at QM and I agree that at any sign of trouble they will take you for a c-section, they are much more cautious than the private hospitals. I too was very worried about the whole VBAC thing and was totally confused about trying for natural or just going for a c-section. In the end it went very smoothly with him arriving 20 mins before his scheduled c-section time!! Put your mind at rest, spend the money and see a private Dr to ease any concerns you have.

All the best
 
I really feel for you having expected one thing and gettig another but I do agree with some of the comments on here about over reacting about not having a Dr perform a scan. In the UK you very rarely see an ObGyn during pregnancy, scans are performed by radiologists and babies are delivered by midwives. Babies don't see peds after they're born unless there's something wrong and they need specialist care, they just go to the local family doctor like everyone else in the family. There seems to be a huge over emphasis on specialist care here
 
TheQuasimother said:
Just an idea. Why don't you look into being a private patient at the Queen Mary? At least you'll get the same OBGYN and better care? Or try to find an OBGYN who can get into a private hospital. I remember there are many cases of mums who move to HK mid pregnancies and have managed to find a bed at a private hospital.
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just wanted to say that from experience even if you go through private at QM it does not guarantee you 100% that the doctor you see will deliver for you...the thing is they are busy with patients at tsan yuk too and if it so happens your doctor is there, they will not be obliged to come back...unless you have a confirmed c-section...if not, and they are busy, then they will "communicate with the doctor in charge" about your condition - my doctor at QM did that to me when I was at 34wks - she told me she would be on holiday on my due date! i went private at QM and i couldn't even guarantee whom my doctor was! granted doctors need holidays too - but knowing my history (won't dwell on that here) she should have told me way in advance so that i could mentally prepare myself...i switched doctors and hospitals (went to private) instead and got "private" services - ie. i knew the doctor whom delivered for me! hey - the price of delivering private and public at QM is SO SO big! can't charge me an arm and a leg for something that i could have got for less than $1000! :)
 
I had my fetal anomaly scan redone this past week with my former private doctor at Union. It was awesome. He went over every cm of my baby's body and didn't stop till he could show me every finger, knuckle and toe. It was about 30 min, cost $1600 and worth every cent. His equipment was far superior-we could even see the blood flow when he pressed a certain button- and he told me about 90% more about my baby than the defensive midwife at PMH.
He also gave me frank answers to my VBAC questions and told me some information I hadn't known that changes things a bit. I have decided not to submit my surgery notes from my previous c-section and request a planned c-section at PMH. I think it's best, unfortunately, to have another, and I have come to terms with that.
Thanks for sharing your opinions and insights, everyone.
 
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