Public or Private

When you find out you are pregnant in Hong Kong, the first thing you need to do is visit a doctor (any clinic or general practitioner will do) to verify your pregnancy and get a referral notice.  The next step is to decide if you want to use this referral notice to navigate the private or public hospital system.  There are pros and cons of each.  You can only go to the public hospital in your region but you can go to any private hospital.  It’s all about weighing those pros and cons and deciding what is important for you and your family. 

 

The hospital I gave birth at, Tuen Mun, has a bit of a reputation for being awful… so much so that people get their utility bills or bank statements sent to a friend’s house so they can register at a hospital in a different region.  Tuen Mun’s bad reputation is a bit outdated.  It is one of the closest hospitals to the Chinese border so it used to be very overcrowded with Chinese ladies wanting their children to be born in Hong Kong.  There are now measures in place so that only Hong Kong residents can give birth at the hospitals here (unless there is an emergency), so the extreme overcrowding is no longer an issue.  I have friends who switched to different public hospitals for other reasons, or chose to go private, and I fully support them.  However, overall, I was pleased with my experience at Tuen Mun and I’d do it that way again.  

As a Canadian, I can’t wrap my head around paying for healthcare, so that was a huge factor for me.  (Prices I talk about are in US $ because that’s a currency most people are familiar with without having to look it up.)  This is just my experience and I know it varies widely between hospitals, and even between patients.  I know everyone has their own reasons for choosing certain things and if the end result is a healthy baby and mommy, that’s what matters.

My view from the hospital

Public Pros

It’s pretty much free.  I paid about $10 US per night in the hospital, and that included absolutely everything (medicine, dr fees, anesthetic, shots, etc.)  I had a few overnight stays while I was pregnant too, and that was also the same price.  All my antenatal appointments were free at the hospital and all Jack’s and my follow-up appointments are also free (including all his vaccinations) at our local clinic.

Top-notch medical care.  Even if you are in a private hospital and something goes wrong, they will transfer you and/or the baby to a public hospital.  Many of the public hospitals are teaching hospitals so the standards are very high. 

Pro-breastfeeding and rooming in with the baby.  There are signs all over the hospital stating how very in support of breastfeeding they are and it really is true.  They had lactation consultants checking on me all the time and the nurses were so excited that I was breastfeeding.  However, the majority of the Hong Kong population still thinks that formula is best so, in my ward of 30 women, I was the only one with my baby in my bed, breastfeeding on demand.  The education on breastfeeding here is somewhat lacking (but this goes for the private hospitals too).  Many women here intend to breastfeed but turn to formula in the first few days because their milk hasn’t come in yet (and they don’t realize that’s normal).  Then when it came time to discharge us, they almost weren’t going to because they said Jack had lost too much of a percentage of his birth weight.  By formula standards, he had, and that is what the hospital goes by in their charts.  I had to prove to them that the stats are different with breastfeeding babies.  Eventually, the nurses brought in a pediatrician to confirm what I was saying and we were allowed to leave.  So while the good intentions are definitely there and breastfeeding is encouraged, a bit of education is needed in this relatively new field for them.  

Public Cons

Very bureaucratic to the point where they have trouble thinking outside the box.  This is just Hong Kong in general, but it’s all the more frustrating when you’re full of hormones.  I needed a c-section for medical reasons and it was very stressful that they wouldn’t confirm it “in case something changes”, despite my condition being chronic.

You stay in a ward with other women and babies after the birth.  This didn’t bother me a bit, but it may bother others.  In fact, it probably did bother the others in my ward because I had referred shoulder pain (common after abdominal surgery) so I spent the first night wailing.  Sorry, ladies!

Not focused on the father’s involvement.  This was probably the most troublesome con.  Fathers can only come in the delivery room when the mother is in active labour and the baby is crowning.  For my c-section, we had a meeting with the hospital staff ahead of time to beg for Harold to come in.  He still couldn’t (because it had never been done before so there wasn’t a protocol for it… see above statement about not thinking outside the box) but we compromised on him coming into the recovery room immediately after.  They also let me bring a CD into the operating room, made especially by Harold as my birthing soundtrack. 

Crowded waiting rooms.  Public system waiting rooms look worse than they are.  They are actually organized and efficient, so you just have to ignore the mass of people surrounding you and listen for the bastardization of your name to be called over the intercom.  “Step Blank”, “Lynn Le Stifny”,  “Father’s name: Stephanie”

The crappiest visiting hours EVER, with only 3 hours at night and 1 hour during lunch.  The Middle East and Asia were having an outbreak of potential pandemic proportions (that never escalated in our area) so visiting times were scaled back even further while I was hospitalized. I hate that they don’t value family time, but we tried to look at my hospital stay as just a few days out of our lives and stay focused on the big picture.  Visiting hours were chaotic anyway, so I can kind of understand not wanting that to happen all day long.

Getting prepped for the c-section

Private Pros

You are the patient of a specific doctor, so you don’t have to explain the same things over and over, or wait for someone to read your chart. 

More personalized service where patients’ needs are accessed on an individual basis

Rooms have been compared to a luxury hotel

There is an ultrasound at every appointment (could be a con though, as you are paying for this and the effect of having so many ultrasounds is unknown).

Private Cons

You know that down-payment for a house you’ve been saving for?  Consider it gone. (Seriously, about $21,000 US, on average)

High pressure to schedule a c-section.  Hong Kong has a very high c-section rate, but in the private system, many patients and doctors alike prefer to schedule a c-section for non-medical reasons.  Also, the threshold at which emergency c-sections happen is a lot lower than other countries because Hong Kongers really like to err on the side of caution.  This can actually be a pro if you really want to schedule a c-section for some reason.
 
Some hospitals have babies stay in a nursery where the mom can only visit at specified breastfeeding times.  I have a friend who had a c-section and couldn’t get out of bed for the first few days.  She had wanted to breastfeed but no one would bring her baby to her and she couldn’t make it to the nursery so the nurses just started giving her baby formula.  Again, if your focus is on getting yourself relaxed and rested, this can actually be a pro.     

So there’s the admittedly biased pros and cons list.  I couldn’t go into too much detail for the private hospitals because I only have other people’s stories to go by.  And I kind of lost steam about halfway through writing this.  

Mommy and Jack, shortly after birth

Welcome to the world, baby Jack!