Giving Birth in Hong Kong: Everything You Need to Know about Going Public
Do I really have to wear a pink pyjama uniform? Is it true that I can pay for my birth with my Octopus card? Planning a birth in Hong Kong can raise some very quirky questions, however having a baby in the public hospital system can be a very positive experience, if you know what to expect. We chatted to doula and breastfeeding counsellor Cathee Jackson to find out about the process, how to prepare, and what to pack!
First thing’s first
All women with a Hong Kong ID are eligible to use the low cost, high quality public hospital system to give birth. You will need to get a referral from your GP confirming your pregnancy, which you will then need to present at Tsan Yuk Hospital to be registered into the public system. Here you will have your initial scan and tests at 13 weeks, before being allocated a hospital for your future check-ups and the birth, depending on where you live. This could be Queen Mary Hospital in Pok Fu Lam, Princess Margaret Hospital in Lai Chi Kok, or Queen Elizabeth Hospital in Kowloon, just to name a few.
The Waiting Game
You will now be given regular appointments for check-ups at your allocated hospital (monthly at first and more frequently as the due date approaches). Cathee says planning and preparation are key. “You will find a number of other mums-to-be will have the same day and time as your appointment, so you should expect to be there for about two hours. My best advice is to try and arrive 20 minutes early to be at the head of the queue, and come armed with plenty of magazines and snacks. See it as a few hours of ‘me time’ to just relax and read, and you won’t feel so frustrated.” Expect to be weighed, have your urine tested and your blood pressure checked. You will then be seen by a doctor, however don’t expect to see the same doctor each time you visit. The check-ups are very thorough and will include a Doppler ultrasound to check baby’s health, and in week 13 and week 20 of your pregnancy, you will have an ultrasound where you will actually see bub in action. While you are at one of your monthly appointments, be sure to register for a hospital tour and antenatal classes, or look into one of the more in-depth private pregnancy classes offered across Hong Kong.
If you are well prepared for your hospital stay in Hong Kong, the entire experience will be much better! You will need to take everything with you including maternity pads, nappies, wipes and protective bed pads—it’s a great idea to grab one of the pre-prepared birth packs from the 7-Eleven located at the Queen Mary Hospital and tick it off your to-do list early in your pregnancy!
Cathee suggests packing three separate bags. One for the labour, including your birth pack, a change of underwear, a towel for the taxi in case your waters break, essential oils, music, socks, a water bottle, easy-to-eat snacks, your Hong Kong ID and birth plan. Your second bag for after the birth should include nappies, nursing tops, breast pads, nipple cream, baby clothes, swaddles, maternity pads, toiletries and a towel, spoon, mug, bowl, cereals and snacks, entertainment, your phone charger and a change of clothes. Finally, your birth partner needs a bag to keep their own snacks and entertainment in while they wait.
Ready to meet the newest addition? When labour starts, Cathee recommends staying at home for as long as you’re comfortable, resting and keeping hydrated. When you first arrive at hospital your birth partner will admit you with your paperwork and birth plan, and you will be given pyjamas and a bed in the Labour Ward, where a nurse will check your progress and your stats. Once in the Labour Ward, your support partner/doula can only be with you during visiting hours—another reason to stay at home for as long as possible. (Although when you are not being monitored you can leave the ward to pace the corridors or sit with your birthing partner).
Cathee suggests pulling the curtain around your bed, popping your headphones in and focusing on your breathing. Remain positive and assertive—if you feel you are being bombarded with medical questions, wait until your contraction is finished before answering, or if you don’t want to wear the hospital pyjamas, just say so. Don’t be afraid to speak up, although Cathee does recommend to pick your battles wisely and considering in advance which things really matter to you. Also, don’t forget to keep your phone with you at this time too, so you can keep your birth partner updated.
Once you are past three centimetres dilation, or in active labour, you will be moved into a delivery room with your birthing partner. This is the time to whip out your birth plan again, and ensure everyone is aware of your wishes. For example, you can stipulate that only English is to be spoken in the room, or all questions should be directed to your birth partner. You will also now have a dedicated midwife to see you through the birth, and unless there are any complications, the midwife will deliver your baby. Delivery rooms are equipped with birth balls and a sound system, so bring your favourite playlist. You can birth in whatever position you feel is optimal, and while you can ask for pain relief, staff will generally encourage natural methods, such as breathing techniques and TENS machines, which are supplied. If you are seeking an epidural, you will need to speak up early on and ask for it, as well as put it in your birth plan. Like in most maternity settings these days, there is a strong emphasis on skin-to-skin contact as soon as baby is born, and delayed cord clamping is welcome. If all is well, you can expect to spend a few special hours in the delivery room bonding with your new bundle of joy!
In Hong Kong’s public system, Cesarean sections are only performed if deemed medically necessary, so you can’t request one out of preference. You will be given a date and time to check in for the procedure, and your birth partner can be by your side, unless it is an emergency C-section. Once baby has arrived, he or she will be shown to you, before being checked over by the pediatrician. You can expect to be in the hospital for a few extra days (normally 3-5). You will be encouraged to get up and about soon after the surgery, however the medical staff are very risk averse so you will be told to avoid lifting anything, stretching or doing anything that puts pressure on your scar.
No matter where you give birth in Hong Kong, if your baby needs special care, he or she will be taken to the Queen Mary Hospital, which has state-of-the-art intensive care facilities for newborns. Rest assured your little one will be in very good hands.
And Baby Makes Three…
Now the fun begins! Once you are moved to the Post-Delivery Ward, you will quickly find that everything is very regimented. There are set times for certain things such as bathing, and visiting hours are strictly adhered to—even for dad—while children under 12 are not permitted. There are likely to be about seven other women in the ward, so bring ear plugs and don’t expect too much sleep as things can get noisy! There is a strong emphasis on breastfeeding, while bottles and baby formula are discouraged. You will need to keep a track of baby’s feeds (and poos!) on a chart for the doctors and midwives to check on their rounds, and while the ward can sound chaotic, there is a nursery where you can leave baby if you need to take a shower or pop out. The food in the hospital is very basic and Cathee recommends your support person brings you a constant supply of meals and drinks, but remember you won’t have access to a fridge. On your last day in hospital, baby’s reflexes, weight and head size will be checked, before he or she gets a memento photo on the way out! Make sure your partner brings the car seat in today to fit to the taxi for the trip home. Expect to pay on average about HK$300 for your hospital stay, and it’s as easy as swiping your Octopus Card.
In the weeks that follow, you will have your check-ups at the local government run Maternal and Child Health Centre, however Cathee suggests checking with your own General Practitioner or Pediatrician to see if they run baby clinics. This can be a much more convenient option in the early days when getting around with a newborn is challenging. A GP should be able to weigh the baby and give them their check-up, so speak to your doctor to see what they can offer. You will find there are also many fantastic local breastfeeding support groups, like the donation-based Discovery Bay Breastfeeding Circle, or La Leche League.
As Cathee says, giving birth in a Hong Kong public hospital doesn’t have to be scary at all if you do your groundwork. “The system is free, safe and very good, but you must have realistic expectations. Be positive, flexible and assertive, yet always remain respectful of the medical staff.” This is key to getting the most out of your birth experience, and of course, you will be rewarded with the best gift of all!
Cathee Jackson moved from the UK to Discovery Bay with her young family 3 years ago. She is a birth doula, breastfeeding counsellor and works with couples leading up to their big day teaching antenatal classes. Email Cathee or 5993 3699.