I found out in the beginning of March that I was unexpectedly pregnant. (This is also my poor attempt at an explanation for why I haven’t posted here in ages). Of course, I immediately had a million questions. But along with the questions everyone asks in those moments, I was also faced with figuring out how to have a baby in a foreign country where I had never even been to a doctor. Here’s what I’ve learned along the way.
Public Vs. Private
Basically, the moment you have conceived you are already behind in making a decision about your delivery options. Public or Private? If private, which doctor? Which hospital does that doctor have privileges at? Now make sure you put a deposit on your spot at the hospital TODAY or you won’t get a bed!
If you are going public, look up which hospital is in your catchment area. You’re already 7 weeks? Go register with the hospital TODAY or they won’t be able to fit you in for your 12-week scan.
To boil it down, the public system is similar to the NHS in the UK and is available to all HKID card holders at minimal or no cost. The downside is that the public hospitals are crowded, and the care, while medically excellent, is very no frills. There is also no continuity of care as you see whoever is on call for your antenatal appointments and the delivery. In other words, the person who delivers your baby will be a complete stranger.
Private hospitals and doctors are more similar to what you would find in the US where you can customize your experience and choose a doctor whose philosophy you agree with. Also like the US, the private hospitals and doctors are quite expensive unless you have amazing insurance.
I actually have medical insurance through my company, but when I tried to find out what the coverage would be if I chose to go with a private OB and a private hospital, I learned that my medical insurance does not cover anything related to maternity. Because (and I quote) “Pregnancy is not a medical condition. It is a natural stage of life.” Mmmmhmmm. Right. A natural life stage during which you must go to the doctor and are required by law to give birth in a hospital. (Intentional home births are not allowed in Hong Kong).
Since I don’t have a spare $10,000 – $40,000 lying around, I will be using the public system, which I am eligible for thanks to my residency status.
The Monetary Cost of a Birth in the Public Hospital
So far I have paid $0 for my antenatal appointments through the public hospital. We did choose to pay about $120 USD for an early ultrasound with a private doctor when we confirmed the pregnancy. We also paid for a birthing class with a Western midwives clinic. Other than that, the pregnancy has not cost us anything.
If everything goes normally with the birth, I will stay in the hospital for 1-2 nights depending on the time of day the baby is born. I will pay $100 HKD (approximately $12.75 USD ) per night for my hospital stay. And… that’s it.
Even if (God forbid) I have to have an emergency C-section and the baby has to stay in the NICU, we will still pay a flat rate of $100 HKD/night.
Best case scenario, my baby’s birth will cost $25-$30 USD total.
Paying for the birth is literally as easy as paying your bus fair. You can even use your Octopus card (the transportation card we use for the subway or buses) to pay for it.
The Non-Monetary Costs of Birth in the Public Hospital
The beauty of the public system is that it is so affordable and is very safe. The negative is that it prizes efficiency over comfort and has very little interest in catering to the preferences of patients. Since the government is paying for everything in the public hospital, they will only provide what is medically necessary.
Some of the things that are not provided are small and annoying, but not really a big deal. For example:
- Urine collection cups for your urine sample. You have to bring your urine sample in from home in your own container.
- For the birth, you have to bring absorbent pads for the bed, mesh underpants, maternity pads, diapers for the baby, etc.
Some are a bit more bothersome:
- Unless you are classified as “high risk,” many hospitals do not offer the 20-week structural/anatomy scan, though they do encourage you to have it done privately. This means you will only get one ultrasound during your pregnancy, at 12 weeks.
- Although I was very lucky to be able to have both scans at the public hospital because of some concerns early on, I didn’t get any copies of the ultrasound pictures to take home. The only ultrasound picture I have is from the 8-week visit I did with a private doctor to confirm the pregnancy and get the referral to register at the hospital.
And some are slightly terrifying:
- Natural birth is expected. While you can ask for an epidural, it is very unlikely that you will get one without some extenuating circumstances (an extremely long labor or possibly if you’ve had an induction). This is because of the cost to the hospital and the availability of the anesthesiologist. They do often offer gas and air for pain relief, but not much else.
The priority is safety and efficiency, not comfort.
- The labor ward is women only. This means if you are at the hospital when you are still in early labor, your husband or male partner cannot go in with you until you are moved to a delivery room.
- Once you go into the delivery room, you may only have one birth partner in the room with you. So if you are one of those people who wants your mom and your best friend and your cousin there with you, it isn’t going to happen
- The postnatal/maternity ward is not private. There may be 8 women and babies sharing the room. Visitors (including the baby’s father) are only allowed in during visiting hours, usually an hour at lunch time and an hour or two in the evening.
Hopefully this was helpful for someone or at least interesting to learn about. At this point, I’m 30 weeks along and trying to prepare myself for what’s coming next while also trying not to think about it too much. In a few months I’ll be able to share my full experience of giving birth in Hong Kong. I will take all of the prayers, thoughts, and good vibes I can get!