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GBS & QMH delivery

  1. #17
    mummymoo is offline Registered User
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    Although it might not seem as if much is happening in the NICU, the staff do very regular observations on the newborns and there is a slew of high tech equipment and personell nearby should a little wee one crash (and this can happen quickly because the newborns have zero to no reserve). Yes its inconvenient to mums and yes with more $$$$$ in the system they could have it so that mums and babies could stay together whilst these obs are being done BUT in a cash strapped, resources/manpower strapped system I think the Queen Mary does really, really well.
    Agree with Carang, the hospital just can't win, damned if they don't take the precautions and criticised if they do.....
    carang likes this.

  2. #18
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    nicolejoy is offline Registered User
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    I've got plenty of experience with QMH NICU and honestly I think they do go to the almost damaging point of overly cautious. My daughter was in NICU for 4 months - other babies in the US who were MORE severe than my daughter were out of NICU and home within 2 weeks. There was no change in my daughter's condition between 2 weeks of age and 4 months of age - and the doctors told me she was there pretty much "just in case". When she was in NICU between 2 weeks old and 4 months old, there was nothing that they did there that we could not have done at home. Of course if she took a turn for the worse, we couldn't give her the emergency care that would have been necessary, but she never once needed that.

    Also, my daughter's surgery to mend her cleft palate was also delayed more significantly than it should have been. It was finally repaired when she was 22 months old, although in other countries, kids who have similar conditions have their cleft repaired closer to 15 months (slightly delayed from the average 12 months old). Due to the long delay, we are now (at 26 months old) dealing with more significant speech delays than if the cleft had been repaired sooner. (That wasn't a NICU decision, it was a plastic surgery decision).

    I'm not saying that they should not take necessary precautions, but over here they take far more precautions than is necessary in my opinion/experience - and there are frequently negative consequences which I feel outweigh the benefits of that gap between "regular-cautious" and "over-cautious".

    Ultimately, I would prefer my doctors to be a bit more cautious than average - however the extremes that I've experienced in the system over here are crazy. That said, my situation is not a regular case... but I have seen a common theme occur over and over...

  3. #19
    Lali07 is offline Registered User
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    Taking a newborn baby from a GBS positive mother "for observation" makes no sense. The chances of a GBS positive mother passing the infection to her baby during birth are:

    - 0.5% without IV antibiotics in labour
    - 0.025% with IV antibiotics in labour

    The risk is extremely low as you can see from these CDC statistics!

    There are many other infections a newborn baby is more susceptible to and more likely to contract (e.g. respiratory infection, gastroenteritis, non-GBS meningitis etc.) and by taking the baby away from his mother, his chances are even higher of contracting one of these. A newborn baby in constant skin contact with his mother and receiving her colostrum has better oxygen saturation, a stronger immune system and better stats overall.

    So in short, taking a baby from his mother for the 0.5 - 0.025% risk of contracting GBS, is putting the newborn at a very real risk of more likely and more common other infections…

  4. #20
    MacauMum is offline Registered User
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    Ok so back from QMH: was admitted with 1 minute contractions every 5 minutes for an hour. About 9 hours later my cervix had only dilated by 2cm, baby's heartbeat was "not good" with each contraction and induction was not an option as i had had a previous c-section. Dr said he couldn't see the point in waiting doubted my cervix would open much more so had a c- section about an hour later.
    As expected they took baby up for 24 hour observation because of the GBS and because baby was a bit apneic at birth though was immediately stabilized. Was denied my request for immediate skin to skin contacts after birth and for delayed cord clamping.

    Was also denied to be taken up in a wheelchair to breast feed baby every 3 hours and had to wait until visiting hours the next day. Was told they would have to supplement or baby would need a drip. Might have been able to see him sooner but Dr decided I wasn't passing enough urine, which I tried to explain was normal as I hadn't been drinking since long before the surgery and don't want to drink too much when I go the go ahead as I was afraid to overload my system. Baby was released after 23 hours observation. We were discharged 44 hours after the operation. Not my ideal birth story but glad to be home with baby.

  5. #21
    Aquarian is offline Registered User
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    Congratulations on your new baby :)

  6. #22
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    carang is offline Registered User
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    i'm sorry it wasn't the experience you were hoping for... but i'm glad baby arrived safe and sound! congratulations!

  7. #23
    mummymoo is offline Registered User
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    The chances of a GBS positive mother passing the infection to her baby during birth are:

    - 0.5% without IV antibiotics in labour
    - 0.025% with IV antibiotics in labour

    It's not just about the chances of something happening that is important, you also need to couple it with the OUTCOME (catastrophic or mild), if the outcome occurs. That is called a risk rating and the hospitals have made their risk rating, and deem that for GBS positive mothers they will admit the newborn for observation for 24 hours. If the outcome is of no consequence then health economists tend not to put too many resources into it no matter how commonly it occurs i.e. mild gastroenteritis.

    End of the day, if you prefer to take the risks upon your own shoulders there is a form you can fill in to free the hospital of its responsibility and you can direct your own care (but I'm not sure if you can direct the care of your newborn but having seen the form I think there is a bit for parents to fill out if I remember right). Most people don't go down this route because ultimately, it is one thing to think you are right (and possibly vent on an open forum) and another to really take responsibility for it.

    Nicolejoy, I totally sympathise with your situation and the problem with the long wait to have your LO's cleft repaired, but wish to point out that waiting lists are FERAL in HK. Looking at the waiting list for cardiac investigations here vs in Australia, there is a difference of some 12-18 months (which is quite frankly ridiculous - you probably don't need the test any more if you had to wait that long and are alive after doing so) but I think this is the fault of the low taxes here and the fact that bugger all is spent on healthcare.

    As I say, I think the QMH does well with the resources it is allocated, and I agree with Carang when she says the fact is that the children are born healthy in the public hospital, but not to expect the bells and whistles/hand holding (unless you are willing to pay for it - my opinion). It makes me really annoyed on the staff's behalf when we bash the system that provides a good basic no frills service for 90% of the HK population (and I am told by my husband that its not only the expats that do this - the locals are really into it).

    All of us would agree that if you made a decision to pay less for a phone you might get a phone without a camera/music/video recorder other bells and whistles. And no one would go bananas at the phone companies. Same goes for when you go for spa/ to a restaurant/use a plane, yet when it comes to healthcare, it upsets me that service users feel that is it right to demand service over and above what the hospital resourced is provide. There is an alternative with loads more bells and whistles in healthcare - if you don't like what the government hospital is providing than go the alternative route or sign that DAMA (discharge/disagree with medical advice form).

  8. #24
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    nicolejoy is offline Registered User
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    I understand some of the reasons why the situations are the way that they are here, but I still firmly believe that it has detrimental effects that can outweigh the benefits.

    When my daughter was in NICU I felt so strongly that my daughter shouldn't be there that I considered taking her home against medical advice. I even discussed that with the doctors. You're right though, ultimately how can anyone make that decision and then they have to take full responsibility if something adverse happens. (I probably would have done it but there's no way my risk-averse husband would have agreed to it!!)

    I'm not attempting to "bash the system" - even if you search this forum, you will read many posts written by me that are positive about QMH and other public hospitals (my best experiences have been at Duchess of Kent) - however I do feel strongly about this one issue. I have discussed it with doctors and nurses there too. It's not a matter of service (I'm not commenting on the rooms, the manners, the closing of Starbucks ;) ), it's a matter of the way that medical decisions are made here compared to elsewhere.

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