Pregnant in Hong Kong: Public vs. Private Hospitals
Clueless about having a baby in Hong Kong? Find out what your birthing options are...
Assuming you've been planning on having a baby, and have had pre-pregnancy check-ups to ensure your body is in fine child-bearing form, pregnancy test results can still be a Pandora's Box of excitement and stress.
When you first find out you pregnant, the levity surrounding the news can overshadow the less fun, administrative, and practical details of what's to come.
But there are some things you just can't leave unconsidered. Below we've laid out a few of the more important things you should keep in mind over the next 9 months.
The most important thing is the health and status of the baby. No matter how many weeks or months you are into the pregnancy, it is essential to keep up with antenatal care, in order to follow the development of the baby, and also ensure your own health doesn't waver.
For each step in this process, you can choose either public or private care. You can also split between the two, visiting a private doctor for all your antenatal check-ups, and then delivering your baby in a public hospital.
Choosing Public Hospitals
"In recent years public hospitals have started to offer birth balls, yoga mats, and the option for hypnobirthing methods. The routine use of episiotomy has finally been discontinued, which is great news for all childbearing women.
The main disadvantage of public hospitals is that they're always busy and staff are constantly rotating, which means it's not as personal an experience as one might like. Also, there are quite a few "rules" and protocols that are followed more strictly than in private hospitals, which can affect your birthing experience.
As such, most women who choose to give birth in public hospitals prefer to stay at home for as long as possible. For those who choose to stay at home for the early stages of labour, hiring a private doula or midwife for support has recently become very popular."
- Hulda Thorey
Registered midwife and founder of Annerley
If you're a Hong Kong Resident and hold a valid HK ID card, costs associated with pregnancy are minimal.
Simply register at your nearest Government Maternal and Child Health Centres for your antenatal appointments; the first appointment is at 10 weeks, and as long as you're eligible it's free.
The most you'll have to pay for the entire process is the ultrasound fee ($300/copy) and the hospital bed fee ($100/day). Government clinics only perform 2 ultrasound scans but most women will supplement this by visiting a private doctor for additional ultrasound appointments.
The affordability of Hong Kong's public hospitals does not reflect the quality of service. They have a fantastic reputation for being clean and safe (though not always the most comfortable).
If you're not a Hong Kong resident and don't hold an HK ID Card, the Obstetric Package from the Hospital Authority is $39,000, including 1 antenatal check-up, delivery service, and 3 days of hospitalization. Any extra days of hospitalization will cost $3,300 per day, and any extra antenatal appointments are $700 each.
It should be noted, if you register for an Obstetric Package as a non-resident but did not undergo an antenatal check-up provided by the Hospital Authority, your fee will be an additional $51,000, bringing the package total to $90,000 . This additional fee will also apply if you arrive at a public hospital for delivery without having confirmed a booking.
Non-residents (those without Hong Kong Identity Cards) that plan to use public services must register at the Government Maternal Clinic ASAP as each hospital has a strict quota for non-residents, and booking must be done in person by the pregnant individual. Additional info for non-residents can be found here. For a list of public hospitals and public health institutions click here.
HK residents and non-residents can both make appointments at the Maternal and Child Health Centres in the city. During these check-ups, doctors will give you a physical examination, test your urine, and test blood to scan for Hepatitis B, Thalassemia, Rubella, Rhesus Factor, and other Sexually Transmittable Diseases. The foetus will also undergo tests for abnormalities.
Choosing Private Hospitals
"Private hospitals offer excellent services, have fewer restrictions, occasionally offer the option to bring your own midwife and have better facilities including access to private rooms.
However, private care does not always mean you get the natural birth option you would like; statistics for most private hospitals reveal that C-section rates, epidural use, induction, forceps and ventouse deliveries are much more common. Specifically, private hospitals have C-section rates between 50 to 85%.
Mothers need to be assertive (yet polite) with their needs as many women are quite vulnerable when they are in labour, so they end up falling into the role of a patient rather than following their own instincts, which would make requesting a natural birth more difficult. As such, the key to a successful birth is to educate yourself and prepare well. Know the hospital and how they practice."- Hulda Thorey
Most people who can afford it or have maternity insurance will go the private care route.
According to the Consumer Council there are, "a wide selection of deluxe maternity packages that compete on the size of the private suite and the range and grade of the facilities provided." These packages are usually priced the same for residents and non-residents, but that's not always the case.
The doctor's fees, obstetrician fees and anesthetist's fees are generally separate from the maternity package fee, so you'll want to get a rundown of the specific services that are included, and the special services that aren't uncommon but which are billed separately. Maternity packages vary from hospital to hospital, with more affordable packages hovering around $17K for a 4 to 6 bed standard room.
To put the price difference between public and private care in perspective, Bloomberg reports, "a day's supply of oxygen to a baby at a private NICU (Neonatal Intensive Care Unit) is about $30,000. Public hospitals charge $50 a day, inclusive of medical services." That’s quite a difference.
The entire cost of delivering at one of Hong Kong's private hospitals could easily amount to upwards of $100K, but this price hike features luxuries that won't be available in public facilities. Most private hospitals also require that you put down a deposit, ranging from $10-20K.
St. Paul's Hospital offers one of the most affordable private maternity packages, at $17,800 for HK residents, and $34,000 for non-residents. This is for "Spontaneous Vaginal Delivery" in a Standard Room with 3-6 other expectant mothers.
Meanwhile, a hospital like Adventist has maternity packages that come highly recommended, but a basic three day stay with a vaginal delivery will cost $61,000, not including epidurals, use of forceps or the collection of stem cells for storage et cetera.
Additional 'special' fees include paying for a paediatrician to be in attendance during delivery (not optional), a 30% surcharge for each additional baby (twins etc.), and a $33,000 surcharge if you'd like your baby delivered within a certain, pre-determined time frame (feng shui???).
Alternative Birthing Styles
Natural Birth: Natural birth describes a birth with minimal intervention, including minimal pharmaceutical pain relief, no automatic episiotomy, and being allowed to choose your birth positions, which may significantly reduce the intensity and duration of labour. Natural methods of pain relief are preferred, such as breathing or more recently hypnobirthing.
Hypnobirthing: Want a relaxed, natural birth? Interested in enhanced self-hypnosis techniques? For those who would prefer to have a drug- and intervention-free birth, hypnobirthing trains the mind and body for natural birth, and is supported by some hospitals in Hong Kong. Hypnobirthing classes are available at Annerley, which includes advice on giving birth at hospitals, breastfeeding and baby care.
Homebirth: Many believe that home births are illegal in Hong Kong, but this is not the case. Nonetheless, home births are not well supported in Hong Kong because it's not easy to find staff who are willing or trained to assist, and not all homes are located conveniently enough to access a hospital in case of an emergency. Homebirths are recommended only for healthy mothers with low-risk pregnancies. Outcomes for home births are generally good with only 5 - 10% of cases requiring a hospital transfer because of medical complications. Generally, first-time mothers, women with high risk-pregnancies or women who live far from hospitals should refrain from homebirth because of the risk involved.
- Contact Annerley for more information
We've listed the most basic package prices for standard rooms here. If you go for private rooms or deluxe packages, be prepared for a Doctor's Fee that can be double or even triple the standard rate. This fee is separate from your package fee, and in some cases can be negotiated with the doctor. More detailed prices on maternity packages and OBGYs can be found here.
Also, just like in a public hospital, if a patient has not had the mandatory antenatal lab tests done in Hong Kong prior to admittance, Adventist will charge an additional $40,000.
According to Bloomberg, privately run Union Hospital in New Territories has instituted, "a minimum charge of $58,000 for a three-night stay in a standard room with a vaginal delivery. That can rise to $130,000 for a four-night stay in a private room with a cesarean."
Expecting mothers should know private hospitals have a surprisingly high C-section rate: 60% of births were cesarean in 2010 according to government sources, whereas only 24% of births were C-sections at public hospitals.
If you do choose the private route, don't think you can afford to book whenever you feel like. There are regular shortages of beds in HK's private hospitals, so you should reserve yourself a place as soon as you know you're pregnant. Even if you wait until you're 6 or 7 weeks in, it's more than likely you'll be waitlisted.
Half and Half (Public and Private Care)
If you're an HK ID card holder, the fees for giving birth in the public hospitals are relatively inexpensive, as stated above. However, the wait at the Government maternal clinics can be long and appointments are short.
Most women prefer to go the half-half route, and have all their prenatal care done privately with a doctor of their choice. Budget at least $10-15K for prenatal care if you select this option.
Lastly, relax and enjoy your pregnancy; this is a special time in your life. Feel free to share it with other expectant parents in our Due Date Clubs.
Know the hospital and how they practice. Tell your doctor in advance what your thoughts are, and bring along a birth plan to help make your requests as clear as possible. Regardless of where you go to give birth, you should prepare yourself as much as possible since you will be the one doing the actual work.
- Hulda Thorey, registered midwife and founder of Annerley
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