Hooray I'm pregnant! That's the good news.
Unexpectedly though, I ended up temporarily relocating to Hong Kong from Canada for my last trimester. It's un-important why. The important bits to share are related to the information I found out about giving birth in Hong Kong.
1) I was planning for a "natural" home-birth with 2 wonderful midwives and a doula in Vancouver. The Canadian system is all set up to support this.
2) I moved to Hong Kong in my 24th week. The HK system is not as well set up for a natural birth at home.
3) I did a lot of research so I could figure out how to give brith as naturally as possible in HK (assuming no complications).
Where to give birth in HK.
Although home-birth is not illegal in Hong Kong, it is not supported, the midwives cannot get insurance so no one will help you with it. Therefore you are left with two options.
1) Private hospital birth
2) Public hospital birth
Private hospitals are expensive. If you don't have insurance, you'll want to look into the costs first. Also, with the private system, you need to find your own doctor. You have a private OB/Gyn and that doctor is the one who takes care of you through your pregnancy. How much "intervention" is urged upon you during labour depends completely on which doctor you have and their style of care.
- You have one doctor taking care of you, and you develop a relationship with them
- You have a private room
- You can have multiple people be with you in your room while you are giving birth. For example, you could have your partner, a midwife and a doula as long as your doctor agrees
- It's expensive (unless you have insurance)
- They are more likely to offer intervention, induce you if you are older, push for cesarian, etc
- Most, if not all, private hospitals (I didn't look into it) have a nursery where the baby goes post birth. There are "feeding hours" and outside of them, you don't have access to breastfeed your baby. I believe new moms are encouraged to get some rest instead. A friend who had a cesarian told me how she had to hobble to the nursery at night to feed her baby, and she was the only mom in the room, and had to listen to the other 40 babies crying.
If you have a HK ID, you have access to the public system. If you don't have a HK ID, but you do have a HK based address, I believe you can still use the public system, it will just be more expensive. The public system, especially Queen Mary Hospital, has a great reputation for obstetrics and is foreigner friendly.
- The baby stays with you after birth (there is no nursery system) so you can breastfeed when you/baby want(s)
- They are pro-breastfeeding
- They are pro supporting natural birth and keeping intervention until you absolutely need it
- They encourage you to submit a birth plan, where you can make decisions such as delayed cord clamping, skin-to-skin post birth, fetal heart monitoring, pain relief, positions for labour, etc
- If you have a HKID, it is very, very inexpensive
- It is the public system, so every appointment you are at the hospital for 3 hours, even though you only talk to the doctor for 5 mins
- You have to be proactive about asking for copies of your records. I made the mistake of forgetting to ask them my blood test results while I was at my appointment, and the bureaucracy makes it nearly impossible to get them until my next appointment 3 weeks later. At 35 weeks, that's pretty near to useless
- You see whichever doctor is on shift, so you don't build a relationship with the doctor
- You can only have 1 birth partner during labour. If this is your regular partner, then you can't bring your own midwife or doula to labour with you
- The pre-labour ward (the time you start labour until you are 4cm+ dilated) is not private, and since there are other women, you can't bring anyone with you into the pre-labour ward
- The post-labour ward (after giving birth) is not private, so you share a room with other new moms and babies, and presumably it won't be very quiet. Access to the post-labour ward is only during visiting hours, and I believe they are quite limited
If you have a HKID, or are able to register at a public hospital, then it's your best option for support for a natural birth. However, I would highly recommend paying for a private midwife to provide pre and post natal care so that you have one person you build a relationship with, to help you through your pregnancy and with breastfeeding. Even if they don't come with you to the hospital for labour, you'll have their support pre and post.
With a midwife, you can do the pre-labour at home. A midwife is certified to check your dilation. That means you can spend the first hours at home, until you are 4cm dilated, before going to the hospital. At that point, you go straight into your private labour ward, and you skip the shared pre-labour ward. You can bring your 1 birth partner with you into your labour ward.
If you go with the private system, then do your research and find an OB/Gyn who supports natural birth, and is not "pro intervention". There are some out there, and basically your OB/Gyn will be with you in the labour room, so if you are inline then it's ok. Remember you have the right to say NO to things they suggest. You make the final decisions. However, it's likely less stressful if you have a doctor who understands and agrees with what you want to begin with.
With a private hospital, having a doula might be a nice option. I've read wonderful things about having doula support. If I were able to bring 2 people with me, I would bring a midwife and doula. However, the public system only allows 1 birth companion so it wasn't an option for me.
Midwives in Hong Kong
1) Annerley Website
Annerley is the most well know midwife clinic in HK. They seem very experienced and were lovely when I went to meet them. Ultimately, I did not go with them, because they only offer Pre-natal and Post-natal care, but not Labour support. Since I didn't have a partner in HK with me, I wanted my 1 birth companion to be a midwife.
2) Wellness and Birth Website
Karin Siegler and Beatriz Leon de Ponce are the two midwives in this clinic. Karin came highly recommended from a friend of mine, but since she wasn't available during my expected due date, she recommended her partner Beatriz. Beatriz is wonderful, highly knowledgable and very experienced. A bonus is that they don't have a set clinic space, so they did all the pre-natal (and will do post-natal) check-ups at my place. Since I work from home, not having to go to a clinic like I would have done with Annerley saved me a lot of time and energy.
3) A French midwife named Pascale Maitre. Email: email@example.com. She was very responsive but would only provide Pre and Post Natal care, but not the labour support in the hospital.
4) Sophie Jacobs Website. I heard good things about Sophie when I was doing research but was not able to get in touch with her.
5) Eugenie Vallot Perraud Website. I heard lovely things about Eugenie but she never responded to my email / phone messages so I never spoke with her.
Ultimately, the HK midwives I spoke with were all very happy to meet with me first, so that I could get to know them before making a decision. In HK I found that there didn't seem to be a rush to make a decision. I waited until 28 weeks before meeting with Beatriz and deciding to work with her. However, I had midwives in Canada who I was seeing from 5 weeks onwards until 24 weeks just before I re-located to Hong Kong. You should get a midwife / doctor early on, but if you are moving to HK late in pregnancy, don't panic because you'll still be able to find a midwife later on.
Doulas in HK
I spoke and met with 2 lovely doulas in Hong Kong. Ultimately, with the 1 birth companion restriction at a public hospital, I went with a midwife instead of a doula. However, if you can have multiple companions, both these ladies came highly recommended.
1) Molly Grenham Website
2) Jeanne Hauguel Website
Good luck with whatever you choose. Feel free to email me at firstname.lastname@example.org if you'd like to chat about your options. I'm happy to share what I learned.