Private or Public Hospital? Navigating Hong Kong’s maternity wards

I never had the brains, work ethic, or personality to pursue a career in medicine.  The sight of blood made me queasy and biology was one of my least favorite subjects. All I remember is that mitochondria is the powerhouse of the cell.  When my wife (who is a medical professional) told me that she is pregnant, I knew I’d never to be able to offer anything in the way of medical knowledge, no matter how much research I did.  And let’s be honest, my wife probably had everything handled in this department.  What could I do to help then?

expecting millennial couple mom and dad holding little baby converse shoes

I do work in finance, however, and I figured I could focus on the financial side of having a child in Hong Kong.  Questions that immediately jumped into my head included – Is healthcare in Hong Kong free like in Canada?  How does the private system work?  What were the costs of the different delivery options?  What insurance coverage do I have?  How much is each night’s stay in a public or private hospital?  What other expenses would we incur from now until delivery?

female millennial counting usa dollar bills money
Mo’ Money Mo’ Problems

If you’ve done the research already you probably quickly found information is quite piecemeal. There may be some good info on a forum here and there but a lot of it is also wrong and ill informed.  Your family may be able to offer some advice, but it was probably more relevant 30-40 years ago.  And most people don’t have time to visit hospitals and clinics to get multiple price quotes.

Fortunately, between my wife and I, we were able to sift through the many sources of information already. I hope that this summary of our research is able to help others in a similar position. Make sure you have all your essential baby gear before the big day!

First decision – public hospital or private clinic?  Or a combination of the two?

Hong Kong has both a public and private healthcare system.  These systems run in parallel at both public and private hospitals.  Doctors at public hospitals are employed by the Hospital Authority which is a branch of the government. They practice at a single government hospital where they’re employed.  Shifts vary month to month, so there is almost no chance that you will see the same doctor throughout your pregnancy. In a private clinic you will meet with the same obstetrician every time.

Public hospital – cost effective but with some caveats

When it is time for your check-up, you will sign in at the obstetric outpatient department and wait for the obstetrician. You’ll see whoever is staffed on that day. He/she will examine you while referring to your existing records in the system as they may not have ever met you before.  Wait times can be long, sometimes upwards of 2-3 hours. Cost is very manageable as outpatient consultations are HK$50 with a valid HKID card. Schedule of costs can be viewed on the Hospital Authority Website.

If your pregnancy is diagnosed as very routine, you may even be referred to the Maternity and Child Health Clinics (MCHC) where you’ll be seen by a nurse throughout your pregnancy. You may then be referred back to a hospital if there are complications. If you do have complications, public hospitals have great resources. You’ll have a pediatrician on call who can get to the baby within minutes if needed. Big hospitals also have neonatal intensive care units (NICU) for ill or premature newborns.

clean well lit hospital admission ward with spanish sign

You must live in the appropriate catchment area and may be asked to provide proof of address for your local hospital.  Visits with a doctor are shorter compared to a private clinic. It’s best to have all your questions ready ahead of time to take full advantage of your time.

Typical schedule of visits throughout your pregnancy would be 9-10 routine check-ups throughout your pregnancy or roughly once per month with 2-3 ultrasound scans and a larger and more detailed 20-week anomaly scan. Some of the larger public hospitals in Hong Kong include Queen Mary Hospital in Pok Fu Lam, Prince of Wales Hospital in Shatin, and Queen Elizabeth Hospital in Mongkok.

Private clinics – shorter wait times at a price

Private doctors operate from their own clinics, often in business centers of Hong Kong like Central, Tsim Sha Tsui, or Causeway Bay.  These clinics are where you will get your regular consultations and ultrasound scans.  Check-ups vary in cost depending on the clinic. For reference, a routine check-up would cost us ~HK$1500 which includes an ultrasound scan.  The big 20-week anomaly scan was ~HK$4000.

hong kong central business district skyline day time with clouds

Visits are typically longer as the doctor sets aside more time for you.  The interactions are more relaxed and there is more time for questions. Wait times are also shorter, rarely more than 30 minutes.  There is no limit to the number of consultations you can schedule with your doctor during your pregnancy. However, if your pregnancy is routine, there is no need to visit more than once per month except towards the end of the third trimester when one consultation a week may be needed.

Private doctors can deliver in any of the many private hospitals around Hong Kong. They tend to prefer one or two depending on the location of their clinic and where they personally live.  Some of the more prominent hospitals for giving birth in Hong Kong are Matilda International Hospital, Hong Kong Sanatorium & Hospital, and Gleneagles Hong Kong.

Decision Time

Whether you choose the public or private route depends on a number of factors including complications in your pregnancy, affordability, convenience of locations, etc.  Many people supplement the public system consultations with visits to a private clinic.  You can take advantage of some of the lower cost (yet still world class and state of the art) services at a public hospital and supplement these with some additional check-ups and scans at a private clinic.

Private clinics usually offer an ultrasound scan at every visit. This isn’t standard in the public system.  Scans can be a great bonding experience for you and your wife. You’ll share precious memories like hearing your baby’s heart beat for the first time, seeing the first signs of his organs developing, and maybe even get a quick thumbs up from him on the ultrasound screen.

ultrasound image of a 28 week baby with their thumb up

Labor and delivery – where the real money is spent

HK residents with a valid HKID can access public obstetric services where childbirth costs $120 per day plus a $75 one-time charge. These costs are all-inclusive and cover any and all complications. Whether you have a completely medication-free natural birth or a cesarean section under anesthesia the costs will all come out the same.  Delivery is usually done by the midwives unless there are complications or forceps/vacuum is needed.

You’ll most likely be put in a public ward after your delivery.  In Hong Kong this means sharing a room with up to 7 other women and your beds may be as little as 3-4 feet from each other.

crowded hospital located in an old colonial style building with large chandelier
For illustrative purposes only. Not an actual HK hospital…

Visiting hours are limited to 2 hours in the afternoon and 1 hour in the evening. The hospital is often crowded during these times and they may limit the number of visitors per patient. This means dad won’t spend much time with you and the baby in those initial days.  Food, as you can imagine, is not good. However, this might be low on your list of priorities as it was for us.

Private delivery is expensive but for a reason

Delivery at a private hospital with a private doctor is orders of magnitude more expensive than the public route.  Note that costs change depending on whether you opt for a private or semi-private room.  Don’t ask us why the doctor charges more if you upgrade your room, that’s just the way it is here.  For us, a major reason for going the private route was having more privacy. Therefore, we didn’t evaluate the standard room options where you’d share a space with 3+ other women after delivery. We’ve only broken down costs for private and semi-private rooms across both natural and c-section deliveries for a standard private clinic. 

hong kong private hospital obstetrics delivery charges comparison chart

Visiting hours are usually 12 hours per day and staff are a lot more lenient. Dad can even spend the night with mom and the baby for 2-3 nights in the hospital if you’re up for a camp out on the couch!

Finally, let’s talk anesthesia quickly.  You’ll pretty much have an anesthesiologist at your disposal during your private delivery. Getting an epidural will be your decision and can happen any time you want.  This is not the case in a public hospital. Anesthesia resources are thin and some midwives do not encourage the use of epidural.  Make sure your wife keeps this in mind when making your decision.

syringe thrown into the air with hand and plastic

Do you have maternity insurance?  This could be the big tie breaker

After soaking in all the above costs, it may be a good time to check with your health insurance provider to see if your plan covers maternity costs.  This is typically an optional addition to your standard health insurance package and some companies may not offer this to their employees.  If you are reading this and you don’t plan on having a child for 10-12 months then great! It may be worthwhile to look into supplemental insurance plans that offer maternity coverage.  Note that most of these have a waiting period of 10-12 months, depending on the plan.  During this period, you won’t be able to claim any maternity expenses even though you’re paying the insurance premium.

You also can’t purchase maternity insurance on its own; you must purchase a full health insurance policy with a maternity add-on. This may overlap with coverage you get elsewhere. 

In Summary…

  • Private clinic consultations are relatively inexpensive (HK$1500), so many expecting couples opt to supplement their public hospital visits with private check-ups. You can do this even if you’re undecided on delivery at a public or private hospital
  • Ensuring you visit a public hospital regularly helps create a file in their system. This is helpful in the event you need to give birth in a public hospital
  • The same doctor that saw you throughout your entire pregnancy will be there to deliver your baby if you go the private route.  This can add a level of comfort in an especially stressful time as you’ll have a familiar face in the delivery room. They’ll also be well aware of your birth plan and try to help you stick with it.
  • Visiting hours are a lot more relaxed in a private hospital so dad can stay with mom for most, if not all, of the hospital stay.  More spacious private rooms and better food are just the icing on the cake.
  • Public hospital would be the option to take for a higher risk (as diagnosed by your doctor) pregnancy or for someone who doesn’t mind the cramped space of a public ward and the lack of visiting hours.  For a more complicated delivery, the state of the art facilities at a public hospital and their neonatal intensive care units (NICU) will be useful
  • Check your insurance coverage now! Delivery costs can climb if there are complications and you tack on the extras

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