009: My Birth Story- Giving Birth in Hong Kong
An American Giving Birth In Hong Kong:
My Expat Birth Story
Ever wondered what it’s like to give birth in another country? To labor and deliver a baby far from family and the traditional support system? Well, every story is different, but this is mine. There are many similarities to other expat mommas who give birth in Hong Kong, but as with everything in life a lot is very dependent on your personal circumstances, the people around you, and your expectations.
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Table of Contents:
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Where I Gave Birth in Hong Kong
I chose a public hospital for my delivery. There are lots of very posh and not so posh private hospitals, but the insurance through our school doesn’t cover them, or anything related to pregnancy, and I just couldn’t see spending what could possibly end up being $80,000 HKD (about $10,000 usd) for what I could do in the public system for $100 hkd a day. And if something were to happen they would have taken me or baby to a public hospital anyway. Now if I had insurance, I totally would have gone private.
Anyway, I used Queen Mary Hospital on the Island and I’m very fortunate. You don’t actually get to choose which public hospital you use, you’re zoned for it based on where your residence is. On Lantau Island, there are two zones. Tung Chung city center goes to Princess Margaret (where Hubby has been twice) and everywhere else goes to Queen Mary. It’s further away, but the facilities are better and are known to be more “expat” friendly. And they have a Pacific Coffee and a 7/11 right there, what’s not to love?! Okay, a lot, but the system is what it is.
Day 1 At Queen Mary Hospital
I wish I could say I labored at home as long as possible and just went to the hospital when I got to active labor. I mean that was basically the plan, I didn’t even want a hospital birth so I wanted to stay out as long as possible! I even had my own TENS Machine (which I LOVE!) so I could. But alas, little mister had other plans. Despite walking all day, including walking up the steps to Big Buddha (268 steps to be exact), eating ALL the pineapple and it’s core, bouncing on a birth ball, and even sex, NOTHING was working to kick-start labor. So on Wednesday, March 15 we drove into my scheduled admission at the hospital.
By 9 am I was changing into the pink outfit they provide and Hubby was on his way to work. Visiting hours are only twice a day at lunch and dinner and he only got 3 days off, so no point for him to stick around. What they didn’t tell me when I was scheduled to be induced was that the induction process can take up to a week! So here I am stuck in the hospital with approximately 60 other women in the ward with no end in sight! Yup, that’s right, 60. There are, I think, 6 rooms all connected to the center midwife station that makes up the pre-labor ward. Each room contains, on average, 10 people… so. much. fun…
Doctors, midwives… I’m not sure anymore…
The thing about the public health system is that you have zero control. Like nothing. They change doctors pretty much every day, you have midwives for most of it and I guess what could be considered orderlies… I’m not really sure. They rarely introduce themselves and explanations are kept to an absolute minimum. They do NOT like giving you any information that is actually useful.
So that first morning I had a male doctor… he comes in, looks at my chart, might have asked me something, probably not. My only impression of him… He’s an arrogant young buck who needs a lesson in manners. He checked for dilation said “not favorable” and then put the gel up inside by the cervix to help start labor. It HURT. Oh, it was so uncomfortable. And then I’m stuck back on the bed for the non-stress test for the second time that morning to see if I would contract… I didn’t really.
The Waiting Game
After lying on your back for a couple of hours (because if the monitor moved or lost signal you had to start ALL OVER AGAIN!) and nothing happening, they leave you to wait till evening rounds. Yup, nothing to do, stuck in a space the size of my outstretched arms. Oh and next to me was a new mom. Why she was in the pre-labor ward instead of the post-labor ward I’ll never know, but that certainly didn’t help the rest and relaxation component of the hospital stay.
I also took some time to bounce on the labor balls. They had two lined up on this non-slip mat with a bar to hold on to. I practiced all the movements that I saw on the little sign on the wall, all while listening to the squeaking sound made by the plastic ball on the rubber mat. But hey, it super helped with any back pains I was having and I just jammed away to my music!
The Unexpected Surprise
When you’re stuck in one place with nothing really progressing you take your wins where you can get them! Well, I got super lucky my first night there because another expat mom was admitted for the night that was in my Whatsapp due date group so I had someone to chat with and really help pass the time! She even got placed in the bed next to mine so we completely acted like high school girls on a sleepover. Though we did try to keep it down for the poor new mom next to us.
Then Hubby came with food! Like real food, not hospital food. It was awesome to have some real food. He stayed for the visiting hours and then went back home so that he could get up and go to work again the next day. Of course, we were hoping labor would start and he could just come back. That didn’t happen though…
Last Check by Doctors and another NST
After dinner, it was back on the NST machine again. I swear I spent more time on that bed than anywhere else sometimes. You see, I’m fat. Yup, I have some loose skin even with a baby belly and that stupid monitor just doesn’t stay in place, especially when I need to adjust myself because my hip was going numb. So a couple more restarts, a lot of readjustments of the monitor and pulling of the gauze, and more gel. Still no progress.
Lights finally go out at 11 pm after being poked and prodded by the midwives. I use the TENS machine and headphones with soft music to get some rest.
Day 2 of My Induction in a Public Hospital in Hong Kong
Lights on by 6 am! Jolted awake for checks at 6:30. Try to go back to sleep and jolted awake again for another type of check. I give up. I eat some of the food I brought (thank God for oatmeal packs!) and wait for the doctors to make their rounds.
A lady doctor this time. She checks me to see if I’d dilated anymore and then disappears. A while later she comes back with a group of doctors, including the head doctor… They talk about me like I don’t exist. I’m American, of course, I don’t let that pass. I want information!!! They tip-toe around my questions but just say “unfavorable”. Always unfavorable. Back to the non-stress test and more gel. I find out I MAY be 2 cm dilated.. depends on who you talk to.
I eventually learned that you could leave the ward as long as you informed one of the nurses/ midwives (seriously have no clue which was which). So off I went. I was determined to kick-start this labor and get out of here! So I walked down the stairs, across the breezeway that goes over the highway and down some more stairs only to turn around and go back up. While everyone else took the escalator I’m going up and down stairs jamming away to some music. I’m sure I got lots of looks in my pink outfit, but you do what you gotta do! I did about 9 flights of stairs in a row!
My friend had been discharged so it was back to just me and the labor ball and NST machine… I ended up crying and the midwife needed to calm me down. I usually would play on my phone while laying down for the NST, I mean they end up being like an hour long, what else is there to do?! Unfortunately, the head midwife on duty yelled at me for doing so and so I was bored out of my mind and just kept thinking about everything going on and worrying about how long I would be here, what was going to happen and all. I mean I was also exhausted from lack of sleep so that certainly didn’t help. I ended up calling and waking my mom up to cry to her… stupid hormones lol.
Overall the rest of the day was just more waiting, but in an effort to raise my own spirits and to further my efforts to serve “J” his eviction notice, I danced the night away in my little cubicle. Nothing came of it as far as contractions, but at least I had fun and could laugh at myself!
Day 3 of My Induction
More early wake ups and being thankful for the oatmeal packets I packed so I didn’t have to eat congee (think oatmeal but rice…).
Meeting With The Doctors… Again…
The whole group of doctors came by after the initial examination again. I was STILL unfavorable, literally, nothing had changed except that I could actually be considered 2cm for sure now! I had been doing my research though and had read about the Foley balloon so I argued for it. I pointed out that the medicine they were giving me wasn’t doing anything and so the doctor agreed that I would get the balloon after letting my cervix rest for the day.
That’s pretty much the name of the game in public hospitals, so nothing new here. Lots of time on my back doing the NST and more walking and labor ball rolling!
The Foley Balloon
So before they could insert the Foley balloon I had to have another NST. It was only supposed to last 20-30 minutes, but little man decided he really liked the smoothie I had for dinner and was having a party in my tummy. Then the monitors kept losing contact so what was supposed to be only 30m ended up being over 2 hours! 2 straight hours of laying on my back…
Then it was time. Getting it inserted wasn’t nearly as uncomfortable as laying back on that bed, but it sure was awkward! By the time it was all said and done it was 11 pm and I had to do yet another NST…
The good news… I was finally having some contractions. The bad news… they were all in my back.
Finally time for bed.
Day 4 of My Induction
Sorry, no pics on this day as it’s not really allowed…
The Morning Ritual
I think by now you know how this goes lol. But this time I had the Foley balloon taken out. Unfortunately, as with every other morning, I hadn’t really progressed as they wanted. Of course, I only had the balloon in maybe 8 hours, and most of it while I was sleeping, so it didn’t have much time to do its thing. Either way, they decided there wasn’t much more they could do for me and it was baby time!
Moving to the Labor Ward
I thought I would have some time, but it turns out it was a slow morning and they wanted to get me in there asap! I had barely had anything to eat or drink, but I was able to convince them to let me have a shower. Oh, glorious shower! And of course, just enough time to call Hubby to drive the hour to get there!
After my shower, I was given purple clothes to wear and they inserted the butterfly needle. Let me tell you what. Braiding your hair with that needle in your hand is not so easy! The guy putting it in was super nice though and we joked that he didn’t want to see me again. Because seeing me, of course, meant putting it in again and my veins are a pain!
And then I was in the room. It’s a small room. Probably about 12’x12′ with the hospital bed, a single chair, the monitoring equipment, and a windowsill. You could also request a labor ball. All my stuff was thrown on the windowsill… I don’t remember much, it was all so fast, but I do remember basically arguing with the nurse/midwife/ doctor (seriously have no idea who was who in that room).
Labor Finally Starts
To be completely honest it’s all a bit of a blur from this point on. What I do remember is learning you can’t have anything to eat or drink once they start the Pitocin (or whatever their version is) and break your waters. No matter that the new research says it’s best for mothers to be able to do so, it was against policy and they could not allow. Hong Kong is advanced in so many ways, but their beliefs on pregnancy and labor are very far behind. So far behind that in some hospitals, the husband isn’t even allowed in the room! And no matter what, you’re only ever allowed one person in the room.
So after a bit of arguing I finally agreed, I mean what else could I do it was either that or not have this baby! But it wasn’t a very good start to the process. Then I learned what I could have; 2-4 ice chips an hour… However, those ice chips were about the size of my thumbnail, and they often refused to give them when I asked: “just in case”.
By 9:30 the Pitocin was in and my water broke. They said the goal was to get me having contractions every 2-4 minutes within the first hour. Within half an hour I was on the second highest dose of Pitocin and in active labor… well at least as far as contractions were concerned. The problem was I wasn’t having normal contractions, nope, all I felt was my spine splitting apart. I had pure back labor.
What is Back Labor?
Back labor is when you experience intense pain in the lower back, usually right above your tailbone. It’s usually because the baby is turned with its spine to your spine instead of spine to the belly. But it can happen even when the baby is faced the right way sometimes as well. Usually, all women have some pain in their back during labor, but when you have back labor you don’t usually feel the contractions in your abdomen and it fully concentrates on your spine.
I think my problem was compounded. I have sciatica and I had been on my back for all those long NST tests for days and it made him flip, so I was doubly screwed. I have experienced a lot of horrible pains in my life and on a chronic basis, but nothing prepared me for this pain. It was like someone was stabbing a knife into my spine and twisting it over and over. And unfortunately, I didn’t have much time to recuperate before the next contraction so it became a constant pain.
How I Dealt With My Back Labor and Contractions
I REALLY wanted to use the labor ball. I had found some stretches that helped with the back pain while going through the induction process and I was determined to do this as natural as possible. I figured I didn’t need to risk more back issues with an epidural and I didn’t want it to stall me, so I had other methods I was going to use first. Unfortunately, the labor ball was not meant to be. I was basically too fat. All my excess skin made it impossible for the monitor to stay in place and the staff would not allow me to use the ball if they couldn’t monitor the heartbeat.
So I relied on other methods.
At first, I could have my husband press very firmly into my back. This counter-pressure seemed to release a lot of the sharpness of the pain during the contractions and allowed me to breathe a bit more, but it was a lot for him to have to keep up and I started to feel bruised. So we moved on to the best piece of equipment ever… A TENS machine.
I can not recommend a TENS machine enough, heck if you even suffer from period cramps or sciatica I fully believe you need one. I used the Elle TENS and absolutely could not have made it through what I did without that boost feature! It basically disrupts the pain signals to your brain giving some much-needed release.
I did try other methods, including leaning over the bed, leaning over the windowsill, and getting on the bed and leaning over the raised back, and they helped a bit, but again the fetal monitor made it very difficult to move at all as I wanted. I even tried the gas mask, but that reminded me too much of having an asthma attack and I just couldn’t do it, plus it really smelled.
The one good thing about their procedures is that they don’t check you as often as they tend to do back in the USA. They will only check if they suspect a problem or every 4 hours. However, because they broke the water they give you a deadline. I had 12 hours to get to 3cm dilation or I had to have an emergency c-section. I admit there were MANY times where I just wanted to give up and get it over with. I mean you’d think dilating the one more cm that I needed wouldn’t take that long with my water broken and in active labor, but it did…
The First 4 Hour Check
No progress. At this point they are actually begging me to get an epidural, probably so they don’t have to hold the fetal monitor on me all the time as they don’t normally “allow” them without firm insistence. I still refuse. Hubby is getting more and more agitated seeing me in pain and because they keep asking me stupid questions IN THE MIDDLE OF A CONTRACTION!!! I wish I was joking, but that was the only time they could think to ask me questions, it was crazy.
Otherwise, the contractions keep coming, harder and faster, at this point there doesn’t seem to be a lull more than mere seconds… And going to the bathroom? What a joke. They covered the chair with one of the pee pads I had to bring and then put a bedpan on top and I had to sit on this bedpan to pee… Not exactly comfortable, but you’re not allowed to go sit on a toilet (despite that being a position that’s been known to help…)
At this point, I’ve sent Hubby out to update family and catch a break so he can calm down. His anxiety was making mine worse as I felt I had to protect him from staff and staff from him. They requested again that I get an epidural. I finally agreed. If I had progressed I probably could have continued, but I knew something needed to give. The problem though was the only person who could give it to me was in emergency surgery and no idea when he could come. At this point, I started demanding they turn down the Pitocin levels as I knew I could never sit still for the needle at the current dosage and I couldn’t handle it anymore.
An hour later… Still no doctor, he was called into another emergency. Contractions are still horrible, but more doable, but I know they’ll only let me keep it this low for a little while longer…
FINALLY, he arrives! Nope, not the baby, the doctor. Actually, the same guy that did the needle in my hand showed up to help and we joked that I had said I didn’t want to see him again. It was a funny moment in a rather tense time.
They kicked Hubby out while they inserted the needle. It was SOOOOO difficult remaining still while he did the needle in my spine while still on Pitocin, but he was very skilled and finally, it was in. I don’t remember how long it took to take effect, but I remember the ice-cube test to see if it was working. It was a steady drip at 60% power, but it was enough to take the pain away… for now. The problem was now I had to stay in the bed, on my back. Not ideal, but none of my options were.
I finally got some sleep! Oh, it was glorious and Hubby slept in the chair and was finally calm himself.
The 8 Hour Check
Still not at 3cm, no real progress at all! But at least the epidural is working. I’m resting and only feeling twinges in my back despite being back up to my second highest dosage of Pitocin.
The 12 Hour Check
Finally!!!!! 4cm! I finally progressed enough to be allowed to continue to labor normally! Now I have to give birth by the 24-hour mark or, again, c-section… It’s a lot of pressure for a poor momma.
Now, however, I start having a slight fever and lots of chills. My teeth were chattering and I couldn’t stop shaking. Of course, this did not please them because that meant the monitor was again moving, but I seriously could not stop shaking. They eventually covered me with warmed blankets and I was able to settle back down to sleep again… until I woke up burning hot lol. Oh, and every 30 minutes they had to take my blood pressure so we’re really only talking cat naps here anyway.
I honestly don’t remember much after 12 hours beyond more fits with shakes and chattering. I do know there were a couple of scares where his heartbeat slowed down and they were worried about my fever, but it always came back to where they felt we could continue. Little man was fighting and so could I.
The 16 Hour Check
Honestly, I couldn’t tell you how dilated I was at this time. I want to say 8cm because I know that they wanted a steady progression of 1cm per hour and I know I had met that goal. (And I say this like I had any say at all in it lol).
At this point, the back labor pain was coming back on one side and I had to keep rolling from side to side in order to make sure the epidural wasn’t just pooling on one side or the other. It wasn’t AS bad as before the epidural, but it was still intense and made me scared to come off the epidural. Which is what they wanted me to start doing. I just wasn’t ready.
They let me take a little longer to decide, but told me I needed to feel the urge to push so they wanted to decrease it by 50% at the very least, if not stop it altogether. As much as I would have loved to be able to birth in a different position, I couldn’t completely come off the epidural. The back pain was too excruciating. So I eventually opted for the 50% reduction.
Time to Push
It was finally time! However, I still had no urge to push and I still only felt the labor in my back. I knew from my classes that I actually shouldn’t push and should let my body do its job, but let’s be honest I didn’t have much faith left that it could do it without help. And more importantly they were yelling at me to push and that if I wanted the pain to go away that I needed to push with all I had…. and I needed the back pain to go away, so I pushed.
I did poop on the table, but hubby didn’t even know and they just wiped it away, no fuss at all and in the moment the very LEAST of my concerns.
At this point, his heart rate keeps dropping again and then they see there is meconium in the fluid so they’re calling the pediatric unit to be on standby and all I know is PUSH!
So I do, I even pop a blood vessel in my left eye! But he came out in a final whoosh (man was that the weirdest feeling ever, feeling your stomach just drop). They suction him out and wipe him off to make sure he’s okay and we wait for that cry. Thank God he cried! He was breathing on his own and he was stable! They continue to do checks and the Ped comes over to talk to us. You see we wanted to delay the Hep B vaccine and she would not respect our wishes.
Here we were scared out of our minds on if our son was going to be okay (we didn’t even know yet), I was still so out of it from the labor, and Hubby was beside himself in fear for both of us, and all she could do was yell at us about how we had to do it and how we were risking his life and all and demanding to know why we weren’t vaccinating him right away. We had planned on it as we do live in a high-risk area and Hong Kong isn’t super clean in some ways, but we wanted to wait until he had some time to build up his system but she would not respect that. In the end, I left the decision to Hubby as I couldn’t form a coherent thought, and he finally agreed. But I still feel completely badgered by it.
The First Hour
This is probably the only thing on my birth plan that I actually got, and I almost didn’t. Luckily, J ended up being stable enough that they allowed me my skin to skin the first hour before taking him to the NICU for observation. They “helped” me latch him for the first time (if you call just shoving him on help…) and Hubby and I had our first peaceful moment in days. He was finally here. All 8 lbs 5oz of perfect little boy born at 4 am after 19 hours of labor. He fed like a champ on both sides and looked like a little old man with his own stork bite!
The Post Birth Hospital Stay
After they took him to NICU for observation they rolled me to the post labor ward. I was still so incredibly out of it. Hubby couldn’t be there anymore as it was after visiting hours so he went home to sleep. Once they wheeled me into my new cubicle they showed me how to hand express into syringes and left me to do it on my own (mind you I’m still loopy as all get out). I filled up a syringe and had it sent to the NICU, changed into my pink clothes, and fell asleep as best I could with my sides rubbed raw from the monitor straps (they would just pull the gauze creating a rub burn effect).
I woke up about 4 hours later feeling like a whole new person. I realized however that my son was probably starving so started the hand expressing again… right as the midwife came in to yell at me that my son was starving and crying… I felt like a horrible mom, but at the same time, I didn’t know I’d sleep that long with no one telling me anything. Nor did I think he’d be there that long…
Finally, 1 pm came around and I was finally able to go see my son (and first time to see him with glasses on) and feed him directly. They didn’t think I could so soon, but I was determined. So with a catheter and all, I waddled to the elevators and made my way past security to the NICU. Unfortunately, there weren’t any breastfeeding rooms available so the only chair I had to sit in was one of those hard plastic chairs, but we made it work. I latched him all by myself and was able to hold him for a little while before visiting hours were over and I had to go back to the post labor ward.
I only needed to go back one more time (again on that hard chair, which is soooo bad post birth!) before he was cleared to be released to me finally!
The Last Day at the Hospital
While they typically want you to stay 3 days after birth, there was no way I could do that. It was horrible. Not only did you have the expected crying babies, but the nurse and midwife checks were insane! There was no way to rest because if it wasn’t your baby waking you up, it was another, and then when you finally get to sleep they would be in to yell at you for not filling out the diaper output chart!
The only saving grace was the orderly ladies. One was young and sweet and the other a little older and motherly. They made the whole thing manageable! Hubby was able to come at dinner time during visiting hours but then had to go to work the next day. I then insisted that I go home the next evening after Hubby got off work. They were very resistant and made us come back the next day to check his jaundice (and then wanted us to come back again, but I said my midwife would let me know if I needed to), but after 2 days and 1 night, we finally went home!
The Experience Overall of Giving Birth in Hong Kong
I admit I’m actually quite traumatized by the whole experience. There were many good points and helpful people, but overall so NOT the experience I wanted. I’m happy that in the end Boogie and I are healthy, but I don’t want to do it again. I don’t know yet (25 months later) if that means forever, or just in Hong Kong, but I never want to relive that again. I know that medically I was in good hands, but for such a vulnerable time in your life, it just wasn’t good… like I don’t even have the right words to express it.
However, if you find yourself in Hong Kong and can’t afford the private hospitals, Queen Mary is the best public hospital and they are at least very thorough.
What was your birth experience like? Have you given birth in a different culture than your own? How did you manage? Leave me a comment below!
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