It's been an interesting ride these past few days as I get to know my sweet daughter, and in my free time I've been thinking about the ways my care at Tuen Mun Hospital was better, worse, or the same as when I delivered my son in the US. It's hard, actually, to say which experience was better overall.
Doctors:
US: in the US I had one doctor, Dr. Keith. he respected all my wishes and whenever there was a conflict between me and the evil nurses, he always had my back. He made all the right choices, medically speaking, and helped me safely deliver my son.
HK: During the time I was at TMH, a team of five doctors consulted with each other and me about my "case". One doctor should have her license removed and be banned from medical practice. The other four ranged from very good to phenomenal. Once I realized many of my problems came from the one, I asked her to remove herself from my case and I never saw her again, which greatly improved my quality of care and peace of mind.
Nurses:
US: I disliked every single one of the nurses at CHOMP. They were rude, mean, aggressive, and sometimes downright nasty to me. No one was anything like your image of the nurturing and kind nurse.
HK: (there are three sections: ante natal, delivery, and post natal, and there are specific nurses assigned to each section) Some nurses in the post natal ward clearly didn't like me and there was some racism going on. Other nurses were simply too overworked to be anything but as efficient as possible, meaning they were abrupt, but not purposely trying to be rude. Some of the nurses, though, were simply wonderful. All the nurses in the delivery ward were amazing. I loved loved loved them all.
In both the US and HK, I found some staff to be on some kind of power trip, but this was a bigger issue for me in HK because my cesarean made me far more helpless and in need of care than my regular delivery in the US. For example, there was one nurse in particular who really enjoyed the power she had to deny my repeated requests to go to the bathroom. After a day and a half of begging to be able to relieve myself, either by bedpan or in the toilet, I finally got so angry at her and her inhumane refusal to allow me to meet a basic human need of elimination, I tore off my IV and my leg massager, pushed my bed away from the wall and threw myself off the bed to get to the restroom. Naturally, this caused quite a stir.
After relieving myself and the adrenaline of my temper tantrum wore off, I realized I was in considerable pain in multiple places and bleeding rather badly. However, I proved I was no longer immobile and the catheter, massager, and IV were taken away so i could get up and down myself the rest of the time.
Service and mother care:
In the US, after delivery, my son was bottle fed despite my request not to do so because I was breast feeding. I was pretty much left to my own devices after delivery, and advised to get up and walk a bit as soon as I cold. Nurses used a fist to punch deeply into my abdomen to "massage" my uterus back into shape. my son was wheeled into my room to visit me a few times, and I was wheeled into his room to visit him, but I mostly didn't see much of him until the day I was discharged.
HK: In HK, I was connected to a machine that massaged my legs for two days while I wore special leggings to prevent swelling and deep vein thrombosis. No one in the US cared about that, and I remember my legs and feet doubled in size right after birth and was quite uncomfortable. However, this time, I only had swelling in my feet, and that was until I pushed the leggings down to my toes..then I had no swelling at all. The uterus massage the nurses taught me in Hk was considerably a kinder gentler version of the gut mashing I got in the US, and was far more tolerable, while ultimately performing the same job of helping the uterus to shrink back to normal. The nurses tried their best, given extreme circumstances (at night, for example, there is only one nurse to care for over 150 mothers and babies, plus a few other staff), to meet everyone's needs.
Despite the far better ratio of nurse to patient care in the US (1:1 or 1:2), I felt I was generally treated better by most of the staff in HK, with a few exceptions of some people on a total power trip who shouldn't be in the business of caring for others. I also generally felt my wishes were mostly met better in HK. I had asked to BF my daughter right after birth, and they honored that as soon as I was patched up. I asked not to bottle feed while she was away from me, and they also honored that.
Baby care: here the US probably does better, although to be honest, i really didn't get a chance to witness how the babies were cared for by the nurses, but it couldn't possibly have been worse than at TMH. I felt so sorry for those babies. Because the nurse to patient care ratios were so incredibly high, babies were often left to cry until they were screaming in hysterics, and they spent most of the night screaming in hysterics day after day. Meanwhile, their little brains are being hardwired that their cries don't matter and no one is caring for them no matter how they try to call for help. This "let them cry it out" method of care just breaks my heart. I felt very upset and I didn't want my daughter's earliest experiences of care to be that way; so I found ways of "beating the system" so that I was either occupied "breast feeding" or not in the room when it was time for the babies to be returned to the nursery, knowing the staff was far too busy to track me down, or pick her up later.
Food: Equally crappy. In the US, you get to choose what kind of crap you eat from a menu of items whereas in HK, you get what you get. I guess having a choice makes the US hospital better, but only by a hair.
Amenities:
Here the US really outshines HK. I labored in a room all to myself, which had a couch for my husband to sleep and relax on when not attending to me. He was allowed to be with me the entire time. I had my own bathroom which also had a tub and shower in it, which was kept immaculately clean. I could have the lights off, on , or dimmed as I liked. There was a baby bed for the baby (which I never used because Kai was in NICU while we were in the hospital). There was a big screen TV, DVD, and music player to watch videos or play music during labor. All materials (diapers, towels, chux pads, baby hats etc) were provided to me. This was not a fancy hospital; this is rather standard in the US. Anyone and everyone is allowed to visit any time.
in HK, I was expected to provide everything for myself and my baby. There are two public toilets, kept as clean as possible when shared by 100 bleeding women. My room had only 8 women in it, but one of the rooms had about 40 beds. Despite having about 70 beds, there were also cots put in random places anywhere they could fit, as there were far more women delivering than the hospital had capacity for. Many postnatal patients were also put in the antenatal room to help with overflow, so the antenatal room also had cots, and additionally many women there who were low priority had to spend their time on chairs instead of beds. There was one TV which had no sound which played Chinese soap operas. My husband was not allowed to attend the labor or delivery, despite the fact we specifically filled out a request form for this purpose and was approved months earlier.
Cost:
US: every pre-natal visit to the doctor was 100. Blood testing was 300. the shots I had to take for being Rh negative was about 200 I think. the total hospital bill for me and Kai for three days stay was over 60,000 USD. Fortunately, the state of CA picked up the bill as I was still a student at the time and didn't have a job or insurance so I qualified for the SCHIP program/WIC etc. But if I had even had a part time job, I would have had to pay it all. It would have completely bankrupted me. And we had a relatively normal run of the mill birth. All post-natal visits were also about 100.
HK: every pre-natal visit to the doctor was free. Blood testing was free. the shots for being Rh negative cost 150 HKD (about 20 USD) the total hospital bill for Kiara and I for 5 days stay was 650 HKD (not quite 100 USD). We paid the bill in cash and walked out debt-free. all post-natal visits have been free so far. I did have to pay 17 HKD (about 2.50 USD) to get my stitches removed.
If I had unlimited money and resources, I would have wanted a very different birth experience, that's for sure. But given how cheap the health care is in HK, I think the quality of care is rather good. And either way, I ended up with two beautiful babies, so that's what really matters in the end.
