As a Singaporean, I qualified as a subsidised patient. To find out more, you may wish to visit the link below. It does detail comprehensively one’s eligibility: https://sg.theasianparent.com/kkh-gynae-charges
After the scare at KKH and much comforting words from a private clinician, we decided to also get a second opinion from a recommended gynae by our IVF doctor. To our surprise, instead of fretting over the nuchal thickness which KKH and both our IVF doctor had highlighted or recommend alternative treatment, he casually mentioned that we would just continue to observe baby’s growth and decide the next course of action. After all, in Singapore, the legal termination period of any pregnancy is before 24 weeks.
We decided to follow his words and in our following visit, the thickness remained. We were still worried but he reassured us that baby could just be an outlier, just like how some of us are tall or short, fat or thin! We felt a huge rock off our shoulders.
In my entire pursuit of having a child, I also came to realise that different doctors believe in different practice. My private gynae is pro-natural. That said, he is a man of few words. Ask him the questions you have and he’ll give you his most honest opinion in a concise manner. On the contrary, at KKH, they’ll be overly-cautious and provide you with all the worst case scenario, assumed all the worst of you and take extreme care to make sure all possibilities are eliminated. Because of this difference in practice, these are what I’ve gone through.
In KKH, things are a little chaotic. Subsidised patients see different doctors who are on duty at Clinic C. Upon arrival, one is required to register using a automated machine. After getting the queue number, proceed to room 18 (this is expected and not told to you though) to take the routine tests such as height and weight, blood pressure and pee test. I failed one of my pee test and was immediately scheduled for gestational diabetes test. I realised much later that as I mentioned, KKH was just being extra cautious. Typically, they test pregnant ladies at week 30-ish but I did my first around week 20 and another at week 32. I wasn’t even consulted or asked for an opinion. Also, upon reflection, I recalled I had an apple, a milk tea and a muesli bar before the pee test. All sweet stuff! Of course I failed the pee test!
At my private gynae, I also failed one of my pee test. But instead of getting panicky, they asked when was my last meal, what I had and brushed it off as I had a kueh (sweet pastry) and sweetened soya bean milk before my pee test.
Comparatively, the prices are rather affordable at KKH. Doctor’s fees, and ultrasound scans are charged at 50% off (~$60 and ~$35 respectively after discount) per visit whereas the professional fees at my private gynae costs me ~$120 and each scan costs me $65. Each pee test at KKH costs $13 so even after adding it to the doctor’s fee, it is still $50 cheaper than a private gynae visit.
The NIPT costs me $375, a huge difference from private clinics which easily charge $900 – $1200 for the test.
Ultrasounds are done at the Antenatal Diagnostic Centre in KKH by a trained/training sonagrapher whereas ultrasound scans are usually done by the private gynae themselves. The doctor that one see in KKH would usually only use the doppler to hear the baby’s heartbeat.
One other difference I noticed about the sonagraphy equipment in KKH is that it is unable to capture 3D images whereas my private gynae managed to capture my baby’s face shape and features. He could also tell me if there’s the umbilical cord around my baby’s neck although the sonagrapher at KKH told me tissues cannot be detected.
In KKH, if you hit your estimated due date, the doctor would recommend the patient to go for induced labour. As my private gynae is pro-natural, he does not even do cervix check (this basically requires the doctor to insert his finger to feel for the opening and estimate the size of the gap by centimetres) or a membrane sweep (which is inserting a device to stimulate the walls of the cervix so as to stimulate labour. He even mentioned that most induced labour ends up in emergency cesarean section surgery as the cervix is often not ready to allow the baby to be born naturally – This has some truth as I’ve known of mummies going through 4 different kinds of induction but ended up having to do a c-sec. In fact, he will just wait for me to enter spontaneous labour, even if I exceed 40 weeks. In the US, doctors wait up to 43 weeks. We’ve had a friend that was induced at 41 weeks.
Waiting, however, does have risks. 1. The placenta could age, malfunction and cease to provide nutrients to the baby. In that case, baby’s life could be endangered. 2. If baby passed meconium (poo), he could end up breathing them in and that might cause damage to his lungs. The reason why he breathe is because he can, and that he might, not that he will since he’s in the amniotic fluid which he does not need to and he could do it because he’s distressed. 3. Stillbirth. This could be unexplained or due to reasons 1 and 2. While there are 2 school of thoughts, I think it’s best to practice what you are most comfortable with.
In KKH, I rejected the offer by the doctor to perform the cervix check and membrane sweep at week 39 but I was rather keen on spontaneous labour as that would mean baby would arrive at his own time and I didn’t feel like rushing him. But on the hindsight now, I might just go for it if I exceed week 39 as I would rather have him in my arms and not know what’s going on in my womb. Afterall, as the doctor in KKH rightfully pointed out, it was so tough conceiving him that i would rather not risk losing him because of some oversight or personal preference by either myself or doctor.
The wait at the private gynae is comparable to the one at the KKH to a certain extent. The average waiting time is approximately one hour at both facility though sometimes stretched to 1.5 or 2 hours depending on the crowd. It’s best to arrive 30 minutes earlier to do all the routine tests in KKH so that you are on the dot to see the doctor at the time of the scheduled appointment. At my private gynae’s clinic, I prefer to be the last patient so that there’s no rush as there’s no patient after myself.
The cost of supplements are also different at both facilities as KKH subsidises the drugs prescribed and in the end, it boils down to individual’s preference, e.g. if you prefer to have the attention of one doctor or not (though it might not matter because some doctors don’t remember their patient anyway), depth of your pocket (how much you are willing to spend per visit and also, how comfortable are you with the facility’s staff (the nurses, the toilets, the waiting area, the cashier, receptionist etc.)
twoweekswait 