In Hong Kong, local residents pay no or nominal fees when using public healthcare services. In addition to the public hospitals, there are maternal and child health centers in the public sector, where prenatal and postnatal services are provided for free to local residents.
Midwifery is a regulated healthcare profession in Hong Kong. Any person who wishes to practice as a registered midwife in Hong Kong must be registered with the Midwives Council of Hong Kong. In order to register as a midwife, a person must complete an eighteen-month midwifery diploma program and pass the examinations. Doulas do not appear to be regulated or funded by the government in Hong Kong.
I. Public Healthcare System and Maternity Care in Hong Kong
Hong Kong has the most efficient healthcare system in the world, according to the 2018 Bloomberg Health-Efficiency Index. In Hong Kong, the government provides subsidized healthcare services to local residents. When using public healthcare services, Hong Kong identity card holders and resident children under eleven years of age pay no or nominal fees and therefore generally do not need medical insurance.
The Hospital Authority is the statutory body responsible for managing Hong Kong’s public hospital services. It currently manages forty-three hospitals and institutions, forty-nine specialist out-patient clinics, and seventy-three general out-patient clinics. According to the fee schedule published by the Hospital Authority, public hospitals charge local residents around HK$100 (about US$13) per day for inpatient stay.
In addition to the public hospitals where maternity care is available at a low cost, the Department of Health manages maternal and child health centers where prenatal and postnatal services are provided for free to local residents. The centers monitor the pregnancy and delivery process in collaboration with the public hospitals. The centers also provide advice on family planning and help postnatal mothers adapt to changes in life through individual counselling.
Women in Hong Kong may also choose to use private hospitals and clinics that provide more personalized maternity care services, where they must pay for the services. Considering the high cost of delivery in the private sector, some women choose to use private services for prenatal healthcare and to then give birth in a public hospital.
Midwifery is a regulated healthcare profession in Hong Kong. Under the Midwives Registration Ordinance, any person who wishes to practice as a registered midwife in Hong Kong must be registered as a midwife with the Midwives Council of Hong Kong (MCHK). A registered midwife must hold a current practicing certificate in order to practice. As of December 31, 2018, there were a total of 4,445 registered midwives in Hong Kong.
In order to register as a midwife, a person must have completed such training as may be prescribed by the MCHK and passed the examinations. At present, the only midwifery training program approved by the MCHK is an eighteen-month diploma in midwifery program. A person must be a registered nurse in Hong Kong in order to fulfill the entry requirement for the program.
It appears that registered midwives may choose to work in the public or private sectors. The MCHK issues the Code of Professional Conduct and Practice for Midwives in Hong Kong, aiming to provide general guidance to registered midwives on the conduct and practice of midwifery. According to the Code, midwives may practice “in hospitals, clinics, health units, and domiciliary conditions or in any other service.”
Midwives in Hong Kong may provide services during the pregnancy, labor, and the postpartum period. In fact, at public hospitals, babies may be delivered by a midwife, with a doctor on hand to assist in case of complications. The MCHK defines the roles and responsibilities of midwives as follows:
The midwife is recognized as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.
Doulas do not appear to be regulated or funded by the government in Hong Kong. A doula may assist women before, during, or after childbirth by providing physical assistance and emotional support, but may not independently attend women in childbirth. According to the Midwives Registration Ordinance, only a registered medical practitioner or registered midwife may attend women in childbirth, except for a person in training to become a registered medical practitioner or midwife, or in the case of an emergency.
Foreign Law Specialist
 Lee Miller & Wei Lu, These Are the Economies with the Most (and Least) Efficient Health Care, Bloomberg (Sept. 19, 2018, by subscription).
 Hospital Authority, Introduction, http://www.ha.org.hk/visitor/ha_visitor_index.asp?Parent_ID= 10004&Content_ID=10008&Ver=HTML (last visited May 13, 2019), archived at https://perma.cc/JDW6-LFJK.
 Hospital Authority, Fees and Charges (effective June 18, 2017), http://www.ha.org.hk/visitor/ha_visitor_ index.asp?Content_ID=10045&Lang=ENG&Dimension=100&Parent_ID=10044&Ver=HTML, archived at https://perma.cc/PWX7-M8MN.
 Family Health Service, Department of Health of the Government of the Hong Kong Special Administrative Region, Fees and Charges—For General Public (effective June 26, 2017), https://www.fhs.gov.hk/english/ fee_cha/general_pub/general_pub.html, archived at https://perma.cc/AV9G-5GWM.
 Family Health Service, Department of Health of the Government of the Hong Kong Special Administrative Region, Maternal Health (last revised Apr. 12, 2019), https://www.fhs.gov.hk/english/main_ser/process. html, archived at https://perma.cc/95SW-KRDS.
 Maternity in Hong Kong: Public VS Private Hospitals, April International (June 4, 2019), https://fr.april-international.com/en/healthcare-expatriates/maternity-hong-kong-public-vs-private-hospitals, archived at https://perma.cc/8J7Q-QP5F.
 Id. s 22.
 Midwives Council of Hong Kong (MCHK), Statistics and List of Registered Midwives, https://www.mwchk. org.hk/english/statistics/statistics_of_registered.html (last visited May 16, 2019), archived at https://perma.cc/J2ZH-B836.
 MCHK, Midwifery Training in Hong Kong (last revised Mar. 3, 2016), https://www.mwchk.org.hk/ english/training/index.html, archived at https://perma.cc/UTU2-KB4P.
 MCHK, Code of Professional Conduct and Practice for Midwives in Hong Kong (3d ed., Mar. 2016), https://www.mwchk.org.hk/docs/conduct_practice_e.pdf, archived at https://perma.cc/YY5T-H9U4.
 Id. at 6.
 Maternity in Hong Kong: Public VS Private Hospitals, supra note 6.
 MCHK, Handbook for Midwives 3 (May 2014), https://www.mwchk.org.hk/docs/Handbook_for_ Midwives_e.pdf, archived at https://perma.cc/H9B5-U7XK.
 Id. s 22.
 MCHK, Statistics and List of Registered Midwives, https://www.mwchk.org.hk/english/statistics/ statistics_of_registered.html (last visited May 16, 2019), archived at https://perma.cc/J2ZH-B836.
Last Updated: 11/13/2019