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Author: Dale Edmonds

About the author

Admin for, Dale has five children and a strong coffee habit.

Planned topics for – can you contribute?

Here’s a running list of planned topics for If you would like to contribute information or write a piece for our website or suggest another topic we should cover, please leave a comment or email us at

If you have a personal story about your family in Singapore’s healthcare system, please read Share Your Story on how you can raise your voice in our national conversation on healthcare for children. 

  • How could we pay free healthcare for children?
  • How are medical costs determined by the government?
  • An ordinary citizen’s guide to the Ministry of Health
  • What happens when your medisave runs out?
  • How much more do single parents end up paying?
  • When will medisave be extended to cover congenital birth defects?
  • Subsidizing IVF but not pre-natal checkups?
  • The HPV vaccine should be free for children
  • How do other countries with free healthcare for children make it work?
  • Do we have enough child psychiatrists, psychologists, counsellors and social workers?
  • Trustfunds for children with disabilities
  • Breaking down Singapore’s healthcare budget
  • Downgrading and upgrading classes – practical tips
  • Your baby is in the NICU – practical tips
  • What your MP can do to help with medical costs
  • Children’s healthcare charities in Singapore
  • What’s a medical social worker?
  • Special education, special costs – how do families manage?
  • How the Baby Bonus works and doesn’t


photo by: photosteve101

What percentage of our healthcare costs are spent on our children?

This page is to gather all available data on healthcare spending on children in Singapore. New information will be added, here so please leave a comment or email us at with more data.

Hospital admissions for 2010

In 2010, tadalafil children (0-19) made up 20% total of hospital admissions. Surprisingly, while adults went overwhelmingly to public hospitals vs private (85% vs 14%), parents chose to send their children to private hospitals far more, with public hospital admissions dropping to 68% vs 32% for private hospital care.


Margaret Jane Ying Edmonds-Yap

Margaret Jane, or Maggie as we all call her now, was born in an emergency c-section on November 17, 2011 at National University Hospital. She weighed 1,512 grams and measured just under 40cm long. She was a 30 weeks and 2 day preemie and spent fifty-one days in the NICU.

In a few days, it will be a year since she was born. Right now, she is wandering around our flat, a board book in one hand and a puzzle piece in the other. She can’t quite decide which is more delicious for chewing, so she is carrying them along with her as she  ambles around after her big brothers and sisters. She has round cheeks and chubby thighs, developmentally all caught up with no signs of damage, and when she gets sick, an ordinary childhood cough, I now only imagine she’s going to die every other minute.

It’s hard to break the habit when all through my pregnancy and then for the first months of her life, we prepared for the worst. Maggie is the exception.

I had had nine early miscarriages and we were fairly sure that we couldn’t and wouldn’t have another child. We had four wonderful teenagers, adopted siblings from Cambodia, and we were starting to think of Life After Kids, going as far as buying guidebooks to Paris and New York and making plans.

Surprise, you’re pregnant

Instead, we found ourselves referred to a high-risk obstetrician at Gleneagles who prescribed weekly progesterone shots, asprin and daily self-administered heparin shots. The shots left bruises over my stomach, but they also let me feel like I was doing something. For some women with unexplained early miscarriages, blood thinners seem to prevent miscarriages. There are far more theories about early miscarriages than solutions, so doctors pretty much rely on what has proven to work: frequent visits to a doctor and interventions that probably don’t hurt. Somehow, that combination of attention and placebos produces a statistically significant decrease in miscarriages.

I had ultrasounds so often I lost count of them. We bought a fetal doppler kit and every day I would sit and listen to that heartbeat. Was it the asprin, the fish oil tablets (yuck), the injections of what turned out to be extremely expensive cow snot – heparin, or just a random genetic match that worked this time?

Early rupture

Maggie grew. I scheduled my last work trip to Cambodia, and a few days before tried to carry some heavy packages on my own. Something hurt sharply but I decided it was just a pulled muscle. In Cambodia, I felt idiotic to complain about my weird symptoms when I was talking with women who worked on the streets as prostitutes right up to the day they delivered, who hauled construction materials and buckets of laundry through crowded slums and didn’t have any access to medical care except if they were lucky a midwife who washed her hands.

But back in Singapore, I mentioned my symptoms to my doctor who put me immediately on his table for a scan. He was a friendly warm man who liked to chat, full of endearments for all the babies he had helped bring into the world, the wall behind his desk covered in their photographs. This time he was quiet.

“You’ll need to get a referral,” he said and started making phone calls to NUH.

I was leaking amniotic fluid. I was just coming to 23 weeks and the biggest surprise was that she still had a chance, even as tiny as she was. Bedrest was prescribed, plenty of fluids and regular scans. Wait and watch.

There was likely a small tear high up on the amniotic sac. When I moved, I leaked more so I ended up lying in bed. At each scan, they would measure how much fluid was left. It’s not an exact science because the baby moves around, but an experienced doctor or technician can get a good estimate by measuring several different pockets of amniotic fluid around the baby’s limb. When it’s low, the medical term is oligohydramnios. Too much fluid, polyhydramnios, can be a danger too.

Amniotic fluid cushions the growing baby. The baby drinks the fluid and pees it out, and eventually starts practicing breathing in it. Without enough amniotic fluid, the baby’s growth can be restricted and harmed, and during delivery the umbilical cord can get fatally compressed. There’s a wide range of how much fluid is needed though, and most women diagnosed with low amniotic fluid have normal deliveries.

I had detailed ultrasounds to make sure the problem wasn’t Maggie’s kidneys or other congenital issues that can cause low amniotic fluid. She seemed healthy, just small. Then the ultrasounds were simply to check if there was any fluid. The Amniotic Fluid Index number became the most important number in the world. Could I get past 2 again? Climb up to 4? Would I make it all the way to 5 if I just spent the whole day drinking?

There have been theoretical attempts to seal tears or to ‘top-up’ the amniotic fluid, but they were all risky and only theoretical in Singapore. Instead, I just drank endless cups of water and milk, hoping to replace what was steadily leaking out.

I hadn’t planned to start maternity leave for another three months, and we were in the middle of renovations and moving house which somehow had to be managed along with our other four kids while I was in bed. I remember being either incredibly bored or incredibly busy, and insisting that we should have evolved from birds and laid eggs like civilized creatures.

I had to start taking my temperature and was put on a round of antibiotics. Inside the womb, the placenta and the amniotic sac form a nearly perfect protective shield over the developing baby against infections. The tear made her vulnerable.


Eventually I was admitted to the hospital for monitoring because of irregular contractions. I checked out for two days, missing my other kids so badly, and then had to check back in. I was put on tiny blue pills, nifedipine, to slow down the contractions. They turned my brain into a cabbage and the world narrowed down to a hospital bed and the eight hours between each pill.

The doctor in charge of my case had set 32 weeks for delivery. If I could get there and I was stable, I would try for more time, but that turned out to be optimistic. I made it to 30 weeks and 2 days, developing gestational diabetes on the way as well.

I woke up feverish and with a terrible backache and by the afternoon, I had been wheeled into L&D where I declared everything to be very pretty and sparkly when I was on the nitrous oxide, and that I would kill my husband when it wore off.  There was no question of a vaginal delivery – Maggie was breech, her growth had slowed down recently and they were concerned about the umbilical cord. I was relieved almost to have all those decisions taken away by sheer medical necessity. I was just so grateful that she might live through this.

The gurney paused outside the operating theatre, and I turned to my husband, scrubbed up to accompany me, and said at last what I had lain in the hospital at night worrying silently about: “If I die, don’t blame the baby. Make sure the kids don’t blame the baby.” It felt stupidly dramatic, but I had spent so long preparing for Maggie’s death that I felt almost as if her safe delivery would require some other price.

The epidural was a beautiful warm relief and a few minutes later, the surgeons wrestled Maggie out. She was taken to a table where she was wrapped in plastic film to keep her warm and a team of doctors and nurses checked her and whisked her off to the NICU. Then I lay back and happily chatted with my shell-shocked husband while the surgeons stitched me up. Queen Victoria was right – childbirth drugs are brilliant.

Nothing prepares you for the NICU

I had read about premature babies and NICUs for months. It was still surreal to be wheeled down to that room with its hushed chorus of beeps and chimes from machines, and to see near the door where a kind nurse had written in bright pink letters our daughter’s name above a plastic crib and inside, so small she looked like a funny doll, not pink or plump enough, Maggie.

The very tiniest preemies don’t wear diapers – they get a little scrap of muslin that won’t hurt their delicate skin. Maggie wore a newborn size diaper folded over that her bony legs stuck out from. Plastic wrap was stretched over her crib instead of a blanket because of all the wires attached to her. Tubes that seemed impossibly big but turned out to be the thinnest available ran down her throat to gently breathe air into her still developing lungs. I had had steroid shots a few weeks earlier to help her lungs develop faster and Maggie had been given artificial surfactant, a fairly recent treatment that has saved hundreds of thousands of preemies thanks to Dr Avery.

Maggie had been born before all her organs had fully developed. She had no fat stores to draw on. She didn’t even have eyelashes.

Machines helped – a heat lamp to keep her warm, the monitors that warned when she struggled to breathe or her temperature fluctuated, the x-ray machines and ultrasounds that showed the hole in her heart that refused to close, that her brain had no serious bleeds, the slow drip of nourishment and medication through her IV lines fattening her up until she could digest breastmilk, the blue lights to treat her jaundice, and the ventilator that breathed for her when she was too weak.

But it was people who kept Maggie alive in the NICU. Older nurses told us about the days when the ventilators needed to be worked by hand, a nurse at the bedside patiently and steadily helping a sick baby breathe. They were able to save younger and younger babies now, babies with illnesses that would have been impossible a few years ago.


I don’t remember much of the NICU stay because it was like stepping through the cupboard to Narnia. Time passed differently. Things happened in the world outside, but our lives narrowed down to going back and forth from the NICU and home. Our kids came along although they were too nervous at first to touch the new baby.

She became strong enough for kangaroo care, when a parent carries a baby skin-to-skin. The baby’s temperature and heartrate settle, and babies in kangaroo care gain weight faster and are discharged earlier. We learned to run the cords from her bubble ventilator over a shoulder and balance just-so in the uncomfortable plastic chairs by her crib so that we could hold her, a tiny froglike creature that seemed not-quite human, against us. She would make tiny mewing sounds at first, then settle into a deep long sleep on our chests.

I had problems making enough breastmilk, so there was the pumping every three hours and racing to the hospital at 2am with a bottle of fresh breastmilk so she wouldn’t have to take formula. I envied the other mothers who pumped so much they had problems storing it in the freezer. The preemies started with just a few drops, fed through a thin green tube that ran down their nose or mouth. Breastmilk protected against necrotizing enterocolitis, an infection that destroyed their delicate intestines so although I hated my breastpump, formula was a failure.

Heart surgery

Maggie grew slowly. They gave her three rounds of medication to encourage the hole in her heart to close. All babies are born with this open, even healthy full-term babies. The ductus arteriosus connects two of the arteries in the heart which works beautifully in the fluid-filled world of the womb but not so well when the baby needs to use those new lungs to breathe air. Normally, it will close on its own within hours or days from birth. Most preemies will see their PDA close as they approach the day they should have been born. If it’s small enough, it can be left for years.

Maggie’s didn’t. She struggled to breathe and had to be reintubated once. The hole was large and surgery went from an option to scheduled.

She’d tested positive for MRSA, the hospital superbug, and was shifted to an isolation room with just one nurse assigned to her. She was getting close to 2kg but she was still elegantly strange for a baby, all slender limbs and pale skin. She had no hair and her eyes were an odd grey.

Just before surgery, we had an emergency baptism. The priest at our church was overseas, so a Russian priest we knew well came and did the baptism without candles or immersion, only words and the faintest trace of holy oil on her. Her godmother and her parents sang softly over the sleeping baby.

Surgery was fast. There were problems with intubating her, then with her blood pressure at the start of surgery, moments when we stood in the corridor of the NICU ward while nurses and doctors strode past us into her room, refusing to answer questions or even look at us until it was all over.

In the NICUs in Singapore, parents are distant thirds to the nurses and doctors. There is so much happening, complicated difficult decisions that need to be made quickly, and the parents, even with the best intentions of the hospital, end up in the way. They aren’t trained in how to bathe a baby so small their skin can peel off, how to feed a child through a tube, to know when this beep can be safely ignored but that beep brings a team rushing to an incubator.

I read with envy about NICUs in other countries where there were comfortable chairs next to the incubators, even rooms with beds. Where parents could come in all the time, where parents were encouraged to do the basic care for their preemies. But I was so intensely utterly grateful to the doctors and nurses who took care of Maggie – and too exhausted – to ask for more.

Only once when a nurse scolded me for breastfeeding Maggie while she was on the bubble CPAP, something I had figured out how to do with great difficulty, did I get mad enough to speak up and ask that she not be assigned to our daughter again.

Going home at last

I was scared that they would close the doors on us, that they would shake their heads and say “I’m sorry, but you simply aren’t fit to take care of her.” All the parents knew we had to pass a test to take our babies home when they were healthy enough. We had to wash and feed the baby and demonstrate infant CPR. It was well-intentioned but terrifying.

A few days after surgery, Maggie passed her final tests and so did we. We brought her home on the 6th of January.

We had never left the NICU with our baby, and suddenly we were strapping this tiny squirmy bundle into a carseat on a stroller and wheeling her out past the doors. Without thinking consciously about it I started walking quickly, leaving my husband behind because a part of me was still certain that this was all a paperwork mistake and they would come running after us and take Maggie back.

That first night, like most preemie parents, we watched her sleep. There were no monitors now and we discussed half-seriously renting one so that we could go to sleep without worrying about her heartrate. Within a few days though Maggie made it clear that she would decide when to sleep and eat and that she preferred above all to be cuddled. Pretty soon her older siblings discovered that Maggie did not mind being dressed up in doll clothes and would reward them with a gummy smile for every cuddle.


In February, we wound up back in hospital when Maggie – tiny and pale and quiet still – developed aspiration pneumonia, probably from coughing the wrong way and just being small and weak. She had been to the doctor who said it was a cold, and then in the evening she got quieter and colder. We went to the ER and one of the NICU doctors was on duty and the world dissolved back into hospital time.

Her lungs had partially collapsed so she was admitted to the pediatric ICU and intubated. They only had regular sized beds, and Maggie was a tiny thing in the middle, tubes draped all over, and at the foot of the bed, one of her siblings or me curled up asleep.

She had two weeks, first recovering from the pneumonia and then figuring out what had caused it. She was diagnosed with reflux eventually, and went home with different formula and more medicines. We knew she was spitting up, but didn’t all babies spit up? Not as much as Maggie did apparently. We got more bibs.


And then she decided to grow. Like most preemies, she wasn’t even on the growth charts at first. We weighed her daily, tracking her growth on a spreadsheet with charts, something we found that other preemie parents also did. Then she crept up to the 5th percentile and got round cheeks. She began to reach out for toys and howling when they rolled away. She stopped throwing up. She pulled herself up on furniture and took her first steps.

We went from weekly pediatrician appointments to monthly to “Call us if something happens” at her last appointment.

Everytime she gets sick, I wait for worse to happen. Maybe it will. But the time we’ve had with her, seeing how much she is loved by her older brothers and sisters and how much she enjoys every day, it doesn’t matter how long her life is, just how good it is.

Another child?

But the big question now is: what about another child?

Another pregnancy is likely to be high-risk. The treatments during the pregnancy were expensive, and between my hospitalization and Maggie’s NICU stay, we had to clear out our cash savings and close to half of our medisave. We missed weeks of work and lost income as well.

The baby bonus for Maggie as our fifth child is a matching grant of up to $18,000 in a special account for medical and educational costs. We’re lucky that as a lower middle-class family we will be able to save up the $18,000 in the account and eventually make use of it. We’re even luckier that Maggie doesn’t require more surgeries and therapy treatment like most preemies.

We want another child. The age gap between Maggie and her next sibling is twelve years, and we’d like her to have a sibling close in age. But another NICU stay would wipe out all our healthcare savings entirely.

Most of all, I think of two families I met in the NICU and the pediatric ICU.

The smallest boy

He was the size of a kitten, with dark hair and reddened skin. His mother didn’t come to visit at all at first and then we saw her still in her hospital gown, weeping by his incubator. She would return simply to stand near him and pray silently. He was too small for her to touch.

The nurses and doctors don’t discuss other patients, but the NICU is small and the parents talked to each other quietly. The little boy would not make it. I saw them one more time, their older daughter leaning against her father, chattering away while her parents stared at nothing, frozen in grief. Then the next day, his incubator was gone and another baby in a crib was wheeled into the empty place.

I think of how they went home empty handed and a few days or weeks later, a letter was sent to them with their bill.

The much-loved daughter

In the pediatric ICU, there was a disabled ten year old girl who could not speak or move very much. Her parents took turns to care for her with the ease of long practice. One would turn to the two younger children that tagged along after school to visit their big sister and help them with homework, while the other soothed their ill daughter, adjusting the tubes and cables around her and understanding all the little sounds she made. Then they would swap places so a parent could get a cup of tea and talk to the nurses about the next day’s treatments.

They loved her. They loved all their children, that kind of practical quiet love you hope for in good parents, love that helps with homework and kisses hurt knees and shows in kindness and easy affection. The younger brother and sister showed the same gentleness to their sister as their parents.

I wondered how they managed. There were children in the pediatric ward who went almost the whole day without anyone visiting. There was a frightened little boy admitted whose mother couldn’t find a babysitter for the younger sibling so he crept out and went bed to bed looking for a parent or nurse to comfort him. There was another severely disabled boy whose father came every evening after his shift, still in his work uniform, to lean over his bed and whisper to his son.

Why we need free healthcare for our children

Increasingly, many Singaporeans don’t want to have children. We marry late, we plan on one or two children at most. Some of us decide to stay single or if we get married, to skip having children for careers, travel and other passions. Our birthrate is plunging.

In the pediatric ICU, I saw people who wanted children, who had proven themselves through some of the hardest experiences to be devoted and loving parents.

And they couldn’t afford to have more children because a sick child in Singapore will wipe out a family’s savings.

I am so grateful for the excellent medical care that saved my daughter’s life over and over. But our experience made me aware how much of that was luck – luck that we both had flexible jobs, that our other four children were old enough to cope, that we had enough cash and medisave, that Maggie was “only” in the NICU for fifty-one days, and most of all that she survived and does not yet have any conditions that will wipe out my family’s financial future.

But we can do better as a country.

Contact us

We would love to hear from you! If you’re interested in writing an article or sharing your own story or opinions for, we’re interested in anything related to children’s healthcare in Singapore. You can always email us directly at

photo by: comedy_nose

Share Your Story

Tell us about your family’s personal experience in Singapore. You can email us directly at, or use the form below to start.

If you’d like to write about health care issues, please check out our list of planned topics for ideas and to contribute your own.

The easiest way to tell a story is to start at the beginning and write out the events. It can be super hard to write about something painful at first but afterwards, you can understand the experience better and the memories feels less overwhelming. You might try writing down a memory from each day or month.

Another way could be to explain your child’s condition and treatments just as if you were writing to a friend who cared but didn’t know anything. Tell them what you wish they understood.

Write down the little moments – funny, warm and sad – that you remember most clearly.

Sometimes, telling a story is like throwing a lifeline to the families going through the same experiences behind you — what you learned first-hand can make their journey a little less lonely and a little better.

We will send you a copy of your story before it is published so you can confirm that you would like to share it on

Submitting your story

  • You can submit stories in English, Chinese, Malay or Tamil. English is probably going to get more people reading it, but please write in the language you’re most comfortable with.
  • We’re happy to help edit your story if you need some help. Just let us know and we’ll follow up on your story before we publish it.
  • Please be careful about libel and slander – basically, don’t say anything that you can’t stand behind.
  • Your story still belongs to you, even when it’s posted to You can share it on other websites or media.
  • If you’d like to be anonymous, you can just use initials or different names and change identifying details.


  • To include photographs or videos, please email them directly to
  • If you don’t include a photograph with your story, we will add a non-identifying illustration


  • All stories are posted with comments allowed. Because people can be jerks on the internet, you may get some mean comments. will moderate any harassment or trolling up to banning people and deleting the comments. However, critical comments that are polite will remain. You don’t have to respond to them unless you want to.


  • Minor changes like spelling and punctuation will be updated directly. If you need to make major changes to your story or add additional information, a note explaining the changes will be added to the top of the updated story.
  • If you change your mind and want to remove your story, that’s okay.

Share your story

photo by: alhussainy


Margaret Jane is a community site about improving children’s healthcare in Singapore set up by Dale Edmonds. I want to bring together the voices of parents and children, civil servants, medical staff and other Singaporeans to share our experiences, ideas and information.

The big questions behind Margaret Jane are:

  • Why does Singapore, one of the wealthiest and most advanced nations in the world, make families choose between poverty and their children’s healthcare?
  • Does the relatively high cost of healthcare for children make people hesitate to have children or to have bigger families?
  • Why does our society pass the cost of caring for children with chronic illnesses or challenges to their families?
  • What can we do to make Singapore a place where all children get a chance to grow up healthy and cared-for?
  • How much would it really cost to make healthcare free for children in Singapore?

Margaret Jane is also the name of my little girl born November 17, 2011. She was born ten weeks early in an emergency C-section and spent fifty days in the National University Hospitals’ neonatal ICU. After successful heart surgery, she came home at just over 2kg and after one more stay in the pediatric ICU for pneumonia, has gone on to become a happy and healthy little girl.

We heard so many stories from other families then and discovered for ourselves just how expensive a severely ill child could be. Our first four children had the usual chickenpox and colds, but even in the subsidized ‘C’ ward, Maggie’s hospitalization ended up wiping out about half of our medisave and a lot of our savings. We were very lucky to have relatively flexible jobs, but we heard from other parents who had to take time off work or quit their jobs to be with a sick child.

It seemed crazy then and still makes no sense that in a wealth country with a plunging birthrate, so many parents struggling to care for a very sick child need to hope for either public charity or bankrupt their family.

These children are Singapore’s future. Let’s do more than just talk about making Singapore family-friendly.

Neonatal Intensive Care Units (NICUs) in Singapore

A healthy baby delivered at term will go to a hospital nursery where nurses will look after them when they’re not with their mothers in the mother’s ward or room. These babies are usually swaddled in open plastic cots, with nothing attached to them other than their hospital ID tags.  They’ll be brought to their mother for nursing or bottlefed. Occasionally, a newborn may be placed under “blue lights” to treat jaundice, a fairly common and easily treated condition. They will be screened for common disorders which usually includes a tiny bit of blood being drawn for testing. These babies will go home with their mothers within a few days at most from the hospital.

The NICUs are very different. The babies in the NICUs are usually much smaller and quieter. Some will be cradled within an incubator, trailing lines and beeping machines from a big plastic box. Others will be lying in a cot under heat lamps with bubbling ventilators taped to their tiny faces. At one end of the NICU, there will be open cots with small but healthy looking babies – the “feeders and growers” who are getting ready to graduate to the regular nursery or even be discharged to go home.

Why do babies need to go to an NICU?

Most infants end up in an NICU due to prematurity. Premature births are 8-12% globally. Very young and older mothers, mothers of multiples and women with previous premature births are higher risk, but sometimes premature births simply happen. A premature birth is usually classified as before 37 weeks. Babies at 23 weeks have survived, but the earlier the birth the higher the risk of longterm physical and mental challenges. In Singapore, the guidelines to start medical treatment are for infants above 24 weeks and 500g, although parents can ask for medical treatment in any case.

Other babies come to the NICU because they have congenital problems or suffered trauma during their delivery. Newborns that need surgery will be admitted to the NICU. After discharge and then re-admittance for further treatment or very rarely when a chronically ill baby is several months old, babies will go into the Pediatric Intensive Care Units (PICUs).

Adjusted age
Babies born before their due date often have two ages, their adjusted age and their actual or chronological age. For example, a baby born at 32 weeks on the first of January is eight weeks early because the baby should have been born on the first of March. When the first of March comes round, the baby’s actual age is two months, but her adjusted age is zero. On the first of April, that baby has been out in the world for three months, but her adjusted age is only one month.

A premature baby can’t be compared directly to full-term babies born on the same date. By using an adjusted date, you can account for the extra time the baby should have been in the womb. That premature first of January baby can be expected to start rolling over by August when she’s four months adjusted age, while a full-term first of January baby would be expected to start rolling over by May.

By two years of age, premature babies don’t need to use their adjusted age and can be assessed using their actual or chronological age.

NICUs in Singapore

There are 9 neonatal intensive care units in Singapore.


  • National University Hospital
  • KK Women’s and Children’s Hospital
  • Singapore General Hospital


  • Gleneagles Hospital
  • Mt Elizabeth Hospital
  • Parkway East Hospital
  • Mount Alvernia Hospital
  • Raffles Hospital
  • Thomson Medical Centre

NICUs are usually ranked by the complexity of cases they can handle. A Level 3 NICU can handle the most complex cases. Singapore’s public hospital NICUs are all Level 3, and some private hospitals such as Gleneagles Hospital also have Level 3 NICUs. A Level 2 NICU may also be called a special care nursery. KK Hospital has probably the biggest and busiest NICU in Singapore.

Singaporean NICUs generally encourage breastfeeding and will help loan breastpumps and offer breastfeeding help. Donated breastmilk is not available. Kangaroo care is encouraged and most NICUs have reasonable visiting hours, although usually visitors are limited to parents and grandparents only.

What’s the difference between the NICUs?

The biggest difference is cost. NICU charges in public hospitals are tied to the category charges of the mother. If you checked in as a Class A mother for a private room, your child’s stay in the NICU will also be charged under Class A. The quality of care given is exactly the same – all NICU babies receive the same high nurse:child ratio of care and are treated by a team of specialists – but the bills can be very different.

NICU charges range from $58/day for a Class C-subsidized at KK Hospital to $562/day for Gleneagles’ Level 3 NICU. This is just the room charge – NICU babies will often have many medical treatments and possibly surgery charges as well. It is fairly common to have NICU bills of $20,000 for a straightforward premature birth, up to hundreds of thousands for early multiples.

Financial tips
  • Ask to be downgraded. Usually the hospital will downgrade you on the same day you request, and all charges from then on will be under the subsidized rate.
  • If you know your baby will spend time in an NICU, plan for a public hospital. You won’t be able to choose your own doctors, but if you are a high-risk pregnancy likely to wind up in an NICU, you will be assigned a specialist in high-risk pregnancies anyway.
  • All public hospitals have medical social workers who can help you apply for financial aid and appealing your charges. Private hospitals will often work out a payment plan as well.
  • Medisave from both parents can be used. The government has allowed grandparents’ medisave to be used in exceptional cases. Medisave covers up to $450/day per baby, which will still leave you with at least several thousand in a cash payment for an NICU stay.
  • Medishield does not cover any NICU charges, although the government is now considering whether babies with serious birth defects will be included.
  • Some insurance policies will cover NICU charges, depending on the package. In general, you can only qualify if you bought the insurance at least a year before you became pregnant.
photo by: tamakisono

Singapore NICU stories

Personal accounts from other parents about their children’s stays in Singapore NICUs. If you’d like to recommend a link to add to this list, please leave a comment below.

photo by: bradleyolin