Having a Baby in Taiwan 在台灣生小孩

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The nursery or "infant room 嬰兒室 Yīng'ér shì," where the baby will stay for three days after birth.

Taiwan is a safe, inexpensive, and convenient place to give birth. Taiwan has a world class healthcare system, capable doctors, and top of the line medical facilities. If you are hesitant about whether or not you want to give birth in Taiwan, let me tell you now that there is nothing to worry about, and having a baby in Taiwan will be fine. I have created this brief guide here for you so that you can understand a little more about what it is like to give birth in Taiwan.
 
Forward: Please note that I am writing this blog and FAQ section from the perspective of an American father, married to a Taiwan National, covered by Taiwan's National Health Insurance. I have recently gone through the birth of two children in Taiwan, born in 2017 and 2020. One was born in a private local clinic and the other was born in a public city hospital. 

This blog will begin with my experience, and at the end there is a frequently asked question (FAQ) section.

□ Planning your trip to Taiwan? □

Here are some top travel tips for you:

• Best time to visit: Spring and Autumn when it is not too hot or cold and less rainy
• How to get there: Plane tickets via Trip.com
• Best places to stay can be found on Agoda
• Book tours and activities in Taiwan on Klook
• Stay connected with a local SIM
• Rent a car to explore distant sights

Our Experience:

Getting pregnant:
Just so you know, you can buy a simple urine pregnancy test at any drug store (藥局 Yàojú). Once you are sure you are pregnant, you can go ahead and book your first appointment with a gynecologist/obstetrics doctor (婦產科 Fùchǎnkē) at a local clinic or hospital. There are hospitals and clinics close by in all major cities in Taiwan (not so much in mountain areas or outer islands). Once the doctor confirms the pregnancy (and that you want to keep the baby, this is a question they will ask) they will issue the Maternal Health Booklet (孕婦健康手冊 Yùnfù jiànkāng shǒucè or "媽媽手冊 Māmā shǒucè") which will record all pregnancy checkups and ultrasounds. It also has some information about pregnancy and birth in Taiwan. This book is also has English, Vietnamese, Thai, and Indonesian versions (you can ask for a different language or download it here). They will also give you a parking sticker you can put on your car which will allow you to park in some specially marked parking places around Taiwan.

An example of the "mother's handbook" with ultrasounds.

Choosing the right clinic or hospital:
In Taiwan you basically have two choices, a clinic or a hospital. Clinics are usually smaller but more convenient because there are lots of them around. Hospitals are bigger but wait times can be longer and they might not be close by. We chose a clinic for the first birth because it was close by, but for the second birth we chose a hospital because we wanted a better doctor and, believe it or not, hospitals are cheaper.
Most doctors in Taiwan speak some English, and definitely speak enough to communicate about your pregnancy symptoms. There are many doctors in Taiwan that have studied overseas and speak perfect English (you will have to Google these doctors, we didn't use one).
Language was not an issue for us because I can speak Chinese and my wife is Taiwanese.
We didn't really choose our doctor the first time. Our doctor the first time usually got us in and out fast and didn't say much. But the second time my wife was a little more choosy and looked online for the doctor reviews at our local hospital. Of the three obstetrics doctors there, she chose the one that was most thorough. This means also that her appointments took longer because the doctor inspected longer, and the wait times for that doctor were also very long. It also meant that the doctor was overly cautious about the baby's weight and fetal position, and was convinced my wife had gestational diabetes until she tested negative (due to a massive weight gain while we were in the USA for Christmas).

Monthly pregnancy checkups:
For the first 8 months of pregnancy, you are expected to return monthly for pregnancy checkups. National Health Insurance covers the costs of up to 10 checkups at an NHI clinic or hospital. Checkups after the 10 are up are only about 300 NT at normal a local clinic or hospital.
If you are working in Taiwan, your employer is required to give you 5 days paid leave during your pregnancy for checkups according to Taiwan's Labor Standard's Act.
These checkup include an ultrasound and sometimes a urine test. The doctor will tell you the gender once it is apparent (12-20 weeks) and let you know of any problems.
These checkups were pretty uneventful for us but sometimes the doctor prescribed my wife supplements or stomach medicine when she was feeling sick during the first few months.
At about 9-13 weeks they will ask that you perform a Down's Syndrome test, for which you may have to go to another testing location. These tests are not covered by NHI, and are about 1000-2000 NT. We didn't do the Down's Syndrome test the first time, but we did the second time. 
At about 24-28 weeks they will test the mother for gestational diabetes. Gestational diabetes is not a big deal but they will require you to change your diet if you test positive.
After 36 weeks, you are required to come in for weekly checkups until the baby is born. If you have regular contractions during this time you should immediately go to the clinic or hospital.

Miscarriage: 
Unfortunately, we have undergone a miscarriage in Taiwan. In this situation, there is little in terms of benefits or paid leave that the government provides, but it also depends on how old the fetus is. In our case, the fetus was under 20 weeks old, so we did not receive any benefits or paid leave for the miscarriage. However, women are entitled to paid miscarriage leave from their employer as follows:

• For normal births: 8 weeks paid leave
• For miscarriages for which the fetus was three months old or more: 4 weeks paid leave
• For miscarriages for which the fetus was more than two months old but less than three months: 1 week paid leave
• For miscarriages for which the fetus was less than two months old: 5 days paid leave
• Fetuses 20 weeks old or more are considered live births and are eligible for a birth stipend.
• Miscarriages where the fetus is 20 weeks or less is considered a miscarriage and is not eligible for birth stipends. However, there is a taxi subsidy given by Taipei City and New Taipei City given when you are presented the momma handbook.  

After you miscarry, it is up to you what you want to do with the fetus. You can choose to dispose of it in the hospital's waste container or take it home for a burial. 

Giving birth:
During both pregnancies, my wife had an app that could help her record the timing of her contractions. Both times we went to the hospital for a false alarm and the doctor told us to go home.
Once contractions come every ten minutes or so, it's time to go give birth.
You need to have three days of clothes ready and also some vaginal cleansing materials and pads.
At our latest birth at the Taipei City Hospital, once the regular contractions were coming, I took off work and immediately went to take my wife to the emergency room.
We paid 390 NT for using the emergency room entrance, which is the way you are supposed to go when giving birth at a hospital.
I then took our older child to grandma's house. During that time my wife went ahead and got the epidural for 7900 NT (260 USD) which is not covered by NHI (in the US an epidural costs an average of 2,000 USD, so its worth it to fly to Taiwan to give birth just for the epidural cost).
When my wife gave birth at the clinic, they would not let me in to see my wife give birth until right when the baby popped out. I sat an angry half an hour waiting outside while my wife screamed, wondering why Taiwan's healthcare was still stuck in the 1950s.
When my wife gave birth at the hospital, they let me wear scrubs and watch the entire birthing process from start to finish. I have to admit it was a terrifying and intense experience; there was lots of blood and I did almost faint. So, even though it was more fun seeing the whole thing, it was a lot less emotionally racking than just coming in when the baby popped out at the clinic.

A two person room that you must stay in for three to seven days after the birth. For a four person room, it's just double the beds. For a private room, there is one less bed. One bathroom per room. The chair on the left folds into a bed for the husband, which is really uncomfortable to sleep on because it is very narrow and cold air can creep up.

Three days in the hospital after birth:
After the baby is born, they let the mother and baby cuddle together for about an hour, which is an important time for the infant to bond with the mother. After that, the mother goes to a separate room and the baby goes to the nursery or "infant room 嬰兒室 Yīng'ér shì" for three days. This is so they can run tests on the baby and mother and make sure there a no problems before they leave the hospital. However the mother can request to be with the baby for as long as possible during the three days, but most of the time mothers choose to sleep while the baby is in the other room. 
For both the clinic and the hospital, we had a choice of three room types (this will differ with different hospitals and clinics):
1. 4 person room - free, covered by NHI (健保房 Jiànbǎo fáng)
2. 2 person room - 1500 NT per night (pictured above)
3. 1 person private room - 3000 NT per night
You have to realize that the mother will have to stay in that room for three days. If you take the free option, you will likely be woken up way more times by other people and their baby. With the two person room, you might luck out and have to whole room yourself if there are not that many people giving birth at the same time. With the private room, you can be assured to have more privacy and quiet.
The hospital had filtered and hot water, a rice cooker, ice machine, and sink.
Meals for my wife at the hospital were 300 NT per meal. I also bought some lunch from outside and brought it in with no problems.
Also you should note if the birth requires a C-section, the mother will have to stay in the hospital to recover for 5-7 days. We did not have a C-section for either birth.
For both births, we chose the two person room. We had the room mostly to ourselves for the first day and a half, then another person came to stay the second day. We had curtains that separated us, but it was not that private because we had to share a bathroom. Usually the husband will sleep on the fold-able couch next to the main bed, which is really uncomfortable especially when it's cold because the cold air seeps in. I would recommend a sleeping bag in the winter.
For the second birth we had the whole room to ourselves the whole time. Also, because of COVID-19 pandemic, only one visitor was allowed at a time, so it was just me and her the whole time. Whereas pre-pandemic my wife's whole family came to visit.
Also, getting in and out of the hospital was a pain during the pandemic, because I had to sign a bunch of forms every time I walked in. Also one time I forgot the visitor pass, and so they had to call my wife's room to confirm my identity.
​During these three days me and my wife tried to sleep. The baby was carted to us every three hours or so (see above photo of the baby carts) for feeding. My wife practiced breastfeeding. The fist time, we had to use some formula because we did not know how to breastfeed. The second time, my wife successfully breast fed without pumping but it was painful. Breastfeeding was and is definitely the most difficult, time consuming, and painful part of having children for us.
Also, doctors and nurses came into our room about every hour every day and night. One time I was still putting on my pants, so just know private room or not you will have little privacy.

Our total bill for the birth at the hospital with NHI was 11,725 NT (350 USD).

Total fees for the hospital birth: 13,478 NT (448 USD)
Birth certificates: 250 NT
Epidural: 7900 NT
Medicine: 55 NT
Meals: 520 NT
Room fee: 3000 NT (they only charged for two nights because we gave birth right after midnight).
Child tests (not on the above receipt): 1753
Total: 13,478 NT (448 USD)

Total Fees for the Clinic Birth: 25,750 NT (855 USD)

​Taiwanese registration:
If you or your spouse are Taiwanese, you will want to do house registration for your child. To register your child as a Taiwan citizen you need to bring the following to the local house registration office:
1. Birth certificate
2. Mom's (and dad's) ID/ARC
3. Original house registration book
4. Stamps/chops of the parents or child (Chinese name on the stamp, this is the same as a signature in Taiwan)
At the same time, they will register the child's NHI and send an NHI card, add the child to the family health insurance, and register you for birth stipends.

Birth Stipends
Currently in Taiwan, citizens receive 2500 NT per month per birth until the child is five years old, and in Taipei and New Taipei they also receive a lump sum stipend of 20000 NT. These rates are set to increase soon.
If the mother is working, she can receive a stipend from the labor bureau of two months of her labor insurance salary grade range (20,000 - 45,000 depending on the salary). Foreign female employees can receive this too.
If the mother is not working but is a Taiwan citizen, she can receive a birth stipend through the national pension system (國民年金 Guómín niánjīn), which is about 18,000 NT x 2.
Our total payout for the birth was 56,000 NT, plus 2500 NT every month for five years. It pays to give birth in Taiwan. In other words, we made money giving birth in Taiwan.
Also, for Taipei City residents that have been registered in the city for two or more years, they can receive a discount on hospital fees for their newborn children (ask about it at the household registration office, they give you a blue sticker to put on the NHI card).

Bank Accounts:
As soon as you have a birth certificate, house registration, and stamp for the child you can open a bank account for them in Taiwan. I would recommend saving money for them in this account preferably through index funds. You want to save for your child's future, without using the money for yourself.

ARC for the child:
If both parents are foreigners, you will need to get an ARC for your child as soon as possible from the immigration office. Usually this means bringing the birth certificate, photos, and other information to the immigration office to apply for the infant's ARC.

American or other citizenship:
As soon as the child is born, you need to go to the consulate of your home country and apply for the child's citizenship and passport.
Because my wife is Taiwanese and I am American, we put off this step for our child for a long time and just used Taiwanese citizenship for everything. But then we realized that we were missing out on tax refunds from the US due to the child tax credit. So I went ahead and did this, but I missed out on a few thousand dollars from the US government because I did it too late.
Applying for citizenship of a child with an American father and Taiwanese mother:
Because my wife is Taiwanese, I had to prove to AIT that I had lived in the USA for five years before my child was born. I had almost no original documents, but I brought copies of my high school diploma and transcript and my college diploma. Because I was born in the USA and had these documents, the officer didn't even look at them and believed me when I said I had lived in the USA for five years. So it's not as scary as you think.
Another hard thing is getting good photos of your baby. You need to place them on a white piece of paper etc. and get them to open their eyes, look at the camera, and show both ears. It can take over a hundred tries to get a good photo of a fussy baby.
Also you need to bring in signed forms, English birth and marriage certificates, passports, and proof of living in US five years. After you receive the passport, the SSN needs to be applied for separately, because it is processed in Manila.
In the end it is worth it because you will likely make money with the tax benefits of registering your child. For more information about an registering an American birth abroad, see the AIT website here.

The child handbook "兒童健康手冊" which is given to the child to track vaccinations after birth.

Raising a Child in Taiwan:
​After the child is born, they will give you the "Children's Health Booklet 兒童健康手冊 Értóng jiànkāng shǒucè" or Baby Handbook "寶寶手冊 Bǎobǎo shǒucè" to track the child's vaccinations (English, Thai, Indonesian, and Vietnamese versions here). You will have to go back monthly for vaccinations until the baby is 1 year old, then they are less frequent. Most of these are covered by NHI, and the child needs them to start school. Vaccinations are good for your child, to prevent them from dying from preventable diseases. 
Childcare: expect to pay at least 20,000 NT per month for baby sitting. 
Preschool expenses: expect to pay about 2,000-10,000 per month for a public preschool (if you win the lottery) or 5,000-30,000 NT per month for a private preschool!
K-12 expenses (local Chinese school): Expect to pay about 5,000 NT per semester
American/European School: Around 300,000-700,000 NT per semester
College expenses: Expect to pay 50,000 NT to 100,000 NT per year (plus 20 years inflation, so be investing that money in index funds)

Frequently Asked Questions (FAQ) 常見問題

Q: Does Taiwan have a good healthcare system? What is Taiwan's healthcare system like?
A: Yes, Taiwan's healthcare system is amazing! It has convenient, fast, effective, and inexpensive healthcare. Fore more information about Taiwan's healthcare system, see our FAQ article here. 

Q: Can foreigners' babies get NHI (National Health Insurance)?
A: Yes, as soon as your foreign baby is born they can be added to your NHI plan.

Q: Can foreigners' babies get Taiwan citizenship for being born in Taiwan?
A: No.

Q: Is a clinic or hospital better for giving birth?
A: This depends on what is important to you. Please see below for a simple comparison:
Hospital:
Pros:

• Cheapest way to give birth
• Sure to have capable doctors

Cons:

• May be far away
• Slower wait times
• Might not be up to your standards (privacy, procedures, etc.)

Clinic:
Pros:

• Likely closer to where your live
• Faster checkup times
• May have special treatments/services or added benefits you would not find at a hospital

Cons:

• More expensive
• Doctors or equipment may not be as good as those in the hospital

Q: What is the cost of giving birth in Taiwan without National Health Insurance?
A: Based on the receipt above, having a natural birth in a Taiwan hospital with epidural would cost us 43,776 NT (1,455 USD) without National Health Insurance.

Q: Is it easy to find baby clothes and accessories in Taiwan?
A: No, at least when comparing to the US. Baby stuff in Taiwan is mostly imported from the USA, which means it is more expensive. Also there are not many people having babies in Taiwan, and the ones that do are usually well off and late in their career. If you want a cheaper option, you can buy Chinese knock off products, or buy cheaper products online (like on Shoppee).​

Q: Does Taiwan encourage breastfeeding?
A: Technically yes, but they are not very good at teaching it. At the clinic we went to, the nurses did not know how to breastfeed. For our first child, we gave up and used a pump and bottle for all feeding, which is a huge waste of time as opposed to direct breastfeeding. We had much better breastfeeding training at the hospital, but still it was not up to par with the training you would receive in America. 
The three days of having the child in the nursery might mean that the baby is not sucking enough, meaning not creating enough milk and not latching properly. If you are worried about this, you can ask to have the baby in the same room with you the whole time (although most people will not think to ask this). 
Also, Taiwan doctors do not encourage or prescribe cutting lip ties or tongue ties, which would really help with latching during breastfeeding. 
Due to the overall terrible breastfeeding training in Taiwan, most moms end up pumping milk or using formula. I wish they had more breastfeeding resources. As a first time parent, don't expect to be taught how to breastfeed properly from Taiwan health professionals. 

Q: Does Taiwan offer water births?
A: Only a few clinics offer water births. You will not have this option in a hospital, or in most clinics. Most all natural births are give laying down with feet in stirrups. 

Q: Is it safe to give birth in Taiwan?
A: Yes! Very safe! The infant mortality rate in Taiwan is about 3 deaths for every thousand births. The infant mortality rate in the USA is 5 deaths for every thousand births.  

Q: How is giving birth in Taiwan compared to the USA?
A: In the USA, you only have about three checkups whereas in Taiwan you have ten or more.
The out of pocket cost for giving birth in the USA is 2,000-10,000 USD, whereas we only paid 10,000-20,000 NT (300-600 USD), and we got a bunch of stipends, which means we made money giving birth in Taiwan. 
I would choose giving birth in Taiwan every time. 

Q: What birth stipends does Taiwan give?
​A: (as above) Currently in Taiwan, citizens receive 2500 NT per month per birth until the child is five years old, and in Taipei and New Taipei they receive a lump sum stipend of 20000 NT. For the third child onward, the monthly stipend raises to 3500 NT.
If the mother is working, she can receive a stipend from the labor bureau of two months of her insurance salary grade (20,000 - 45,000 depending on the salary). Foreign women can receive this benefit too.
If the mother is not working but is a Taiwan citizen, she can receive a birth stipend through the national pension system (國民年金 Guómín niánjīn), which is about 18,000 NT x 2.
Our total payout for the birth was 56,000 NT, plus 2500 NT every month for five years. It pays to give birth in Taiwan.
Also, for Taipei City residents that have been registered in the city for two or more years, they can receive a discount on hospital fees for their newborn children (ask about it at the household registration office, they give you a blue sticker to put on the NHI card).

Q: What kinds of paid leave does Taiwan give for pregnancy, birth, and having children?
A: According to Taiwan's Labor Standard's Act, workers are entitled to the following:

• Mother's pregnancy leave: 5 days paid leave
• Mother's birth leave: 2 months paid leave
• Father's birth leave: 5 days paid leave
• Parental leave: 6 months with 60% of the labor insurance salary grade (highest of 45,000 NT per month x 60%), or two years with the final 1.5 years of the two years being without pay (but you will still be an employee and receive benefits). This is applicable to both parents.

​​
Q: What special customs do Taiwanese have for births?
Postpartum confinement (做月子 Zuò yuè zi):
It common in East Asian countries for mother's who just gave birth to stay confined at home for about about a month. During this time, they may not eat certain foods or fruits that are cold or spicy, and in the olden days they could not take a shower during this time (although most shower during the postpartum confinement now). There are so many do's and don'ts here it is hard to keep track. If you are a son in law, this may be a huge culture shock for you, but just accept it. Mother and baby are going to be fine, and you are never going to win a fight with your mother in law about what can and can't be done after birth. The most important principle is that your wife gets the rest she needs.
Some Taiwanese women like to stay at confinement hotels during this time, which are super expensive. A month stay at a confinement hotel can be anywhere from 3,000-10,000 USD per month (which is almost the annual salary of some Taiwanese people). During this time she will have three meals a day and someone will take care of her baby for her. This also might mean that she likely will not breastfeed properly or may give up breastfeeding completely. 

Gifts after one month:
If Taiwanese people give you gifts of money or clothes before the birth or during the first month after birth (which is Taiwan custom) you need to give them a gift after the baby is a month old.
For boys, this usually means you give oil rice and a red egg. For girls, this usually means you give honey cake. However these customs and gifts can vary from family to family. 

Q: What are the pros and cons of giving birth in Taiwan (as compared to the USA)?
I would say the overall pros and cons of giving birth in Taiwan are as follows:
Pros:

• Inexpensive: The price of giving birth is low compared to other countries, especially with NHI (see above).
• Convenient: There are clinics and hospitals everywhere in the cities.
• High quality: The doctors know what they are doing and have the expertise to find and solve any problems during pregnancy and birth to ensure safety.
• Safe: Taiwan has some of the lowest infant and mother mortality rates in the world.

Cons:

• Lack of English resources: Even though the doctors can all speak some English, there may still be some communication barriers. Be sure to get the English version of the Mother's Health Booklet. Also forget about any English blogs about pregnancy or birth. 
  At the time of writing, I could only find two other blogs in English about pregnancy and birth in Taiwan. 
• Lack of breastfeeding training and practices: You can tell direct breastfeeding is not taken seriously here (see above). This means most moms in Taiwan end up pumping or using formula, which is a shame.
• Chinese medicine mindset: Even if you give birth in a "western" medicine hospital or clinic, doctors will still throw in Chinese medicine anecdotes with no scientific basis. For instance, the doctors told my wife that she should not have anything cold such as ice cream, only drink warm water, and after birth eat lots of ginger. This is clearly a Chinese custom and not anything supported by science. Use Google to double check what the doctors are saying especially when it comes to diet, but even then it is hard to tell what is Chinese medicine advice and what isn't. These Chinese medicine anecdotes likely won't cause any harm, but they probably won't have any tangible positive effect either. 
• Lots of checkups: This can be a good thing or a bad thing depending on your point of view. Some people will not like monthly ultrasounds and fear it may effect the baby somehow. 

Other blogs about giving birth in Taiwan:
Tricky Taipei - Notes on Pregnancy & Giving Birth in Taipei
Tales of a Vagabond - Jackie - Experiencing pregnancy in Taiwan

You can also check out more of our Taiwan FAQ topics here. 

Thanks for reading! Have any more questions? Leave them in the comments. 

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