Hong Kong Training Courses

hong kong 555

Hong Kong

Background

In 2008 the Childbirth Essentials® team was invited to Hong Kong to teach the LK Massage Programme®, and since 2009 we have been teaching midwives from many hospitals in and around the city. During the last 14 years we have shared the evidence and practice of the Programme and learned a great deal from midwives, who come from a city where massage practice is an integral part of traditional culture. This has been a very enriching experience.

Following recent evidence on spontaneous labour, many managers and midwives were keen to promote non-pharmacological pain relief for women during labour and the initial courses were attended by managers and senior midwives, who wanted to evaluate the efficacy of the Programme for local conditions. Since then, hundreds of midwives have completed the course and audits on their practice of the Programme have demonstrated less use of pharmacological analgesia and a more rewarding experience for couples and midwives.

2021 Research Results

In 2017, a randomized controlled trail (RCT) was organized in two Hong Kong hospitals, to test the effects of one two-hour teaching session on the Programme, at 36 weeks gestation, followed by supervised practice by midwives experienced in using the Programme during labour and birth (Lai et al 2021). Resulting outcomes showed that 29.2% of women in the study group did not require any pharmacological analgesia compared to 21.5% in the control group and use of epidural analgesia was 2.1% in the study group compared to 5.7% in the control group. In relation to maternal pain threshold in labour, women in the study group requested pharmacological analgesia at 3.8cm mean cervical dilation compared to 2.3cm mean cervical dilation, in the control group. In both groups, labour occurred at the same gestational age and there was no difference in the number of women who laboured during the light: dark cycle (Stefani et al 2013, Kanwar et al 2015).

Taken together, these findings confirm and extend our initial pilot RCT showing that regular use of the intervention from 36 weeks’ gestation effectively increases maternal pain threshold in labour and significantly reduces maternal-fetal exposure to all forms of pharmacological analgesia, particularly epidural analgesia (Kimber et al 2008). The later request for pharmacological analgesia in the study group in Hong Kong cannot be attributed to differences in gestational age or to the number who laboured during the hours of darkness (Stefani et al 2013, Wallstrom et al 2015. Kanwar et al 2015).

Research PDF

References

Kanwar S, Rabindran R, Lidlow SW. 2015. Delivery outcomes after day and night onset of labour. Journal of Perinatal Medicine 43(6): 729-733;
Kimber L, McNabb M, Mc Court C, et al: 2008. Massage or music for pain relief in labour: A pilot randomized placebo- controlled trial. European Journal of Pain 12: 961–969.
Lai CY, Wong MKW, Tong WH, et al: 2021. Effectiveness of a childbirth massage programme for labour pain relief in nulliparous pregnant women at term: a randomised controlled trial. Hong Kong Medical Journal 27: https://doi.org/10.12809/hkmj208629
Stefani LC, Muller S, Torrres ILS et al; 2013. A phase II, randomized double-blind, dose-response trial of the melatonin effect on the pain threshold of heathy subjects. PLOS ONE 8(10): e74107. https://doi: 10.1371/journal.pone. 0074107;
Wallstrom T, Hellgren C, Akerud H, Wiberg-Itzel E. 2015. Skin conductance activity in post-term pregnancies. Journal of Maternal Fetal and Neonatal Medicine 28(16): 1912–1916;

Theory Sessions

Hong Kong midwives attending phase 1 pregnancy - birth course at the Hong Kong Midwives Association

Practical sessions

The midwives enjoying a relaxation massage

Phase 2 Pregnancy to Birth (Trainers) Course

Committed midwives attending the course in Hong Kong

The Practising Midwife Article

The last 10 years have seen a passing on of Mary McNabb’s and my expertise, experience and passion for this Programme, but I have also learnt so much from so many of the Chinese midwives. This has been an extremely enriching experience for me.

After three years of sharing our passion and knowledge in Hong Kong a collaborative article was written in The Practising Midwife and is available to read

Read the Article (PDF)

midwives managers

I look forward to continuing to work with the Hong Kong Midwives Association to deliver the LK Massage Programme and to meet the enthusiastic and interested midwives in their desire for promoting natural birth.

Audits

Once the LK Massage Programme was introduced in Hong Kong, audits have been conducted to check the Programme's efficacy. The following charts show data collected from two public hospitals and show a reduction in the use of Pethdine and also Entonox 2009 - 2015.

Hospital A Pethidine use kwh 2 pethidine decline