
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 a number of hospitals.
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.
Many of the managers and midwives were keen to promote non - pharmacological pain management for women during labour and a number of the managers attended the first couple of courses to evaluate the efficacy of the training. Following this, more midwives attended from different hospitals and audits followed which have demonstrated positive outcome(s) on labouring women.
The reports have shown the use of the Programme has been very helpful in alleviating labour pain and it has been welcomed by couples, midwives and many of the obstetricians.
Recently there has been an RCT conducted in 2 HK hospitals and some of the initial data show a reduction in the use of analgesia and an increased sense of well being for couples.
I look forward to continuing to work with the Hong Kong Midwives Association to deliver the LK Massage Programme and meeting the enthusiastic and interested midwives in their desire for promoting natural birth
Linda Kimber
Midwife/Director
Childbirth Essentials
Theory Sessions
Hong Kong midwives attending phase 1 pregnancy - birth course at the Hong Kong Midwives Association


Practical sessions
Phase 2 Pregnancy to Birth (Trainers) Course
Committed midwives attending the course in Hong Kong
Introducing the Massage Programme in Hong Kong
Audit
Once the LK Massage Programme was introduced in Hong Kong, audits have been conducted to check the Programme's efficacy. As shown below, some data collected from two public hospitals showed a reduction in the use of Pethdine and also Entonox 2009 - 2015
Hospital A Pethidine use
Hospital B Pethidine use
Hospital B Entonox use

Research
Because of the different culture and systems of working, the Programme needed to be modified to suit local working conditions. -
The following is on initial findings.
Effectiveness of a program of massage, controlled breathing and visualization used in Chinese primigravida during intrapartum pain relief management from 36 weeks gestation:
A Randomized Control Trial
Lai CY1., Wong KW2, Tam ML2, Tong WH2, Lau KY2, Chau MC2, Lao TT1
1 Department of Obstetrics and Gynaecology, Chinese University of Hong Kong
2 Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hospital Authority
Background
Labour pain is distressing and effective pain relief is a major context in midwifery care.
Aims
To evaluate the efficacy and satisfaction of childbirth massage programme for intrapartum pain relief.
Methods
From September 2016 to December 2017, adult low-risk Chinese primiparous women with singleton pregnancies planned for vaginal delivery were recruited at 30-36 weeks gestation in the clinics of Prince of Wales and Kwong Wah Hospitals. Inclusion criteria were understanding Cantonese and usage of written Chinese. The subjects were randomized into an experimental group receiving massage training (n=300) and a control group (n=300) using computer-generated random numbers in sealed envelopes drawn at recruitment. The experimental group was taught massage techniques, relaxation and pain relief methods, breathing control, and visualization at 36-week gestation. Control group received standard care. Partners of both groups were encouraged to accompany the subjects during labour and delivery. The use of pharmacological pain relief methods, labour augmentation, pain score during labour, mode of delivery and birth outcome, and satisfaction regarding the experience were compared.
Results
240 control and 221 experimental cases were eligible for final analysis. No significant difference was found in the use of Entonox (36.2% vs 42.5%) and Pethidine (10% vs 11.3%) between the experimental versus the control groups, but need for epidural analgesia was lower in the former (1.8% vs 5.8%, p=0.02). The control group also required more warm pads (46.3% vs 28.5% p=0.001) and transcutaneous electrical nerve stimulation (TENS) (17.1% vs 7.2% p=0.001). There was no difference in augmentation, birth outcomes, pain scores, or satisfaction, but the partners’ presence was more helpful for pain relief in the experimental group (14.7% vs 27.7%, p=0.003).
Conclusion
Childbirth massage reduces need for other pain relief methods without influencing birth outcome.