Hong Kong Training Courses

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

Members

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

Introducing the Massage Programme in Hong Kong

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

Download the report PDF

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

For 10 years the midwives in Hong Kong have been learning the LK Massage Programme and recently an RCT was conducted looking at the efficacy of the Programme.
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.

Sarah

Midwife

"My name is Sarah and I am a midwife in Northamptonshire.
I recently attended the professionals course phase 1 pregnancy - birth course of the LK Massage Programme."Towards Natural Childbirth and Beyond - Neuroendocrine responses to Massage during Pregnancy and Childbirth"

As a community midwife, I was able to apply the knowledge and practical learning
immediately with pregnant women and their partners.

You will gain an in-depth knowledge of massage and relaxation which will enable
you to help women facilitate better sleeping patterns antenatally and use massage techniques as a coping mechanism during labour.
Linda is an expert in this field and is extremely supportive both during the course and afterwards.

This course will enhance your practice and allow you to promote normal physiology and normal birth".

Ellen Cheung

Midwife /Lactation consultant

"Using the Programme enabled me to feel in control of my labor pain. Focusing on my husband's hand movements when he was doing the massage helped me with visualisation and led my breathing "

Amanda

Midwife /Manager

"This is a highly enjoyable and well thought out course. The in depth physiology and information regarding the neuroendocrine system was absolutely fascinating and provides, not only, a strong foundation on which to build the physical skills, but also enriched my practice as a community midwife in that I was able to give women the reasons why they were experiencing certain things such as extreme tiredness in early pregnancy.

The course greatly increased my confidence in using touch as a tool to support women, and the massage techniques have always proven effective , even when introduced for the first time in labour.

The days are well paced, thorough and not a moment feels superfluous. Linda is passionate, extremely knowledgeable and a compassionate guide through the techniques.
Having witnessed many couples using the LK Massage Programme in labour, previously having taught them during pregnancy, the effect is quite unique in that the bond between the couple appears to be much stronger with the partner having more confidence in their ability to be an effective supporter.

They have reported that the antenatal massage has been invaluable as a tool to aid better sleep, general wellbeing and in strengthening their relationship.

I know this proved true for me during my pregnancy also.

I could not recommend this more highly as it will benefit you as an individual, your practice as a midwife and the families fortunate enough to be cared for by you".

Sing Chu

Midwife /Maternity Department Manager - Matilda International Hospital

"The LK Massage Programme is outstanding.
It not only enriches the professional knowledge and massage skills to apply for pregnancy and during childbirth for our midwives, but also benefits the pregnant women and their families in Hong Kong.The professional teaching of the Childbirth Essentials tutors is well received by learners. They are just wonderful!
I have been involved with the Programme for 10 years and have found it well accepted not only in Hong Kong but also China and Taiwan. I hope this Programme continues to grow and benefit more and more women and families".