Archive | Birth

Silver Nursing Cups

Silver Nursing Cups

Posted on 06 November 2017 by Kristrun

silverettesphotoI have been a midwife for many years in the UK and have had clients trying a variety of creams and strategies for healing their sore, cracked or bleeding nipples. However, it wasn’t until I started working at Annerley, that I became aware of Silverettes (or Breast Angels).

Silverettes are made in Italy from silver 925 and they are little magical nipple covers. Silver has natural antibacterial and disinfecting properties. helping to prevent infection and the moist healing environment aids with fast healing of damaged nipples. To use – just squirt a little of your breast milk into the cup and place over your nipple, inside your bra, between feeds.

The breastmilk inside the cups helps with moist healing and the cup prevents rubbing and irritation from clothing.

No need for any other creams or products so nothing is being ingested by baby.

Extremely hygienic – clean with a little water and bicarbonate of sod, and air dry.

Eco-friendly – can be safely passed on to other mums after you have finished with them. Or keep for your next baby.

Sore nipples can often be a result of poor positioning of baby at the breast and then the help from a certified IBCLC lactation consultant is invaluable. I have seen first hand the (sometimes miraculous) difference these little silver cups can make within a few days, accompanied by correction of baby’s position and latch at the breast.

Sue x

Sue Pollard is a registered midwife and IBCLC lactation consultant at Annerley the midwives clinic www.annerley.com.hk

Silverettes can be bought directly from the Breast Angels UK website or from us in our clinic shop – see here for details.

Give us a call to make sure we have some on the shelf as we regularly sell out!

Comments Off

10 Top Tips for New Parents – Sue shares her advice in ‘Around DB’ magazine

10 Top Tips for New Parents – Sue shares her advice in ‘Around DB’ magazine

Posted on 06 November 2017 by Kristrun

Becoming a parent is a life-changing event to say the least. Add in sleep deprivation, sore breasts, cramping and a demanding newborn, and it’s no wonder new parents struggle at times. Here are 10 tips to help keep mum, dad and baby healthy through the first few weeks. If your spouse snores at night and you’re having a hard time sleeping at night get some comfortable ear plugs for sleeping to help block out the snoring.

1. Expect that you will fit around the baby’s needs, and not the other way around. Don’t put undue pressure on yourself to keep to your old routine.

2. Sleep when the baby sleeps—Facebook can wait. A proper rest will leave you feeling refreshed and better able to cope when the baby wakes.

3. Accept help when it is offered. Although many people in Hong Kong are fortunate enough to employ domestic helpers, there are still times that you need that extra pair of hands from a friend.

4. Sit in front of the TV with the family while feeding. You don’t need to live in the bedroom for months!

5. Go out for gentle walks. Getting out is good for you both physically and mentally, but halve the distance you think you can walk—your body has been through a lot!

6. Eat and drink well. Have healthy snacks and a bottle of water nearby when feeding. Give your body the nutrients that it needs to cope with the demands being placed on it.

7. Babies cry. Accept it.

8. There is no magic formula for sleeping and feeding routines. There are, however, many wealthy book authors.

9. Listen to the friendly, contradicting advice of friends and relatives, then take what you want and disregard the rest.

10. Babies are tiny for such a short time. Enjoy them. Remember everything is just a phase.


To read the full article in Around DB – click here

Sue is a registered midwife and lactation consultant and she and our other midwives are available for office consultation, home visits as well as teaching group antenatal classes at Annerley. Please call 29831558 or visit www.annerley.com.hk for more details.

Comments Off

What exactly is Hypnobirthing?

What exactly is Hypnobirthing?

Posted on 08 June 2017 by Kristrun

WD-TamaraQuinn med 081The name tends to put most people off.  Like some one is going to be front of you holding a watch on a string, telling you “ you’re getting sleeeeeeepy”.  But HypnoBirthing is really about teaching yourself to breathe and relax.  Its just a deep relaxation that you will learn to do to/for yourself and your partner is there to help you stay as relaxed as you can through loving words and touch.

When working with women in labour you find that women who are able to stay more relaxed usually have shorter and less painful births than those who “fight” against their bodies.  HypnoBirthing is simply a method to help you understand what your body is doing and how to work with it and not against it.  Its about letting go of the fear. Remember that Fear is not your friend in labour!  It causes women to tense up and go against what their body is trying to do.  This is why prenatal classes are so important! Knowledge is key.

I’m not going to guarantee you a pain-free labour (although I have had moms who have done it!) but  I will give you great tools to help you cope and deal with it.  You will learn to understand what/ how/ and why your body in labour works the way it does, which helps to give women the confidence and trust to work through their labour.  Also the confidence to ask questions, be included in all decisions, understanding every decision that is made and having no regrets.

One thing I always say when I teach is that you have these moments in labour where fear may try to sneak in and you second guess yourself.  Its like having two little birds sitting on your shoulders – one telling you to “fight it”, the other saying “just breathe and relax”.  Its about listening to the right bird! Its about looking forward to your labour and embracing what it can do.  Don’t psych yourself out before you’ve even begun. Remember – you are not your friend, mother, sister or someone you read about on an online forum.  This is your own experience – you and your baby.  I want every woman to embrace it and love it because… what a gift at the end!!

Tamara Quinn, Hypnobirthing instructor

You can find more details about our Hypnobirthing course here, or give us a call for more details.

Comments Off

How many layers? Midwife Michelle shares her advice

How many layers? Midwife Michelle shares her advice

Posted on 08 June 2017 by Kristrun

MichelleRescoNew parents are often unsure about room temperature and what to dress a baby in at night.

Current guidelines for room temperature recommend a temperature between 18-22 degrees. This might seem a bit cool but overheating is known to be a risk factor when it comes to SIDS (Sudden Infant Death Syndrome).

A comfortable body temperature for a baby is around 36.5-37.5°C. The easiest way (especially in the middle of the night) to assess if your baby is too hot or cold is by placing your hand on the back of their neck, just at the top of their shoulders. Baby’s skin temperature should feel just right/warm to the touch. If too hot or clammy then remove a layer, too cool – add a layer. Hands and feet commonly feel cool and as such should not be used as a measure for checking baby’s temperature.

Don’t put a hat on your baby at night as any excess heat is released though their head. When babies get too hot they also tend to place their arms up above their head to let heat escape, hence swaddling the arms down inside a wrap if the room is too warm can cause them to overheat. If your baby needs a swaddle to help them settle, try gradually swaddling to a lower point on their body so that eventually just the torso is swaddled leaving the arms free.

For clothing, add one extra layer of clothing than you would be comfortable wearing in bed. Remember if you have a ductless air conditioner on you will likely have a duvet or blankets to keep off the chill, so your baby will need a cover too. Make sure to sleep baby on their back at the bottom of the cot (babies feet to the bottom) and if using a cover tuck it in securely at the edges of the cot so that it is just up to the level under their armpits. Tucking the sheet like this will prevent it from rising up over your baby’s face.

As a general guide:

In room temperature of 18°C your baby will need a sheet and two blankets,

In room temperature of 20-22°C your baby will need a sheet and one blanket.

If you’re struggling to keep the room temperature below 23°C your baby will likely need a sheet only.
Statistics and heat distribution numbers sourced:http://classicairconditioningandheating.com/

 

Happy sleeping

Michelle Resco, Annerley Midwife

If you would like more advise from our midwives, you can book a private consultation or pop along to our Baby & Breastfeeding clinic on Tuesday and Thursday mornings.

Comments Off

New parents tips of the month! Having a baby, fears, challanges and enjoyment

New parents tips of the month! Having a baby, fears, challanges and enjoyment

Posted on 15 March 2017 by Kristrun

Your newborn baby

What did you find most enjoyable about having a baby so far? Katrina: It was an enormous relief to finally meet our baby Gabriel, to see that he’s well and ready for the world.
Do you remember how you felt when you knew  you were expecting? Katrina: I was absolutely, unreservedly terrified.
What has been hardest during the pregnancy? Katrina: The hardest thing for me was the need to face up to my fears, big and small. For nine (and a half…) months, there were endless questions and worries circling around and around in my head, but there was no way to work through them until Gabriel arrived.

How about the birth? Katrina: I think it’s very hard not knowing when things will kick off or how long labour will last – how do you pace yourself through a massive physical endeavour that might begin at any given point on, before, or after your due date, and that could go on for hours or days? I thought of stories about the long labours of friends and relatives, and couldn’t help but think, “if this labour lasts XXX hours, I’ve still got about XX hours to go…”. In fact my labour went so fast that the real problem was convincing doctors to move me to the labour ward in time for birth. We made it with less than half an hour to go before Gabriel’s big entrance.
….and after the baby is born, what are the biggest challenges? Katrina: I’ve had to learn to be patient, which does not come naturally to me. And trying not to fall asleep at a critical moment (such as Gabriel’s third dinner at 4.35am) can take some will power.
How about most enjoyable for this period? Katrina: I’m having a great time learning to understand Gabriel. It’s like a whole new language. At the same time, he is learning the ways of the world at a much faster pace, and changing every day, so he’s never dull. And it’s been really fun figuring all this stuff out together with my husband Bjorn.
Any recommendations or advice for new parents-to-be? Katrina: This is a request as much as a recommendation: Be honest. No pregnancy and no person is perfect (this includes mums, dads, babies, doctors, relatives, bosses and the rest). Don’t feel bad if your experience is not always as warm and fuzzy as the diaper ads or Hollywood would have you believe. It was such an enormous help to me when other parents-to-be and parents were honest about their pregnancies and parenthood – the good and the bad. And when I was honest in turn, I found that my honesty solicited the most practical advice, and the most heartfelt sympathy. If I’d kept quiet, everything would have been much, much harder, and much less fun.
Any specific dad-to-dad advice? Bjorn: There’s all sorts of things the dads can do to support mum and baby in hospital. You can be there to provide support and encouragement, and you can also play a critical role as an advocate when the mother is tired or concentrating on the birth. But do your homework first so that you know what kind of challenges you might come up against in your chosen hospital. If possible, speak to other parents who have had their children there in the recent past so they can help you to figure out what sort of problems you might face. And if your wife is British, remember to bring her many, many cups of tea to speed recovery…

Anything else? Katrina: I’m so glad I kept exercising all the way through pregnancy. Being relatively fit and healthy have helped with both the birth and recovery, and during pregnancy I relished the feeling that I could still work with my body despite the insane and often uncomfortable physical changes. I know parents and parents-to-be are hardly short of advice or anecdotes, and I promised myself I wouldn’t add to the cacophony… but if I were allowed to preach just one thing to pregnant mums, that’d be it.
Thank you for contributing Katrina, Gabriel and Bjorn!

The Annerley team

Comments Off

Hypnobirthing and normal birth in government hospitals

Hypnobirthing and normal birth in government hospitals

Posted on 31 January 2017 by hulda

As you may know, the  government hospitals are constantly trying to increase their normal birth rates.  They have in the last 15 years introduced the birth balls in all labour rooms, the dad’s massage programme and labour position choice for birth.  You also all know that this is not always obvious, not always offered to you. In fact, you may have to ask for it more than once, but usually in the end, if you know this is possible, it will make your experience and outcomes much better.
Annerley Hypnobirthing Classes

Hypnobirthing in Hong Kong

Luckily for me, when I had my last baby in the Queen Mary Hospital I knew what to do and even if I was asked to stay on my back, I smiled politely and told them that I had been trained to be mobile, even with the IV lines and monitors attached to me.  Then I moved to my knees on the bed and was able to do pick any position I liked.  I guess I would not have done that so comfortably had I not known that it was possible.
What I am trying to say is that the staff is now allowed to allow you to be more free in your movements during labour, they are able to encourage more participation of the dads in the labour room and now, have one more addition:
HYPNOBIRTHING training for the midwives in government hospitals is in the cards.  The training course for the midwives is scheduled for April, meaning that hopefully you will be able to enjoy even more support from the staff, for breathing and relaxation during childbirth.  At Annerley we can do YOUR  part of the training, i.e. the classes that prepare you with the Hypnobirthing techniques.  And then you will know that you will be greeted by staff that knows how to follow up.  Hopefully many midwives will sign up for this course, offered by the Department of Obstetrics and Gynaecology.
What is also very important to know is that none of the above will actually ever become the NORM, unless you actively ask to use it.  I.e. now that it is allowed in the hospitals does not actually have to mean that all staff wants or is used to using it.  It means  you can ask for it and actively participate in helping the staff to train their own skills too.  This is a constant co-operation that needs all of us to participate in.
So again, I encourage all of you mums- and dads-to-be to be proactive, positive, and help others to help you.  Slowly good things happen.
Happy new year to all,
Hulda Thorey, midwife

Comments Off

Can I give birth in a public hospital in Hong Kong if I don’t have an HKID card?

Can I give birth in a public hospital in Hong Kong if I don’t have an HKID card?

Posted on 16 December 2016 by Kristrun

We are often asked if you can give birth in a public hospital without an Hong Kong ID card that comes with being a resident in Hong Kong. The answer is both yes and no. You cannot register with a public hospital without a HKID card, that is a NO. They will not accept you as a maternity patient and you will be sent home. So in short for anyone who is not a HKID card holder you will need to go to a private doctor and sign up with a private hospital to give birth there.

What happens in the case of complications?

For severe complications, a private doctor or hospital may refer your case to the public hospital – so you do need to prepare for this scenario also. Again, even with a referral letter you will not be accepted as a registered maternity patient. If you go into early labour you will need to go to a public hospital via the Accident & Emergency department (A&E) – and you will have to pay a full price.

How much will I need to pay?

According to hospital authorities you will be charged a minimum payment of 90,000 HKD for a non-invasive birth and then 4,650 HKD per day for the hospital stay (given there are no complications with the baby). For any additional interventions such as emergency C-section, or any emergency care for you or your baby, you will be charged further on top of this (based on a phone call to HA on 7th of December 2016). There is no ceiling on these charges so you may need to calculate the worse case scenario.

So, if you are planning to give birth in Hong Kong without an HKID card, you will need to find a private doctor and a private hospital who is willing to take care of your case. Find your obstetrician, sign up with him or her and then choose a hospital.

To keep in mind when going private.  

  • The private system works best if birth is quick, routine and scheduled which is usually in no way what birth is like, unless a scheduled C-section is chosen.

  • There is a financial gain for both the doctors and the hospitals to use epidurals, inductions, vacuum, forceps and C-sections.

  • The private doctors normally work alone.

  • Transparency is limited in terms of outcomes and statistics – not available from many doctors.

  • While private health insurance is usually the way people pay for their maternity cost, doctors may not be as conservative as they otherwise may be in using medical interventions (here is how the EHIC cover explained for European applicants).

  • Some private hospitals will not allow much movement during labour and even though in theory they support active participation of the mum, using different positions etc, in practice they may not allow it.

  • Epidural rates in some private hospitals are up to 90% for first time mothers. C-section rates of up to 90% for some private doctors. Make sure to create a birth plan and attend independent birth preparation classes!

  • C-section rates of some private hospitals are up to 80% (WHO guidelines suggest that they should be under 15%).

  • Midwives are obligated to work according to the doctor’s instructions, therefore are not always free to allow the women to be independent.

  • Breastfeeding is very hard in some private hospitals, unless you book a private room during your postnatal stay.

Conclusion?

When going private, birth planning and antenatal education is essential – make sure to book your classes in time.

It can be very expensive to give birth in Hong Kong without a HKID card and you would need to invest in the time to have someone reflect on your case before you make the final decision.

Are you still confused? Just let us know, we can arrange meetings here in our clinic, by Facetime, Skype or over the phone.

Keep the babies coming

Kristrun Xx

Comments Off

5 things to know about giving birth in Hong Kong – public private health care – published in Localiiz

5 things to know about giving birth in Hong Kong – public private health care – published in Localiiz

Posted on 16 October 2016 by Kristrun

blog

“There are several key things to consider when making the decision on where to give birth in Hong Kong; factors which may come into play might be your medical history, previous experience, cost and insurance, where you live, and how you would prefer your birth to be. However, before you can reach that decision, it’s helpful to understand that there are two systems available in Hong Kong – public and private – and there are significant differences between the two.

In short, the Government system offers comprehensive maternity care for high and low-risk mothers for a minimal cost, usually less than $500. This care includes antenatal checkups, the necessary tests and ultrasounds (as determined by the Health Authority), care during labour and delivery, and postnatal care for your and your baby. This system also provides access to district maternal health clinics, where you can have your antenatal and baby checkups, as well as the hospitals themselves. You will usually be assigned a hospital depending on where you live. The private system, on the other hand, offers the same care for any low and medium risk cases, but with a greater scope on how you deliver your baby and who will be present at the birth…..”

Click here to read more -
Consultation with the midwives, available on Skype (face time or other platforms), over the phone or in the office. Click here to book. More information about our services on our website.

 

 

 

 

 

 

 

Comments Off

Prepare for positions in birth

Prepare for positions in birth

Posted on 19 September 2016 by Kristrun

birthballIt may not have occurred to you to practice birthing positions in different places before the actual day of the event. And why should you? Normally we only attend hospitals when something is wrong and then we are so used to be being told what we SHOULD be doing and how and where we SHOULD be. If you are unprepared, you may end up tethered to the bed – on your back, with feet in stirrups. It can be that this is normal protocol in your hospital – the staff are just doing their job and if you don’t object or have any better ideas, this may be where you may be throughout your birth.

Take some time to understand your options and practice your positions BEFORE going into the hospital on the day of your baby’s birth. The more we learn about labour and birth, the more health professionals, as well as pregnant women, are aware of the importance of being active and upright to help the labour progress. We can describe the advantages of upright positions during labour in short as follows:

Upright positions may:

  • Increase the strength of contractions

  • Speed up the labour process

  • Open up the pelvis

  • Increase space for the baby’s head (around 2-3 cm)

  • Help you to feel in control

  • Make you relax

  • Increase the blood flow to the baby

  • Decrease risk of interventions

  • Decrease use of drugs in labour

  • Relieve back pain

  • Greatly increase your chance of a natural birth

If you have difficulties standing/sitting try to:

  • Squat for a few minutes regularly

  • Change positions frequently

  • Use a birthing ball/fit ball

  • Use pillows/bean bags to lean on

  • Lean on the bed or a chair

  • Sit on the toilet

  • Sit on a chair in the shower

You are stronger than you think:  

  • When you are upright in labour, YOU ARE GIVING BIRTH, a baby is not being delivered to you.

  • In the labour room the BED is usually the centre of attention, and you immediately assume the role of the patient – unless you act strong yourself. Create your personal headspace – and escape.

  • Women who labour alone will almost always use upright positions when they give birth, not lying down and certainly not on their back.

 

2011/updated 2016 – Annerley the midwives clinic

 

Comments Off

When to go to the hospital to give birth?

When to go to the hospital to give birth?

Posted on 28 January 2016 by Kristrun

Midwife with woman during labour

Midwife with woman during labour

It is usually best to wait until you are in active labour before going to the hospital, or around 3cm dilated or if the membranes have ruptured (breaking waters).

This is for a number of reasons. Firstly, some hospitals have a policy where until you are at least 3 cm dilated, you do not go to a birthing (delivery) room. Whilst the policy is good, the implementation is not always optimal.

Labouring women tend to be more comfortable in their own environment. Remember how the hormones work – this will promote the endorphins and oxytocin, which will result in a shorter, less painful labour.

Added to this, until you are in active labour we have no idea of how fast your cervix will open. Getting to 3cm could take 2 hours or 22 hours and once you are in hospital there will be an expectation that you will progress and if you do not, someone will want to help you. This is where the cascade of intervention plays a role. Research has shown that whenever a form of intervention is utilized in your labour, there will be an increased chance of further interventions. Once you are in active or established labour, it is likely that your labour will continue to progress and there will be less likelihood of further intervention or a cascading scale of intervention.

A possible (but not inevitable) example would be that you are at the hospital in early labour and your cervix is open about 1 cm. After 4 hours the cervix has thinned out but is only open 2cm now. You are advised that your membranes should be ruptured to speed up labour, by approximately 30-60 minutes for a first time mum. Evidence tells us that having your membranes ruptured increases pain for the mother, so you choose to have an epidural. Evidence also tells us that the baby has an increased chance of demonstrating a concerning fetal heart rate pattern (CTG) – you are then advised that the baby is distressed and needs to be born imminently. Assuming the cervix is completely open and the baby is in a good position, a vacuum birth is safely attended, with an episiotomy. The baby is born in good condition, but subsequently develops jaundice, which requires photo-therapy and an artificial milk formula to clear the jaundice and you then develop problems with breastfeeding!

Other reasons to go to hospital would be:

  • Amniotic fluid is leaking
  • Concerns about baby’s movements
  • Bleeding, not mixed with mucous
  • Contractions 3-5 min apart, regular in length, strength and frequency
  • You do not feel comfortable at home

You are not trying to avoid the hospital, but trying to identify when there is a real need to go.  If labour comes on very quickly, sometimes there is also a need to move swiftly as you do not want to be on your way to the hospital with very strong contractions – better to have settled into the labour ward nicely.   Any woman with a high risk pregnancy, or if it is a second or third baby, needs to go into hospital as soon as the labour starts.

Please let us know if we can help!

The midwives

Do you want to know more? Consultation with the midwives, available on Skype (face time or other platforms), over the phone, or in the office. Click here to book. More information about our services on our website.

Private Labour Care at home is a great way to secure a private support in your home environment. Read more here.

 

Comments Off