Home delivery – Hong Kong

Posted on 14 March 2012 by hulda

 

Annerley home-delivery births hong KongThis article interview with Hulda on the subject of home deliveries was featured in the March issue of Playtimes Magazine.

Use a search engine to look for information on ‘baby home delivery HK’ and you get a list of companies delivering anything from diapers to organic baby food, but not babies. This is not surprising as home deliveries in Hong Kong are extremely rare for many logistical as well as safety reasons.

Hulda Thorey, registered HK midwife and director and founder of Annerley, one of Hong Kong’s most established maternity and early childhood centres is possibly the only midwife in Hong Kong who will perform a home delivery.

Unlike in Thorey’s native Iceland, and other European countries where home delivery is more common, Hong Kong’s midwives are generally reluctant to perform a home delivery. Thorey explains that home delivery is not encouraged by the Hong Kong Midwives Association, nor the Nursing Council of Hong Kong, and if performing a home delivery, most midwives would prefer the back up of a physician in case of unexpected complications. However, such back up is extremely difficult to get, partly because of insurance restraints, and partly down to time commitments of medical professionals.

Thorey is well known for her passion for natural birth, but even she views homebirths with caution in Hong Kong as Hong Kong throws up some special logistical problems. “In the rare event of an emergency, you have to consider that transport can be a problem since ambulances and ambulance staff are ill-equipped or trained to handle emergency situations,” says Thorey.

“Location must also be a consideration – even down to the size of the lift as you don’t want to try to squeeze  a woman on a gurney, in the throws of  labour in an emergency situation into a tiny lift.”

Thorey describes her ideal candidate as a healthy mother, who is on to her 2nd or 3rd delivery, who is considered low risk with a healthy pregnancy, has good home support – and lives near a hospital. Thorey says: “I would also want to be sure that she had realistic expectations so that there wouldn’t be any resistance if we did need to transfer to a hospital.”

If a birth does go well, the Immigration Department is the next hurdle as they are particularly demanding with their requirements to prove that the baby was indeed born to this particular mother, and in Hong Kong as claimed. “You need two witnesses to the birth, usually the husband and myself,” says Thorey.  “It is a myth that a police officer is required to attend a planned home delivery. This is only mandatory in an unexpected home delivery when an ambulance is called for.”

However, the birth has to be clearly documented with a set of before, during and after photographs showing amongst other things the umbilical cord connected, and the delivery location.

However, the birth has to be clearly documented with a set of before, during and after photographs showing amongst other things the umbilical cord connected, and the delivery location

Besides a camera, surprisingly little equipment is required for a planned home delivery. Thorey’s midwifery ‘bag’ contains such things as a clamp for the cord and of course disinfectant, but also equipment that may or may not be required such as a TENs machine, equipment for administering stitches, a suction pump and oxygen for the baby.  In addition, some mothers may choose to rent a birthing pool; in which case a liner would be required ­– and possibly a change to the plumbing.

Thorey does not arrive dragging cylinders of nitrous oxide nor vials of tranquilisers. “I’ve rarely found the need for further pain relief in a home delivery beyond the TENS machine, water, hot packs, massage and a little more of TLC than usual,” she says. “Perhaps a woman who chooses a home delivery would typically have had a relatively easy first birth, but it is also down to the mindset of a woman who makes this choice. Research have also shown that the environment, and knowing your caregiver plays a big part.”

For mothers looking for such a homely environment in which to experience the birth of their child, the options in Hong Kong can seem frustrating. Private maternity beds are over subscribed, home delivery is discouraged and while thoroughly professional, government hospitals cannot offer customized care. Thorey says: “This is where the role of the midwife is so important in Hong Kong. We can help mothers manage expectations and make the most of their delivery – wherever it takes place.”

Given Thorey’s experience, it is not surprising that Annerley are in the process of setting up a Birth Centre where women can give birth in a more homely comfort, with the care of professional midwives, and presumably with a good-sized lift.

 

 

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  1. Hulda is featured in ATV’s News Magazine show! | Annerley midwives and early childhood professionals Says:

    [...] is the only midwife in Hong Kong who assists with homebirths. Homebirths in Hong Kong are less common than abroad because most people live in apartments that [...]

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