Tag Archive | "homebirth"

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The inconvenience – and beauty – of birth

Posted on 21 July 2013 by hulda

I have been a midwife for more than a decade now.  I have always loved my job and found great fulfilment in it.  There are days in between that I find it really hard and in terms of family and hobbies, it is very unfriendly.   Probably around 6 to 10 evenings or nights each month, plus one to two weekends each month are usually taken over by births or breastfeeding problems.  Additionally, we would like to go out on our boat a lot but very often cannot, as we need to be close by shore, should anyone go into labour.  As for Shenzhen trips or Macau weekends, – pretty much never possible.  Most holidays, my husband goes first with the children and is then joined by me. 

Recently I have been training for a 250 km Race in Iceland that will take place in 2 weeks.  This has taken its toll and pretty much all extra time, so my poor babies have been neglected by their mother as a result.  But even this is hard to do when on call.  Who wants a sweaty midwife who has been hiking in 30 degrees for hours, into their birthing room?  So all long distances have been on hold and it is stressful plus I need to have all my equipment with me for the homebirths, so I can never leave the car far away. 

A glass of wine?  Not so much.

A trip to Bali?  Not either.

Birthdays of my kids?  Seldom.

 

Each birth requires at least 4 weeks of commitment around it, and each one I also must hope that it does not overlap with another birth, therefore, not too many can be booked.  Additionally, each time there is a birth, there are usually around 5 to 10 other pregnant women who need to be rescheduled, some of which have come far away for their consultations with me. 

 

So from all of this, you can see that births and on-calls are highly „inconvenient“. 

 

Therefore, it pleases me immensely when I get to experience these same births eventually, with the families, and feel how this is all worth it.  I find it truly amazing to be a part of the experience where fear, pain, stress, noise etc. is NOT a part of labour, but rather it is replaced by some real Zen, peace and quiet.  The very peach that should surround every birth.  Where the parents are in the main role, as well as the baby, and the rest of us are bystanders that inspire and help, but don’t take over. 

Recently, I have together with my great team of other midwives and staff been very busy with births, including 2 homebirths and a few other births in hospitals, where luckily the doctors and medical team has been respectful and wonderfully professional to the families. 

Sitting there in the quiet, waiting for the births to unfold, giving it all the time it needed, is something that not everyone understands how important is. 

And seeing the little head slowly emerging and the parents quietly but enthusiastically gets the little baby into their hands and onto chest immediately, without any „procedures“needing to be done – just so important. 

Here in Hong Kong, there is so much need for support of normality in labour and birth.  Reading through Facebook pages, news, blogs etc. sometimes it saddens me how little support there is out there.  I read yesterday about myself as having „burnt my bridges with certain hospitals. “  Stories of my co-workers that have had the same are always regularly out there.  Not with any explanation of that IMG_6215these bridges are actually burnt while supporting  patients’ rights. It makes me tired and sad.

Although there are many who are also very supportive about normal births, these voices need to be louder. 

It does not all have to be about a natural birth.  It needs to be about good births, normality.  Support.  Women led – or family led care.  Based on the needs of the family.

I am proud to say that that is what midwifery is about.  This is why I love my work can proudly say that my whole team of midwives at Annerley also do.  We are a private practice that could so easily start to focus on the „inconvenience“ of births.  And make you think that you „need“ this and that.  But we don´t and I hope all of the families we have supported feel the same. 

Dear all mothers, fathers and babies – thank you once again for making it all worth it, allowing me and us to be a part of your births and for proving hundreds of times that births can be normal and peaceful, a good experience.  And for reminding us of that even if births are not very predictable, it is all completely worth it.

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Happy International Homebirth Day

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Happy International Homebirth Day

Posted on 06 June 2013 by hulda

midwife care at home - Hong Kong6 June: The purpose of the day is to educate woman that birth is not a medical procedure and solely the domain of doctors;  in most cases birth can happen quite naturally – with support rather than interference. Too often, and especially in Hong Kong, the default choice for birth is a hospital but this need not be the case.

Many people know that at Annerley we are one of the few places in Hong Kong (the only place?) that supports homebirth for mums with a suitable history, but what you should also realise is that we can support women through the early stages of labour  in the comfort and freedom of her own home, transferring mum to the hospital at the optimal time for delivery.

If you arrive at the hospital when you are already 5cm dilated, there is less need or opportunity for pain relief or induction to be offered than if you arrive not dilated at all. The chances are that you will also be home all the sooner.

Homebirths are a  wonderful experience, and every time I am reminded us of how things can be during labour; how having a relaxing, comforting and supportive environment make all the difference in the world.  If we could just recreate this atmosphere in hospitals here, there would be so much good done.  However the truth for the moment is noise, lights, talk, orders and equipment. If you are interested, please read more at the links below.

- Hulda

 

Read more about one woman’s take on International Homebirth Day here:
 10 Good Reasons to Celebrate International Homebirth Day

Find out more about natural birth at the Blooming Bellies evening

or, read about natural and homebirths on the Annerley blog

 

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Home delivery – Hong Kong

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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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Radio 3 – Life as a midwife and our birthing centre!

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Radio 3 – Life as a midwife and our birthing centre!

Posted on 13 March 2012 by hulda

Jan Tritten, Hulda Thorey, presenter Crystal Kwok, Eneyda Ramos

L-R “Jan Tritten, Hulda Thorey, presenter Crystal Kwok, Eneyda Ramos”

Hulda was recently on ‘Kwok Talk’, on RTHK Radio 3, together with her guests from the US, Jan Tritten, Editor of Midwifery Today magazine and Eneyda Ramos, educator and massage therapist,  both well known names in the midwifery community.

Sit down with a cup of coffee or herbal tea (!) and listen to the broadcast, as Hulda and her guests discuss midwifery in Hong Kong, covering such topics such as homebirths, the high rate of intervention and the planned home birthing centre.

Click to listen

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Government maternity wards and positions during labour

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Government maternity wards and positions during labour

Posted on 19 February 2012 by hulda

Hello all, thanks again for reading.  Exciting things happening and I wanted to share them.  Some of you may be aware of the fact that Franklen and Miranda shared their homebirth story in the Ming Pao newspaper earlier this week and it has raised endless response.  Poor Franklen has had little time to anything else but to keep the home running and take phone calls/emails, and the response is not all good!   Of course, such a controversial topic as a homebirth will always raise more questions and people have strong feelings about this.  To me, this is simply an option in addition to many other good options that Hong Kong has to offer, – it is not a statement to say that other services are not good.

Franklen´s blog: http://continuum-fathering.blogspot.com/

In any case, as a result of demand for more birthing options,  our Annerley Birth Centre will hopefully open not too long from now. Preparations are in full swing and we have felt so much support, thank you all very much.  Any comments, suggestions and birth stories are very helpful to us as we use these to help us make sure the birthing options in the centre will include pretty much EVERYTHING that a woman and family can ask for.  So keep your comments coming, we are listening.

birth options in Hong KongAnother really great thing that I wanted to share with you is that this week I am conducting a midwive’s workshop at the Queen Elisabeth Hospital, where around 30 midwives from the government hospital wards will come and learn how to assist women in giving birth in various different positions, other than semi-upright.  We will cover the squatting position, standing, kneeling, lying on your side, and on all fours.

They are all very excited and I am too. I truly hope that this will help the midwives to continue the great work that they have already started, i.e. to offer more options within the maternity wards.  For women to be able to give birth in a position that they choose is an absolute right in my mind, so if we can equip the midwives to feel comfortable in assisting, then there is nothing holding us back any more!

So this Thursday, the workshop will be on and hopefully all of you going to QMH, POW, QEH, PMH, PYH, KWH, TMH will have access to midwives in the future who will happily assist you in whatever position you would like.

Additionally, together with Katrin — the Icelandic doctor who has been with me for the last 3 weeks in her internship here in Hong Kong — we did a workshop at the Prince of Wales last week for all the midwifery students that are graduating this spring, covering the same topic – positions during labour.  They were very inspired and the class this year was big, 43 students, so this means that the wards will now be filled with students and new midwives that are eager to promote these new positions.

So that this development will continue, it is however, of uttermost importance that all of you, dear pregnant mums, further express your needs during labour, rather than relying on the options that are offered to you.  You must initiate what you are after, and be confident in trying various things.  Then this will inspire the midwives, who will work with you at an advanced level.

So to conclude, more and more birthing options in Hong Kong, positive developments and many great things happening in hospitals and in the community.

I welcome any discussion, please join in!

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