Can I have a water birth in Hong Kong?

If you are considering water birth in Hong Kong, you may be finding it difficult to find information about it or of any hospitals providing the service. Unfortunately, water birth is not presently an option in any hospital in Hong Kong.

Additionally, the Midwives Council of Hong Kong does not recommend midwives provide labour care to women at home, meaning that most licensed midwives will not provide labour or water birth service at home. As such, attempting it can be dangerous for both the mother and the baby.

While this article attempts to answer most of the common questions asked about water birth, you can also email us (annerley@otandp.com) if there are any additional or specific questions that we didn't cover here. Our Maternity Package Manager and midwives are always available to provide guidance.

What is water birth?

Water birth is the process of either having the whole or some parts of labour and delivery in a bathtub or small pool filled with water ^[1]. 

What are the benefits of water birth?

Water is a form of natural pain relief and works by distracting the brain from the more painful stimuli of labour contractions. As a result, the body will produce natural endorphins to reduce both pain perception and the physical stress response. In summary, the buoyancy and sensation of the warm water can promote relaxation and calmness and may lessen the pain of labour and delivery.

This is believed to create a much more enjoyable birthing experience. Water birth has been found to reduce the need for medicinal pain relief and to improve maternal satisfaction with the labour and birth experience. ^[2].

Can you have a water birth in Hong Kong?

The short and safest answer is no because water births are currently not offered in hospitals or recommended in Hong Kong and as such there is no official infrastructure for it. Water birth at home in Hong Kong can be dangerous due to the lack of facilities, hospital back up support, properly sterilised medical equipment or trained staff willing to provide care. Therefore, at OT&P Annerley, we do not assist with water births.

What are the main safety concerns with water birth?

While the research shows that water births can be performed safely with the right equipment and the help of an experienced midwife, some rare complications can occur from time to time ^[3]:

• Although large research studies have not shown any increase in infections, there have been some isolated reports of infections after water birth.
• Although rare, your baby could breathe in some of the birthing pool water immediately after birth.
• Rarely, the umbilical cord may snap before the baby is brought up to the surface of the water.

Alternatives to water birth in Hong Kong

Although you cannot have the complete water birth experience here in Hong Kong, the benefits of water birth have also been demonstrated with the use of water immersion for labour only.

To achieve these benefits here are some alternatives you might consider:

• Some hospitals have facilities to allow you to use water during your labour. Many mothers spend most of their early labour on the antenatal ward, where there are showers available. Unfortunately, this is not usually an option once mums are in more established labour in the labour ward. One private hospital that does still have the option at this stage is the Matilda Hospital, where there is a bathtub in each delivery room to help relieve pain during the first stage of labour, but birth must occur out of the water. If labouring in the bathtub is an option at your hospital, you might also be able to use Entonox whilst in the bath (if Entonox is in a portable gas canister, it can be wheeled into the bathroom for you). With the use of a handheld waterproof doppler monitor, the baby’s heart rate can be safely monitored intermittently by your midwife, meaning that you can spend longer stretches of time in the water.
• You may prefer to spend the early stage of labour at home, so use any facilities you have for using water for pain relief there. Either sit in the bathtub or stand in a nice warm shower. If you are experiencing back pain try going onto all fours or onto your knees in the bathtub or shower.  If in the shower, lean against the wall and aim the showers water pressure onto your lower back. Water can also feel great over your bump or lower back: pour it with a jug or use the shower. It is also comforting to apply a warm wet flannel on top of your bump whilst resting in between contractions. Try adding a few drops of lavender oil into the bath water to help with relaxation. Just be sure to check that any essential oils you plan to use are safe for use in labour.
• If you would like to recreate a water birth experience after the event, there is no reason not to do this once you are discharged home. Fill your bathtub with warm water (around 37-38 degrees), have another person/ your midwife present to help, set the scene, perhaps some relaxing music, low lights or candles, submerge and relax into the water then place your new-born onto your tummy or chest. Make sure the warm water covers most of your baby’s body to keep him warm (alternatively continually place a warm flannel over him). In this position baby’s will often instinctively re-enact the birth crawl towards your breast. When babies are in close ‘skin to skin’ contact with you like this, it will help to calm them and regulate their breathing and heart rate. It can be a very relaxing and bonding moment for you, especially if you didn’t have the type of birth you hoped for.

Help at OT&P

Whatever your birth wishes, if you would like to learn about your options, we have a team of experienced midwives and obstetricians to support you through everything related to giving birth. Please know that experienced OT&P midwives are here and happy to help, and we also offer pre-natal classes for parents.

References

1. American Pregnancy Association. 2017. Water Births. [online] Available at: <https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/water-births-658> [Accessed 10 November 2020].

2. National Childbirth Trust. 2019. How To Labour In Water Or Have A Water Birth. [online] Available at: <https://www.nct.org.uk/labour-birth/different-types-birth/water-birth/how-labour-water-or-have-water-birth> [Accessed 10 November 2020].

3. Hochwald, L. and Besich, B., 2020. Water Birth: Pros, Cons, And What You Need To Know. [online] Parents. Available at: <https://www.parents.com/pregnancy/giving-birth/vaginal/what-is-water-birth/> [Accessed 10 November 2020].