Midwife vs doctor

Posted by: Brigitte Rozario Post(s) by this blogger

Almost all women in the Malaysian urban areas see a gynaecologist when they think they are pregnant. This gynaecologist sees them through the pregnancy, guiding their health and development until they go into labour and then the delivery.

However, in countries like the United States and England, the choice of having a midwife or a doctor as your primary caregiver is up to the patient.

What are the benefits of having a midwife or a doctor as your primary caregiver?

Datuk Dr Nor Ashikin Mokhtar is the founder and executive chairman of the Primanora Medical Centre. She has looked after more than 10,000 women and has delivered no less than 3,000 babies.

Dr Nor Ashikin

Dr Nor Ashikin says:

The advantage of seeing one doctor throughout a pregnancy is that the progress is being monitored, and the wellbeing of the pregnancy for the mother and child is also monitored. In Malaysia, to deliver their baby most women will see an obstetrician or gynaecologist.

These are doctors who are highly trained or specialise in women's reproductive health and also in pregnancy.

In such a situation the other advantage is that the doctor will be able to pick up any abnormalities early and to also be able to prescribe the medication that a midwife may not be able to prescribe.

Should the woman go into labour and if there are any emergencies, the doctor is there. It would be easier to anticipate problems, prevent them and intervene immediately if she has been seen by a doctor from the very beginning.

Definitely, a midwife is not encouraged for all pregnancies and certainly not for high-risk pregnancies.

Especially when you want to diagnose your pregnancy you need to see a gynaecologist. Again there are a lot of myths about testing yourself at home or even going to a GP (general practitioner) but that's not the ideal way to ascertain if your pregnancy is going to be a healthy pregnancy or not. Ideally, all women after they miss their period and they've had a urine test to check if they're pregnant should confirm it with an ultrasound check.

The midwife can't do these tests and not all GPs can do the test as well. Particularly if it's a high-risk pregnancy you should immediately see a gynaecologist because when you do an ultrasound even as early as six weeks you can see whether the baby is alive or not, you can see the heartbeat and you can see if you have one or two babies and if the pregnancy is inside or outside the uterus.

Cecilia Koh is a British-trained nurse and midwife with special interests in babycare with over 30 years of working with mothers and babies in England and Malaysia.

Cecilia Koh

Koh says:

When I worked in Britain, the midwife was a recognised professional – we were trained to look after normal pregnancies. We handled the pregnancy, the delivery and the post-natal care.

If at any time during the pregnancy or during the labour, a problem arises, then we call the doctor. They would also have a doctor assigned to them. So we worked with the doctor in that sense. In fact, most of the normal deliveries were conducted by midwives and the abnormal deliveries were conducted by the doctor.

One of the benefits of having a midwife is that she is trained to conduct the delivery by aiming for non-intervention. We try to take the more natural path. We have a lower episiotomy (a surgical incision made to enlarge the vagina and assist childbirth) rate. Without an episiotomy, even if you have a small tear, it will heal very fast. With an episiotomy there is the risk of it getting infected if you do not take care of the wound.

The delivery technique is different. Midwives have to be very, very patient.

During the delivery if the midwife is looking after you she's there the whole time. So there is a relationship even though you only meet the midwife in the labour room.

Doctors do not have the time nor the patience. They are not there to look after the patient, just the delivery. We spend more time with the patient with less interference. We try to get them to do things as naturally as possible.

Religion vs no religion

Posted by: Brigitte Rozario Post(s) by this blogger

Should you give your child a religion of your choice from the time they are born? Or should you wait until the child is old enough to decide for themselves?

Nadia (not her real name) prefers to leave it up to her children, aged 7 and 3, to decide when they are old enough.

My husband and I were raised with a religion but I disagree with certain things in that religion. I can't teach my kids to believe in something which I don't believe in.

We don't fastidiously practice the religion when it comes to certain conventions. To me these are just rituals.

We are very free at home. My son is too small to understand but my daughter asks me about religion. We just talk about it. Her cousins are quite religious and they teach her how to pray. And when she comes home she always discusses it with me. Usually I tell her that if she feels like praying it's okay, she can go ahead. I don't stop her and at the same time I give her freedom.

When my mother-in-law passed away, we went for the funeral. I told my daughter that her grandmother died and I explained to her that certain people believe that everyone has a 'spirit' and that the spirit goes to heaven and certain people believe in reincarnation. So far she has not asked me what I believe in.

She has asked me why I don't pray the way her cousins pray, why sometimes we join in the prayers and certain times we don't. So I explain to her that prayer is between you and God and if you want to talk to God. I don't believe it has to be at certain times and at the same time I don't believe that we have to do it every day, if we don't want to. This is how I feel. I always stress that this is my opinion and if you feel like it you can just pray at any time. Not giving her a religion and exposing her to all religions involves a lot of explanations.

My daughter knows about God. She believes in God. But I don't associate God with punishment in raising my children and disciplining them. Instead I tell my daughter what are the consequences of her doing certain things. But sometimes she decides to do it anyway. Then she has to bear the consequences for it. That's what I tell her.

My kids are exposed to other religions, too. So my daughter understands that Muslims pray in the mosque, Hindus pray in the temple and Christians pray in a church.

I teach her that people are different so they behave differently and there is no right or wrong. I hope she will understand.

Rev Dr Hermen Shastri, general secretary of the Council of Churches of Malaysia

Rev Dr Hermen Shastri

A child growing up would need a moral formation and values. Religion helps to give life a certain direction and perspective. If you don't give a child a religion from small then the child grows up with values inculcated from experiences in the context in which he lives.

If the child is still under the care of the parents and the parents belong to one religion then you cannot expect the parents to expose the child to other religions because the parents have a vested interest in the upbringing of the child.

I think the most important thing is the initial upbringing. If a child is inculcated with godly virtues connected to a certain religious belief system then that child will have that in mind. He will always have it in the background and perhaps dwell on it and perhaps then choose to practise that religion in a more fervent way.

I think it is important today to have that belief and connect it to life and the things around. Belief can come in many forms. Of course if it's the religious system that the family practices it brings the family closer together, helps bring meaning to important occasions like religious festivals, the birth of a brother or sister, maybe the death of a grandparent. The religious system helps the child cope with that and find its connection within the family.

When you're talking about a child you're not talking about doctrines and all that because a child won't be able to understand that but a child will be able to understand why Christians are Christians and why Hindus are Hindus and be able to see that kind of conviction lived out in the family. And then the child will appreciate and pay attention and it will never leave the child for the rest of his life.

National school vs vernacular school vs international school

Posted by: Brigitte Rozario Post(s) by this blogger

How do you choose the school that's right for your child? Do you enrol them in the regular national school, the national type school also known as the vernacular school (Chinese or Tamil school) or how about the international school? All three options offer their benefits and drawbacks.

Here are three people we spoke to who respectively offered good reasons for sending your child to each option.

Raymond Liew, board president at SMJK Yak Chee in Puchong

Basically I think parents want to send their children to Chinese school so that they will learn and be able to speak in Mandarin. Secondly, the Chinese schools offer more languages – Bahasa Malaysia, Mandarin and English. With these three languages you can work anywhere in the world, even though you might not be an expert in the languages.

Personally I don't believe that only one language can unite the people. I think that the more languages the children learn the better it is. In Chinese schools you learn everything. In our Chinese schools we have Chinese students as well as Indians and Malays. When the children mingle they learn from each other the different cultures.

From what I can see the national schools' way of teaching is different from our way of teaching. We have more emphasis on practical and not just on theory; we make sure the students do their homework; and discipline is very important to us. We also place emphasis on activities and sports.

It is true that students have a lot of homework in Chinese schools but it's because we have a lot of subjects. This doesn't mean that the child will grow up to be studious and not so well-rounded as we also have a lot of activities and sports in the Chinese schools. This is to build up both their IQ and EQ at the same time.

Whether the Chinese school students emerge with a good command of the English and Bahasa Malaysia languages depends on the individual. I don't think you can say that someone who goes to a Chinese school will emerge with a poor command of both these languages. 

I can see that the teachers in the Chinese schools are more responsible and more concerned about the students' development.

I think the best thing about the Chinese school is that it offers unity. The children are brought up to not be so divided. It is easier for the children of different races and religions to bond. Personally, I believe that the more you learn, the better to unite.

Margaret A. Kaloo, principal of ELC International School and chairman of the Association of International Malaysian Schools (AIMS)

Why do Malaysian parents queue up to go to international schools? They want English. They want smaller class sizes. They want more attention paid to their children; they want their children to be able to think, analyse and apply information, and not to keep quiet and not ask questions.

In today's world it has never been as important as it is now to be articulate. It's not enough to have it in your head; you must be able to articulate it; you must be able to ask; you must be able to apply it. That's where our students in government schools are missing out. They may get 14As, but can they think, can they analyse, can they apply information?

At the international school we have much smaller classes, much better student-teacher interaction, excellent extra curricular activities; we take the children out of the school and into the community and we even teach several languages like French, Bahasa Malaysia and Mandarin.

Being educated in English doesn't mean that the command of other languages suffers.

We can have anything from 20 to 60 different nationalities at an international school. Hence the students find out about each others' cultures and views, they learn to develop tolerance, they are encouraged to have a healthy international outlook, they form friendships which transcend traditional barriers and differences and they even learn a range of languages.

In addition, graduates of international schools have lifelong access to their school's international network of social and business contacts.

There is definitely a better chance of raising a well-rounded child at the international school and the middle class parents see that. They want their child to have the option to do all the other things like sports, music and drama.

An international education offers the opportunity to celebrate diversity in a spirit of understanding and tolerance and to develop a positive regard and awareness of other people.

Associate Prof Datuk Mohd Ali Hasan, National Parent-Teacher Association Collaborative Council president

I think that parents, or whoever takes care of the children, must consider who we are. We are Malaysians. We want our children to be grow up with the national spirit, a sense of integration, unity and belonging to Malaysia.

Where else can we send our children in order to achieve this?

Are we going to send our child to an international school considering that its reputation, image, status, even the curriculum is not to our mould. Secondly, we have to consider the cost and thirdly, the eliteness.

The school would consist of the upper echelons of society, perhaps the children of diplomats and high commissioners. I'm sure the general population in Malaysia cannot afford it.

So definitely, the international school is out of the question for the general population.

I can say that the Chinese school does have its strong points. For example, the teachers are very professional and hardworking compared to those in the national school. In addition, the Chinese schools excel in terms of discipline and infrastructure. These are the advantages of the Chinese school compared to the national school.

As for the Tamil schools, there are many in the estates where the facilities, teachers and infrastructure are still lacking and not on par with the national and Chinese schools.

I think for Malaysian parents, or whoever takes care of the children, currently it is a choice between the Chinese school and the national school. I think, we need to consider that we want to develop future Malaysian leaders who live in a proper Malaysian environment.

I would advise parents to send their children to the national school because I think we need to instil integration, unity, feelings of diversity in unity which I think is more prevalent in national schools.

Unity, integration and a sense of belonging to Malaysia is of prime importance rather than being compartmentalised, being with one race and not mixing with others.

For me, that is of prime importance. We want our children to be leaders of their own race as well as Malaysia and the global race, I think the national schools have a bit of an advantage here over the present national type school or even the international school.

Handphones vs no handphones

Posted by: Brigitte Rozario Post(s) by this blogger

Should children be given a handphone? On one hand it is great for convenience if they need to contact their parents or for parents to know where they are in any emergency. On the other hand, giving your child a handphone exposes the child to a whole host of risks.

Here are two opposing opinions to the question of whether a child should be given a handphone:

Noor Nirwandy Mat Nordin, project director of Muslim Consumers Association of Malaysia, deputy chairman of the Communications & Multimedia Consumer Forum of Malaysia (CFM)

Noor Nirwandy

I don't think that children should be given handphones until after the age of 16. It exposes them to too many risks.

During our time we could only talk to boys and girls on the phone under our parents' observation. We could never send SMSes to our girlfriends or boyfriends. So if we did anything wrong, we would get caught and punished on the spot.

The initial intention (for giving the handphone) is to provide facilities for us to know where our kids are but we must think twice before doing so. I advice parents to know how to adopt the technology before giving a mobile phone to their child. For instance, you must know if the phone given to your child only has the basics or if it's more than that.

But I still oppose just giving a basic phone. For me, not giving a phone is the best solution.

Secondly, you must impose regulations and an audit system. You must audit your child's behaviour. For instance, every night take the phone and browse through it. You should also have stricter guidelines such as using a prepaid number and giving them maybe RM10 of credit for one week or give the child a phone that is registered under the parent's name for better control.

There are no boundaries in communications these days – children can communicate through their phones, e-mail, chat. While you may not be able to stop them, you can minimise the communication.

We (CFM) have had complaints where parents say it is very easy for strangers to ask their underaged girl out for lunch or dinner. Having a phone opens up the opportunity for others to do bad things.

We want to minimise the risk factors. Problems in school with not doing the homework because of the handphone – that is secondary. We are more concerned about the bigger consequences of having a handphone like social problems – rape and having sexual intercourse at a young age.

For parents, if there are risks involved and you have calculated and you know that the risks won't benefit you, why take the risk? Better not to have the risk at all by not giving them a handphone.

Lim Fun Jin, technical director at ISA Technologies, father of two boys aged four and 15 months

Lim Fun Jin

I think it is inevitable that we give them handphones. I guess the key question is when is the right time. My personal experience from having a handphone and using it is that my social life is much more enhanced with a handphone in terms of connecting with my peers. I think for kids it's the same.

Parents buy their children phones for security reasons or for them to contact the kids but from the kids' point of view I believe it's to connect with their friends. As we know, today, social networking is part of our lives – from Facebook to simple things like using the phone for SMS.

But I guess the question for me is when is the right time and what is the purpose – is it part of the experience process or part of the IQ-EQ development to develop things beyond the academic side. Getting them to network and having a social life and friends – I think it's a good thing but obviously there's also abuse in terms of chalking up crazy amounts of bills and things like that. Those I think are the main concerns of parents.

Getting them a handphone is about educating them and teaching them to be responsible – what are you going to use it for, what are the guidelines. Yes, definitely there'll be elements of social networking but how far do you go? Kids have lots of friends but up till what age and what are their intentions? Nowadays you can pass a lot of multimedia messages over and some of the content may not be suitable for kids. So you're always exposed to these kinds of concerns.

But I think if the kid has been groomed to be responsible then by all means. I feel it's a good thing to have that responsibility than not to have it. We can always take the view that we will always shield them so that they don't have to face these kinds of difficult decisions and responsibility but in a lot of ways I find that the grounding is more important.

You need to ground them right and from there give them the responsibility and see where it goes. If it gets abused then withdraw the benefit.

My peers and I actually made some observations at a recent reunion. What we found was that you can be very good academically but the social element in terms of overall career development is actually a very important factor. And when does it start?

Social networking actually starts when we're young. But you must make sure the academic part is never missed out in lieu of the social part. I feel that things like phones, exposure to computers, even experiences with technology devices is a very good thing. It's a good experience to expand your social network.