Marking a hundred years of maternity care at KK Women’s and Children’s Hospital

Something was wrong. “Code blue for neonatal at Operating Theatres, Women’s Tower, Level Two,” blared the public announcement system at KKH on April 3, 2024.

Twice, the hospital’s security and fire safety department sounded the alert. A baby, just born, was in respiratory distress.

While the rest of the hospital went about its business, a multidisciplinary resuscitative care team of doctors and nurses from the Neonatal Intensive Care Unit (NICU) swung into action. They rushed to the operating theatre to stabilise the baby.

Following which the infant was taken to the neonatal unit for further assessment and follow-up care.

A profound sense of responsibility, both for the baby and the parents, goes through a team member’s mind when responding to an emergency, said Dr Nirmal Kavalloor Visruthan, a senior consultant at the department of neonatology. “Our top priority is to provide the baby with the best possible care, as rapidly as we can, for the best possible health outcome.”

Indeed, the hospital’s mission is to lead in excellent, holistic and compassionate care for women and children.

Founded in 1858 as a general hospital, KKH became a dedicated maternity hospital in 1924, opening on Oct 1 with 30 beds and 12 children’s cots.

Five babies – three Malay, one Japanese and one Chinese – were born in the hospital on its first day. By the end of its first year of operation, the hospital had admitted 714 patients and taken care of 588 deliveries. In 1934, its 10th year as a maternity hospital, the numbers soared to 2,826 admissions and 2,579 deliveries.

Today, the hospital has over 4,000 staff, of which about 500 are specialist doctors, more than 1,800 are nurses and over 1,200 are Allied Health Professionals.

KKH healthcare administrator Soren Chua, who is in her 30s, gave birth to her ninth child in KKH on April 16, 2024.

She said: “All my children and I were born at KKH, and we have just welcomed the birth of our baby girl. I was overjoyed to carry this new life and add it to our family.”

Madam Chua, who is married to Mr Mohamad Faizul Ali, a bus captain, has six boys and three girls, ranging in age from one to 18 years old.

Professor Alex Sia, chief executive officer of KKH, said that as Singapore progressed, KKH’s focus evolved in tandem with the nation’s health concerns.

Prof Sia said: “In the early 1900s, KKH’s various efforts were aimed at tackling high maternal and infant mortality rates. Today, we are addressing the burgeoning metabolic and mental health issues faced by our population, as well as falling birth rates.”

For couples with fertility concerns, the KKIVF Centre at KKH, one of Singapore’s largest infertility centres, supports couples through assisted reproductive technology and holistic, multidisciplinary treatment.

KKH embryologists have developed a virtual reality (VR) training programme for Intracytoplasmic Sperm Injection (ICSI) training. In ICSI, a single sperm is injected into a mature egg. The VR programme allows embryologists-in-training to independently hone their ICSI skills in an efficient and risk-free virtual environment. Design of the programme began in November 2021, and a prototype was completed in June 2023. Trials are still ongoing.

The VR environment, with the use of haptic gloves, helps trainees strengthen their dexterity and improve their hand-eye coordination in a safe space without needing an in-person trainer.

For women giving birth, the hospital implemented uSINE, an artificial intelligence-powered ultrasound system, in 2023 to help doctors deliver spinal anaesthesia accurately to women undergoing caesarean sections.

Doctors use the ultrasound system to scan a patient’s spine vertically and horizontally to look for the right spot where an anaesthetist should administer the injection. uSINE has been used in 10 per cent of spinal anaesthesia cases at KKH since its implementation a year ago.

“While I was apprehensive about spinal anaesthesia, the entire KKH team of doctors and nurses handled the overall process meticulously. The team guided me throughout the process and made me much more comfortable than I thought I would be,” said Madam Minu Murali, 33, a business analyst, who gave birth to a boy on April 17, 2024.

Her son Aadi Ojas Avinash, five, was excited to see his brother. He said: “Now, I have a new friend to play with all the time. It was such a cool feeling to hold his soft hands.”

At KKH NICU, South-east Asia’s largest NICU, the 40-bed centre at KKH hosts surgical capabilities for preterm babies requiring complex care.

Speech therapists like Ms Chen Yu Hui (below) are trained to help babies at NICU develop their feeding skills. Through assessments and feeding evaluations, they determine babies’ ability to suck and swallow safely.

It is usual for babies who have been born prematurely or who have been very sick to be unable to take all their milk from either the breast or bottle. These babies are given milk via a nasogastric tube or orogastric tube – a thin tube that passes through the nose or mouth down into the stomach.

The feed is allowed to drip slowly down the tube by gravity into the stomach and a staff nurse, like Ms Tan Yan Ni (below), has to hold the tube in this position for as long as it takes for the tube to be emptied.

In recent decades, there has been an emphasis on skin-to-skin contact between the mother and her newborn baby, which has been shown to promote better weight gain and development for babies who are born early or of low birth weight.

At KKH NICU, South-east Asia’s largest NICU, mothers are encouraged to practise kangaroo care, which consists of holding their babies close to their chest against their skin. In 2023, the neonatal unit was recognised in the Singapore Book of Records for the Longest Cumulative Duration of Kangaroo Care for Premature Babies in a month (305hr 9min) from Oct 2 to 31, 2023.

Madam Jesica Glenny, 35, a housewife, said being able to hold her baby skin to skin for the first time evoked mixed feelings. Her second child, Raykennen Ways, was born prematurely at 24 weeks, weighing 600g with under-developed lungs.

“The moment I did my first kangaroo care, I was so excited and overwhelmed with happiness as I was finally able to hug my baby. Yet, at the same time, I found myself feeling very sad,” she recalled.

“Such a simple gesture like hugging your newborn baby that a mother can normally do straight away after delivery, I needed to wait for two months due to Kennen’s breathing issues. He was so small in the beginning, and watching him grow slowly till this moment, when I was able to hug him – that was a very long journey for all of us.”

Kangaroo care is not only for mothers – fathers can provide kangaroo care for their babies too.

Escort driver Adnan Abdul Samad, 41, enjoyed singing to his seventh child Muhammad Noah Iskandar Adnan during a music therapy session. Born at 39 weeks and weighing 3.88kg, Muhammad Noah was admitted to the NICU with breathing issues.

“Having music therapy while providing kangaroo care to our son was a new experience for the both of us, and it really calmed and soothed our baby. Personally, I felt relaxed by the guitar rhythm, the singing and the bonding between my newborn son and me,” said Mr Adnan.