Birth of a ‘blissful birth’
In the developed and developing countries, including India, increased use of medical technologies during childbirth is a matter of concern. It is evident that the development and application of unjustified interventions is causing complex health problems for women. However, the trend of institutionalisedbirths is fast spreading in India.
According to an estimate, caesarean deliveries are more than 30-50 per cent in many states against the mandated 10-15 per cent by World Health Organisation. It indicates an impending public maternal health problem.
In this context, alternative ways of childbirth such as waterbirth and hypno birth are important and medical practitioners have already explored its possibilities. It is found that alternative methods ensure more comfort and maximum safety of mothers as compared to caesarean sections. Here, Future Medicine analyses various aspects of the alternative methods of childbirth.
PriyankaIdicula’s Birth Village in Kochi, Barbara Harpers’ Water Birth in the US and Dr Sunil Prakash’s California Hypnosis Institution in New Delhi are some of the known centres of natural birth.
“I will do anything to experience childbirth the way nature intends it to be.” It was the determination of 27-year-old Seethalakshmi who was pregnant with her second child. She talked about her experience during her first delivery and explained why she took a decision to have natural birth this time.
“I came to Birth Village from a remote place where the information regarding alternative methods of childbirth was limited. In Birth Village, I met PriyankaIdicula, the founder of the organisation, who understood my anguish and the pain of having caesarean. I told her about my desire to have Vaginal Birth after Caesarean (VBAC) this time. I began attending Lamaze classes with my husband. My husband Pramesh supported me.Priyanka explained to me about the pros and cons of VBAC and all the options that a woman preparing for VBAC needed,” said Seethalakshmi.
Childbirth has a spiritual angle to it. The childbirth brings a mother closer to her inner powers. Knowing this fact, Seethalakshmi clad in white dress began chanting ‘mantras’ as labour progressed.
“I drank juice and kanji, (rice gruel). They bathed me in warm water. I should say it wasn’t just a bath but a massage. Pramesh, my mom and my daughter stayed with me. It was truly a fantastic feeling to have your loved ones nearby helping and encouraging at every step. On December 17, 2010 at 7.05 pm, I gave birth to my child on a birthing stool. It was a proud moment in my life,” she said.
Seethalakshmican confidently say that she has experienced every aspect of labour and there is so much power that one feels when she is in control of her own childbirth.
Ojaswini is three years old. The name denotes energy and health. She lives happily with her parents. Ojaswini is the first baby born in Birth Village. A unique natural birthing centre, Birth Village was established in December 2010 by PriyankaIdicula. It is South India’s first established birth centre that offers antenatal, postnatal, mother and baby care with a holistic approach. Its goal is to provide individualised care.
Birth Village is a new concept where parents can also be involved in their daughters’ normal delivery. It is run by midwives and it follows the midwifery model of care. The institution works in association with Birth India (www.birthindia.org) to address maternal and foetal health in India.
“We give mental and physical support and care to the mother. Here, we seek support from both the mother and the father because we want to send across the message that childbirth is not just a ‘woman’s role’ or a ‘feminine process’ but it is the sharing of love and devotion as well. We make birthing a pleasurable, holistic and spiritual experience. It should also be a memorable moment for every mother and father,” Priyanka said.
Birth Village currently has a natural birth rate of 87.5 per cent with 70 per cent waterbirths. They also offer Lamaze childbirth education classes, prenatal yoga, breast feeding support groups, and women care.
As per the latest medical reports, the number of caesarian births has increased steeply in Kerala. Studies conducted by the Kerala SastraSahityaParishad (KSSP) indicate that C-section deliveries increased from 11.9 per cent in 1987 to 21.4 per cent in 1996 in the state. The National Family Health Survey II findings released in 1998- '99 put the rate at 29 per cent and the current estimates indicate that nearly 35 per cent of childbirths in Kerala are through surgical operations.
According to the National Family Health Survey 1992-’93, two states- Kerala and Goa- have shown the highest number of C-sections. Studies show that in India, the rate of C-sections is much higher in private hospitals than in public health facilities.
Parental education, good nutrition, exercise, support, commitment and above all preparing spiritually for childbirth are necessary to stop the growing trend of C-section.
There are over 350 birth centres in the US. Midwives attend the majority of births in the developed countries like Israel, Sweden, France, Denmark, Spain, United Kingdom, Finland, Norway, The Netherlands, Switzerland, New Zealand and Austria. In these countries, midwives attend 70 to 100 per cent of low risk births. These countries generally have the lowest infant and maternal mortality rates.
· Mind and body: Birthing is only a natural phenomenon where mother and child are the main characters. We need to support them. For a natural birth, mother should be healthy. She should eat healthy food and proteins, and do exercise. After delivery, she should keep fit physically. Spiritual thinking is also important.
· Reading books: It reflects in the mind of her baby too. The baby will react to the book’s content. If mother reads spiritual/classical/ inspirational /motivational books, the baby reacts to books in a positive manner. It surely affects positively the mind of a baby.
· Postpartum depression: This is a sensitive topic that is on the rise in Kerala. A mother must be free to express her feelings postbirth to her caregivers and to her loved ones.
· Patience to birth: Every mother has to know when she can give birth. The baby will react to her mother about the birthing and she knows when it will happen. There are reasons when a C-section may be required which may apply to 10 per cent of the pregnant women. The reasons must be backed with science and not comfort and convenience.
Birth Village’s six care practices which support normal birth
· Labour begins on its own
· Freedom of movement throughout labour
· Continuous labour support
· No routine interventions
· Spontaneous pushing in upright – neutral position
· No separation of mother and baby after birth
Plan for the midwifery model of care
a) Antenatal appointments :
· Discussing midwifery model of care, limitation of out of hospital birth, client responsibilities, care costing and payment schedule
· Personal, medical, obstetrical and family history
· Evaluate dates with LMP and EDD, decide if early USG for dating is necessary
· Physical exam
· Order lab work for parental tests
b) 2-8 week monthly check-ups
c) 36–40 weeks twice monthly check-ups with the midwife at the birth centre
The midwifery model of care
The midwives model of care is based on the fact that pregnancy and birth are normal life processes.
The midwifery model of care includes:
· Monitoring the physical, psychological, and social well- being of the mother throughout the childbearing cycle.
· Providing the mother with individualised education, counselling and prenatal care, continuous hands–on assistance during labour and delivery and postpartum support
· Minimising technological applications
· Identifying and referring women who require obstetrical attention
· The application of this women–centered model of care has been proven to reduce the incidence of birth injury, trauma and cesarean section
· Compared to the standard medical management, the midwives model of care is a fundamentally different approach to pregnancy and childbirth
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