Tuesday, May 20, 2008

On being born

I'd never actually seen a baby being born before. I'd just internalised what the movies show you: the rush of stretchers, the graphs, the gloved hands, the screaming. Until Bangalore Birth Network's film screening, where I realised that babies can also be ejected like paste from a tube. Mothers can be squatting. Fathers can be delivering. It can all be at home.

In India, women are recognising that being treated badly during labour and having objects inserted into them without their consent, is a violation - "birth rape". Recent advocacy efforts by birth networks has brought in a rare case to the Mumbai Consumer Court: that of a “fabricated c-section”. Medico-legal activist Dr. M. V. Kamath told me that he gets many such complaints but few people actually go ahead and press charges since proving misconduct would be hard in a profession "with so much secrecy".

In countries like the U.S. and the U.K., rates for c-sections are going up - are women "too posh to push" or are they being pressurised into surgery that will profit the hospital system and the doctors? A mum I spoke to in Mumbai said that at her first, highly interventionist birth, the epidural alone cost her Rs. 15,000 whereas the second, completely natural birth cost Rs. 11,000 from start to finish (without doctor's charges).

Interestingly, all the birth networks, midwife/doula services and advocacy efforts around natural birthing in India seem to be involve foreigners either as mid-wives or as co-founders of the networks. Most Indian women still give birth at home of course, but these are with traditional birthing attendants, or dai's, and urban women are often nervous about leaving their birth completely in the care of a usually uneducated (although highly skilled) woman, especially if they are going to be outside a hospital setting.

Women's births in hospital are so often acknowledged as experiences where they are completely vulnerable, in deep pain, and forced to entirely trust their medical staff who can approach the birth in whatever manner they feel like (separating women from families; making patronising remarks - one midwife told me she heard a doctor tell the patient "she shouldn't have opened her legs then if she wasn't able to open them now, in labour"; not allowing the woman to walk around or kneel or squat and instead insisting on having her flat on the bed; being intolerant of pain and so on) that the push needs to be for the mother-to-be to have "someone on her side". If midwives were integrated into the healthcare system, women would have someone with them during their labour, plumping for a natural birth, telling her that this level of pain was natural and normal (if it was) and most of all, they would have a companion who had the patience and the interest in them as individuals, to stay the course of the labour however long it took, without clicking in exasperation and pushing for a c-section, an episiotomy, an epidural, cervical stripping or whatever else.

Here's my story in Tehelka, which didn't get to say all of this, and which, also, describes my story as likening natural birth experiences to "village style" births, whereas I do think that integrating well-trained, very-skilled and experienced midwives into hospital systems or getting them to work with obstetricians is far from the current model of "village-style" births.