There exists a place that many of us in the birth world in Australia have only dreamed of. I do believe I have found the birthing woman’s nirvana.
In January this year my husband and I with our two children, aged seven and eight years, took seven months from our reasonably normal existence in Country Victoria and went to live in India.
We had arranged to volunteer with a charity called El Shaddai Street Child Rescue (www.childrescue.net). The charity has many facets but overall helps children who are begging on the streets break the cycle of poverty they are in by introducing them to “safe houses or shelters” where they can get food, bathing facilities and basic education. If children are particularly unsafe in their current environment they have several residential homes catering to various age groups and genders. Three of the El Shaddai homes were based in the small Portuguese influenced village of Assagao in Goa, 10 hours south of Mumbai and that is where we were based for the majority of our time in India.
As a student midwife and doula with my own business Birth by Nature I was excited that right next door to one of the homes was a free standing natural birth centre. I have always dreamed of such a place but very aware of how difficult it would be to create in Australia and somewhat an enormous feat. The current medical and political key players do not support independent midwifery and this type of care is unsupported by our current healthcare system.
On my second week I made an appointment to meet with the German midwife who owns the Centre, Corinna Stahlhofen. As I entered the centre the energy was so welcoming and the setting divine. The centre is a beautiful old Portuguese style villa with cool mud tiled floors, interesting art and artefacts and shuttered windows in every direction to allow the breeze to cool throughout. There is one main birth room with a magnificent huge bathtub that looks so inviting with feature lighting creating a lovely ambience. Outside the birth room there is a large open communal space where Corinna has a team of various practitioners taking pregnancy yoga classes, pregnancy dance classes and antenatal education classes. This leads through to a large kitchen that creates sumptuous goodies for all, including a European coffee machine. From here the outlook is of a patio adjoining the most beautiful tropical garden, giving an air of absolute abundance. It may have something to do with the many placentas buried throughout!! There is also a garden cottage which is used during busy times and if a family has to stay to receive additional support.
The Centre was opened in 2002 and currently cares for about 50 families a year. Thirty percent of those families are local Indian families and the remainder are predominantly Europeans on extended stays in India. There is a growing rate of affluent Indians from other states hiring houses for 8 weeks in neighbouring villages so as to access the centre and its unique service. The midwives honour the cultural values of the local Hindu families even though they are bothof European descent. In Hindu families it is culturally expected that the women stay away from home for six days post birth. The mother and baby then usually go to stay with her mother for three months, as many Indian women live with their husband’s families. It is during this time she is taught the art of baby massage with Ayurvedic oils and the ritual of feeding and caring for babies. We had a lovely experience where a dear Indian friend showed me on my own children how the massage was done. We sat in the mild afternoon sun under the coconut trees and laid the children as you would a baby on our outstretched legs. We used oils and vigorously massaged their face, chest, arms and legs. We then turned them over and did the same on their backs with the belief that this will give the babies good health and a strong constitution. Whilst doing this we burnt rock incense that we had bought at the local market earlier in the day. The combination of the massage with the rich aroma made my children delightfully floppy and in need of an afternoon siesta. With the babies they then have a breastfeed, get swaddled and off to sleep they go.
Unfortunately the modern Indian medical system is a far cry from this idyllic scenario. The births are highly medical with enormous intervention and a plethora of drugs being administered without much informed choice occurring. Bottle-feeding is perceived to be the best and most sophisticated as well as heavily promoted by aggressive formula companies. The two local hospitals in the nearby market town of Mapusa have caesarean rates of over seventy percent. The birthing rooms if they could be called that are sparse, uncomfortable and support people are not encouraged.
On a positive note Corinna has a professional working relationship with the hospitals, if women need to be transferred. The local obstetricians have given authority that the hospital midwives must act under her instruction if she brings women in. If they do end up requiring a caesarean either Corinna or the second midwife Navina supports the couple through this and they are transferred back to the birth centre at the earliest possible time to continue their postnatal care.
Some exciting statistics I was given by Corinna from the birth centre I believe need to be shared to highlight how “normal” birth can be. Firstly she has only done 3 episiotomies in her whole midwifery career. Prior to opening the birth centre in Goa she worked and managed one of Germany’s free standing birth centres which catered to over 2000 women per year. Women could choose whether to use the centre or birth at home with two of the midwives from the centre. Water births were considered the norm. The birth centre also catered for twins and breech births with doctor consultation.
Secondly she only uses synthetic oxytocin during the third stage where the placenta is expelled in about 5% of births. This is currently a routine procedure in most hospitals in Australia, with many caregivers not asking women if they want this intervention. Corinna considers it quite rare for it to be used if women are healthy and of good nutrition. This I find in Australia is one of the hardest negotiating points for women in challenging their caregivers’ routine application of the drug. In helping women understand the role of synthetic oxytocin and how it compromises the production of your own oxytocin which is your “falling in love” hormone I encourage them to read Gentle Birth, Gentle Mothering written by Dr. Sarah Buckley an Australian GP Physician.
Thirdly, fifty percent of the births are water births. However, many more of the women spend considerable amounts of their labour in the bath, but choose to get out at the pushing stage to utilise gravity at this time. Currently to have a water birth in Australia you pretty much need to birth at home as very few facilities will allow it.
Upon leaving the first of many visits to the centre I walked back through the village to my home and cried the whole way. They were tears of joy; tears that I knew there could be a better way than what the majority of Australian women experience and tears of excitement, as I now know a centre like this could be created, as there is a wonderful model to work from. This article I hope will sow seeds of encouragement to those who work in the birth world, will encourage women to demand more from our medical system as by being consumers of birth they can create change by writing letters, questioning their healthcare providers on “routine” procedures and honouring the knowledge that each of us have within our own bodies. Finally this article is a way for me to thank Corinna and her team for the wonderful work they are doing for women and their families as well as inspiring me that anything is possible if we choose it to be. I must also acknowledge at this point the impact of our time in India has had on each of us individually and a family as a whole. Mother India commands more of you than any other place I have been on this planet and on the flip side enlightens you beyond your wildest dreams….visit someday if you can.
On my second week I made an appointment to meet with the German midwife who owns the Centre, Corinna Stahlhofen. As I entered the centre the energy was so welcoming and the setting divine. The centre is a beautiful old Portuguese style villa with cool mud tiled floors, interesting art and artefacts and shuttered windows in every direction to allow the breeze to cool throughout. There is one main birth room with a magnificent huge bathtub that looks so inviting with feature lighting creating a lovely ambience. Outside the birth room there is a large open communal space where Corinna has a team of various practitioners taking pregnancy yoga classes, pregnancy dance classes and antenatal education classes. This leads through to a large kitchen that creates sumptuous goodies for all, including a European coffee machine. From here the outlook is of a patio adjoining the most beautiful tropical garden, giving an air of absolute abundance. It may have something to do with the many placentas buried throughout!! There is also a garden cottage which is used during busy times and if a family has to stay to receive additional support.
