Monday, May 19, 2008

Fantastic Birth in Bangalore!

I want to share a little about a birth I attended a week ago. I'd been traveling up north and returned to have a prenatal visit with my clients . My client, who I will refer to as C, looked beautiful, felt good and was excited about the upcoming birth. As her due date was only three days away, she and her doctor had discussed her doc's induction protocol, which was that she would need to go in for induction six days after her due date. C had a feeling her baby would come late, as both she and her brother had been more than a week late. (The American College of Obstetricians and Gynecologists has a guideline of 42 weeks, or two weeks after the estimated due date; given that due dates are often so uncertain and most first-time babies come late, allowing only six days before inducing isn't giving the baby much of a chance!) She very much wanted to avoid being induced, so during our prenatal visit we talked about natural induction methods: sexual intercourse (prostaglandins in semen help ripen the cervix), nipple stimulation, acupressure and herbs.

Her husband, D, called me at 12:30 that night and said she was having contractions that were four minutes apart! I said I'd meet them at the hospital, got dressed and was on my way. Luckily, we arrived at the same time, and by the intensity and frequency of C's contractions, I could tell that she was in transition. We went straight to the delivery room, where we met the on-call doctor and a few nurses. The doctor checked C: fully dilated and ready to push! Of course there was no time for pain medication, and my clients had come prepared with a birth plan, which stated clearly that the doctor and medical staff should avoid common and often unnecessary interventions such as shaving, enema, IV, episiotomy, oxytocin, immediate cord clamping, separation of mother and baby, etc. C was amazing, listening to her body and following its natural urges to push, while D supported her in the most gentle and loving way until their baby boy was born at 2:19 am. He was placed on C's chest immediately and kept there, skin to skin, for 40 minutes. (It's extremely unusual for doctors/hospitals to allow this much time to pass before they take the baby away, but as long as a newborn is pink and breathing, all newborn procedures can and should be delayed for at least an hour so that mom and baby can be skin to skin and establish breastfeeding.)

Unlike in most hospital birth settings I've been a part of in Bangalore, the doctors and medical staff were kind, quiet (for the most part), calm, and respectful of C's wishes as stated in her birth plan. (That said, it was a very short labor, so it's impossible to know how much pressure for interventions there would have been if labor had slowed or did not progress as quickly.) She was not given an IV (just a hep lock) nor did the doctor cut an episiotomy. She tore naturally, and was extremely pleased to have a natural tear instead of an episiotomy. Both parents are very satisfied with the whole experience, and I'm so honored to have been a part of it!