J, who is currently based in Delhi, is a corporate leader at an international technology company. Breaking the glass ceiling and exceling at her demanding job is something she has mastered. When it came to birth, it was only natural that she wanted to go through the experience based on scinetific and evidence based practices that have been proven to be best for mother and baby. Her search brought her to midiwfery, and to Birthvillage.
In J’s words:
“When I first learned I was pregnant, I was very excited. Once I felt confident that the pregnancy was likely to stay, I began to think about how and where to give birth. While abroad, I had heard about the potential negative consequences of unnecessary medical interventions in childbirth, was aware of international efforts to reduce c-section rates, and had heard about the midwifery model of care as an alternative. After reading Ina May Gaskin’s Guide to Childbirth, I was even more certain that I could give birth without medical intervention as long as I had an uncomplicated pregnancy. I had assumed that this movement would also be going on in India. And, in such a big city as Delhi, I figured, I would have many birth options ranging from extremely medicalized to ‘really hippie.’
I probably would have gone for an institution with progressive policies and a progressive outlook, but after I began looking for an OB/GYN I soon came to realise that my assumptions about what was available in Delhi were wrong. I was shocked that episiotomy is routine in India, there are essentially no midwives in Delhi, that c-section rates are not published by institutions, but widely known to be sky-high (one fairly progressive place bragged that theirs is 30%!), and that elective c-sections are seen as normal. When I asked a careprovider who was said to be a leader in the field about what my options for birth were, instead of starting a thoughtful conversation with me about the gamut of options from home to hospital and the pros and cons of each, she gave me a one sentence answer: “You’ll give birth here, and you can have as much epidural as you want.” Her attitude sealed the deal: I was NOT giving birth in a Delhi institution.
But where to go then? Thanks to the new maternity law of 6 months fully paid for those working in the organized sector, I had the luxury of time without diminishment of financial resources, so I knew I could travel to another place to give birth if I wanted to. I considered going abroad, but in that case my husband would have a high chance of missing the birth of our child, and I would also have to use more of my maternity leave before the birth while I preferred to use more of it when the baby was actually there.
I did copious online research and emailed with and met people and soon realized that Delhi had poor out-of-institutions options as well. I soon narrowed my choices down to Birthvillage and an independent midwife in Goa. The idea of travelling to another place where I know no one and don’t speak the language to give birth was rather intimidating, but I had to go find out what it was all about, and after speaking with people who had given birth in both places, my husband and I soon booked trips to Kochi and Goa. The good news is that both places were wonderful and I had a lot of confidence in both midwives. Housing was my biggest concern because both places were unfamiliar to me and I knew I would probably have to spend quite some time alone in whichever location I chose. Eventually I chose Birthvillage because I liked the fact that there was a whole center with an infrastructure and two midwives, rather than one person working alone. The housing, I figured, would end up working somehow, and it eventually did.
When I arrived in Kochi a little less than 3 weeks before my due date, I found myself quickly engulfed in the pleasant and peaceful rhythms of life at Birthvillage. Kochi is also a wonderful place to spend unstructured time for those coming from far away.
Going from a hectic corporate job with long days and the many responsibilities of managing a large team to the peace and quiet of being away from home with no greater responsibility than taking care of myself physically and mentally before the birth was a figurative breath of fresh air, while coming from Delhi’s record-setting air pollution conditions Kochi was literally a breath of fresh air. Beaches and the sea, fresh coconuts everywhere and beautiful palm trees made Kochi feel more like a tropical vacation than anything else. For the first week I mainly read in my room, went swimming, napped and enjoyed sampling Kerala cuisine.
Three times a week there were exercise classes, which were tough enough to put the fear of God in the most vigorous pregnant women and probably would have scandalized any mother-in-law. Luckily, with nine children of her own, the prenatal Guru instructor/midwife , had enough credibility that no one was going to doubt it if she said doing this much exercise was ok! I even started doing 50 squats per day, a habit my husband has carried forward in my post-partum period for its fitness benefits. Aside from exercise classes there were weekly check-ups with one of the midwives and usually one other activity per week, such as talks by women who had recently given birth at Birthvillage, and of course the prenatal classes. The prenatal classes gave my husband and myself an opportunity to reflect at greater length and in more detail about what was ahead of us, and helped us be prepared not only for birth, but also for the post-partum period- a period which seemed truly remote with childbirth looming before it.
Finally the due date came… and went. Even though I knew that first time pregnancies often go over and even though I was not experiencing any great discomfort, as predicted, I did finally begin to become anxious about when this baby is finally showing up! A few days before the 41-week mark I finally experienced some middle-of-the-night contractions. On the second day, one of them was so strong that it literally jolted me out of bed. Standing on the floor in the hotel room, suddenly there was liquid which smelled nothing like urine on the floor around me- my water had broken… but the contractions stopped. I googled furiously and let my midwife know what had happened. Apparently in 60-80% of these cases, labor starts within 24 hours. I called my husband and told him it’s time to come to Kochi… but labor didn’t start again. I was prescribed antibiotics to prevent an infection and I waited- now truly impatiently.
Luckily 2 days after the membrane rupture and before I could go totally crazy wondering about how many days I could stand to wait before asking for an induction, labor finally started. Labor started and by 2 AM it was strong enough that we called the midwives and they told us to come in. Suppressing contractions in an Uber is no fun, but we made it. Little did we know that a 23 hour ordeal stood before us!
As soon as I entered Birthvillage, put on my labor clothes and took off my glasses I entered into a completely different place. Time stopped. There was only the house, my midwives, my husband, Bincy the nurse, and me, all trying to get my baby out. Nothing else existed on earth, and I only had a vague sense of the passage of time because of the changing light filtering into the room through the curtains- night, daybreak, daytime, and then dusk and finally night again.
It is hard to describe the experience of labor. Even though I had read a great deal about it, I don’t think anything could have fully prepared me for it. It was a kind of alternate reality.
Yes, there was pain, though no individual contraction was unbearable by itself. There was also a loss of control over bodily functions that was shocking and humbling and stripped concerns about modesty and decorum away with it. It was not a complete loss of control- breathing and pushing could be controlled and the process could be influenced, but it was indeed a completely different physical experience from anything I had experienced before and an experience that was completely and totally engrossing. The only word I really had to describe the whole labor process for my friends later on was “INSANE.”
Labor went quickly at first. By the time dawn was breaking I was confident that I would be meeting my baby soon. But then something happened and my contractions slowed and were less strong. Labor had “stalled.” The midwives told me to take a rest. “Rest” I will say is a relative term if you are having contractions, even if those contractions are not quite strong enough to push out a baby. After some time of so-called ‘rest’ I was ready to get this thing over with.
But it wouldn’t happen as fast as I wanted. After a few more hours it seemed that ‘nothing’ had happened in terms of getting closer to pushing, even though my dilation had increased. I began to get frustrated. I wondered if this baby was ever coming out. The midwives reminded me that all babies eventually come out and told me that mine would be out by the end of the day. But they persuaded me to take a glucose IV and lie down to get more energy.
After some time I was ready to keep going. I pushed in all different positions, went up and down the stairs and did all manner of things. Eventually my midwives had a conference and told me that there was something blocking the baby from coming out. They both reached in during the middle of a few of the strongest contractions to adjust the baby’s position. This was especially painful! Finally the baby was in the right position, and they told me the baby was really, really close to coming out, but after by now nearly 20 hours in labor and little food (I had not appetite at all, not to mention that I could barely keep anything down), I got one more rest and glucose IV for the final push.
Finally the midwives were preparing as though the baby would be there at any moment. At this point I didn’t really believe the baby was coming soon, and thought it would take at least a few more hours, but I was ready to do whatever the midwives told me, so I was no longer especially concerned about the time. I pushed in different positions. They told me that the baby was crowning (finally!), and then all of a sudden the room was filled with loud baby crying, or actually, top-of-the-lungs angry screaming! It was a strange sensation that suddenly another person had entered the room with his own will and opinion and way of expression. That way at least I knew immediately that the child was alive and hearty. My only thought was, “Thank God it’s over!”
The baby looked like an alien with a cone head and leathery, peeling skin and flattened ears. He lay on my stomach flailing around and greatly surprised me and my husband with his vigor and apparent will power. But he latched quickly, and we eventually spent the first night in exhausted sleep, even though I had thought there was no way I would be able to sleep with such a precious, strange little creature at my side.
Over the next days and weeks we learned how to change diapers and observed with fascination as the baby learned to feed, as his features slowly changed, as he first lost and then gained weight, and as he achieved the magic target diaper count.
I am writing this now from my living room sofa in Delhi one month to the day after the birth. The baby is lying next to me on the sofa and has just successfully rolled from his back to his stomach. He is healthy and a delight. My own bleeding has stopped, stitches are healing well, I have long returned to my pre-pregnancy weight, and the birth itself already seems like a thing of the distant past, an alternate reality that I entered for 23 hours, was guided through by the most competent hands that could be, and came out of blessed with the sweetest little baby imaginable.”