The Motlaghs

In the depths of my time warp in which things seemed to be going a millimeter a day, a nice beach trip to Canggu introduced two lovely people that I have a feeling will be my friends for life. Jason and Meisha are from the D.C. area and came specifically to Bali to have their baby. Jason, a journalist specializing in the middle east and Meisha, a modern arts dancer with her own dance company are both uninsured. When Meisha & I met waiting for our driver I immediately felt a connection. She has this gorgeous smile, sweet mildly detectable mid-western accent, long beautiful brown hair and brown eyes that grab at you to become a part of her spirit. Jason, interestingly, has mannerisms, a voice and a character that is that of my brother. I absolutely trip out when I hear him call my name, say certain words and do certain things because it’s as if my brother had a twin and he was accompanying me on this trip to Bali. He was fumbling a football back and forth in his hands the day I met him. He too had this smile of happiness and pure joy, a warmth & comfort that felt like home. In a glimpse of a moment, I even sensed a bit of relief from the both of them.
During our one hour ride to the beach, I learned that Meisha & Jason left the U.S. simply because they didn’t want to spend their savings nor go in to debt to have this baby. Jason & Meisha are both uninsured. Meisha already had 5 appointments in the states with an OB/GYN and acquired a $1500 laboratory bill from a 5-minute lab draw on just one of her appointments. Not to mention, they wanted to charge her $100 every time she came to pee in a cup when she had no risk factors or symptoms for developing diabetes or hypertension. Every appointment was a chore for Meisha because they were paying out of pocket. At each appointment, she would ask if it was really necessary for this test, this exam or to pee in a cup each time. No one would ever give her any rationale nor could they figure out what each procedure was going to cost her so she could decide for herself. Each appointment cost her between $200-$300 for just 10 minutes of the doctor’s time. Meisha said she tried to apply for public health insurance but the cut off was an income over $13,000 and she did not qualify even though she was currently unemployed. Just from her 5 appointments, Meisha had already racked up bills in the $3250 range and she was only 30 weeks pregnant. After Jason heard through a friend of a friend of their happy, successful & healthy delivery at a non profit birthing center in Bali, they investigated. They discussed and realized it would be cheaper for them to live unemployed in Bali for 4 or 5 months and have the baby then it would be to stay in the states working and living in an apartment. Meisha received a warm, welcoming letter from the lead midwife in Bali and was easily convinced by her that Baby Simone would not only be her Guru but that Bali would be her birth place.
And so, my friendship with Jason & Meisha flourished. Particularly with Meisha when Jason left for Moscow to do a “quick” story during her 37th week, we immediately started forming a tight female bond. I would check in with her every day to make sure she wasn’t contracting during Jason’s absence and she would call for some company to the local pool to relieve her ongoing pregnancy aches. I introduced her to Deeksha on Wednesday nights and nervously motorbiked her around Ubud for special meals, to kill boredom or to attend the yoga classes she needed for her sanity (Meisha shocks everyone with her headstands and back bends with a full term fetus in her belly). We had good, long talks about life, the men we love, our passions and where we see ourselves in a couple of years. She, like me loves to travel and envisions her, Jason and Baby Simone as being citizens of the world. I think we identify a bit of ourselves in each other. We’re both confident, independent women yet feel vulnerable to life changing events. I’ve learned from Meisha the quarks, fears, concerns and bodily changes of pregnancy (you’d think I’d be so familiar with these things, but I’m an expert in birth and complicated pregnancies not the 40 weeks leading up to it! ) and Meisha was able to ask any labor & delivery question she wanted to mentally prepare for the big day. We fulfilled each other’s loneliness from our men, the female friendships we missed from home, the comfort of our family and a human connection that is almost necessary when traveling abroad. Even if my experience in Bali had its ups and downs and lacked moments of purpose, I know my sweet angels sent me here to find my new sister, Meisha and to help her retrieve her daughter from the Land of the Souls during her labor.

Bali & the Place I Sleep

Every morning, if I can remember, I try and pick up a freshly fallen plumeria flower and place it in my hair like the Balinese do. Hibiscus, roses, heliconia, oleander & torch ginger grow virtually without any maintenance in my yard. Sometimes, monkeys wake me up on the balcony wondering if we left any food out. They clean each other, have sex and move on. The rice field that expands about an acre is my front yard. Every morning, I open my hand-carved, heavy, double-wooded doors I see the green tips of the rice plants dancing in the breeze. I think they should be ready for harvesting before I leave. The birds sing to me, our helper Dewi makes new offerings to Ganesh our home protector. I make breakfast and tea and wonder what this new day will bring.
There are so many things that make me spontaneously smile in Bali. I love if I leave at the right time in the morning, I can just be cruising down a beat up road and smell incense everywhere from the morning offerings. In Bali, the unseen such as the gods, ancestors, spirits and such are treated as guests of honor. In typical Balinese fashion, these guests of honor require certain hospitality in the form of offerings. The morning offerings usually consist of sweet cakes, rice, fresh flowers & incense so not to disturb the normal rhythm and harmony of life here in Bali. On ceremony days, the offerings are much more elaborate. At home, every morning, Dewi (our helper) comes and does the offerings to Ganesh and our other prayer box. If Dewi isn’t here, somehow the neighborhood knows and a Balinese woman shows up dressed in her traditional lace top, sarong (patterns and colors need not match here), stomach tie and flower in her ear to make sure the harmony of the house isn’t interrupted by the unsettled gods. This morning, the last day of Galungan, called Kuningan, 4 people have already showed up giving offerings in various places on the property.

My temporary home looks pretty creepy from afar. At the end of a road, a sharp turn is made and suddenly you see this small, yet expansive rice field with a house sitting all alone on the other end. It kind of looks like the Munsters house. The roof is medieval looking and the only window to jet out from the array of bushes & flowering trees looks like giant eyes watching over the rice field. I live downstairs with my own marble bathtub & bathroom, a hand-carved Balinesian princess day bed and the kitchen is attached. There is another “guest house” steps away that is used for the Acupuncturists’ clinic who lives here. The upstairs of the clinic is an open-air yoga/meditation room that overlooks the rice field.

There are so many sounds that I’m trying to identify living back here on the rice paddy. In the morning, there’s the grunting sound of a crazy man. It sounds like he’s exorcising some sort of demon every morning. I learned while sipping a Bintang from the gorgeous pool I go to every day that the crazy man is actually the rice keeper using some sort of instrument (like a duck calling whistle, but a crazy man calling whistle) to scare the birds away from the rice. THANK YOU! I still haven’t figured out what the slapping noise is…but that will come with time. Aside from the enormous geckos the size of small volkswagons yelling, “Fuck You! Fuck You! Fuck You!” at random times of the day (this morning at 4am was not cool), I can pretty much put off the noises of the beetles, the birds, the roosters, the mosquitos buzzing my ears quite easily. At night, around sunset, it’s nice to hear the whole village come alive at the temples with Balinese gamelan (orchestras) composed of bronze metallophones, various gongs, flutes, drums and other percussions.

The Balinese believe in karma so there is virtually no crime here. When driving around on my red motorbike with my rockin’ bright yellow helmet, people cut each other off and wisp around without traffic flow or organization. But somehow, no one has any road rage. Even the horns are made to sound friendly. There are several reasons why the Balinese beep. They beep to say, “hey I’m coming through” or “move over a little bit” they beep to say “hello” and even beep to warn someone of another hazard not related to themselves. Everyone helps each other out here. Particularly in the village. The village is literally owned by the people, so everyone grows up as a family. I think people in the states could learn a lot from the Balinese, their traditions, their family values, their respect for the unseen, their culture and overall genuine joy to be pleasant to everyone.

I love Bali. Every day I’m surprised by the pleasantries here. Wouldn’t you know, just as I wrote this sentence, a woman walked into my room with a tiny, hand woven gift basket made up of fruits, pastries and fried bananas. She was the fourth person to come today for offerings on the property. She had rice grains pasted to her forehead and neck, flower pedals over her ears (an indication they have been to prayer this morning). I guess this is her offering of hospitality, to the white girl, a seen guest sitting in her room blogging on Kuningan Day. I’m closing now to the sounds of the gamelan (temple orchestras) and chants being heard from across the rice field. Oh Bali!

My First Bali Birth

Sitting in the Ashram working on one of the many projects that are going on, I get a call to go to the clinic right away. A western woman is in labor. And, she is very active. Great! This will be my first birth here in Bali. I quickly change my clothing (no tank tops allowed and clothing to cover up to the knees). I could hear her screaming when I arrived in the parking lot of the clinic. I arrived to her room and she is on her side. Her long blond hair pasted to her face from the sweat & tears. Wait a minute, I remember her. She was in the acupuncture clinic the day before for a treatment to put her into labor because she was 1 week past her due date. Well, you can say her acupuncture treatment worked! One of the Bidans is examining her. Just a light separation of the labia, I could see the water bag still intact with a bit of dark hair from the baby’s head. The head midwife arrives (a bit of a celebrity here in the village) and I help to quickly fill the tub with warm water to prepare for a water birth. Another Bidan steps in and frolics fresh yellow and white flower pedals all over the water to float about the tub during her labor & birth. We help our new mother-to-be to the tub as she holds her naked belly and waddles in. Once she gets in the tub, the screaming stops. Her husband, at her side is supporting her and making sure warm water is sustained on her belly.

Our Momma goes in to a trance. Her eyes are closed and she becomes unavailable to the external reality of the room. The midwives, myself and her husband can access her if needed, but all of us can see it’s a place she needs to go. The head midwife explains to me that in Native Indian tradition, when a woman transitions in to this trance like stage of labor (usually about the time she starts pushing), it’s her spirit going to the Land of the Souls to retrieve her baby.

As the contraction surges, her body gets more restless, she tosses back and forth in the water slowly until her face grimaces, her teeth grit, and she cries a bit with the grunting in an uncontrollable urge to push. I can see the bag of waters bulging through her perineum. Her membranes haven’t ruptured yet and the midwives don’t plan on rupturing them either. I’m so calm during this labor. The head midwife is resting her head on the next with her eyes closed. Although far from any hospital, between contractions I contemplate the overt differences between the birth I’m attending now and how it might unfold if she were birthing in the States.

I flash to a scene of heightened energy, nurses scrambling to put external fetal monitors on, the patient is rushed to her only option of laboring, in the bed. Others scramble for the blood pressure cuff, a thermometer, another nurse to collect blood and get an IV in her, one frantically calling the doctor to make sure the doctor makes it on time, consent forms, more consent forms and an endless pile of paperwork. Oh! And the radiant warmer, is it on?! Does the oxygen and suction work? Are there plenty of warm blankets? What about the sterile table? Do we have one made up with all the instruments, blue drapes, betadine and cord blood collection tubes? What about the baby scale and all the baby’s meds?

I return to the present, I’m gently splashing warm water on her tummy and breasts to make sure those exposed parts don’t get cold. I nonchalantly retrieve the Doppler to check heart tones. 130 beats per minute, precisely what they were when she arrived. I take the Doppler off. Another contraction surge begins and I direct her to grab her knees and to curl around the baby. No counting, no screaming, no chaos. She pushes, she pushes all on her own with what her body is telling her. She listens to that incredible urge that cannot be denied. I can’t even tell if she hears my direction. She’s still in this trance like state, but she follows through so she must hear me. Quiet voices, everyone is calm, all our movements and efforts are smooth & collected. There’s one Bidan sitting on the bed recording our efforts, the other at the tub. Our Beauty is giving her best efforts in whichever position she chooses. We suggest getting in a squat. She slowly responds and makes it to the position. As she’s pushing, I see some changes that indicate the baby must be close. We gently assist her back to her backside and we see the head crowning. The membranes must have ruptures spontaneously. We check the baby’s heart beat again after the bag of water broke. It’s still pumping at that perfect 130 beats per minute.

My mind returns to the scene in the states where the physician rushes in to the room panting. He puts his sterile gloves on to check her. He shoves his hand inside of her as she lets out a scream. He asks for a hook and the attending nurse hands him a sterile amnihook to break the bag of waters. He sticks his second hand in her and starts stretching her with both hands yelling at her to “PUSH, PUSH!!!!”. Then, the “1-2-3s!!!” start being belted out and the head begins to crown. The doctor, having rushed out of his office hours with a waiting room full of patients begins to get impatient and says, “You’re going to need some extra room here.” He grabs for the scissors and cuts an episiotomy on her even though all the current research states that episiotomies take longer to heal, have more pain associated with them, are more likely to extend in to bigger lacerations and will probably be a recurring tear for future births. But, hey, he’s in a hurry and wants this baby to come out so he can get back to his office hours.

Back to my current reality, a bit of a scream escapes her mouth for the first time since she arrived and the head delivers. I check for a cord around the neck and feel only but a few fingers scrunched up near his neck. He must have had his arm and hand across his chest in the vaginal canal. We wait for the next contraction to delivery the rest of the body. As the rest of the body delivers, I tell our Mom to open her eyes. For the first time since that transition to the Land of the Souls, she opens her eyes and sees her baby. The baby starts to cry, Mommy starts to cry and Daddy starts to cry too. We keep the baby skin to skin, umbilical cord intact, place a warm beanie on his head and wave all those beautiful floating yellow & white flower pedals towards the new family.

Contrasting back to the Western Birth scenario, as the mother lies in stirrups with bloody blue drapes encompassing her flower, the baby is wisped away from her for shots, a rectal temperature, measurements on a cold scale amongst other abrupt procedures. The mother tries to see what her baby looks like from a distance, but the distance of the warmer and the nurses are blocking her view. She’ll eventually get to hold her baby when she’s all cleaned up and the nurses are done with their baby procedures. Hopefully she’ll get some assistance with the first breast feed. But in reality, the nurses only have two hours to recover her and the baby before being moved to postpartum. There won’t be much time if the baby doesn’t latch right away.

Back at the Bali Clinic, the baby’s first 3 hours will only be about skin to skin contact with Mom for bonding and breastfeeding. All baby assessments, exams and measurements will be delayed.

I have never witnessed birth in this setting before. I remembered a story our head midwife was telling me the night before. She was explaining how interesting it has been to hear from this years’ teachers in the local village. She’s had this clinic for nearly 6 years and some of her first babies are now entering kindergarten & first grade. She said the teachers are joking that it’s hard to identify who is the smartest kid in class because they are all so well behaved, calm, open and incredibly intelligent. 90% of the children in these new classes are babies born here, in this very clinic where their philosophy is, “Gentle Births for a Peaceful Mother Earth”. It has sparked my curiosity into the current ongoing research regarding the birth environment, setting & natural hormonal concoction (a sort of “Hormonal Love Cocktail”) that happens between a mother and her baby at birth. Is it possible that an important pathway or series of love hormones could be interrupted or non existent as in the case of cesarean sections and westernized births where the baby is separated too early from the mother? What sort of demeanors do babies have as they grow in to young children and then adults if they were born in a gentle, warm environment? Is there a difference between kids born by cesarean vs. natural childbirth in their latter years? What does that mean for a future society of people where the cesarean section rate is nearly 40% in some hospitals? These are some questions I would like to explore while I’m here. I will do my best to pick the brains of the Bidans & our head midwife for this research.

I am a changed woman when it comes to my perspectives of a normal birth. How will I go back to something that I don’t believe in? Will I have to justify my actions (of working in hospitals) by saying I’m her only fighting voice against the interventionists? Why have we moved so far away from our Mother Earth? Our God given right and honor to do something so natural has become so unnatural.

****The water birth photo is not mine, it is from the internet. However, the baby photo is the miracle of this story.

A Bingin Surfing Tale

With just over a week of being in Bali, I’ve experience (in no particular order & not limited to) birth, epic surf, breathtaking sunsets, made new friends, started Bahasa Indonesian Classes, attended the Global Mala for yoga in Ubud & saw a woman be treated with some sort of smoking acupuncture to reduce the size of her thyroid. It feels like I’ve been here a month already. I can only imagine what could come with 6 weeks left. Here is a small surf tale to tell.

Bingin Beach. A small surfing village built into the side of the cliffs between the infamous surf break Ulluwatu & the ridiculously beautiful, Dreamland. I arrived after a two hour drive looking for “Anna’s Place.” Arriving in the parking lot, I was swarmed by whom I renamed the Nyoman-TriSister-Mafia. First, they smile. Then, they greet you with their hand extended asking your name. THEN, they follow you, follow you and keep following you until you allow them to carry your surfboard to the homestay. Since they seemed to know where Anna’s Place was, I allowed them to carry my board. The whole way down one of the Nyoman-TriSister-Mafias is hackling in my ear about, “how much you pay. How much you pay.” As we negotiate price she responds with the most high-pitched, ear cackling laugh as if my offer is an offensive joke. Yeah, yeah..it’s all tactic, I get it. Just as we turn the corner to arrive at the top of the cliff stairs, I see the swell. HoRy cLaP!! Even from afar, I can see mountains of waves rumbling towards the shore. I was mesmerized. I couldn’t take my eyes off them. The N-Tri-Ms are trying to get my attention, but I can’t stop gawking. I nearly biffed it down the stairs. The only other time I saw something like that was the 1st week in December in 2007 at Swami’s. This kind of swell is a frequented occurrence here, not a bi yearly event.

So, Anna’s Place is actually called Stiky’s II. Great Place! Gabriel was right, the views from the deck upstairs are spectacular. It’s super clean and Nyoman (NOT of the Nyoman-TriSister-Mafia) is an incredible cook. I spent hours watching guys eat shit (with reef wounds to prove it) and shred over a shallow reef at Bingin. Impossibles, the break just out to the left of the beach was a long paddle past the reef with the most impressive moving mountains of water I’d ever seen. Perfect, perfect lefts just peeling for hundreds of meters. The 10-12 foot swell was too big for my comfort on the first day but lounging on the beach, receiving a Nyoman-TriSister-Mafia massage (they hustled me all over the beach), drinking Bintang, reading & listening to music in paradise suited me just fine.

After my best night of sleep since I arrived in Bali, I woke to a more tolerable swell size with perfection peeling on. I surfed my ass off for 2 hours catching some of the bigger waves of my life. As I carved up down these water walls, I strangely welcomed the lactic acid build up in my thighs until they pleaded with me to pull out. I often forget about that part of surfing in California. My day ended with a second sunset surf at Impossibles, another Bintang, some Mie Goreng and the sound of the ocean as I laid my weary head on my pillow. I love surfing. It’s a dance with the Great Mother I hope I never lose.

The next morning I left with the Nyoman-TriSister-Mafia fighting for who was going to carry my board. Funny, just yesterday they were sisters who shared all their business and therefore each needed to be paid a fair wage. Hhhmmm.

The Start. The Beginning. My First Perspective

As I pack endlessly for my -2- month trip to Bali today, I have mixed emotions. A bubbling loneliness & physical distance from the one I love, an excitement for the spectacular adventures to come from surfing, exploring and taking in Pacha Mama's beauty that encompasses Bali and a confused self exploration into my profession of nursing in Labor & Delivery.

There is a constant weight on my struggling heart against the westernized medicine that has tainted, impurified and taken away a woman's natural, god-given right to simply birth. Where do I stand here? What is the correct way to practice my profession when I don't believe in what Westerners have turned birth in to? Why does modern medicine believe that they suddenly know exactly how to care for a woman in labor when mother nature has been taking care of it for thousands and thousands of years?

Yes, I do believe there are many great, fantastic, life-saving interventions & treatments for a medically complicated pregnancy rattled with syndromes, conditions, preterm labor and serious preexisting medical conditions that Westernized Medicine requires a role in. But where is their place in a normal, healthy, uncomplicated pregnancy?

Physicians are trained as Pathologists first. Meaning, they are trained for 8-12 years through medical school & specialized fellowship training to find problems, complications, abnormalities. Based on this role of a physician, why should he/she be the first care provider in a NORMAL, HEALTHY & UNCOMPLICATED pregnancy? Why should this highly trained Pathologist & Surgeon be the first to care for women & their unborn children in something that is so innately & animalistically natural as a pregnancy & birth? In my heart, I believe they have no place. In my heart, I need to find something different. Sadly, I am just a small voice barely heard.

I struggle at work everyday to try and allow a woman to simply birth. To birth without the use of internal monitors, the premature act of rupturing membranes, the unnecessary episiotomies & vacuum extractions. The restrictions on oral fluid & food intake. Useless continuous IVs on everyone. The continuous external fetal monitoring, the restrictions on walking & positions changes out of bed. The forced pushing before a woman is fully dilated. I'm exhausted from the fight of it all. But, I have to keep on. I have to fight for the women who aren't as fortunate as me to know the difference. I am their advocate, this was my promise when I graduated from USC 7 1/2 years ago.

This is my dilemma. Do I keep practicing in a westernized mind of birth -- something that goes against my every cell? A fight that gets my blood boiling on a daily basis? The labor & delivery practice in the U.S is a disservice to the very women & babies we are trying to protect. It is, however, mostly practiced at the convenience of the physicians and the nurses (who don't know any better) out of fear. A fear that was created by malpractice insurances and governing boards of medicine that are not using evidenced based practice. Do I leave the western system and practice birth the way I feel it should be practiced? Naturally, safely & with the best interest of the mother and child? Or, do I remain fighting the fight and continue being the small voice and the patient advocate through protecting our women & babies from the use of unnecessary medical interventions in a normal, uncomplicated pregnancy, labor & delivery?

I am traveling to Bali, Indonesia to explore these doubts & questions. I'm going to Bali to volunteer at a non profit birthing center for 2 months. This will be a very personal exploration through my sanctity of surf, my meditation practice and the simplicity that travel gives me by bringing me back to my home, my Pacha Mama.

**These photos I found on the internet. The photos in upcoming blogs will be directly through my eye & the lens of my own camera