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.