DIY mums: No doctors please

DIY mums: No doctors please

Cranking up the volume of the relaxation music during labour, Sara waited for her husband to join her in their bedroom upstairs after dinner, away from the prying eyes of her in-laws, as she went into labour.

Some two hours later, standing in front of the bathroom basin half-naked, her water bag broken, she could feel the tip of her son's head coming out.

At that moment, her husband, who had come into the room, cried out, "I can see his head!"

She squatted down on a rubber mat, spread the hands under herself, took a deep breath, pushed and out whooshed their son, straight into her welcoming arms.

"My husband quickly took him from me -- a first-time father but although our son was covered in vernix, he held him steadily and passed him back to me for his first feeding," said Sara, still rather awed by the experience, which happened just two months ago.

Sara was one of five women the New Sunday Times met up with recently. They had all chosen to give birth on their own at home.

The others were Tengku Erina Nasrudin, Ayuni Zainuddin, Soo Wai Han and Nadine Ghows. All gave birth to healthy babies and are now strong advocates of home-birthing in Malaysia.

While Erina gave birth in a baby pool in the shape of a red car, Ayuni, Soo and Nadine received their babies in the bathrooms.

They are among a number of women in Malaysia who are choosing to do it themselves to avoid what some regard as "overmedicalised childbirth".

"We are not anti-doctors or anti-hospitals. We are just anti-intervention, which we think can be more stressful and cause more complications," said Nadine.

Nadine, and many who have chosen the home-birth path, believes that childbirth is not "a medical illness" which requires the presence and intervention of a doctor.

"It's not cancer. It's a natural body function and we're not patients but parents," said Soo, a mother of three and who gave birth to her second and third children on the bathroom floor at home.

Time magazine reported last year that "compared with hospital deliveries, of which about 32 per cent end in Caesarean section, home-births involve fewer medical interventions and complications".

Until the advent of modern medicine, home-birthing was common for women across the world.

In developed countries, it is defined as "attended or unattended childbirth in a non-clinical setting, typically using natural childbirth methods, that takes place in a residence rather than a hospital or birth centre, and usually attended by a midwife or lay attendant with expertise in managing home births."

In Third World or under-developed countries, where accessibility to medical care is limited, home birth is usually the only option.

But in the context of Nadine and friends, all educated women with access to high quality medical care in Malaysia, they still chose to do it at home because they prefer to experience childbirth in its natural entirety, without being "managed" or rushed through the experience.

They think it allows them to savour and share the intimacy of the moment with their loved ones in the comfort of home.

"I feel it was worth it because the baby was not drugged up. He was just filled with mum's hormones of love," said Ayuni, who had a 21/2-day labour at home before giving birth to a boy.

Erina was open to the idea of home-birth because when she gave birth to her first child in hospital after being induced into labour -- and several anaesthetic shots later, including an epidural -- did not enjoy her first childbirth experience.

"I was exhausted and lost a lot of blood. So for my next birth, I was determined to find other options and have a better experience."

Being a scuba diving enthusiast, she was also keen to give birth to her daughter in water.

"From being carried in water in my body, she was born into water. It was an incredible experience.

"The sight of her turning her body this way and that to wriggle out from inside me into the pool of water and into her papa's waiting arms, that was a great moment for us. We truly felt God is great at that time," said Erina.

From being quite unaware of what was happening "down there" when she gave birth the first time in the hospital, she felt she finally got to experience and see it all fully with her second child.

"I didn't even see what the placenta and the (umbilical) cord looked like when I gave birth the first time in the hospital," said Erina, who detailed her home-birthing experience at kureen.wordpress.com.

Perhaps, Soo can be said as the default leader of the group.

A certified HypnoBirthing educator and proponent of natural home births, Soo's "comfortable" birthing experiences have been featured in various parenting magazines and newspapers in town.

She firmly believes that not only do mothers know how to give birth, "babies know how to be born, too".

Soo said many women today had been "brainwashed" into thinking that birthing was a painful, and even horrifying experience.

To them, the thought of women like her choosing home-birthing would be hard to digest.

"Home-birthing is actually a rediscovery -- of women's natural birthing instincts and behaviour.

"It is getting back in tune with ourselves, and allowing our bodies to do what they are naturally designed to do. It is like sex. You don't need to learn it."

Getting like-minded women together

Adamant about finding a way to give birth at home in Malaysia, Ayuni Zainuddin and Tengku Erina Nasrudin both Googled for gentle home birth in Malaysia. "I choose to do this because birthing is a natural occurrence and I have faith in and trust what God has given us. Why not give nature or God a chance first? Furthermore, I was having a low risk, healthy pregnancy."

She had also prepared back-up plans to get immediate medical help if the situation demanded it -- her gynaecologist lived next door and the hospital is across the street.

"I did a lot of reading and preparation for this.

"Some women can plan and prepare for their wedding a year ahead, but I wonder why they just leave their childbirth to others to worry about.

"I did breathing exercises and practised what I had read about home-birthing. I was in control and I took full responsibility for my child's birth. If anything had gone wrong, I rehda (accept as God's will)."

Doc: It's not a good idea

The disapproval is apparent in obstetrics and gynaecology specialist Datuk Dr Ang Chin Guan's voice.

"I don't think it is a good idea. In case of emergencies, who is going to attend to them?

"If there's a complication and you bleed, in five minutes, you are gone," he said in a telephone interview.

While Soo Wai Han and friends' choice does not indicate a trend as such that more women in Malaysia are favouring DIY home births, there is movement to increase home-births in some places in the world in recent years.

Perhaps the most notable case is in Wales, United Kingdom, where the Welsh regional government launched a strategy to increase home births in 2002 to 10 per cent in 2007.

Although the figure was not reached, it was exceeded in some areas like Porthcawl and Pyle, where 25 to 30 per cent home birth rates were recorded.

"In the UK, they have this Domino system, for people who want to deliver at home. But the response time to emergencies in these places is much better than Malaysia," said Dr Ang.

The Domino scheme, run by a team of community midwives in the UK, provides maternity care to low-risk women with no medical or surgical history which could affect a pregnancy.

The scheme offers midwifery care from the beginning of a pregnancy, during labour, and until the baby is about five to 10 days old.

The midwife attends the birth of the baby whether at home or in hospital, and the basic ethos is to encourage and support normal childbirth with minimum intervention.

But asked if the presence of midwives would be able to increase his confidence in mums giving birth at home in Malaysia, he said:

"Our midwives are different, they are not exactly trained. They just act like a grandma and receive the baby. About all they have is a clamp to cut the umbilical cord."

Citing the infant mortality rate in China recently, he said it had been dropping since the Chinese government encouraged delivery in hospital.

There is just not enough evidence to convince him to think that home-birth is a better option than hospitals.

"If you have a normal delivery, then (even) your grandmother can deliver for you. You can even deliver in a car. But if there are complications, what then?

"The ambulance here would probably take about an hour to get to you."

He also disagreed with the notion that a hospital delivery means a medicated delivery.

"The administration of painkillers is not decided by the doctor, but by the patients. Patients are given the option to use painkillers. If they don't feel the need for them, then none will be given. They (the mothers) are not drugged up at all."

He said by and large what most doctors would do was just to augment labour -- to speed up the labour in lay terms -- to prevent infection from setting in.

But if the patient is against it, the doctor will not do it.

"We don't do anything without the patient's consent. Any recommendations or advice is in their best interest."

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