March 2012: Sunday was our day off from the Eat Pray Doula workshop. Today we had the great honor of being invited to share in a traditional Balinese baby naming ceremony that that is held when the baby is 42 days old. Suami: 1 Wayan Kartana and Istri: Ni Made Antari had given birth to their daughter Anac: 1 Wayan Wahyu Dharma Sentana at Bumi Sehat in Nyuh Kuning. They invited Ibu Robin Lim to join them at their blessing and Ibu Robin asked if they would share with all 25 doulas. Their generosity to open their home and their hearts to us this day left us all with such gratitude and awe.
The day started with our usual breakfast, but before long the doulas were gathering with Ibu Robin Lim, learning to tie the traditional sarongs and sashes, as we were going to temple. The heat of the morning was building as we went outside and there was a line of taxi’s waiting for us. We all piled in and began our journey winding in and out of the small streets, through little villages to arrive at a traditional family compound. The compound is a modest setting where many members of the extended family had their homes and share a family temple. The temple is a central area for weddings, celebrations, and where people rest when they pass on until their cremation ceremony.
We were greeted as family with warm Balinese smiles, hands in prayer honoring all with gratitude to share this special blessing. Food was prepared for us all and I imagine in this simple compound the women must have worked for days to weave the banana leaf plates, cook the vegetables and fruits with rice, and make the many offerings that we were soon to share in their temple.
As we ate, the priest sat and began his chanting and blessings in the area where the baby’s placenta had been buried. After a lotus birth, where the placenta is seen as the baby’s brother or sister, giving life, the tree of life, as it looks like when you view the arteries that have sustained the baby with blood and oxygen. The baby is carried with its placenta attached until it falls off in its own time. Like the petals of the lotus flower, it allows the baby to gentle unfold with its brother/sister from spirit world, until the baby is ready for the transition alone to our planet. Once the placenta is buried the baby will always be able to keep the connection to spirit and ancestors intact – if he/she travels in life, they can take some of the dirt from this area with them to always maintain their connection. Robin Lim’s book The Placenta: The Forgotten Chakra is a must read for all birth keepers.
I was filming today, with their permission, and the family was so excited that they would have a record of this day. I was soon escorted into the husband and wife’s bedroom for the traditional ritual of praying and blessing their bed, where mom, dad, and baby sleep. In this small traditional room, the music of Kenny G, played and their pillowcases were of the American flag. I smiled, feeling the traditions of past times so present and yet the current western trends seeping in. The sun shone in the window as I saw the doulas, family and friends still eating outside. It was time for the temple blessings. The priest in white, was sitting on the special stand chanting, blessing holy water, preparing the space for us. Ibu Robin taught us how to pray – to use incense to cleanse ourselves the first prayer, followed by three prayers where we held flowers in between our hands in prayer form, raised above our heads. Placing the flowers in our hair and last on the ground. As the priest comes around to bless us with holy water sprinkled over us, next we hold our hands open to heaven welcoming our cleansing and praying. Next, right hand over left, we make a cup with our hands to receive the holy water to sip, cleansing our mouths, words, and last to wash our face and head, purifying our thoughts and deeds.
Group by group we pray, the heat of the day upon us. The small sacred temple filled with all the doula’s prayers and gratitude for being part of this special ceremony.
We exited the temple to the main yard of the family compound and more food was served such as exotic fruits – many fruits I had never seen, let alone tasted. Just as I was about to sit to enjoy them, the father came and invited me to join them back in their bedroom. It was just the mother, father, baby, grandmother priest and me. They were inviting me in to film their private blessing. I had tears of gratitude, honor and without words or time, I maneuvered in front of the window to shoot into the small room so they would not be shadowed in the light. So with very little space and simultaneously trying to film while welling with my own emotion, I filmed and listened to the chants, the holy water blessings, and offerings made. The baby began to cry and was soon nestled at the mother’s breast. We all smiled with the universal understanding of the simple pleasure, comfort and nurturing that breastfeeding brings. The priest continues. Again I am struck by the ancient ceremony I am privileged to film and bear witness to and yet the contemporary music of Kenny G continues. I have my own internal smile as I wonder if Kenny G will give me permission to share this sacred footage since his music graces it.
Submitted by: Suzanne Swanson, PhD, LP
Introduction from Debra: We have reached a time in the developed world that it is not enough to survive childbirth, women must survive and thrive physically and emotionally. To ignore the importance of a women’s emotional well-being during childbirth is to leave a mark that can create a lifetime of pain. As Dr. Sarah Buckley says” When women are safe, supported and undisturbed” they can find comfort and pleasure in birth and I would add thrive emotionally. ~ Debra Pascali-Bonaro
Sara doesn’t like to tell her birth story: “I didn’t have a Cesarean. My baby came fast, really fast. People say I’m so lucky I didn’t have a long labor. I’m ok; my baby is healthy. But I felt so alone: no one believed me, no one was ready to help me.”
LaKeesha’s story looks very different, but she’s pretty reluctant to talk about her baby’s birth, too: “I did have a Cesarean. My baby came early and then they had to get her out immediately. But then even when her Apgars were good, they kept her in the NICU. I had to fight to give her my colostrum and breastfeed her. She’s thriving and happy now. My friends keep telling me to focus on the present. Why can’t I stop thinking about what might have happened?”
Cheryl Beck’s research leads her to conclude “birth trauma is in the eye of the beholder.” Sarah and LaKeesha both experienced birth trauma: each one lost her sense of feeling basically safe — emotionally or physically or both — in the world. The births of their children activated a sense of danger, plus the physiological arousal that comes with “fight or flight.” And neither the fear nor the arousal seem to go away.
Sara doesn’t want to go to her 6 week appointment. She’s not sure her 3rd degree tear is healing properly, but she doesn’t really trust her OB to take her seriously anymore. She finds herself thinking, “I’m not really worth listening to.” LaKeesha isn’t sleeping well. She wakes in a panic from nightmares — the baby’s heart rate is dropping! During the day she flashes back again and again to her separation from her baby, her longing to hold her and breastfeed her. She feels like a bad mom “Why didn’t I insist they bring her to me sooner?”
They’re not alone. Eighteen percent of women in the 2008 New Mothers Speak Out survey experienced some of the characteristics of post-traumatic stress syndrome (PTSD): flashbacks of the birth, nightmares, difficulty sleeping or concentrating, anxiety or panic, anger or irritability, numbness or avoidance. Nine percent of the mothers surveyed met all the criteria for PTSD. (Childbirth Connection, 2008)
We women can feel so vulnerable giving birth. We’re in a new world with each birth, an unfamiliar land with no guideposts. With care, respect, and encouragement, a woman’s openness to this unique birth can be transforming and her own confidence can blossom.
But when things happen quickly, when no explanations are given (or laid out without room for informed consent), when a woman does not feel respected, when a physical sensation reminds her of previous sexual trauma, she can feel overwhelmed and unable to integrate her emotional experience. “What’s happening to me? Is my baby ok?” In the middle of feeling threatened, often a woman tries to protect her baby: “Do whatever you need to!” Or she may feel guilty later that she was unable to give her baby the start she’d hoped for.
And we must not forget partners. Ed’s wife Karen gave birth to their baby boy in the water. They felt so connected as a family, so happy with the support of their midwife and doula. Then — hospital policy — the baby’s glucose levels were tested and found to be borderline and he was taken to the special care nursery. Karen was tired and in tears. Ed wanted to advocate for their family, but he was tired, too, and felt helpless. He just couldn’t figure out what to ask, what to say. Weeks later, he goes over and over the conversations with the RNs and the pediatrician. He doubts himself as a father and is not as involved with his son as he imagined he’d be.
How can we work with birth trauma? What do these parents need? They need, first of all, to be heard and respected. If we respond to their stories with “but you have a healthy baby; that’s what’s important,” we dismiss them one more time. Minimizing re-activates that sense of emotional danger (“I don’t matter”) and invalidation. We need to provide the safety of acceptance to parents whose births (and that includes the postpartum period) have been traumatic — the safety of witness, of being validated and cared for. We ask open-ended questions (“what was that like for you?” and “what had you hoped for?”). We make open-ended comments: “There’s so much you’re turning over.” “What you wanted matters.” We don’t superimpose our own beliefs or experiences on theirs.
We listen some more. We may, as we get to know the story, notice with them that there are some parts of the story that are not activating, parts of the birth that actually felt — and still feel — safe and satisfying. We don’t use that knowledge to dismiss the sense of danger. We simply notice that — for some parents, not all — the story is a little larger, a little wider, a both/and (safety/danger), not only a story of panic and trauma. We can sit together with grief and sorrow and loss.
We can offer traumatized parents simple techniques to ease their anxiety and panic: meditation, relaxation, 4/7/8 breathing or butterfly tapping to lower their baseline level of arousal. We can encourage them to develop a postpartum mantra that includes both the distressing experience and affirmation. For example, Sarah might repeat, “Even though I felt like nobody was listening to me, I deeply and completely accept myself, and I believe I am worth listening to.”
What else? We can point out resources online to share experiences or learn more about trauma:
- Solace for Mothers http://www.solaceformothers.org
- Prevention and Treatment of Traumatic Childbirth http://pattch.org
- International Cesarean Awareness Network http://ican-online.net/
- The Birth Trauma AssociationTrauma and Birth Stress (TABS) http://www.tabs.org.nz/
- PTSD after Childbirth http://ptsdafterchildbirth.
- Postpartum Support International www.postpartum.net
- Postpartum Progress www.postpartumprogress.com
We can suggest classes, workshops and groups that focus on healing birth (see see FB pages for ICAN, Healing Birth Stories, Another Birth/Another Story).
We can encourage parents to consult psychotherapists, bodyworkers and postpartum doulas (and birth doulas during another pregnancy) who are familiar with both physiologic birth and birth trauma.
Women and their partners do heal from difficult or traumatic birth. We can help them reclaim their confidence, strengths and connection to each other.
* * *
Beck C. 2004. Post-traumatic stress disorder due to childbirth: the aftermath. Nursing Research 53(4): 216-24.
Declercq E, Sakala C, Corry M, Applebaum S. 2008. New Mothers Speak Out: National Survey Results Highlight Women’s Postpartum Experiences. Childbirth Connection: New York
Suzanne Swanson, PhD, LP is a psychotherapist who has been working with pregnancy, labor, postpartum, loss and mothering for over 30 years. She was Founding Director of Pregnancy and Postpartum Support Minnesota; she is a Minnesota Coordinator for Postpartum Support International and a board member of PATTCh (Prevention and Treatment of Trauma in Childbirth). Suzanne is the author of What Other Worlds: Postpartum Poems. She is mother to three adult children, and grandmother to one sweet baby.
What Bumi Sehat really needs now is a lab where they can do their own HIV testing. HIV is on the rise in Bali and Ibu Robin and Bidans (midwives) need their own lab. Testing for HIV and treatment can greatly reduce Mother to Child transmission of HIV. Help save mother’s and babies lives by donating to this vital lab.
The CDC writes, “HIV transmission from mother to child during pregnancy, labor and delivery, or breastfeeding is known as perinatal transmission and is the most common route of HIV infection in children. When HIV is diagnosed before or during pregnancy, perinatal transmission can be reduced to less than 1% if appropriate medical treatment is given.”
Read Every Mother Counts recent article to learn more: “Why National Women and Girls HIV/AIDS Awareness Day Matters to Maternal Health.
Every Mother Counts recently posted an article sharing Ibu Robin’s direct experience with this issue and why it is more important than ever so support this cause. Touched by HIV/AIDS- When Healthcare Workers are Exposed:
On Valentine’s Day, our dear friend, midwife Robin Lim, founder of the Bumi Sehat Birth Center in Indonesia performed mouth-to-mouth resuscitation on a newborn. He was premature and the oxygen masks she tried to use didn’t fit properly and wouldn’t deliver the air he desperately needed to his brand new lungs. With only moments to spare before lack of oxygen damaged his brain and stopped his heart, Robin did what any midwife would do. She breathed life into the boy over and over again, until he was able to do the job himself…. read more
There are several ways you can donate to Bumi Sehat, here are a few ways:
– Donate directly to Bumi Sehat
– Purchase a pair of GBF Bumi Booties, available in 6 unique patterns,and 100% of the proceeds will go to Bumi Sehat (thanks Salihah Kirby for donating the Bumi Booties so we can do this!)
– Purchase anything from Global Birth Fair this quarter, such as Bali birth jewelery or Birth Batiks, or Rebozos, or DVDs, or any birth gifts and tools, and a percentage of your proceeds will go to our Bumi Sehat, our spring featured organization.
Submitted by: Debra
I awoke yesterday to an email from Ina May Gaskin sharing that she will be inducted into the Women’s Hall of Fame! I yelled, I danced, I cried tears of joy both for Ina May and this well deserved honor for her dedication, wisdom and love she has shared with so many of us around the world. Later in the day Ibu Robin Lim said “Ina May is lifting up all midwives and birth keepers around the world.” From one hero to another!
It has been an amazing 18 months as Ina May Gaskin has received the Right Livelihood Award in 2011. Often considered the “alternative Nobel Prize”. They wrote; “Ina May Gaskin is a role model for midwives who still dare to think in different paths, trying to implement more humane obstetrics in their countries, and providing women with the chance to choose the way of giving birth that seems right for them.” Watch her gracious and powerful acceptance speech. What a powerful call to action including:
“care given during the time surrounding birth should give the needs of the mother-baby pair precedence over the needs of caregivers, institutions, and the medical and insurance industries. Individual hospitals should consider implementing the 10 Steps to Optimal MotherBaby* Maternity Services (www.imbci.org)…if all countries put the welfare of mothers and babies at the center of maternity care policy, midwifery would have to grow strong again.”
Please join me in honoring Ina May, posting this to your friends and sharing your favorite Ina May Gaskin quote right here.
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“The equality and empowerment of women and girls is truly the moral, economic and humanitarian issue of our time.” – Marie Forleo
Marie’s quote was going thru my mind as I was pushing thru the pain in my morning yoga class at Eat Pray Doula in Nyuh Kuning, Bali. Gabby, our beautiful teacher, kept saying move thru the pain, go deeper, move, move move, breathe breathe breathe. Her words not only ring true to the physical stretching we were doing, but also emotionally and spiritually. As a woman, we all have our own pain, past grief, loss, and in many cases, trauma. We must first heal ourselves, and in doing that, we give ourself the gift of love and empowerment. As we push thru and past our pain we become healers, ready and able to serve other with our example, to share our love and compassion.
On International Women’s Day, my honoring and celebration starts personally within, and expands to how each one of us can help bring respect, dignity, and honor to every girl and woman.
You can make a difference. How often do you read something and think it is too much to take on. You don’t have the time or money? Someone else will do it?
International Women’s Day is a day that I urge you to take a stand! You can make a difference in many simple ways to help empower women and girls. You may already be doing this in your own family or community. If not, now is the time to begin. To begin with yourself. What do you need to do to feel your power- to “Awaken Your Inner Wisdom?”
The Face of Birth Documentary The women of our Eat Pray Doula Workshop will be part of the global screening of “The Face Of Birth”– see our recent blog post “The Issue of Homebirth in Australia” to learn more about this film about Birth as a Human Rights Issue and find your local screening. http://www.faceofbirth.com/
No Woman No Cry Another important film that will be screening on facebook today at 11am eastern time is from Every Mother Counts is “No Woman No Cry” This is a powerful documentary from Christy Turlington-Burns of the tragedy of maternal mortality around the world.
Half the Sky Have you read or seen the documentary Half the Sky: Turning Oppression into Opportunity for Women Worldwide ? This powerful book and film is on my must read for everyone! It looks at the tragedies of women enslaved in sex trade, dying from preventable causes in childbirth and more. While hard to read at times, I encourage you to open you eyes and heart to what is happening globally to women and girls. The co-writers and husband and wife team, Nicholas D. Kristof and Sheryl WuDunn, show us how in each case just one person made a difference and transformed a girls or woman’s life. You will cry, smile and move to action!
Video “Most AMAZING INSPIRATIONAL Transformation” by Sun Gazing While this video clip is not about women, it does show how our determination to push past our pain, past our beliefs can create miracles in our own life and touch other’s lives by our examples. Grab a tissue and watch.
IMBCI There are many organization that are dear to my heart that are working to improve the lives of MotherBaby in childbirth. Two I would like to share with you and encourage you to visit and support today are The International MotherBaby Childbirth Organization– a human rights framework around quality care with a heart for all pregnant and birthing women around the world. As Chairperson of IMBCI I know first hand the difference your donations will make!
Bumi Sehat Bali I am writing this from Bali where I am working with Katherine Bramhall and Ibu Robin Lim a CNN Hero as they raises awareness and money for Gentle Birth at Bumi Sehat Bali. Please give $1.00, just one dollar, or more… you will make a difference in the lives of women today. Bumi Sehat is the Global Birth Fair Spring Featured Organization. This month purchase a pair of adorable Bumi Baby Booties & all proceeds go to Bumi.
I am thinking of you today, celebrating every girl and women of the world. Join me in standing for every woman right to respect and dignity in life and in birth!
As www.womendeliver.org say – “Invest in Women- it pays!”.
Love and blessing,
Submitted by Debra
Today is a special day as Ibu Robin will bring our group to a Nyabutan Ceremony, where a baby first touches the Mother Earth. In Bali, babies do not touch the ground until they are three months old. The first months are sacred as a baby’s connection to spirit is kept intact, they are not ready to touch the earth yet. Many have a lotus birth, keeping their connection to spirit and placenta with them in the first hours, and sometimes days. Ibu Robin believes delayed cord cutting and clamping is essential for a gentle birth. Her book “Placenta the Forgotten Chakra”, is a gift to open our minds and hearts to the importance of how we care for placentas and keep babies life giving connection intact. In the next days and weeks after birth, Balinese baby’s are always held in someone’s arms, Mother, Father, siblings, grandparents, aunts, uncles, neighbors, community. Families and communities are intact and vital in Bali. The saying “It takes a village” is put to action.
Bali is a culture full of many rituals. There are many surrounding pregnancy, birth and the first months of a baby’s life. Last year our doulas participated in the 42 days old blessing to honor, name and welcome the baby into the family. Now at three months, on Koming’s 105th day, another ceremony as important, or even more significant, than the child’s wedding.
We are honored to be invited and included in this sacred ceremony for baby Koming. In their modest family home, they welcome Ibu Robin Lim and all of the doulas from Eat Pray Doula 2013. We learn that Koming’s father is very sick- so sick he has not been able to work and cannot attend the ceremony. The grandmother is going blind and desperately needs cataract surgery as she struggles to see. The mother shares how hard times are and sometimes there is not enough food, but they get by. I am so humbled and honored to be here with them today.
For the ceremony, the family has invited a priest to their family temple where they provide offerings to the Sun God and the Five Elements. The child is blessed with holy water and her feet are allowed to touch the earth. The parents or in this case the mother and grandfather (the mother’s father) carry Koming three times around the water representing the passage of birth, life, and death. There are many symbols and rituals and the priest is in almost a trance-like state as he chants and speaks many sacred blessings. Although I do not understand the words, the sacred moment and symbolism transcends language and we are all so moved.
After a long day, on our way home Katherine and I stopped at Bumi Sehat to check in. Two mothers were laboring, one had just given birth and another was pushing. We gently joined the circle in the room with the young mother pushing. I slid behind her on the bed to hold her and offer my comfort and support. Katherine offered love and support to both the mother and to the student midwife, as this was her first catch. Wow, the circle of women, including one of the Balinese Bidan’s ( midwife). As is tradition at Bumi Sehat as the baby’s head begins to emerge- we all sang the baby earth side with the Gayatri Mantra.
Before I knew it we were back on our motorbike heading home from a long day. Thoughts of the birth, baby Koming and her blessing ceremony, the needs of her family, the rituals of Bali swirl in my head. Rituals play such a vital role in Bali.
What are the rituals and traditions in your culture?
Submitted by Kate Gorman, Co-Director/Producer The Face of Birth Are you looking to do a fundraiser for your group or to gather all your friends and colleagues together around a new birth film? Starting March 8th International Women’s Day you can host a screening in your living room, community theater, or wherever you choose of the much anticipated Documentary,The Face of Birth Documentary (87 minutes 2012, Australia).
The Issue of Home Birth in Australia
In Australia in 2009 it nearly became illegal to have a home birth! A new government introduced maternity law reforms that required every midwife to have Public Indemnity insurance. Whilst this may be not a bad thing in itself, no insurer would cover independent midwives who attended homebirths. And at the time apart from a tiny number of hospital/home birth programs the only way to have a homebirth in Australia was with an independent midwife.
It was proposed that if a midwife continued to attend home birth without insurance she would be fined $30,000 and deregistered. If a mother paid a midwife to attend her at home she could be charged with criminal intent. How could this have happened? Australia once had close ties to the UK with historically similar health care systems, however in the UK, still to this day, a woman can chose where to give birth and a mother can chose a home birth all completely funded by the National Health Care System.
Following announcements of the proposed new laws, in September 2009 over 3,000 people, mostly mothers, prepared to march in protest on the national Parliament House. Just hours before the protest commenced the government announced it was giving independent midwives a reprieve allowing them to practice for another two years (this later was extended to three, then to five years). With this announcement came regulations that the midwife would have to collaborate with an obstetrician who would have to ‘sign off’ on the midwife being able to attend.
It was at this rally at Parliament House that filming started on the Birth Documentary The Face Of Birth. Since the film’s release in Australia in 2012 the government has again extended the exemption for independent midwives and amended the collaboration agreement allowing midwives to also collaborate with health professionals/services such as hospitals and General Practitioners. A slight improvement but in the meantime many independent midwives have given up and their numbers have dwindled across the national, especially in rural areas. Despite this the Home birth rate has nearly doubled from 2008 to 2012! It seems women want the choice despite it having become more difficult to access.
The film was taken up by various lobby groups who used it to apply additional pressure to the ‘powers that be’. Further changes followed where independent midwives can also qualify for a health insurance rebate, meaning that the mother paying the midwife can recover some costs for ante natal and post natal care (but strangely not for the actual birth).
Some of the Australian State governments have also looked for solutions. In Victoria two large hospitals started up home birth pilot programs – offering not only the option of birth at home but also continuity of care with caseload programs. The programs became incredible popular incredibly quickly.
While women in Australia are struggling and fighting for their rights, in New Zealand, Australia’s close neighbours, they have in place what US Anthropologist Robbie Davis-Floyd has declared the best maternity service in the world. Where women can choose home, hospital or birth centre birth all funded and also choose their lead maternity carer (80% of women choose a midwife). The lead maternity carer stays with the woman during the care and if the mother chooses to change place of birth, i.e. from hospital to home or birth centre to hospital, during the pregnancy even during the labour, their lead maternity carer can go with them.
With birth choices being so limited in countries like Hungry, Croatia, Russia and the US – where it is illegal is some states to have a homebirth – films like The Face Of Birth, Freedom for Birth and Organic Birth are going a long way to help educate and create change for all the women who are yet to have their babies. It is at screenings of these films that women and families gather and share experience good and bad. Groups, rallies, websites, activism and general support for women is born from these community screenings. The human rights issue of choice for place of birth is an issue for all humanity.
To see more and have your own screening visit www.faceofbirth.com.