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Dear Saxena ji,
Thank you for inquiry.
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Films>> Birth in the Squatting Position by Polymorph Films 1979 (10 mins, Brazil) The business of being born by Abby Epstein (83 mins, USA) Birthday by Naoli Vinaver (10 mins, Mexico) Born at Home by Sameera Jain (60 mins, India)
Commercial cinema, at least the variety common in this country, tends to show childbirth in a kind of half-light the mother screaming and blood flowing profusely. If the end is happy, a doctor enters with a scalpel and saves the woman. The baby is taken by its feet and smacked on its back to make it cry and everyone is happy.
If the way you see childbirth is influenced by such imagery, four films screened on April 29 and 30 by the Delhi Birth Network would have been perfect to correct your perception. These films were about natural births and home births. They showed that doctors are in most cases not required for childbirth.
Birth in the Squatting Position from Brazil is a good introduction to the concept of natural birth. The woman and the child work out the process of delivery between them right in front of your eyes. The baby comes out in the mothers hands or just lands softly on a bed kept ready for its arrival. Doctors, if present, stand there and just watch the process. The documentary follows five births and as the babies pop out effortlessly, one after the other, you get comfortable with natural births.
The Business of Being Born shakes you out of this comfort. It shows that natural births rarely happen if a doctor is involved. Hospital births are more likely to end up in a caesarean for the simple epidural injection starts a cascade effect ensuring that the only way to save the baby is to extricate it by making an incision in the mothers abdomen.
Natural births are said to strengthen the bond between mother and child. The third documentary, Birthday , emphasizes this. It shows a family in Mexico taking part in the process of getting the new baby into the world in a water bath.
The fourth film, Born at Home, is about India where home births and natural birth are only options for the majority. It shows traditional dai s (midwives) in rural Rajasthan and Bihar, and in Delhi slums helping in delivery.
Born at home brings out interesting tid bits of traditional knowledge, which are being lost because they do not fit in with modern practices. One such pertains to when the umbilical cord should be cut. Traditional wisdom lets the connection remain till the child is acclimatized to the new environment. It is only when the cord stops pulsating, that it is cut. This also ensures that the placenta comes out of the body. Modern doctors cut the cord immediately after the child is born and placentas are known to remain in and lead to further problems.
Besides their visual appeal, there is a lesson in these films there is a role for doctors in childbirth, but not one in which they stage-manage the show. The problem is when doctors are involved, cases of natural births are rare, more so in private hospitals that use surgery. For surgeons trained in obstetrics and gynaecology, money is the incentive. They do not have the patience to let nature take its time.
usa, where most births take place in institutions, has a higher rate of death of both mother and the infant than Europe where natural births are common.
Studies show that the number of normal births in India in government hospitals is relatively higher. However, achieving 100 per cent deliveries in public hospitals suffers given the sorry state of public health system in the country. In urban India, even when natural birth is talked about, it is with an emphasis on the learning from the West. As a result, we lose out on indigenous practices.
For example, in Rajasthan, to ensure that surroundings are sterilized, a dai uses clean sun-baked sand and warms it. This sand is layered on the bed and covered with a cotton cloth. The heat eases child birth. But now this practice has given way to use of plastic sheets that are rarely cleaned and so increase chances of infection.
Consider another example. This is to take care of the mother after she delivers. Medicinal herbs are burnt and covered by a huge basket. The mother squats on the basket; the smoke has antiseptic properties.
The way forward would be to train more mid-wives because 99 per cent of childbirths need just a disinfected blade and a thread. They are also cheaper. Doctors should of course be available for emergencies.