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02/12/2015

Babies made-in-India - 6. Medicalization of birth

Babies - 6.jpg

70% of Indian babies are born at home, with the help of a midwife (dai). Paradoxically, the 'modern' hospitals (which rank from very bad to at par (or even better) than Western infrastructures) do not recognize this profession! As a result, my (British) midwife was often denied access to the delivery room, or Gynec would refuse to team up with her (in any case, the Gynec would remain the boss and not consult her).

 

Indians tend to blindly trust doctors. Therefore, the practice of episiotomy (a preventive cut of the vagina), while in sharp decline in the West (5), remains widespread. Most mothers don’t even know that it is optional. Worse, most new mothers don’t even know it is going to happen to her! And they can’t be blamed: even my Gynec never mentioned episiotomy and it is thanks to my midwife that I got to know about it it...

 

Moreover, Indian women are not well aware of anesthesia during childbirth. To the point that I couldn’t find statistics, except a small survey which confirms my opinion. When I mentioned the epidural to friends and colleagues, they generally had never heard of it and were unable to understand how to deliver a baby without feeling contractions – a valid question I must say, that I could answer only after having my baby!

 

Nowadays nearly half of the deliveries in India are acts of surgery (compared to 21% in France, 25% in England)... And as much in the countryside as in the cities.

 

Even more striking is the increase in scheduled C-sections (vs. medically necessary ones). The culprits? A bit everyone. For doctors it is more profitable (they charge more for surgical procedures), easier to fit in the agenda and (some claim it) less risky for the patient. A for women, it is often reimbursed by private insurances, perceived as less painful, easier to fit in the agenda (especially when they have Astral imperatives and want the baby to be born with an auspicious star configuration (I am not kidding!)) and (some believe so) less risky.

 

(5) In France, "the episiotomy rate has decreased from 71 to 45% between 1998 and 2010”.

 

Sources: http://www.midwiferytoday.com/articles/india.asp ;http://www.liberation.fr/vous/2011/10/18/70-d-accouchements-avec-peridurale_768628 ; http://www.who.int/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf ; http://www.huffingtonpost.com/2014/04/16/c-section-rates_n_5161162.html?ir=India ; http://qz.com/326402/cesarean-births-in-india-are-skyrocketing-and-there-is-reason-to-be-very-worried/; http: / / www.cesarine.org/ front/etat_des_lieux.php . http://www.hscic.gov.uk/catalogue/PUB12744/nhs-mate-eng-2012-13-summ-repo-rep.pdf; http://www.Liberation.fr/vous/2011/10/18/70-d-accouchements-avec-peridurale_768628

 

(To be continued...)

02/10/2015

Babies made-in-India - 5. Versus French ways

india,birth,water birth,pregnancy,baby,infant,newborn,delivery,midwife,swaddling,swaddle,diaper,breastfeeding,hospital,fertility,contraception,sterilizationSince there is nothing wrong in getting pampered, these customs of returning to the maternal fold, staying at home and keeping bed rest persist through the ages and social classes. Several times I have asked colleagues, newly elevated to the rank of fathers, if they were not too tired. And got the reply “no no, you know, my wife and baby are at my in-laws, they’ll come back only after three months!".

 

New French mothers don’t have this luxury of a ‘safety period’ (although apparently (according to Tracy Hogg) British ones do, for 40 days as well) and they soon have to do everything alone: cooking, cleaning, shopping, etc, in addition to taking care of the newborn. That is what I tried to explain to my Indian circle: being an independent businesswoman and daughter of an independent businesswoman, I was genetically programmed (except for medical complication) to get on my feet very fast. And on top of that, with the 'services' we avail in India, i.e. maids, home delivery from shops and restaurants, it is even more manageable than in the West…

 

As for childbirth, fathers traditionally don't attend, as it was the case till the fifties in the West, where the necessity and benefits of the man's presence are still debated (but at least the choice is open). So in India, you usually have your mother or mother-in-law in the labor room...

After the delivery, help is generally required as some hospitals don't even serve food. So, my mother-in-law kindly offered to stay with us at night in the hospital (4)... As tradition has it, it was her role to get up at night when the baby would cry; not mine, nor her son’s or the nurses’. To pass me the child for me to feed him. Well, to be precise, it was the role of my mother, who was with us but obviously not keen to sacrifice her sleep! My mother must have seemed quite irresponsible by spending more time dragging her counterpart to shopping sprees every day rather than squatting our hospital room! In fact she was doing her job as the mother of the Samurai, meaning she ensured that the three of us would get some privacy all three of us… (And ‘Privacy’, ‘Intimacy’ are definitely not Indian concepts, even though they were the key words of our birth plan!!).

 

The hospital that we had chosen was topnotch. Which means that not only did they serve food, but they also had a nutritionist and a lactation expert to help us in the transition. Also, by imposing strict visit timings they were 'pro-intimacy' (which is very innovative in India because normally, once the baby lands in the world, the whole family comes visit. Imagine the chaos!). And a plethora of nurses was there to ensure we would not lack help and that our intimacy would not be too complete...

 

(4) In India, each patient has the right to have a relative sleeping over; hospital staff even looks at you like you are some kind of alien (a lonely alien (like most of the expats)) if you don't have anyone staying in your room. And I am convinced that this type of moral support helps healing.

 

(To be continued...)

02/08/2015

Babies made-in-India - 4. Naming

india,birth,water birth,pregnancy,baby,infant,newborn,delivery,midwife,swaddling,swaddle,diaper,breastfeeding,hospital,fertility,contraception,sterilization

I was frequently asked, till the baby turned two months if we had already chosen his name!

Indeed, in India, the baby is named at the end of the safety period, generally 40 days. It gives time for the astrologer to find the name, or at least its first letter. Meanwhile, the baby is called baby, and evil spirits are kept at bay!

 

And if everything goes well, the family organizes at the end of the 40 days, a 'naming ceremony' during which the baby is introduced to the world and sweets are distributed to everybody they know (especially if it's a boy). It is usually on this occasion that hijras (cf my posts on the topic) come to claim their due, ‘guarantee’ that the evil eye will be kept at bay.

I was not too happy when the watchman let them, by the way better informed than the municipality, come up.

 

Some Indian local customs go even further by having the new mother observe complete bed rest (for example during the first 10 days in Kerala). During this period the new mums have nothing to do but get to know her baby and recover from this undeniably physical hardship. The idea seems good but hyperactive women might fear boredom...

 

(To be continued...)