The Japanese earthquake in March 2011 shook this fragile and beautiful country to its core. Never before had a tremor of this magnitude struck with such ferocity and determination. As the ground in Japan shifted and shuddered, in Hawaii, thousands of kilometres away, the full force was registered in the Tsunami Alert Centre and within 10 seconds a warning that massive waves would spread across the Pacific was issued. No-one could have predicted the intense power of the overwhelming wall of water that spread at terrifying speeds across the Pacific Ocean that day. The Japanese, well prepared for earthquakes and fortified against the tsunamis that regularly plague their shores were taken by surprise. As the world watched on real-time television, nature unleashed an unimaginable scene of horror and destruction.
Wooden houses, a feature of Japanese architecture, mostly withstood the wrenching shake of the earthquake, but they were no match for the wall of water that swept all in its path. The destruction was complete, whole areas were wiped out, thousands died and hundreds of thousands were displaced.
The Fukishima nuclear plant, largely unaffected by the earthquake, succumbed to the inundation of the tsunami that overcame the defence walls around the plant’s compound and flooded its control rooms and equipment. As the nuclear reactor’s core began to melt down, the released radiation spread across the countryside, thousands were removed from their homes, possible never to return until the land is made safe from the pervasive contamination. In one terrible moment, and then over the following days, Japan lost 30% of its electrical power. The vulnerability of technology was exposed as it’s source of energy was withdrawn.
While some disasters cannot be managed, others are of our own, m an-made origins. Nature has railed against our desecration of the planet before. Terrifying reminders of the risks of disturbing her delicate systems are increasingly confronting our awareness and prodding our consciousness about the dangers of disturbing the natural order of life for those inhabiting this interconnected world
More and more we are being forced to learn the folly of trying to tame natural forces and shape their destiny through human, interventionist means. The hope is that technology will find ways of overcoming the impending threats to our lifestyles and that science will find ways of limiting the damage wrought by our escalating assaults on delicate ecological systems .
Our future functioning on this planet is in the balance and our entire world is facing a precarious future.
There are always positives to be gained from any tragedy or disaster. Sometimes these take time to reveal themselves and can provide surprising results. The Saito Birth House is typical of midwife houses in Japan. Nestled in a suburban neighbourhood in northern Japan, it provides traditional midwifery care to the women in the area.
Tatami flooring, comfortable, quiet surroundings and home-cooked meals make this a true home-from-home for birthing women. These midwife houses played a vital role in the aftermath of the tragedies that hit Japan. Faced with power shortages, blackouts and thousands of displaced people, these birth homes provided refuge and sanctuary for the pregnant women who found themselves stranded, far from home and without family support networks.
In January 2011 Queensland suffered huge floods, the aftermath of torrential rains and a powerful cyclone. 60% of this huge State in Australia (an area the size of France and Germany combined) was under water. Despite the huge disruption to the population, housing and infrastructure, a number of babies still arrived safely into the world, in flooded houses and even in shopping centre evacuation stations. When life is at stake, when everything that is held dear is threatened by a natural disaster, people find themselves questioning their attitudes and beliefs, with a focus on considering what is really essential and fundamental in their lives. One realisation is that despite everything, babies can still be born safely, that women have the capacity to bring forth the next generation so that life will go on.
These events confirm that millions of years of evolution have resulted in a remarkably robust system for producing the next generation. This piece of artwork, created by a member of the oldest continuing race on earth, the Australia Aboriginal, vividly depicts women carryong out their primary biological purpose of having babies.
We know that 90 – 95% of women across this planet can safely give birth to a baby without any external assistance Not all babies or their mothers will survive. This is a solid evolutionary necessity so that those who are strongest and most able will be selected to carry the species forward.
Women’s bodies have developed to make pregnancy and birth both possible and safe. Women have the mechanical capacity to carry and give birth to a baby through a clever system of flexible pelvic joints working with a mouldable baby’s head.
When technology fails through power cuts or is just not available, we are reminded of the few simple tools that are required for a safe birth: clean hands, clean cord ties, a sterile razor blade, clean gauze swabs to wipe the baby’s eyes and a small piece of soap. A headlamp torch, in case there is no candle, with light the way in the darkness. Add a mother’s arms and her milk filled breast and the baby’s chance of survival are high.
Women are able to produce an individual cocktail of natural hormones that not only grow a baby without specific maternal effort, but which also controls the progress of labour. This mix of oxytocic hormones and endogenous opiates, promotes feelings of well-being, focuses attention, reduces stress and enhances nurturing and bonding behaviours. As long as she feels safe, and her adrenalin levels remain low, any woman anywhere can give birth, regardless of her education and family circumstances. And every woman will do this in her own unique, individual way. There are as many ways of giving birth as there are women on this earth. Given these simple facts, I pose this question – has the assumption that technology and medical care been proven safe for women in western countries and have these applications improved birth outcomes, as we were promised? Should we encourage those in developing nations to aspire to our birth practises? Let’s examine what we have achieved as far as western birth practises go…..
The standard and quality of Western medicine is the envy of much of the world. The technology, drugs and equipment are revered as the answer to better health outcomes and the increasing longevity of the human race.
Much of this has been driven by big multinational corporations with globalisation adding new opportunities all the time. Driven by a desire to keep ahead of their competitors, manufacturers have expanded their research and development divisions in an accelerating race for the “newest and best”. There are many examples of the unscrupulous nature of this business drive to succeed, e specially in areas of health care. As western countries enact laws to make smoking less attractive to people and less damaging to their health (and health care budgets), campaign to encourage smoking are appearing in developing worlds. Manufacturers of artificial milks for babies are now hawking their wares in third world countries as their profits in developed nations fall due to aggressive anti-formula campaigns and curbs on advertising of breast milk substitutes. Where there is money to be made, corporations will strive to be part of the action, regardless of the health impact on populations.
These companies are supported by thousands of health professionals with a position and status to maintain, and spurred on by populations sold the idea of “quick fixes” through slick advertising campaigns, the manufacturing giants and the pharmaceutical companies jostle for market leadership.
Governments are also seduced by promises made by industry of better health outcomes. In an effort to reduce strains on limited health care budgets Departments of Health have wholeheartedly embraced the message from industry, and eagerly spend their limited funds on ever increasing costly gadgetry. While some of this technology may be appropriate for assisting sick people, what of the impact it is having on healthy people? What has the industrialisation of medical care done for women going through a normal, natural biological process such as pregnancy and birth?
These figures have been taken form the current WHO website and reflect statistics for 2008: Caesarean section rates have never been higher and they continue to climb: Italy 37.4% USA 30.2% Australia 30.8% Canada 26.3% Germany 27.8% Ireland 25.4% France 18.8% It is notable that in these countries childbirth is primarily managed by doctors, with midwives playing a lesser role, especially in primary care.
In countries where midwifery is the preferred model of care, the results are different: The Netherlands 13.7% Norway 16.6% Sweden 16.5% In these two countries there is a transition going on from a medicalised model of care to midwifery led care: New Zealand 23.7% United Kingdom 24.3%
These figures raise serious questions about the risks associated with medicalised birth. Whilst western lifestyles have had an influence on these outcomes, we should also remember that other indicators for maternal well being are also very poor with reduced fertility rates, emotional stress and psychological trauma featuring highly. Maternal mortality figures, once championed as proof of the value of timely medical intervention are now beginning to rise, as the limits of medical expertise are outweighed by the risks of the procedures being used.
More and more babies are being born with their immature systems flooded with the drugs given to their mothers during labour. Their future health is being compromised by the very treatments that are supposed to improve their chances in life. Are western birth outcomes something we can be proud of? Do we really want to inflict these kinds of statistics on the developing world? Would more babies survive if we did? Are we willing to take responsibility for any unintended outcomes of our business-led models of medical care? The results of our endeavours to control childbirth through the use of medical interventions and technology have left hundreds of millions of women with broken bodies, broken minds and broken hearts. We should be careful what we wish for……
The developing world, and indeed many impoverished countries, can provide us with many useful lessons. Health care can be improved by making access to primary care in community settings the standard for pregnant women.
Assistance with family planning, protecting women from rape and physical abuse, the provision of a decent diet and clean water plus safe living conditions have been shown to dramatically reduce maternal and perinatal mortality. It is the improvement of social conditions that make a difference between life and death for women and babies in the third world.
We can also learn that traditional birth attendants, working simply, in harmony with women in their own communities can produce enviable results.
We have perhaps more to learn from them than they will ever need to learn from those of us in the “civilised” world
Provide women with midwifery models of care, not medical interpretations of nature’s plans for childbearing. Midwives are not the problem, they are the solution to better birth outcomes. Midwives are the protectors, supporters and advocates for normal, natural birth. Midwives use simple, non-technical ways of working with labouring women, and often achieve outstanding results. For example: The use of moxibustion to turn breech babies Using sterile water injections to relieve back pain – just as effective as an epidural with none of the side effects. Using warm water immersion to ease pain and provide a protected birth environment The use of localised heat to reduce the discomfort of powerful uterine contractions.
Give women freedom to move and use their body to enhance the mechanical design of the pelvis
Provide a safe haven when birth can unfold without distraction or disturbance
Avoid all drugs during labour, including routine oxytocics, sedatives, and especially anaesthetics. Offer kind words, gentle support and encouragement that will reduce fear and enhance the flow of endorphins
Avoid all routine procedures, especially time limits for pregnancy and birth, invasive vaginal examinations, electronic monitoring and surgical procedures such as episiotomy.
Drop the arrogant assumption that Nature’s designs can be improved upon and respect the unpredictable impact that will result from meddling with natural processes.
We must learn to again trust Nature. Believe in the birth process and its inherent drive for safe outcomes. Midwives and midwifery models of care must take the lead. This work is done one woman at a time, by making each birth and individual event for mother and baby. It is not easy, but it is achievable. All that is required is the will, some basic skills and a passionate commitment to furthering the human race in the best possible way. My final simple message, therefore, is
and Leave us women alone, to birth our babies as Nature intended
Secret for enabling natural births
The secret for enabling natural births Andrea Robertson Director, Birth International Sydney, Australia
Baby Callum was born safely in his parents flooded house and were airlifted out by helicopter a day later.
The Australian aboriginal people are the oldest race – 40,000 years of continuous presence on earth
Birth scene from the Bayon Temple, Ankor Wat Cambodia, circa 1000 AD
Current WHO statistics : <ul><ul><ul><li>Italy 37.4% </li></ul></ul></ul><ul><ul><ul><li>USA 30.2% </li></ul></ul></ul><ul><ul><ul><li>Australia 30.8% </li></ul></ul></ul><ul><ul><ul><li>Canada 26.3% </li></ul></ul></ul><ul><ul><ul><li>Germany 27.8% </li></ul></ul></ul><ul><ul><ul><li>Ireland 25.4% </li></ul></ul></ul><ul><ul><ul><li>France 18.8% </li></ul></ul></ul>
Countries with a midwifery model of care <ul><ul><ul><li>The Netherlands 13.7% </li></ul></ul></ul><ul><ul><ul><li>Norway 16.6% </li></ul></ul></ul><ul><ul><ul><li>Sweden 16.5% </li></ul></ul></ul><ul><ul><ul><li>New Zealand 23.7% </li></ul></ul></ul><ul><ul><ul><li>United Kingdom 24.3% </li></ul></ul></ul>