Scientific Midwifery with Obstetric Backup – a Unique Collaborative Model in Maternity Care from Healthy Mother
We started the Scientific Midwifery based Healthy Mother Natural Birth Center, The Sanctum® in 2009 when I realized the sheer scale of sub-optimal care practices in the maternity and new born care system. To put it in perspective, during one of the early antenatal checkups one of our moms told me “It is no longer normal to expect a normal delivery”. Women who were under the care of the conventional medical system as practiced in big and small hospitals and clinics told us that their care provider never really felt empathy for their feelings and that every checkup was highly clinical and lacking a welcoming feeling and celebration of their motherhood. But then that is what I suppose the standard medical model in maternity is all about – At any given stage of pregnancy check the “patient” for problems, compare her “stats” with the normal, conduct tests, prescribe drugs, and send her off with advice. Questions, if any, were answered, but only upto a certain point. At the end of the session a mother, even if she was upbeat before going into the doctor’s office, really felt like a patient who was due for surgery. Moms who had a previous cesarean, or those who were even marginally outside the “normal parameters” were often told theirs was a “risky” or “precious” pregnancy and advised strongly that cesarean operation was the only option they had for a safe and healthy baby. Now that was a sure shot way of transforming her from an excited, happy individual to one whose confidence is in tatters, her mind full of fear and anxiety. Now these are not examples drawn from studies or third party sources – all of them are first hand accounts narrated by our moms, dads and their families.
We believe the time spent with moms during the antenatal checkups is a critical factor in instilling confidence in her that she capable of giving birth on her own. The time spent in answering questions from moms, dads and their families is always well spent – it has direct bearing in the ability of the family to support her during her pregnancy, and more importantly, during the hard moments of labor. We have seen husbands really rise up to the occasion every time a mother felt disheartened, unable to manage her contractions, unable to bear her pain and wanting to give up. We are constantly amazed at how husbands were able to trust the process of birth with confidence and convey that confidence to their wives during those moments. By talking and assuring the mother that she is strong, by giving her much comforting massage, walking or dancing with her, husbands are able to transform seemingly tense and discouraging situations where mother is about to give up, into moments where she rebounds with an insuppressible feeling of victory. And all along, her midwife is the one constant, staying with her through thick and thin, never thinking about the fact that she herself has not eaten or slept for those many hours, and has been there for her from the first checkup to this moment. Her midwife is her ultimate goto person even at the dead of night when she needs someone to talk to, when she feels that uncomfortable feeling that she cannot pinpoint, or to validate and assure her that she and her baby are doing well.
Difference between Midwifery Model of Care and Medical Model of Care
And midwives believe that birth itself belongs to the mother! Not to the hospital, not to the doctors, or in the labor room! Birth is very personal, it is primal; and the woman’s body knows how to give birth. That is how nature has perfected the woman’s body to give birth since thousands of years. We acknowledge this strength in women, their bodies’ intuitive wisdom to bring together all the necessary components to create the baby and grow her. Throughout the pregnancy, we carefully nurture this amazing journey curated by nature where the baby and mother’s body complement each other to ensure birth happens when the baby is ready. All along the way, we counsel, educate and empower the mother and her husband/partner on what they can do to ensure a smooth journey. We as midwives prefer that mother takes charge of her own pregnancy and birth, by listening to what her body is telling her, connecting and bonding with her baby, and noticing the subtle queues her baby might be signalling. Many a times, this intuitive feeling may be a more accurate indicator of her and her baby’s state than all the technology driven tests and scans. We midwives are trained to notice these subtleties and to take appropriate steps, in any. During labor and birth, it is the mother who does the work, with encouragement and support from husband/family while her midwife ensured things were going well and the mother-baby team was working in tandem. At Healthy Mother Sanctum, every mother has the chance to go through labor for as long as she wants or is able to. Most importantly, it is She who has the choice, of course, within the parameters of safety for herself and for her baby.
So the question begs to be asked – “If mother is given the ultimate choice to continue to labor, what if there is a true medical emergency or if labor does not pregress beyond acceptable limit”? Yes, in rate cases situations do arise where, inspite of tremendous effort on the part of the mother, her husband, her midwives and birth team, labor just does not progress or the safety and health of the baby or mother may be compromized if labor is allowed to continue further. What do we do in those rare cases?
We have taken the natural birth focused Scientific Midwifery model that we pioneered in India, and judiciously married it with conventional Obstetric Medical model to create a unique Collaborative model of care. It is in precisely these situations that the Collaborative model is a life saver. Under this model, if there is a true emergency, all the emergency care infrastructure like Operation Theaters, ICU, Neonatal ICU, Surgeons, Anaesthetists, Pediatricians etc are available onsite and at the snap of a finger to tackle that emergency. The mother or baby does not need to be transfered to specialty hospitals except in the very rare cases. And even in those very rare cases we have preferred specialty hospital partners who work with closely to care for mothers or babies who need speciality care.
Healthy Mother Scientific Midwifery Based Collaborative Care Model
This Collaborative model is unique, not only in India, but also across the world. There are only five or six such instances where independent birth centers run by midwives have partnered with speciality hospitals to provide a one-stop solution to aspirations of mothers who want the empowering feeling of trying for natural birth but want the assurance that in case of any emergency they and their baby will have immediate care.
Thus the Healthy Mother Collaborative Midwifery Model of Care provides mothers, babies and families with the Best of All Worlds in their desire for empathetic, respectful care during pregnancy and labor, and empowering, transformative, safe birth.