My Traumatic Birth in India
by Ruth Malik
© 2008 Midwifery Today, Inc. All rights reserved.
[Editor’s note: This is an updated version of an article that appeared in Midwifery Today Issue 87, Autumn 2008.]
I had always been fascinated by birth. I found comfort in birth as an experience that bonded me with my child, partner, family, myself and with women. Birth was not something I wanted to avoid, but an experience that I wanted. I had been excited about birth since I was a little girl. I knew there must be benefits in a natural birth, for both myself and the baby. I was not afraid, I was excited and I knew I could do it. I expected that the doctors would support me and that they also believed that natural birth was healthy for mother and baby. I felt that all I needed to do was go to the hospital, birth my baby, and they would not intervene unless needed.
I was 32 and living in India when I became pregnant with my first child. I was both excited and apprehensive, and I spent much time searching for a place where I would feel comfortable to give birth. I found a nice private nursing home in New Delhi, India, with a female obstetrician; I was seven months pregnant by the time I found this hospital. The doctor was abrupt; she always had many other trainees and colleagues in the room. She attempted to do a vaginal exam with a room full of people without asking my permission, and she was also extremely rude to my husband. I discussed my desire for a natural birth with her but did not feel comfortable handing over a birth plan. As an Australian, I thought this must be normal practice in India, and I did not feel comfortable to question her or insist on what I wanted. I put her abrupt behavior and my doubts about her in the back of my mind and tried to relax and prepare for the pending birth. I was reading all the right books, and thus I felt that I knew what I had to do when the time came.
I went for an appointment on my due date. The doctor said that if I did not gone into labor by Monday, the first of April, I had to report to her. I reported to her on Monday, and she asked me to go for a sonography, three days past my due date. I assumed this was normal and did what was asked of me. During the sonography, I was told that the cord was tight around the baby’s neck. The doctor described it like a noose and said I had to have a caesarean. She told me to go home and come back at 4 pm. I questioned the doctor and was angrily told that my baby would die as I slept that night. My doctor made me feel terrified. I briefly considered going for a second opinion. Both my husband and I were scared and confused by conflicting information and horror stories. I was fed up with the stress, trips to the doctors, alarming relatives, and the tests—it was all too much. I needed it to be over. We felt it best to do as the doctor said for fear that we may harm our baby. My son was born by cesarean surgery, without labor, under general anesthesia. When I awoke, I was alone.
I cried like I had never cried that night. My son was kept from me for 24 hours in the nursery, not for a medical reason but because it was hospital policy. Despite being heavily sedated, I managed to wake myself up all night in a panic and press the buzzer, asking for my baby. They would not give him to me, and I knew they were feeding him formula that I did not want. When I finally first saw my son, I looked at him and fell back in the bed thinking, “I need to go home and come back and do this again.” His birth was an out-of-body experience; my brain could not relate the baby to the event. I had never experienced so much distress in my life; I felt the experience was so awful, that having a child was not worth it. My response to my child shocked me. I thought, “What kind of mother am I?” I dragged myself up, with a large painful cut across my abdomen, and began a struggle of bonding and mothering under the exhaustion of an awful depression and post-operative recovery. I did not know how I was going to face the world. I dreaded the visitors. I did not want to meet with other mothers as I felt they shared the wisdom of labor and birth, and I could not talk about it with them because I did not experience it. I also felt ashamed that I had not managed to do the right thing for my son and myself. I had not protected him. Breastfeeding was painful and excruciating. I had lost the birth; I could not lose the precious experience of feeding. I showed my bruised and bleeding nipples to pediatricians and obstetricians, but no one could help me. I refused to give up. My son needed to feed and be close to me; he was as traumatized, perhaps even more, than I was. The experience took away all of my confidence. I felt that I had failed; the sense of failure was debilitating. I did not know how I was going to go forward and mother.
I learned that choosing a birth support is the most important work that needs to be done. I felt that the expensive five-star private hospital with the famous doctor was where they must know best, where I would be safe. I now realize money does not translate into care or the protection of my rights. I now know that in choosing an obstetrician, I chose a surgeon. I chose a professional trained to handle emergencies and not the normal process. I chose a person who doubted women could birth; I chose a professional who viewed normal birth as something to fear. There was nothing wrong with me. I could have birthed my child. She lied to me and stole birth from me; she damaged and hurt me and my child.
The point of getting to know my doctor was to learn about her level of respect, and if her beliefs matched mine. I needed to be sure that at any moment when I did not feel comfortable that I was prepared to address this with her, consider her response, and if necessary, walk away, no matter how tired, fed up, close to the due date, afraid and troublesome it seemed. After the birth, I felt I had been a stupid fool; after all of my birth preparation, I was clueless. In hindsight, I was not clueless; my doctor’s behavior was all the information I needed to warrant me to leave. My intuition had been talking to me since I was a child, reminding me of the awesome potential of birth. My intuition was giving me all the warning signals: doubt, suspicion, anxiety, and fear. I chose to ignore this valuable resource.
I was unprepared to take on the responsibility, and I handed over responsibility. I said, “That will do,” when I knew it was not good enough. Reading books, going to childbirth classes, making a birth plan, exercising and eating well was not enough. Learning how to cope with labor by reading active birth was of no use if it was unlikely that I would be supported to go into labor. There was no point in attending a class that did not provide the information and skills I required and instead hid things from me. I was angry with my Lamaze birth educator—12 out of 13 in her class had a cesarean. The educator did not prepare us for what I now know is the most common way to birth in urban India: a cesarean section without labor and under a general anesthesia.
I now know there was nothing wrong with me; being overdue is not an indication for a sonography. Gestation is 38 to 42 weeks. Even the Indian obstetrics textbook supports this. Research also supports 43 weeks as perfectly normal. I was in a perfectly normal state. I now know that as many as 30% of babies are born with the cord around the neck and rarely does it result in a problem. The decision should have been to recognize that both I and the baby were well, let labor start naturally and monitor fetal heart tones every 20 minutes. I was coerced and led into a cesarean section by a diagnosis that was outside of evidence-based medicine. I could have safely gone home and waited for labor. I could have asked more open questions to doctors and childbirth educators about local birthing practices. I could gathered information from other women. I could have hired a midwife for a homebirth or a doula as a support for a hospital birth. How was it possible that I, an educated, independent woman, had allowed this violence into my life? Losing power over the choice of what was done to my body left me deeply ashamed. I wanted to scream out, “How we are treated, what is done to us and our children is important.” I was mostly angry with women, my mom, the female doctor and all the women who had gone before me. How could women have let birth become so damaging and why didn’t anyone warn me?
I wanted to believe in the professionals. I could not face that I may have been lied to and manipulated. I asked, “What kind of world am I living in?” However, I did eventually have to face this, and it shattered my worldview. It was the hardest realization of my life, but oddly enough it was also one of the most liberating. I had been naive up until this point. When I first came across the notion that I may be responsible for what occurred, it was extremely disturbing, and I feared to accept this fact may destroy me. To let go of anger was difficult. In time, I came to understand my role in what happened and taking on responsibility was liberating. In fact, the birth of my son has been one of the most profound experiences of my life. The learning I have gained by reflection has created a healthier mother. Almost daily, there are opportunities to enlighten and empower my children.
My process of healing has been a need to know the truth and to offer avenues for other women access the truth.
Ruth Malik, BA, is an Australian who has been married for 12 years to Indra Malik, an Indian. She is mother to son, Jai, six years old, and daughter, Sophia, two years old. Ruth came to Delhi, India, when working for Australian Education in promotion and student recruitment. She was in business with her husband for five years, then worked in Bollywood in Mumbai. She has spent the last six years in intense mothering and will be taking hypnobirthing and doula training this year.
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