My Journey into Planned Homebirth in Venezuela
Editor’s note: This article first appeared in Midwifery Today, Issue 93, Spring 2010.
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Having my first son, Fernando Javier, at home back in 1983 was one of the most challenging times of my life, but also opened a door to the sacred pathway I would follow in the years to come. The experience assured me that homebirths were possible and safe, in spite of what they teach us in medical schools.
Back in those days, I was completing my OB-GYN rotation in a University of Los Andes teaching hospital, and everyone was surprised by and critical of our decision to have our baby at home despite “all the technology” that was just around the corner from where we lived. They lectured me on “the danger” I was putting my wife and son in, should an emergency occur. The message from the head of the department was that I had to “stop inventing things” if I wanted to have a passing grade in obstetrics.
Two years passed and we moved to Puerto Ordaz, an industrial city in the southeast part of Venezuela, where I started working as a general practitioner in different hospitals and was again immersed in the technocratic model of obstetrical care. But I was always hearing a little voice telling me there must be a better way to treat a woman and her baby during labor and delivery.
In January 1991, I completed my family medicine residency in Caracas and returned to Puerto Ordaz, a cosmopolitan city of about 1 million people, where I started my private practice. Back then, many of my patients were from abroad, mainly from Australia, the US, the UK and Canada, where they were used to having a family physician. Some had already experienced homebirth in their countries. In their search to find an English-speaking obstetrician willing to do homebirths they all ended up at my office and that little voice came back, telling me this was my opportunity to rediscover my dharma and to start doing homebirths in my hometown. That’s what I did for the next six years; but many times I would bring technocratic protocols into the home, such as active management of labor and birth, immediate cord cutting, separation of baby from mother, aspiration of baby, vitamin K, and all the other newborn procedures I had learned in medical school.
February 1998 came along and I was not too happy about following these procedures. The little voice returned again, this time telling me to seek further studies, knowledge and experience. My father advised me to go to California and meet Dr. Deepak Chopra, who would guide me in my personal and professional transformation. In April 1998 I was certified as a “Magical Beginnings, Enchanted Lives” prenatal instructor, at the Chopra Center for Wellbeing. There I learned to embrace the mind, body and spirit for a conscious pregnancy and childbirth.
During these 11 years, I have adapted and expanded the course, using information taught by incredible speakers at different congresses, such as the ones sponsored by Waterbirth International, Midwifery Today and Amayal, doing my best to guide every woman and her partner toward discovering the divine power they have to give birth together, joyfully and naturally. Yes, we have been able to incorporate the father into the whole process of giving birth, particularly during the last four years. My wife, Haylen, works with me as a doula. All the women love her wisdom, massages and support during labor. To this date we have graduated 56 groups, with an average of five couples per group. As a matter of fact, we ourselves were part of group number 40 when our daughter, Paola, was born in water, and group number 50 when our son, Fernando III, was born in the living room.
What has it been like doing homebirths in a technocratic city and country where the cesarean rate is close to 90% in private clinics and 35 % in public hospitals? Well, of course it has not been easy, but it has been an interesting and nurturing struggle, for us and for the women and their partners who have chosen homebirth. Most obstetricians, pediatricians, relatives and members of the general public tend to focus on, “What if something happens?” and “What is technology here for?” They insist, “The hospital is the safest place to give birth” and say, “You and your baby will suffer during birth.” Others say, “A c-section is fast and safe.” So far, only three obstetricians will give us support if needed, but are not fully open to homebirth.
Another obstacle we have had is getting the local government office, the Prefectura, to recognize my work as a doctor doing homebirths. With the birth certificates I issue, the government workers were always asking for the hospital seal. It took some time for them to realize that all I had was my personal seal and that a homebirth should not have any other seal. Also, at the local sanitary department they asked for proof of my knowledge and capability to do homebirth and waterbirth because I was not an obstetrician. I handed them my credentials from Waterbirth International and ALSO certification. It seemed to me that it was hard for them to accept that one does not have to be an obstetrician in order to be capable of attending births. My God, we are talking about natural, physiological homebirth. Again, we’re breaking paradigms. Finally, everything is running smooth having cleared those obstacles.
But let me take you to the fun part of doing homebirths—to the happiness, joy, smiling faces, trust, hope, love, devotion, privacy, respect and empathy. Last week at the graduation ceremony for groups number 55 and 56, this is what some of them said:
“We were looking for tranquility, harmony, love, friendship, and we found it here at Magical Beginnings. We found a friend within the doctor and the doula. We received more than what we were looking for.” (Jessica and Luis)
“With the information and wisdom we received we came to know that the body can give birth all alone. The course is very well designed to make us feel in control. You gave us love and trust and it was great to know you as people.” (Alejandra and Leonardo)
“I do not like the coldness of the delivery rooms at the clinics, so I am going to have a cozy waterbirth.” (Graciela)
Maria Angelica had already had a waterbirth five years ago and came for the second time. She said, “This time I received more information and feel more in control.”
Sandra and Leandro came for a VBAC and said, “Before, we did not have any information at all. We want to feel the emotion and experience of a natural birth. With Fernando there is no other option than to give birth.” Xionelma and Joel said, “We came looking for information, energy and wisdom. We have visualized our birth at home full of happiness.” These are just some of the testimonies.
The prenatal course we teach, Magical Beginnings, takes three months to complete. We have eight classes one night a week from 7:00 to 10:00 pm, all with audiovisual support. It has become a tradition to take turns bringing dinner. In addition, we have added another night for meditation and visualization sessions. On Sunday mornings we teach yoga for pregnancy and birth at a local park with waterfalls in sight. Here we embrace the mind, body and spirit through respirations, relaxation and movement. We practice all the possible birthing positions you can think of. On another Sunday we meet at our house to practice waterbirth positions and to get acquainted with the waterbirth pool. Afterward, a barbecue is served and other couples who have taken the course and have had a homebirth/waterbirth are invited to share their experiences and show their birth videos. All of these activities have allowed us to see our participants as mothers, as fathers, as friends and as people I need to trust as much as they need to trust me during their labor and birth at home.
We have had some women dilating well up to 6 or 8 cm. Then everything stops and shows no progression at all. We have come to know that fear and unresolved emotions play a big role here. In order to prevent this from happening, we have been working with Sylvia Jastram, who works with rebirthing and liberating emotions and conflicts before labor. If necessary, our doula, Haylen, does a tremendous job with relaxation massages during the passive stage of labor seeking the release of all the endorphins you need to be literally transported to another state of mind. But most of the time, depending on the personality of the woman in labor, we recommend complete privacy and darkness during labor, with no cortical stimulation whatsoever. The results are fast and easy labors. Three weeks ago, Maria, primiparous, went into labor at 7 am. She had dilated 1 cm by 8:30 am. She stayed in her dark room in silence doing conscious breathing. She was completely dilated at 11:30 am. During these three hours, no digital examinations, no Doppler, no cameras were used. Maria told us she felt labor pain only once—when her husband innocently interrupted to ask if she wanted anything to drink.
These past 11 years have been an incredible gift from the universe—a chance for us to grow, learn and shift from the technocratic model to a consciousness- and physiological-based paradigm for labor and birth. Our experience has been awesome, to the point that I have found the midwife within me. We consider it an honor when a pregnant couple asks us to guide them through their sacred journey of pregnancy and birth. Of course we also give them an insight into what comes afterward. Our compromise with life is to guide as many women and men in our community on this path of joy, love, understanding and commitment. Their babies will only have one chance to have a gentle birth, and they may have only a few chances to experience the sacred moment of giving birth naturally.