Being a doula on a journey ?
When we set out on our journey one of the dreams I had written in the Bucket List was to attend and support a childbirth in various places. I knew it probably would not happen while we were traveling, moving a lot and not staying in one place. Well, childbirth requires availability, accessibility and, of course, being in the same place long enough to get to know the woman and being at least a month on standby before her birth. And not to forget, you can’t just disappear a minute after the birth, but rather be there for her and support her. When the visa allows a stay of a month or two, of which during most of them we want to travel and see as much as possible, it becomes practically impossible to do it. Besides, it took me almost a year to calm down and get used to the addictive and intoxicating new status of “Silent Phone”, and not being On Call after many years of almost constant state of alertness. This certainly was in an even higher place on my Bucket List.
Then we got to Koh Phangan in August 2015 and the rest is history as they say. A week after we arrived in Koh Phangan, I said to The One – “I’m not moving from here”. A month later he said let’s do another visa, and then another … and there we are ever since. And Facebook, and life itself, and slowly people here began recognizing me and tagging me on relevant Facebook posts of pregnant women who are looking for a doula.
Attending first Birth in Thailand
The first birth in Thailand I had seen, in March 2016, was a hospital birth that unfortunately ended up with a cesarean section. I did some research before the birth, as I usually do, and I realized very quickly that the situation for those who want a natural birth in Thailand, rather than a cesarean birth, is not brilliant. First, it’s expensive. Local health system for foreigners living in Thailand, is of high-quality and expensive. The accommodation level of the hospital in Koh Samui, where most of Koh Phangan women foreigners go to give birth, is very high. The room looks like luxurious five-star hotel rooms (not including a swimming pool, but including cute branded small shampoo bottles in the shower).
Second,fondness of cesarean birth in Thailand by locals is immense. Thais have this thing of choosing a lucky day for birth according to the Buddhist calendar. It is considered good parenting, choosing your newborn a lucky day to be born at, rather than letting him be born when mama nature wants to. What if that falls on an unlucky day ?? It’s for life! It is inconceivable. (I’m exaggerating a bit, but you get the idea). There is also a cultural issue with keeping the vagina intact, and of course the admiration of whatever is considered western which results in clear preference for medical interventions at birth and cesarean section foremost.
After that birth that ended with cesarean and a river of classical medical interventions including (partial list) confining of the woman to bed while she’s lying down on her back, isolating her from her relatives and breaking her spirit until she signed a consent form to have a cesarean, her husband showed me the administrative paperwork he received from the hospital upon their admission. I do not know if this is an unusual incident or a general policy (let me guess that Option B of the two is the right one…), but it said in black on white that a normal delivery cost is like this and that, planned cesarean is double, but the most profitable case to the (private) hospital is a birth that started as a normal one and “somehow” ended up with a cesarean section. It’s just really worth it for them to do everything they can and ensure that it will end that way. The preferences of the woman or her birth plan does not really stand in their way.
It kind of frustrated me and I decided that if another women will come to me and ask me to support her at her childbirth, I’ll have to think carefully how I give them professional assistance, without exposing them to those risks on one hand and without interfering with their decision of where and how to give birth on the other.
A midwife friend comes to Thailand
I was very glad when a colleague of mine, a midwife, told me she planned to come from Israel to Phangan for two months and live right next door to me. I understood it very well as she said she was eagerly waiting to be “silent phone” mode, but I told her – sure, bring your equipment just in case
It was clear to me that reality will somehow set itself just perfectly, as it usually does, and indeed a few days later landed on my veranda a couple, parents-to-be, who badly desired to deliver at home. They already knew that it was really difficult to get a normal, natural birth in the local hospital, and perhaps even more difficult to get a doula in our little island, but finding a midwife, that’s really a dream coming true.
Lihi hit the island in early July. The couple’s expected delivery date – mid-July. We were both on standby. The couple lives just a quarter of an hour from us, in a small hut he built to his wife during her pregnancy, on a land owned by her family, surrounded by relatives, a real tribe, in the middle of the jungle not far from the “city.
Home birth in Koh Phangan
On Friday night the contractions that began that morning became stronger and more regular and frequent. At half past 10pm we both headed to the cabin. A dirt road off the main road winding into the small house, one room with a small unstable wooden ladder leading to a shower, outdoor kitchen and western toilet without a flushing tank.
Before birth, the woman consulted with me about a birth pool, she bought in an excellent local online shopping website. It was a great pool, even better than those used in Israel for home births. It fitted into the couple’s shower room without a problem. Getting hot water for the delivery was a whole different story. In money time with a good five inches opening, while the woman wanted to get into the pool, the water heater stopped working, and her husband spent his time, as many husbands did before him and probably many more to come after him, filling the pool with hot water boiled a pot on the stove.
Meanwhile, Lihi and I took turns between us, because there was no way the three of us could fit altogether in the small room and the woman wanted privacy as much as possible. Already being troubled by the presence of many family members in nearby houses she asked her husband to play some music in the background to allow her to let go and make sounds at will.
Massages, breathings, birth is birth is birth. It was obvious that she was doing great. Lihi checked her once at five centimeters, shortly after we arrived. I gave her orange oil to smell when it seemed she was at surely eight centimeters. Some more contractions and then we heard her pushing. It was around 1:30am. I handed Lihi the mobile monitor device (during the pushing stage in a home birth the midwife listens to the baby’s pulse frequently). I pulled back the curtain used as the shower room’s door and sat outside to meditate. Between us, what else could I do ? At the beginning of the meditation a thought came to my mind. She will push for 40-50 minutes and will give birth beautifully. I saw the thought drifting away like a cloud, greeted her and went back to concentrate on breathing. At 2:35am the baby was out.
The placenta came out intact minutes after the woman left the labor pool with our help, with a newborn baby in her arms, skin to skin. The vegetarian husband blanched slightly at the sight of the placenta but then got his courage back and cut the umbilical cord after it already stopped beating. A birth in Thailand from the movies.
The only thing that bothered me were the mosquitoes I noticed circling around the mother and the newborn. That’s exactly what we need right now, fucking dengue. I became a little nervous and wanted to let the lovely mother-infant bonding inside the big bed under the mosquito net that fills almost the entire floor of the cabin. We drank, ate two dates, and two hours after the birth we drove back to our homes on the beach, happy and good-hearted.
Koh Phangan, is it reality or a dream ?