Student Response: Working with Hospitals for a More Gentle Birth in Malaysia

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Kuala Lumpur, Malaysia at sunset(Editor’s Note: This is was an alternative assignment that was accepted for our Doula Foundations Course, Unit 2 Project. Our student, Maira D., lives in the capitol city of Malaysia.)

 

The project in Unit 2 is marked as incomplete on my report. And it is right, because I managed to get only one person – she is a midwife – to e-mail the form back to you guys. And I think she did it about three months ago.
So I went to another hospital to get the form filled out. This hospital is the most gentle, birth-friendly in Kuala Lumpur, capital of Malaysia. So that you know, there are no birth centers in this country.They were the first ones to implement water birth in the country, for instance – which was banned this year by the Ministry of Health, but which will probably be back sometime soon.
Three months ago, I talked to the head midwife of the maternity ward and she said she would seek approval before answering the questionnaire. She never responded. Yesterday I had a chance to visit the hospital again and met this very woman again. She advised me to e-mail the training department directly to see if they can fill out the form.
I am writing to you because I actually had a very interesting and positive meeting in that very hospital yesterday morning with three other collegue doulas and the most pro-gentle birth og/gyn in that facility. I was wondering if what I report to you can be validated as part of my Unit 2 Project, since I do not know when I will get the form filled out by anybody in that hospital.
This is an ob/gyn who was a pupil of  a very recognized doctor in Malaysia, who was one of the first and most important doctors to support natural/gentle birth. We requested this meeting with him to hear first hand what the situation of the water birth ban was, to learn more about his hospital’s approach towards gentle birth and ask him what we, as doulas, could do to improve in our relationship with the hospital and the labor ward staff.
In general, doulas are allowed in this hospital – most doctors not in the high risk zone will accept us. They have tubs that used to be used during labor and birth but which cannot be used right now, until the ban is released from the Ministry. The midwives and nurses have all heard of HypnoBirthing since many of their clients have taken the course and end up talking about it and requesting more freedom to practice what they learn.
The tone of both the ob/gyn and the head midwife is mainly one of mutual communication and understanding. They know that the presence of doulas, for instance, reduces the stress in the labor ward and result in calmer births. Sometimes, however, we felt the tone was more medically centered, especially when it came to breech births and skin-to-skin after C-sections.
The ob/gyn said he used to be more open to vaginal breech deliveries and that he has performed some, but that nowadays with the horror stories he has heard from colleagues, he has preferred to intervene if the hand manueve does not work. Regarding skin-to-skin after C-section, he said it is very unlikely that any time soon mothers will be able to do it. He explained the problem of baby’s body temperature dropping, including the freezing air of the surgery room to reduce the risk of infection. For this matter, we only reminded him that skin-to-skin could be done by the father and then he was more open to it.
He agrees with us when it comes to intermitent fetal monitoring rather than the one mothers have to stay in bed, although the standard practice/protocol of the hospital is still 20 minutes on the monitor on the bed for every mother that comes in. He reported that the new wi-fi equipment for fetal monitoring the hospital was testing did not show good results and therefore, he does not know when that 20 minute protocol will be able to be removed.
He said he is open to propose to the hospital the purchase of active birth fixtures such a squatting bar, a birthing stool and a rope. He said that he does not recommend the hospital to have a ball anybody can use due to hygiene issues, but that balls are allowed. He stressed the fact that mothers can bring into the labor ward whatever aromatherapy, music and whoever they want as a birth companion.
Despite being shy to speak in public, as he claimed, he said he would be very happy to give a talk on gentle birth and talk some of his colleagues into joining. He sounded eager to unite with as many like-minded birth professionals as possible so that our goals can be met.
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