You asked, we listened, mamas. As a follow up to our 2-part Guide to Caesarean Sections from last autumn, we wanted to examine the full spectrum of birthing options and attitudes in Singapore. For every woman who feels stigmatised for having a C-Section, there’s another who feels pressured to have a medicated birth. From Hypno-babies to home births, there’s a growing movement for natural birth in Singapore – and we’re here to help you find it. Click here for part 2 of the series, in which seven real mamas recount their experience with natural birth in Singapore.
As always, this is a judgment-free zone, mamas. We respect every woman’s decision around what to do with her body, we just want to help her get informed!
When I got pregnant, I was ECSTATIC. Then… I thought about the fact that the baby would eventually need to come out of me. Part of me was hoping I’d get a magical hook up from a lovely stork. Netflix intervened on my behalf. My husband and I watched Babies (2010), a gorgeous documentary following the early life of four babies from around the world. Netflix suggested I watch The Business of Being Born (2007). And so I did. Embarrassingly, I had no idea midwives were still a thing. And a doula? Do-what? So I started learning.
I read about relaxation and breathing techniques. I tried holding an ice cube in my hand. I made a cheat sheet with all the recommended birthing positions. I learned about the benefits of a drug-free vaginal delivery, such as a shorter and easier labour, a faster recovery time, a lack of needles, and how the baby’s gut gets populated with beneficial bacteria. I read about women describing a feeling of empowerment, as if they’d run a sort of uterine marathon. It seemed incredibly powerful to feel connected to the women across the world and throughout history who delivered sans intervention.
When my 15 hours of labour arrived, four of them were endured painfully on my back in a U.S. hospital bed, strapped to an IV, with a nurse telling me I MUST relax or get an epidural. So I did. I felt let down, like I had failed, but in truth, I was vastly unprepared to manage the contractions. I had basically decided to run a marathon after watching one on TV and buying some cute sneakers and a really supportive bra.
So I totally hear you when you say, “I am interested in a natural birth but I AM TERRIFIED OF THE PAIN”. I was, too. So let’s talk about how to actually be prepared, right here in Singapore.
Get Yourself a Doctor and a Hospital
Ashley Davies, yoga instructor and former doula, has a great first question for your prospective doctor: “Can I have a doula at my delivery?” If the answer is yes, this doc is likely to support a natural birth. There are a lot of other questions you can ask as well—like how your doctor’s C-section rate compares to the Singapore average (31% according to the Ministry of Health, although only public hospitals are required to disclose statistics and it’s believed private hospital rates are closer to 40-50%).
Doctors who frequently come recommended for natural births include Dr Paul Tseng, Dr Lai Fon-Min, Professor Chong Yap Seng, Dr TC Chang, and Professor Mahesh Choolani. Dr Lai is the only one willing to attend a home birth, while Professor Chong is responsible for introducing water births to NUH. And that’s right, all of Singapore’s most pro-natural birth doctors are male.
With NUH’s EMMA Care program, you can have both an OB and a midwife at your birth, though there is an extra charge depending on the services you want to use. Check out your hospital as well by attending the maternity ward tour a few months before your due date. Only certain doctors are willing to support a water birth, and only NUH and Thomson are equipped to allow them as of January 2015.
Learn what to expect, how your body will respond to labour, and what it will do to help you progress naturally. Learn how various labouring positions open your pelvis and help you utilise gravity to make that gorgeous butterball easier to deliver. Learn about the various interventions, why they are performed, and what to expect.
Ginny Phang, head Doula at Four Trimesters talks about what is happening on a hormonal level in her TEDX talk. Oxytocin is released when you are making love, and it is also released during labour. Sweet, right? But fear produces adrenalin, which shuts down oxytocin, causing you to tense up, which causes more painful contractions, which makes you more fearful…and so it cycles negatively onwards. Ina May Gaskin (the baby birthing guru) also talks about the impact of fear.
To start, take a class from Four Trimesters, Parentlink, or Mother & Child. Prepare your mind and body as the months of your pregnancy bring you closer to meeting your baby. Find out how techniques like HypnoBirthing and the Bradley Method can help you manage contractions. Elisa Bartolo, two-time hypnobirther, says, “Eliminate fear and find a place to go to in your mind so you don’t over intellectualize what is happening to your body”. Build up your determination to trust your body and let it do what it is meant to do.
Anthony Bartolo, hypnobirthing husband, says, “Would you ever go to court without a lawyer? Fork out for the doula.” A doula or midwife seems to be the common element in successful drug-free births here in Singapore. A doula helps you navigate the demands of the nurses and the requirements of the hospital, which is especially important as a first time mum or as a new arrival to Singapore.
You often have to be quite assertive to get the kind of birth you want. Yoga instructor and writer Sarka Kocicka was told by a nurse that she had to be monitored while labouring in the tub. Her preparation told her otherwise and gave her the strength to say no (her doula had not yet arrived). She was later told by a nurse she was not fully dilated and should not push, though her body was telling her to bear down. Her doula told her that she was fully dilated, but the doctor had not yet arrived. This information let Sarka feel okay in stalling her baby a bit, as she knew what was going on.
My own doula helped answer nurses’ questions as to my progress, so I was able to stay focused on managing my contractions. In-demand doula Tania Grose-Hodge says, “I focus a lot on encouraging the woman to find her inner voice and figure out what is most important to her and her partner for the baby’s birth”. Doulas are there to support YOU and help you achieve an amazing birth, however you define it.
Get a Plan
Make a birth plan, and make sure everyone (doctor, doula, partner) is on board with it. While you may plan for an intervention-free birth, you cannot predict what will occur. Knowing what to expect and writing out your preferences – if you need pain relief, if labour stalls, or if a C-section is needed – will protect your experience.
“You want to come away from the birth feeling positive”, says MJ Davis, a new mother who was completely thrilled with her intervention-filled birth experience. Because she was prepared for the possible eventualities, she came away knowing she had done everything in her power to have the most natural birth possible for her daughter. Her planning left her feeling calm. “Nothing felt like a crisis”.
At the end of the day, the most important thing is safely delivering a healthy baby, no matter the method. This is one day in your life (ok, sometimes two). It’s a big one, but it is still just one day. As MJ Davis says, “A decision you already made was good. It led you to having a wonderful child.”
So don’t look back if you have already climbed this mountain. You made the best decisions you could have, given the information and support in your possession, and that’s the most any of us could hope for, mama.
Coming up in Part 2, I’ll share the personal stories of women having the best birth they could—including Samantha’s potty power, MJ’s fab Plan C birth, Elisa’s hypnobirthing prowess (even at the dentist!), and how my body knew what to do despite my lack of faith in it.