Have you ever asked your mother about the circumstances of your birth, or asked other family members about theirs? We are taught all our lives that the day we were born was a great trial for our mothers. Certainly it takes a heroic effort for a mother to give birth. But aside from the physical suffering, can we not conceive of birthing in more imaginative ways?

 

Moni’s Classroom offers the expertise of a diverse group of professionals. “They all came to me of their own accord!” Chen Yu-ping (left) says with gratitude.

What do we mean by “gentle birthing”? Many people equate it with home birthing or water birthing, but that is incorrect. Gentle birthing views birthing as a natural physiological phenomenon, not as a medical condition in need of treatment. It is a birthing method guided by the mother’s willpower, her needs, and the natural instincts of her body.

In Europe, Japan, Australia and New Zealand, where gentle birthing is mainstream, midwives deliver babies for non-problematic births, while obstetricians help with patients with potential difficulties. The 70‡80% of women who can be expected to have a non-­problematic birth are taken care of by midwives, who have all under­gone modern medical training and obtained professional accreditation. They play an assistive role, facilitating birthing methods that combine conventional and alternative medicine, including birthing in a variety of positions (crouching, kneeling, reclining) or water ­birthing. To assist the mother and help reduce pain, they also employ a variety of supportive techniques, including the use of birthing balls, pelvic massage, acupuncture, aroma­therapy, yoga, and meditation.

Choosing the gentle birthing method puts the onus on mothers, so they usually seek out prenatal classes to ensure they are fully prepared. (courtesy of Moni’s Classroom)

In the past Taiwan’s maternity wards largely relied on midwives to deliver babies. But later Western medical practices became more common, and in 1983 the government issued regulations requiring midwives to deliver babies only under a doctor’s supervision. This ended the previous division of labor between midwives and doctors. Furthermore, from 1991 to 1999 all midwife training courses were discontinued and the training of midwives stopped. These and other factors resulted in Taiwan’s current methods of birthing, directed by obstetricians in a hospital atmosphere focused on treating disease and pursuing efficiency. The system relies on highly medicalized and standardized procedures, such as giving birth in a reclining position, attaching a fetal heart monitor to the mother’s abdomen, artificially breaking the amniotic membrane, injecting drugs to induce labor or for pain relief, shaving the pubic area, enemas, episiotomy, vacuum-assisted delivery, fasting, and so on. If birth is delayed despite these techniques, then doctors readily resort to a Caesarean section, causing the woman to suffer twice in the birthing process.

A midwife performs a pelvic massage to reduce pain during contractions and facilitate a smooth delivery. (courtesy of Fish Yu)

Birthing as a team effort

Doctors and families agree that Chen Yu-ping is an obstetrician with a unique outlook. A graduate of Kao­hsiung Medical University, she was formerly a resident obstetrician at Mackay Memorial Hospital. When she had her own children she traded her medical profession for a full-time job as a mom for eight years. During that time she earned a master’s degree from the Institute of Science, Technology, and Society at National Yang-Ming University, and began to reassess medicine from a more humanistic point of view, planting the seeds for her future advocacy of gentle birthing.

Chen opened Moni’s Classroom in June 2016. Located in a nondescript residential area, the tranquil space hosts frontline birthing specialists such as obstetricians, nurses, midwives, and practitioners of Chinese medicine and aroma­therapy, who offer their expertise to expectant mothers through consultations and courses. Offering both Chinese and Western medical techniques, the specialists cover pre- and postnatal care, including lifestyle and nutritional changes, breastfeeding, accupressure, and information for partners and family members.    

courtesy of Fish Yu

Midwife Kao Chia-tai is one of the practitioners. “If the doctors want to introduce gentle birthing practices, but the nursing staff are against it, then mothers will still get just standard nursing care, so you are only half way there,” she says. “If the midwives want to do it but the doctors are unwilling, then obviously there’s nothing doing. And many hospitals have no midwives at all.” After all, as Chen Yu-ping says, “Medical care is a team effort.”

True confessions of a midwife

Chen explains that most doctors’ training leads them to regard the people who come under their care as “patients” whose “illness” requires their active intervention. “For me,” she says, “an important turning point in moving toward gentle birthing was learning to sit on my hands.”

Fish Yu’s second child was delivered by Chen Yu-ping. Yu has experienced both conventional and gentle birthing methods. Six years ago she gave birth to a daughter vaginally without an epidural, but like most mothers in Taiwan she was given an episiotomy. When she was pregnant with her second child she chose the gentle birthing method with the support of family members. “I was very proud to have my first child, but the surgical procedure left me feeling wounded emotionally,” Yu says. “When I gave birth to my second child, I had no wounds to recover from. I gave birth at 8 a.m. and by 2 p.m. I was on my way home. National Health Insurance covers three days for a vaginal delivery, but I didn’t even need it.”

“I was amazed, and immediately wanted to have another child,” Yu recalls excitedly.

Most mothers using gentle birthing discover that it creates a closer bond between the mother and child and even the rest of the family. “Gentle birthing requires the support of others because it is a matter for all the family,” says Grace Liao, who chose this method of birthing.

Aki Yu (left) says that gentle birthing is rare in Hong Kong, but thorough prenatal preparation allowed his family to have an unforgettable experience.

After all, the birth of a new family member concerns the whole family. What kind of birthing method should be chosen? What effects will it have on the mother and child? What preparations should be made beforehand? Of course the mother must take a keen interest in the preparations, but so too should the family members who will support her.

“Of course at the very least the husband should be there for birth,” says another mother, Candy ­Liang. She describes how during her labor her husband had to give her 30-minute pelvic massages with ten-minute intervals between them, to reduce the pain of her contractions. “He said that even he lost weight during the birth!”

“I was really happy that I chose that birthing method. It was a beautiful experience and made our family closer,” ­Liang says. “Being involved in the delivery also helps the husband prepare for his future role as a father, so that it’s not the mother going through labor alone and the father realizing he’s a father only after the birth is over and he’s given the child to hold.”

Rita Wu’s husband, Aki Yu, hails from Hong Kong, where the couple live. He had to stay behind when she came back to Taiwan during her pregnancy, and so had to rely on online materials to prepare for the delivery, before coming to Taiwan to be present at the birth. “My daughter was born in the amniotic sac. Most doctors would break the sac to facilitate the birth,” says Wu. “I’ve even heard that in Ireland being born in the caul is an auspicious sign!”

Because there is little use of medications in this birthing method, the child emerges alert and healthy and the mother recovers quickly. Thus mother and child can share a recovery room, where the mother can breastfeed and look after her newborn.

There is little use of medications in gentle birthing method, so the child emerges alert and healthy and the mother recovers quickly. (photo by Lin Min-hsuan)

Chen Yu-ping likes to compare giving birth to scaling a mountain. “It’s like reaching the top of Yu­shan,” she says. “You could choose to be carried up by others, but if you climb it yourself the feeling will be entirely different.” These unique, profound moments in life bring a family closer together and prepare them to welcome the future. 

Devil in the details

“Giving birth is a complicated affair with a million potential complications,” Chen says. “Doctors should pay close attention to the mother’s condition. But hospitals are often short on staff and other resources to give adequate care to each mother, so they tend to simplify the procedures.”

The practice of pressing on the mother’s belly during delivery is a good example. We often hear stories of nurses climbing onto a mother’s body during delivery and applying pressure to the mother’s abdomen to assist delivery, but it can cause great discomfort for the mother. Chen’s method, however, applies pressure only with the contractions, pressing on the baby’s bottom, which can help the child move through the birth canal.

Candy Liang’s sister made a short film about Candy’s pregnancy. It has been viewed nearly 70,000 times online, introducing the wonder of gentle birthing. (photo by Lin Min-hsuan)

Once she performed the procedure and after birth the husband asked his wife, “Didn’t it hurt when the doctor pressed on your belly?” “I thought the doctor just gently rubbed me for a moment,” the wife replied. This shows the difference between the two approaches.

Similarly, doctors often raise the possibility of perineal tearing as a justification to perform an episiotomy, but if one waits patiently for the vagina to dilate and become lubricated, the baby will emerge naturally. Any tearing is likely to be slight and there will be no need for an episiotomy.

“Moreover, during contractions the body will naturally release the hormone oxytocin and endorphins—painkilling substances naturally produced by the body,” Chen says. “As long as the body is allowed to rely on its own internal workings, the mother not only will not suffer, but she will feel like a marathon runner nearing the glorious end of a race!”

Gentle birthing is a form of empowerment that allows women to display the natural wonder of their bodies.     

A smooth delivery makes parents, relatives and medical professionals feel like a big family.

Local moms stand up

While Moni’s Classroom provides a physical space for demonstrating the gentle birthing method, others have taken up the subject in different ways. Joyce Hsu, a coffee shop owner, hosts a Facebook group, “The Gentlest Encounter—Gentle Birth,” while filmmakers  Mimi Chen and Angel Su made a documentary, Happy Birthday (2016), and journalist Chen Shu-ting wrote a book, Welcoming Gentle Birth. Coming from the worlds of academia, medicine, and other fields, these mothers rely on the power of their own stories to create a grassroots approach to the subject, hoping only that one day Taiwan can become a place to be proud of for its handling of childbirth.