childbirth in Peru — Mum's The Word (Writing)

How Will I Know It is Time To Go To The Hospital?

On the day of deliver, Antonio Lévano, a well-regarded OB/GYN in Peru is in contact with his patients.

Many women ask him, “Antonio, how will I know when it is time to go to the hospital?”

He encourages them to spend as much time at home as possible. At home they are comfortable. They can eat, move, take a shower, etc.

“How do I know I am having contractions?” they ask.

He says, “You will know the difference. It will feel different than how you normally feel.”

He asks his patients to make a note of the time, every time they feel a contraction. When it is ten minutes in between the start and stop of contractions, they send him a message. He has an app for them to send all of the contractions and times, so that he can see the progression.

He prefers that they are at home until contractions are every 3 to 4 minutes and they feel a lot of pressure or pain in the pelvis. He emphasizes that it is not just the amount of time that is the indicator for him, if they are ready to go to the hospital to deliver. He wants to hear their voice to hear if they are out of breath or unable to talk as usual; this is a sign that it is time to go. If they can talk normally, it is not time yet.

Obstetric Violence. Are You Aware It is Happening Globally?

Obstetric violence was not a term that I was familiar with until I started doing research on my book about holistic childbirth around the world.

The first person who mentioned the term to me was actually an OBGYN in Peru, Antonio Lévano, who admitted that obstretric violence was prevalent in Peru. After my interview with Dr. Lévano, a doula in Peru, Ariela Waltzer also brought up this topic without coaxing, which made me realize this was not a term that they invented, but a widespread issue in Peru and many other countries around the globe.

“What is obstetric violence?” I asked.

“Obstretric violence means they do not see your needs. They see their needs. They are not listening to you. They are listening to their book and the charts and numbers and what needs to be signed…. Obstetric violence is very big in Peru especially in private clinics.”

She admitted that obstetric violence is common in Peru and that people have been talking about it for the last fifteen years.

I was shocked.

I asked her if she could share specific examples. She described how the large percentage of c-sections in Lima, Peru is the biggest example. In Lima, the capital, 90% of births at clinics are c-sections. She mentioned that it wasn’t just taking away a woman’s choice about how she would give birth, but that it happens every step along labor

It's Time For Compassion and Female Empowerment!

Home births are illegal in Peru. With the pandemic many mothers in Cusco, Peru are electing to have home births over hospital births. Health officials in Cusco are aware of this new trend and that many are offering to assist women with home births at this time. No arrests have been made yet, but health authorities are greatly discouraging women from giving birth at home saying that it is not safe. They are trying to ensure that every protocol has been made to ensure their safety at this time with the virus and that they should refuse help at home and have their births in hospitals.

This is so sad! Home births should not be illegal. Home births are not more dangerous than hospital births. Women should have the choice where they want to deliver their babies. If they feel safer at home, they should be allowed to give birth with assistance in the comfort of their homes. In Peru people are still in lockdown. They are not allowed to go out unless it is necessary. Requiring pregnant women to leave their homes when they don’t feel safe is not right. This causes unnecessary stress and potential trauma to mothers and their babies. They are scared for their health and their babies health during this pandemic. Why would they want to go to a place where there are people sick with the virus? Women should have the choice. Women should not fear being arrested nor should the people who are assisting them to have a healthy birth.

Pioneer Women in Childbirth

Maria De Los Ángeles Chero and Ariela Waltzer pictured above are the first doulas of Peru. Dr. Angela Brocker is a doctor and a midwife in Peru who learned about doulas from living in Germany (where she is from originally) and decided to bring this tradition to Peru. In Lima, Peru, of all births in the private sector, the c-section rate is 85-90%, which is much higher than the national average of 35 to 40%. As a doctor in Peru, Dr. Angela Brocker witnessed a lot of obstetric violence and was even encouraged during her training to do practices against women that she did not agree with. In 2005, Dr. Brocker created a doula training program in Lima; Maria and Ariela were some of the first ladies to learn this tradition from Dr. Brocker at her birthing center, Pakarii. Both ladies continue to be doulas today and love it.

Ariela admits that in Peru doulas are not popular (compared to other countries) and that many women still do not know what a doula is, however, over the past fifteen years, more and more women are becoming aware of obstetric violence. She is happy to be one of the pioneers to support women.

Have You Ever Heard of Natural C-Sections?

When I was in Peru, I interviewed a well-regarded OBGYN named Dr. Antonio Lévano. He is a pioneer in his county for natural c-sections. Natural c-sections originated in the United Kingdom in 2008, but in 2010, Dr. Lévano was the first OBGYNs to implement this technique in his home country of Peru.

It has been well-researched that babies that reach full-term are healthier than premature babies. Babies that are born premature may have respiratory problems such as sleep apnea or require ventilators, and may even have asthma and allergies throughout their lives. Mothers have a harder time breastfeeding babies which are born via c-section too. To remedy these issues, natural c-sections also called gentle c-sections were created.

Lévano described to me how he does natural c-sections in Lima, Peru. These c-sections are planned. Women decide ahead of time that they would like to have a c-section over a vaginal delivery. Unlike scheduled c-sections, after the mother begins contractions, not before, she arrives to the hospital to delivery her baby.