Birth is natural in all it's form

Dec 22, 2006

I've been very fortunate for two reasons when it comes to birth issues. First, it's the voices of thousands of families in my head that permits me to speak on behalf of ordinary people like myself. Second, I've lived and visited in many traditional communities that have no access to modern medical care.

This is what I've learned ... birth is natural and normal no matter what happens. This is the reality of life as human beings. Let's take away modern medicine and ask the question .. 'What is natural birth or physiological birth?'

The answer is simple. Birth is always natural and normal even when death, injury or illness are part of the experience. How can we take away the bad from the only experience that perpetuates our species? We can't.

So, the bottom line is simple. Everything about birth is normal and natural. There paradox remains: what do midwives mean when they support 'natural' or 'physiological' birth? Do they want to have birth in modern countries to do without medical care? Obviously not. Most people would consider having no medical care around birth in modern countries would be ridiculous. This would be considered to be 'backward', primitive and stupid.

In reality many traditional cultures would like to see more medical care available to the women during pregnancy and birth because they know for certain that death, injury and illness are a natural and normal part of pregnancy and birth. Some of these things they would like to prevent.

This is the same as the use of antibiotics and immunization. Traditional people don't want the normal and natural 25% of children under 5 years old die.

For women who live in modern countries, we must acknowledge that birth is full of potential problems and modern medical care is used and available in order to prevent or reduce those potential problems. Midwives would agree with this as well. There aren't many modern midwives who would prevent or encourage women to refuse medical care when a 'problem' becomes apparent.

As for us as women, we'd lay down our life for our children. So, if a doctor or midwives tells us there is a potential or obvious problem during pregnancy and birth, we will do anything to make certain our baby is safe.

So, we know everyone wants birth to be safe for mothers and babies. We also know that the increase in cesarean delivery implies more and more babies and mothers are at risk and would have been injured or dead if a cesarean hadn't been performed. But is that right?

let's use this blog to investigate your opinions about birth issues. You know my stance. I'm a trustee to Common Knowledge Trust and the goal for our educational branch, The Pink Kit Method For Birthing Better® is to grow a skilled birthing population world wide. Once expectant parents become more skilled at how to work with their baby's efforts to be born, then some of the potential problems can be prevented.

Through our own preparation during our pregnancy then using our skills to work with the natural pain of labour contractions rather than fighting them, we can improve the positive aspects of birth and outcomes.

Conversations will continue. Balancing how we live between ourselves as traditional and modern human beings bring up fascinating issues and not just around childbirth.

Physiological birth versus natural birth

Dec 20, 2006

Well, one of the nice things about being trustee to Common Knowledge Trust is that I can speak about issues in childbirth always from the view point of ourselves as 'consumers' or expectant parents or ordinary people instead of when we take on a specific role or hold a personal belief.

Let's see if I can explain this in relationship to a new trend by New Zealand midwives.

I've just been informed that New Zealand midwives are now supporting 'physiological birth' rather than 'natural birth.' So what does that mean to us as ordinary people having babies? Families in New Zealand are very lucky because continuity of midwifery care is standard for over 85% for expectant families. There is no shared care. General practice doctors no longer attend births. If a woman requires specialist care she is referred to an obstetrician and still is cared for by her midwife.

Since the cesarean has more than doubled under midwifery care, have midwives been successful in promoting and protecting 'natural birth?' There is obviously a huge difference between what these dedicated women would like for us then what we are achieving.

In the 12 years I've been in New Zealand (I arrived 5 years after midwives became Lead Maternity Carers) many women and men have confided in me that they don't have a clue what 'natural birth' really means. Most believe it means ... home birth in water. Because most of New Zealand women have no intention of doing so, they feel they will only have a medical birth.

For those few women who attempt a 'natural birth' (home birth in water) and who end up in hospital feel totally let down and a failure. So shame, blame and guilt abound in a midwifery model of care. That's certainly not what women who work as midwives want yet at the same time they are setting up a goal many of us can't or don't want to achieve.

Part of the reason the reason so few people achieve 'natural birth' is the lack of definition of what that term means. Obviously, natural birth goes well beyond giving birth in water at home... or does it? With unassisted births becoming a trend, some families believe a birth can not be 'natural' if a midwife is present.

So, let's look at the new term 'physiological birth'. If natural birth has never been clearly defined then what does physiological birth mean? Does this just confuse us further as families? Probably. When midwives define both natural and physiological birth to me they make statements like:

• 'There should be no medical interventions.'
• 'Women should be left alone to discover her own way of birthing and not be told what to do.'
• 'Not in hospital.'
• 'Not with a doctor.'
• 'Any vaginal birth.'

Gosh is that how you define natural birth? Please send your comments and let's share what all of our understandings are.

So what does 'physiological birth' mean to you? When I was told about this change of direction, the midwife told me:

• A midwife will now have to justify why she ruptures the membrane.
• Midwives will be promoting no 'medical' interventions at all.
• She recognized that there were many types of interventions not medical being used: castor oil, homeopathics, accupunture etc.

As a Trustee, I can honestly say that I'll be hearing from many women and men who once again believe they can't achieve this goal, don't really know what it means and will continue to feel they have failed to achieve something their birth professional promotes.

Let's have a conversation.

Our first comment

Dec 19, 2006

I still haven't figured out how to put audio on this blog. I have some interviews with the women who translated in The Pink Kit presentations throughout Pakistan. But I'll sort it out. We received our first 'comment' which is neat. Blogs are new to me so we'll see what happens.

The work of Common Knowledge Trust doesn't stop because I'm back in New Zealand. There are so many projects we're working on. We'll have whole newly organized websites and content but that will take some time.

I'm doing a Powerpoint presentation that will be able to be downloaded from the website for those 'work-at-home' folks who want to gather expectant parents and explain the benefits of The Pink Kit. Hopefully that will be done in a few weeks but not up on the site for a while. We're still figuring out how to load audio and video etc.

We've got interviews from the two New Zealand midwives who have kept statistics for the past 5 years. Their Powerpoint will also be up on the site so every one can see how successful the self-use of The Pink Kit resources are in creating more positive births.

We'll have the photos and interviews from Pakistan and a 16 section audio series podcast.

In mid-February I'll be headed over to Australia to train a group of people to become the first Australian Pink Kit Presentations. That's exciting. Folks are beginning to understand the difference between 'teaching' and 'presenting'. For women who work as birth professionals this differentiation is hard to grasp at first. Doulas, childbirth educators and midwives feel very passionate about childbirth and their role as 'protectors' of natural childbirth.

From Common Knowledge Trust's view point as the producer of The Pink Kit Method For Birthing Better® we always see things from our view point as women and men who are pregnant, going to be or have been. So we are the 'consumer viewpoint.' Of course, consumers are everyone and can't be pinpointed as being identified as this or that. So training Pink Kit presenters focuses on how consumers (we) can be reached rather than identifying The Pink Kit with any particular approach to childbirth.

Believe it or not this is very challenging to doulas, childbirth educators and midwives. They really want everyone to attempt, try or have a natural birth. For us this might not be possible, what we want or what we have whether we believe or not believe in the concept. When doulas, childbirth educators or midwives promote a particular type of birth then they limit the people with whom they can work. The Pink Kit skills are for everyone because they come from us .... everyone, in all births, in every situation, lifestyle, religion, education or whatever. It is this universal approach to childbirth that makes The Pink Kit so loved and cherished.

Interestingly one of the midwives who kept statistics, Suzie, has just informed me that her professional organization, New Zealand College Of Midwives, has changed the language it uses to define what midwives do. They no longer support 'natural birth' but now support 'physiological birth.'

I'll comment on this tomorrow. The question I am always required to ask as a Trustee to CKT is: How does this statement affect us as consumers?

Anyway, best to all of your families during this holiday season.

Back in New Zealand

Dec 17, 2006

I left Pakistan on the 18 Nov. Life was not going to settle down and The Pink Kit presentations were not going to go ahead. Thankfully success had been achieved in the first few weeks in Sindh. Now I'm in the process of writing a report which will determine whether The Pink Kit has a future in Pakistan.

Because I was able to give 10 presentations, I've been able to write a simple script. This will be expanded into a simple resource of the first three Pink Kit skills. Hopefully some of the people in Pakistan will want to help in translation etc. Time will tell.

Well, New Zealand is alive with political issues about childbirth at the moment. Anesthesiologists want more money for non-essential epidurals or they threaten to stop giving them.

The College of Midwives has changed it's approach. Instead of supporting 'natural birth' the College will now support 'physiological birth.'

I'll be heading to N. Queensland, Australia 18 Feb 2007 to train more Pink Kit presenters. Now after everything I've said in the blogs above you'll wonder how a Pink Kit presenter is different from 'teaching' The Pink Kit. I'll be able to use blogging to speak about these issues.

Visit:

http://www.commonknowledgetrust.com
http://www.birthingbetter.com
http://www.thepinkkit.com

Oopps everything goes on hold

Nov 10, 2006

The past few days have been coloured by Hidayat's fathers stroke the night after I arrived. What a wild ride. Last year I was scheduled to arrive 3 days after the devastating earthquake. That trip was cancelled. Try again this year and another major problem. I've spent the past few days writing this blog as a diary. I don't have access to the internet.

Everyone has gone to the hospital 3 hours away so all gatherings have been cancelled. Instead I have been taken to the homes of several friends who have health problems. Homeopathics are used extensively in this area of Pakistan but they are very expensive. The problem that I most encounter are swollen knees and women who are overweight.

There must be a store in town but I have not walked further than up the road half a block in either direction. In this area of Pakistan women are just not permitted to be out of doors. I’ve been told there is a market in town .. one for men and one for women. I can't go outside on my own. The family homeschools so I've had lots of time alone.

Visit:

http://www.commonknowledgetrust.com
http://www.birthingbetter.com
http://www.thepinkkit.com

What are we doing here?

Nov 8, 2006

Today I met with the CEO of a Pakistan NGO who thought I was offering a 3 day ‘training’ for their Traditional Birth Attendents and volunteers. I was quite surprised Hidayat had given her this impression. This started a very confused conversation. My experience in Sindh mirrored the type of presentations Common Knowledge Trust had requested. Suddenly I was thrust into a very different model and one CKT does not

We had a rather long discussion about what is the purpose of the word 'training'. Hidayat had given her the impression I was there to train their people to go out and give PK workshops to pregnant women. In the middle of a conversation, it was difficult to determine how we had gone from my giving informal Pink Kit presentations to training people who knew nothing about The Pink Kit to then go and 'teach'.

(I am posting this mid-Dec so I'd like to put my reflections into this entry. Words can be confusing particularly when they are translated from one native language into another. Look up the word 'training' in the Thesaurus. Other words that can replace 'training' are : instruction, schooling, teaching, preparation, guidance, education.

When we had planned this trip, Hidayat had used the word 'training'. I had responded in a manner that led to the Pink Kit presentations in Sindh. Somehow I had conveyed Pink Kit presentations were all the above words. However, to Hidayat the word meant specifically that I would train people so they could teach. For me this was a wild interpretation and leading down a path Common Knowledge Trust has never gone with The Pink Kit.

The Pink Kit Method evolved in the 1970s from expectant parents and not from 'professional' thinking. When we had our own set of skills, we always had positive birth experiences regardless of the aspects surrounding that birth. CKT has staunchly maintained and promoted the self-learning of The Pink Kit. Although we have tried a number of trials in 'teaching' The Pink Kit to women and men, time and again the results are not consistent. As soon as women and men believe the skills come from professionals they don't take responsibility to own the skills for themselves. I'll discuss all this later).

Thankfully she gave me some time to discuss what was apparently a huge misunderstanding, surprising to all of us. I am not certain she fully understood. Their NGO trains TBAs (traditional birth attendants) with the hope of making them develop a safer, cleaner and more modern practice. Her hope was that the TBAs would be trained to teach The PK to small groups of pregnant women. They were then offering to monitor their performance.

The issues that arose were many. Here's a short list. I have not put them in any order of importance:

• What is the best way to get The Pink Kit skills to women in any country?
• Is The Pink Kit a trend that will pass in a few years or something more basic?
• Why do women need to be taught by someone else rather than learn by herself?
• Should 'teaching' come through the generations from mother to daughter or be held by a professionally trained group?
• Should only pregnant women be given The Pink Kit skills?
• Should only some of the skills be passed on or all of them?
• Why should the TBA take on more resonsibility and be the 'teacher' of The PK?
• Should The PK be perceived of as a 'delivered program' from either Government or Non-Goverment groups?
• If one small NGO takes on the Pink Kit and only delivers the content to a few targeted pregnant women then other women do not get these skills.
• And many more.
  

The goals and objective of Common Knowledge Trust must be considered. We have the experience and know what works and what doesn't.

• From experience, the vast majority of women want these skills.
• The vast majority of fathers who will help at birth desperately want to learn how-to really help rather than hold a hand, rub a back or wipe a brow.
• Any resource in developing counries must be able to be available to all women.
• In order for the general population to embrace skills, as many people as possible need to be exposed to the skills and see if they fit in.
• CKT's hopes to work with the Ministry of Health in any country and having them distribute The Pink Kit as a simple to read and use resource or with international organizations such as WHO or UNICEF.
• Experience shows midwives, TBAs or other birth professionals have not been the best person to share the skills.
• The Pink Kit Method For Birthing Better® is a massive system of lots of skills.
  
• There is a significant danger any one group would dilute the skills.
• There is a significant danger any group would imply to women 'Do this'. Along with this would be an expressed or implied statement 'What you're doing is wrong.'
  

Let me share an example. Why were The Pink Kit skills so well respected in Sindh? The foremost reason was they were shared with as many women in the specific community as possible. If we had only offered this to pregnant women (including their female family members) the likelihood of these women using the skills would be very slim. People do not use behaviours or skills not commonly used by the members of their group. They'll listen but then often ignore what was shared. This is why delivery programs through either Governmental or NGOs can have little impact on cultural change.

The eagerness of all the women in the presentations is entirely due to the nature of The Pink Kit skills. It's obvious each of us can own them for ourselves. If I had implied I was a 'professional' I won't have been listened to.

In Pakistan everyone wanted to give me a title: Dr. or Madam. I kept telling them, 'nope, I'm wintergreen.'

The strength and success of The PK is personal knowledge. When women (and in modern countries … fathers) own these skills then they will pass them on to their children. It will take one generation to develop a skilled birthing population but it can happen when enough people have owned their own skills and applied them to their own birth situation.

For a time this lovely woman didn’t quite get what I was saying. I then used another approach. I shared with her a small segment of the breathing skills. She enjoyed that very much. She acknowledged she could now use the skills herself. I then asked her whether she felt capable of sharing those same skills with a woman she didn’t know. She said 'no.' I asked her if she could share those skills with her sister. She said 'yes.'

She realized I was correct … self knowledge is easy to use for oneself or shared among intimate family. It's very difficult to share with strangers. The PK is not about ‘delivering’ a program. It is about sharing world wide these universal skills.

The question still remains … what type of resources, what type of training is well suited for developing countries? We’ll have to see what happens from this meeting. I suggested I give Pink Kit presentations as I did in the south. Then this NGO and CKT could work together if appropriate to work toward a successful approach in the future. First step was for people to experience the skills personally rather than jump right into some type of poor quality and undefined training. Back to that word again.

Visit:
http://www.commonknowledgetrust.com
http://www.birthingbetter.com
http://www.thepinkkit.com

Up North

Nov 7, 2006

I took a bus up to Ghazikot Township outside of Mansehra in Northern Pakistan. This is where I’ll stay for the remainder of my visit for the next 6 weeks. This is where Hidayat, Nazli and their three children live. Hidayat and Nazli run a small NGO called Resource Centre for Development Alternatives. Since we’ve corresponded for 4 years and my trip last year was postponed by the massive earthquake, it was wonderful to finally meet.

Like every Pakistan family I’ve been with, they live with their extended family: grandparents, brother and his family. People in Pakistan spend so much time in their house because of the Muslim culture. Women live almost exclusively inside and rarely venture out.

Hidayat and Nazli are Baha’i so living with Baha'i families, as I have mentioned, is great and relaxed. Until the earthquake last year no foreigners were permitted in this area or further north. This is one of the very strongest muslim areas in Pakistan. Since the earthquake, close to 90 NGOs have moved into the area with plans to stay for 2-3 more years.

Hidayat said the mullahs are now asking the Government to require all the NGOs to leave although many would like to stay and continue rehabilitation from the devastation. The week before one of the Safe Houses for Children had been burned down. People were becoming increasingly nervous about the atmosphere. Hidayat and Nazli live in the area where many of the NGOs have set up shops.

This has also caused considerable problems. The rentals of the houses to NGOs is very high. Families have moved out in order to get large rents while they can. This creates anger and tension in such a small township.

Hidayat and Nazli say they have planned many gatherings. Oh yes, the weather. We are now at 7,000 feet and it’s cold at night … two wool blankets worth. I’m pleased the days are less hot. It’s also much greener although the perpetual pale of dust still lives in the air and all around. I feel a bit closed in and would love to walk around but it’s prevented by custom.

When we go out we must cover our heads with a shawl.

Visit:

http://www.commonknowledgetrust.com
http://www.birthingbetter.com
http://www.thepinkkit.com





Visit:
http://www.commonknowledgetrust.com
http://www.birthingbetter.com
http://www.thepinkkit.com

Passing through Islamabad

Nov 6, 2006

I arrived just at dusk into Islamabad and was met by Ramin and Nazila. They took me to their beautiful home then to an Afgani restaurant. The food was delicious and we walked around the shopping area. I got to see the amazing gold wedding jewelry of Pakistan. I've never seen anything like it.

Ramin then drove around Islamabad pointing out different places of interest. He said people joke that Islamabad is 20 minutes from the real Pakistan and that’s no joke.

Islamabad is a very modern, well laid out, massive city divided into numbered and lettered areas. People will live in Block G-321. Not very personal but seems to work. Each Block area has it’s own shopping area so most of the commerce is de-centralized into local shopping areas. This gives a vibrancy to the commercial areas.

The houses are large and gracious. Pakistan craftsmanship is superb. The sister city 20 minutes away is Pindi and is just as chaotic as Karachi or Hyderabad. What a contrast between modern and …. the rest. Certainly Pakistan is not ‘traditional’ in any sense of the word but just full of poor development. Everyone still has mobile phones.

Tomorrow I'll take a van up north and finally meet Hidayat and Nazli. I'm looking forward to a cooler climate, although I've been told it's actually very cold. I don't have clothes for that.

Visit:

http://www.commonknowledgetrust.com
http://www.birthingbetter.com
http://www.thepinkkit.com

Change in plans

Nov 3, 2006

There's been a change of plans. There was a demise in the family who were to host the Pink Kit presentation this evening. Instead another Baha’i family has invited other Baha’i to come as well as their Muslim neighbors. When Samsheer, Siddika and Satara arrived to pick us up they were very excited. The Pink Kit presentation last night had been a great success. All day they had been approached by other neighbors who had said how sorry they were not to have attended last night and could 'this woman come again and teach more of us.'

I was certain last night when I started to talk about the internal work, Naheed who was translating and Siddika and Satara must have wondered how we got from talking about breath, language and touch to such an intimate topic. Once I was told I would meet with a very conservative group I knew I had to offer them the most intimate of skills. Being 'conservative' is a perception and not a personal action. Although people are often confused by my relationship to The Pink Kit and birth topics, I actually have no opinion about birth topics. My interest is in making certain all women (and men) have The Pink Kit skills. Skills are vitally important to me.

The Ultra Orthodox Jewish women are conservative yet personally they will take responsibility for themselves and their families. Doing the internal work is something to be done personally and not publically. However, if a woman has never learned the skills then she won't prepare her body in this manner. It is far better to give all women these skills and they will choose whether to do it for themselves.

The neighbors who came to this presentation had never visited one another. The Muslim women entered the home where the talk was to be given with much uncertainty. You could see suspicion on every face. In hindsight I wonder whether they thought I was going to talk to them about religion. Anyway, this would be the hardest group to talk with by far. The women were very conservative even among other women. They wore head coverings and full length garments to this meeting.

I have learned the secret of bringing people together so they are open to listening. First I acknowledge our differences and I don't do this in a general, vague way. There's no doubt people see someone else and often see them as 'different'. That's enough to keep people apart. I just name those differences. In Pakistan they will be things like: different language, probably not the same religion, unfamiliar with their culture, unknown to them, look different and may be talking to them about something they have no interest in. I feel different from them as well.
I can't imagine what it is like to be a conservative Muslim woman.

Then I ask them whether they blink, cough and can tighten up their rectum? That always gets a laugh and sets the stage. There we are immediately within the common. It's easy after that because The Pink Kit skills never move outside the common.

The pleasure of sharing The Pink Kit skills comes from the knowledge all women like what they learn even if they start off feeling uncertain and confused. Because this group seemed so very cautious I decided that I would only share the Breathing Skills. This still takes over an hour to share so I asked them to be patient.

At the end of the hour they asked me to share more so we spent another 1 ½ hours going over the internal relaxation and touch relaxation. They were so thrilled at learning all these skills and I was invited back next year. They lingered for a long time over tea and sweets. This lingering is a form of social touching and bonding.

As I have traveled to villages and spoken to urban groups as well there have always been two or three women who would like to become Pink Kit Presenters. There were two women in this group who I could invite to be trained.

Tomorrow I return to Karachi for the day then fly to Islamabad the next day. There begins 6 weeks of talks throughout the North of Pakistan and Punjab. I am finally adjusting to some degree to the heat, pollution and dust.

Visit:

http://www.commonknowledgetrust.com
http://www.birthingbetter.com
http://www.thepinkkit.com

Conservative women love The Pink Kit skills

Nov 2, 2006

Tonight we went to the home of Samsheer Ali. He is the Baha’i coordinator for this area of Pakistan and has also been our driver. Women do not drive here. Where ever we have gone, he has continued his Baha’i work with village people he has had previous contact with.

Since Baha’i is a religion that promotes equality, the relationship between the more educated Baha’i and the illiterate village people is very relaxed and informal. Even the ‘class’ (educated vs illiterate) ambience is notably absent when Baha'i people get together. Having lived for many years within these villages where there are Christian missionaries, the Baha'i interrelationships are very relaxed and at ease.

Samsheer and his family live in a newly developed ‘suburb’ of Hyderabad. He proudly told me that he ‘didn’t live in the city’. Although the whole area is very dry and dusty, I wondered what this area would be like. To tell the truth I was totally unprepared for a middle class development located 200 mtrs from a spewing, huge, massive cement industry and directly under the largest high voltage lines in the area and two blocks from two maximum security prisons. So much for suburb living!

Samsheer’s wife and eldest daughter have often come to the talks close to Hyderabad. Samsheer has 4 daughters and 8 granddaughters. Aren’t they fortunate they are a Baha’i family. In fact, I was informed that in the original texts of the Baha’i faith say if a family has just one son and one daughter and have little money for education the daughter’s education should take presidence over the son’s because she is the mother of the next generation.

Baha'i began in Iran in the mid 1900 ... a very enlightened time.

Samsheer’s wife, Saddika, and his daughter, Satara, gathered their very ultra conservative Muslim neighbors for a talk about childbirth. This Muslim group is originally from Pashawar in Northern Pakistan. They wear full burqa when in public. They know Samsheer and his family are Baha’i. There is religious freedom in Pakistan. However, talking about childbirth is very intimate and they were very nervous about this meeting.

Since The Pink Kit skills come originally from my work with many families who were very conservative Christian families I knew this would be an easy meeting for me. About 10 women arrived. I started the meeting by telling them a story about a very conservative, ultra orthodox Jewish group of women in another country. These women use The Pink Kit skills for their births. They will have 10-20 children and often suffer trauma and damage to their birth canal. Having so many children did not mean they liked birth at all.

The women in this very conservative Jewish community were introduced to The Pink Kit by a wonderful Catholic midwife who wanted them to do the Internal Work so they could reduce tears, the need for episiotomy, prevent piles (hemmoroids), delayed 2nd stage and frequent occurrence of scar tissue that caused pain when intimate with their husbands. Many years passed before this wonderful midwife could find a way to share the Internal Work.

An opportunity arose when one of the Jewish women called her to say she wanted to learn. It was appropriate for the teaching to occur over the phone with the Jewish woman going into the bathroom to practice what she was being told. The Catholic midwife was surprised at how easily the woman learned. The woman informed her all the Jewish women know ‘down there’ because they have a special white cloth they must use after their monthly period to go inside and make certain there is no pink stain. Then they can resume relations with their husband.

Since the first woman was taught the Internal Work and had great success at her birth, the women in this community all do their ‘homework’ along with practicing the other Pink Kit skills. When they give birth they pride themselves of having done their homework well. Once I told this story to the Muslim women they were ready to learn the skills themselves. Even within this group of well educated and middle class women they told personal stories about babies that died because they could not let them out of their bodies so they were keen to learn.

We had a wonderful evening in fact after 3 hours they wanted even more skills so I shared the Breathing skills with them as well.

Tomorrow we go back to the first Muslim group I met on my first night in Hyderabad. They liked the skills so much that they would like more before I leave.

Visit:
http://www.commonknowledgetrust.com
http://www.birthingbetter.com
http://www.thepinkkit.com

Expecting something different

Nov 1, 2006

Today we rested until late afternoon and then went to speak to a Christian community woman’s group. Pakistan is the first country I've been in where the separation of groups into religions is so pronounced. The people who have organized the Pink Kit Presentations always tell me 'you will be speaking to a group of Muslim women or Christian women or a mixed group of mostly Hindu and some Christian or a Baha'i group'.

Sixty women arrived at this meeting. As always I asked them what topic they thought I was hear to discuss. We suddenly discovered they had been told that I was there to treat women’s disorders. This misinformation has been a problem in most of the meetings. In Pakistan there appears to be a tradition either through NGOs or Government agencies of health information meetings. This is an effective way to get information around the country. It also has a disadvantage for what we would be trying to do in order for the Pink Kit skills to become common knowledge to the women there or in any developed country. We don't want The Pink Kit skills to fall into the black hole of 'this is the trend right now' thinking.

There is another element of why all these groups believe I am coming to treat them. Pakistan communities have a great deal of shyness about private matters. Grouping everything together in ‘women’s problems’ is the easiest thing to say. As soon as we clarified why we were there, 35 women got up and left. There is always a few moments of confusion. People feel resentful that I am not there to offer what they are familiar with. They feel deceived. The ones who stay are a bit confused because they really don’t know if I will share anything of worth.

Each woman's group has distinctly different energy. Whenever you go into other cultures, you're always seen of as an outsider. This awareness of 'otherness' is both picked up by individuals in the group and by the group as a whole. The collective response to 'other' is always a factor. Underlying that issue is the collective beliefs held by the group about certain issues. I'm not privileged to those beliefs. All I can do is start somewhere and go forward and see what happens.

In some ways this is the true test of how neutral, acceptable and universal The Pink Kit skills are. Regardless of my 'otherness', I am another human being. Regardless of the cultural or religious beliefs, childbirth is just a series of contractions followed by an ejection of a baby from our body. The Pink Kit remains in that space commonly experienced by all women everywhere. Once women realize this then they evaluate The Pink Kit skills to those they have and share within their groups. The Pink Kit success is entirely due to its ability to fill in the huge gaps ... we are more likely to learn from our mothers how to make a simple bread like a roti or chapati than how-to birth. This is a world wide phenomena. Why? If any of you have thoughts about this please share them with Common Knowledge Trust.

Fortunately all the women to whom I've talked have like my sense of humor and stories. The 15 women who stayed learned the breathing, relaxation and language skills. They were very happy we had come. One woman had had two cesareans and wanted to know whether learning these skills would help her have a vaginal birth. She explained a type of birth common for women in many countries.

She had contractions fro 24 hours with no dilation and was given a cesarean. She was very angry with her childbirth experiences. We discussed how important it is for women having a cesarean to still practice these skills throughout pregnancy and use them during the delivery and in recovery. Cesarean delivery appears to be very common in Pakistan not just for urban women.

It's very strange perceptually to go into villages with no electricity, running water, plumbing, roads or even the basics of 'modern life' and hear how many women have had this major surgery. This was also true in Zimbabwe when we had the Gathering of Traditional Midwives in 1998. I visited the hospital and 20 women were lined up in the hall waiting to go to theatre.

When asked whether she had been tense during her two labours she said no. She will have to decide for herself whether she will try these skills next time.

Tomorrow evening I will speak to an extremely conservative Muslim group. I am told these will be the most challenging of groups and not to expect too much acceptance.

Visit:
http://www.commonknowledgetrust.com
http://www.birthingbetter.com
http://www.thepinkkit.com