The Story

The Guerrilla Midwife by Déjà Bernhardt

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Guerrilla Midwife DVDGrowing up the daughter of a midwife there were certain givens; there were many midwives and pregnant mommies and an abundance of stories about them. My seven siblings and I often joked that our birth-related dinner-table conversation was inappropriate while eating, but the truth is that at every meal, every day with our mom, we heard heroic stories of average women at the most vulnerable time in their life — childbirth. The experience helped to form my opinions, beliefs about the world and later inspired me to make the film,Guerrilla Midwife.

“A revolution will occur in our vision of violence when the birth process comes to be known as a critical stage in the human development of the capacity to love.”

Piles of books about birthing and pregnancy have been creating around French obstetrician Michel Odent’s simple wise words. I picked them up and never forgot them — they gave me insight as to why my mother is compelled to fight for pregnant mothers and their baby’s human right to gentle childbirth choices.

Soon, I became a mother myself. As a filmmaker, the stories I wanted to tell became those same stories I heard from my own mother — all of which had a recurring theme, that of LOVE. My mother, Robin Lim, is a midwife in Bali. She is the founder of Bumi Sehat Bali, a non-profit organization devoted to facilitating gentle childbirth at a grass roots level. The clinics she and many other dedicated individuals build and support are found in villages throughout Bali, where hemorrhage after childbirth is the leading cause of death due to lack of nutrition as a direct result of poverty. There is another in Sumatra where the massive waves of the 2004 Tsunami have forever changed the culture of a people almost completely wiped out by disaster. And in January 2010, Robin was called to Haiti to assist in the building of a gentle birth clinic in response to the need of women and children after the massive earthquake there. She has caught babies of all race, religion, economic conditions and in all parts of the world. The women that come to have their children in these clinics or that she attends to in their homes are no different than many of you who will be reading this — they want the best most-natural experience for the birth of their child, only many of them don’t have a home or live in a situation either politically or domestically where they are not safe to do so. Bumi Sehat serves as their safe home to become mothers.

As I write this, I realize that some of you may not feel you are safe to make these choices for yourselves either. After all, the society we live in today, even as American women, does not fully support gentle, peaceful childbirth. Childbirth is often driven by economic factors; i.e. how much a cesarean costs versus a vaginal birth or how long a doctor in a hospital may allow a woman to stay on a natural birth plan before he/she interferes. Hospital protocols are motivated by fear instilled by insurance companies. This is what is known as the “industrialization of childbirth.” I am not against cesarean, it is a life-saving operation —and a medical miracle when needed and used wisely. However, I, like many gentle birth advocates, am against the misuse and overuse of a procedure that has many repercussions that can affect the bonding process of mother, child and family. In fact, the elevated cesarean rate has driven the maternal mortality rate up due to complications of the surgery and infection post-surgery.

Breastfeeding is affected just as childbirth is. Infant formula has become easy and popular due to misinformation disbursed by the businesses who profit from bottle feeding. There is no way to make money supporting breastfeeding, and despite research that proves breastfeeding is best, there is little support to help new mothers initiate it. There is a devastating belief that formula is superior to breast milk. As our world moves back into a place where we begin to understand how dangerous industrialized farming is and embrace the importance of organic farming, we also can see how childbirth has become industrialized and affected similarly.

During labor, childbirth, and within the first hours after birth, mothers and babies both release the hormone oxytocin along with other hormones that facilitate safe and natural birth and bonding. It’s these hormones that also facilitate the production of breast milk. When we disturb the birth process, we disrupt the release of these hormones and compromise the ability of mother and child to birth and bond normally. Since this disrupts the flow of oxytocin, the safe delivery of the placenta and closing of the uterus is compromised and the mother is put at risk for postpartum hemorrhage and slower post-partum recovery.

Humans release oxytocin at other times in our lives — when we make love, when we see a loved one, when we feed a loved one or share a meal together — all in much smaller doses. This is why we call oxytocin the “LOVE hormone,” because the body produces it naturally at moments of intense love and it is essential for the development of the human capacity to have those feelings. It does not mean that if you are born by cesarean section that you cannot experience love. It means that we should question the mainstream act of disrupting the evolution of humans at their most vulnerable moments — the time during childbirth and the hour after.

If you are a parent you can attest to watching your newborn grow and change at an intense rate in the first days and months. Now imagine what that translates into in the first few moments. In these first precious minutes of human life there is accelerated growth and change and the oxytocin that is produced naturally during childbirth by both the mother and the baby prepares them for this vital human experience of bonding and healthy attachment. This first experience shapes us at an early stage of development — this first act of love is not just the first experience of love for another but also the first experience of self-love. As newborns we still do not see ourselves as separate from mother. If the baby is safe to give and receive love at this fragile time, without interruption and procedures (including early cutting and clamping of the cord, weighing, measuring, bathing, even early vaccinating etc.) during the first hour, a healthy bonding-attachment relationship will occur and the mother’s body should respond by naturally producing colostrum and, later, breast milk. Unless the baby is in serious distress, all of these procedures can and should wait.

The baby’s response to undisturbed, gentle birth is to have an intact capacity to love and trust right from the get-go.

“Imagine a world in which each individual is born with an intact ability to love … andI am willing to work every day and night of my life to make it so.”
~Ibu Robin Lim CPM

When we realize generations are born without experiencing the natural evolution of the birth and bonding process, we see a world that is deeply disconnected. So when we ask ourselves why is the world in such distress, we might first ask, what kind of importance do we place on love? What value do we give to mother-child bonding? Do we opt out or allow ourselves as women and families to be disempowered and talked into a so-called easy childbirth, because it’s supposedly pain-free or misleadingly safer? Are we deceived into believing that our bodies are not capable of birthing in a normal, healthy way?

When we realize generations being born without experiencing the natural evolution of the birth and bonding process we see a world that is deeply disconnected.

When we interfere with the birthing process even a little — by inducing labor or forcing a woman to surrender to anything that does not feel completely natural at the time of birth to her individual situation — we start a cascade of negative effects that all can and often do lead to a cesarean that could have been avoided. It is more challenging and painful for a woman to give birth normally when her body is not allowed to release the hormones necessary to facilitate childbirth.

The World Health Organization reported in 2007 that 40 other countries have lower maternal death rates than the United States. The Centers for Disease Control (CDC) reports that there has been no improvement in the maternal death rate in the United States since 1982.

The following is a data brief directly from the CDC:

NCHS DATA BRIEF – Center for Disease Control
Recent Trends in Cesarean Delivery in the United States

Key findings March 2010

Data from the Natality Data File, National Vital Statistics System

  • The cesarean rate rose by 53% from 1996 to 2007, reaching 32%, the highest rate ever reported in the United States.
  • From 1996 to 2007, the cesarean rate increased for mothers in all age and racial and Hispanic origin groups. The pace of the increase accelerated from 2000 to 2007.
  • Cesarean rates also increased for infants at all gestational ages; from 1996 to 2006 preterm infants had the highest rates.
  • Cesarean rates increased for births to mothers in all U.S. states, and by more than 70% in six states from 1996 to 2007.

In 2007, nearly one-third (32%) of all births were cesarean deliveries. Although there are often clear clinical indications for a cesarean delivery, the short and long-term benefits and risks for both mother and infant have been the subject of intense debate for over 25 years. Cesarean delivery involves major abdominal surgery, and is associated with higher rates of surgical complications and maternal re-hospitalization, as well as with complications requiring neonatal intensive care unit admission. In addition to health and safety risks for mothers and newborns, hospital charges for a cesarean delivery are almost double those for a vaginal delivery, imposing significant costs.

Childbirth is without question risky. In fact, no amount of technology can eliminate the risk that childbirth imposes entirely. In the history of the world, each and every woman that gives birth is truly a heroine. This experience is part of what prepares us for the most important role we will face — motherhood. We need a society which holds motherhood as sacred and respects the fragility of the birthing process. In the words of Dr. Odent, “When we speak in terms of public health, we must first look at the gestational period, this is the time when our physiology is being shaped.” We spend a lifetime trying to undo what our DNA and our emotional experiences at childbirth have left us with instead of first understanding the importance of the time in the womb and the first hour after birth, acknowledging its lasting effects on the human physiology and emotional well being.

As a filmmaker and a woman, I felt it was necessary to share this story with the world.Guerrilla Midwife is a film about my mother as an example of every mother, midwife or physician who goes against the grain when necessary to fight for the right of women everywhere to birth as normally as possible no matter what their socio-economic environment may be.

When women ask me what is right for them during childbirth, I simply respond that it is what is most intuitive for them. Introducing drugs into a labor will definitely inhibit the bodies ability to feel and respond, so avoiding them when it is at all safely possible will help you to be able to make choices for yourself. Don’t allow anyone to fool you into believing that drugs introduced during labor have no effect on your unborn baby — they do. The baby and the mother both play a role in labor, not just the mother. It is absolutely necessary for the baby to be responsive as well.

In my mother’s words; “Many women who have had trauma in their past birth experiences may be healed by a gentle birth experience.”

After making documentaries all over the world on disparate humanitarian issues that range from AIDS in Africa to natural disaster survival and are close to my heart, I realize that this film has been the most important film I will ever make because the experience of birth affects each and every human being.

Find out what your doctor’s cesarean rate is — it is your right to know. Talk to your midwife or doctor and Doula and be clear on what their beliefs are. Do they correspond to what you and your family desire?

Women everywhere have something in common — the astonishing ability to give birth normally. It is our right and we must advocate to preserve it. Here is to the Guerrilla Midwife, who still believes in miracles.

~

Déjà Cresencia Bernhardt draws on her Asian-American mixed heritage to tell the stories of a planet displaced. Her documentaries have captured the social/environmental issues from Africa to Indonesia to Haiti. Déjà is currently in post-production of her first narrative film, “How I Lost My Birthday,” while completing her MFA at University of Texas Radio-Television-Film.