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birthpanama

~ Pregnancy & Birth in Panama

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Category Archives: ABOUT US

Reírse o ponerse a llorar.

20 Friday May 2016

Posted by partonaturalpanama in ABOUT US

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La Sociedad Panameña de Obstetricia y Ginecología, SPOG, no “entiende” cuál es el clamor de las familias acerca del parto respetado y humanizado en Panamá!No logra entender que realizar múltiples  exámenes vaginales, romper las membranas ovulares en etapas incialee del trabajo de parto, poner Oxitocina artificial para “apurar” el parto, obligar a las mujeres a parir acostadas, no permitirles comer e ingerir líquidos durante la labor , estar sola sin el acompañamiento de ningún familiar , tener un porcentaje elevadísimo e inaceptable de cesáreas , mantener a las mujeres atadas a aparatos electrónicos, tracciónar la placenta durante el alumbramiento, separar a veces durante horas a los bebés sanos de sus madres y mucho más constituye ni más ni menos un IRRESPETO a sus más elementales derechos !

Es el mundo al revés: las mujeres saben de embarazo, parto y lactancia más que los médicos especialistas!

La llegada de Adrian Ignacio…Mi parto en agua

13 Wednesday Aug 2014

Posted by partonaturalpanama in ABOUT US

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garbochic

Luego de 10 días de la llegada de  Adrián, aprovecho para escribir la maravillosa experiencia de recibir a nuestro hijo en un parto en agua, en casa de mis padres.

Mucho antes de quedar embarazada, leí un post en el blog Verdades Embarazosas que me marcó. Me dije que cuando me tocara el momento, quería algo así.

Ya se acercaba el gran día y  desde las 6:30 a.m. del 1 de agosto empecé a sentir dolorcitos en las contracciones que antes eran solo incómodas.  Bajé una aplicación de contador de contracciones para ir revisando, ya que la enfermera estrella: “mi madre”  estaba conmigo y quería saber si iban aumentando. Se mantuvieron erráticas y variaban en tiempo. Fui al área social a eso de las 6 p.m. a caminar como lo hice los últimos días para ayudar a que el bebé bajara y se encajara.

Las contracciones siguieron leves durante el…

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Tessie’s Testimony

25 Friday Apr 2014

Posted by partonaturalpanama in ABOUT US, HOME BIRTHING, HOSPITAL BIRTHING, NATURAL BIRTHING, WATERBIRTH

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I’M A GREEK WOMAN WHO LIVES IN CANADA AND HAD NATURAL BIRTH (BREECH PRESENTATION) IN PANAMA. 
We had the most amazing experience in our lives, thanks to the wonderful people and great OBGYNs, Dr. Rodrigo Aybar and Dra. Graciela Anhel-Aybar 
 
The Doctors here in Canada, at least most of them; they see and treat you like a file number. It’s not a nice feeling at all. When I found out that I was pregnant, I started thinking about what my husband had always said about the medical system here in Canada and how nice it would be to have an intimate home birth. A home birth felt instinctively natural to us. 
 
Sounded like a very nice idea but we didn’t know anyone who had done a home birth. 
 
WHEN I WAS 4 MONTHS PREGNANT, we decided to embark on an adventure and to take off for a month to travel through Costa Rica and Panama… our last trip as a couple before we had a child. As Fortune would have it, during the tail end of our trip we met Sara Zomer, a prenatal Yoga instructor and doula. While I was checking her website, I saw articles about Water Births. I got all exited. This is a sign I told my Husband. Last day of our trip, Sara made sure that we had an appointment with Dr.Aybar. 
 
He was great; he took the time to know us and had a genuine interest in how my pregnancy was progressing (actually, I had a very good pregnancy from the beginning until the end). He took time to answer all our questions with much patience. Everything he said resonated with me!!! 
After our experience with Dr. Aybar, deep down we knew that we were coming back to Panama for the birth of our child, but we nonetheless took a wait-and-see approach when we returned to Canada. In Canada, the Doctor’s appointments became less and less pleasant. DURING MY 31st WEEK appointment, the Dr. told us: “We should do a C-Section at 38 weeks because the baby is too small and in breech position”. I almost cried, maybe I did. 
 
As soon as we returned home, I sent an email to Dr. Aybar in Panama for a second opinion! The answer came in less than an hour: “It’s too soon to make decisions about C-sections or about the baby’s size. The baby will grow. You are a small person and you don’t need a big baby. It may yet turn, and even if it doesn’t, a birth from breech position is possible and natural.” 
 
That was it: my husband and I decided to go to Panama! I know some people thought we were crazy to go to a foreign country where we know no one to have a home water birth with a doctor that we had met only met once? And this, to have our first child? Of course, these people wanted what’s best for us but their reactions were coming from fear (victims of the system) and from unawareness about natural births, home births or water births. 
We were glad that both our moms believed in us and supported our decision!  We knew that we are doing the right thing! We felt it! We are people who trust our instincts and our instincts told us to go to Panama and Dr. Aybar. 
 
AT 35 WEEKS, ON MAY 1st, slightly more than a month before my due date (which was June 9), we flew to Panama, rented a nice apartment in Casco Viejo (Old City) and made sure we had time enough to make it feel like home before our baby arrived. And very soon felt like home. 
 
Marie –Andre and her husband Ricardo, who both live and work in Casco Viejo and who also helped me to find our apartment, made us feel very welcome in Panama. They shared with us their water birth experience with their 3rd child, Manolito, and had nothing but the nicest things to say about Drs. Graciela and Rodrigo. I was amazed from their story and I told her that I wish to have such a wonderful experience as hers. Then we met our lovely friends Michelle Toose and her husband James and little Alex, they were there for us from the beginning. 
WE HAD REGULAR DOCTOR APPOINMENTS at Dr. Aybar’s office but some of the appointments were in our home. We were looking to see if the baby would turn. My husband wanted to try a version . Deep down, I didn’t feel that the baby needed to turn for me to have a natural birth.  
Drs. Aybar and Graciella managed to turned the baby but only for a few seconds, because it turned back to its original breech position. “Terca”, Dr Aybar exclaimed! Terca, I found out meant “stubborn” in Spanish. My husband was worried when the baby turned back to breech, but Dr. Aybar told us that “we need to trust our baby. If she returned to breech position, it is because that is what she wants and that there is a reason for it. WHEN THE TIME COMES, MUM AND BABY KNOW THE WAY. IT’s NATURAL, IT’S HUMAN NATURE.” and he was right. 
 
My husband made sure that I have a Doula… my mom! My mom Despina came all the way from Kastoria, Greece to Panama city on June 1st! A great supporter and a huge help! I was so happy to have her with us and to share our life experience with her. 
THE DUE DATE PASSED. Days were going by with no sign of contractions. I was feeling fine, going to the pool upstairs, walking almost 7 km every day, having nice dinners; we even went dancing, but nothing, I wasn’t feeling ready to give birth. All our friends and family waiting on Skype. No news 🙂  We asked Dr. Aybar how long we would wait? I was a week late but everything in the examination seemed perfect (we could wait). Baby was so comfy in my big belly that she didn’t want to come out.  
Almost 42 weeks and still no signs that baby was ready to come out. It was Thursday morning when the Dr. examined her last and said that we could wait a little bit longer, but that if she didn’t come out by the weekend, we should do a C-Section.  I cried. 
But that night, something amazing happened. I knew that I would be having a natural birth on Saturday night with the full moon and that it was going to be a girl, just like that Kuna lady predicted. There were still no signs, but I just knew. In the meantime, everyone around me was trying to help induce the baby naturally. 
I don’t know what helped: Maria’s special tee (boil oregano in hot water)? Some lubricating concoction my husband went and bought? Positive thinking? Baby understanding when I was rubbing my belly and telling her that she is Safe and it’s time to come out because we didn’t came all the way to Panama to have a C-Section? 
MY CONTRACTIONS STARTED EARLY SATURDAY MORNING. I called my Doctors and they told me when I have contractions 5min. apart, they will come. We went for a walk, came back home and waiting…waiting… During this time, Vasili and my mum were trying to make everything comfortable for me…My husband  prepare the house, the lighting, put some relaxing music and my mum massage my feet. 
The Doctors arrived around 8pm. They checked on me and told me that I needed another 5 to 6 hours. They were very respectful, sat in the living room, reading books and they were there for me only if I ask them to be. We also joked and laughed at some point. I remember Graciela holding my hand. I mostly stayed in the bedroom with my husband, very supportive from the beginning till the end. He was giving massages and bringing me anything I asked for. 
The Dr’s encouraged me to eat and drink water…. to move and do whatever I felt like.  I even took a shower… which relaxed me for a bit.  I meditated and made sure that my baby feels safe.  Around midnight (00:10am), the Doctor told me to get inside the birthing pool. Finally the time was coming. 
When I entered the pool, the warm water was a relief. It relaxed me and my muscles; Vasili was holding my hand and bringing me tea with honey. The doctors guided me: How to breath, how to push and how to keep my energy for the end when it is really needed. While I was pushing suddenly I felt it, I put my hands down and I felt my baby. . her butt 🙂 and then she went right back inside. 
But now I was happy; there it was! The reason I was labouring in pain for so many hours. _
 I got my energy back! I knew the baby is coming!
 
Graciela offered to hold a mirror so I can see the baby coming out. I told her no. I just wanted to concentrate and just feel everything that was happening. Also my mum was there going back and forth, praying for a healthy and safe birth. At that moment my husband got into the pool for support. 
On June 23rd, around 1:45am Sunday morning, under the big full moon which I could see from the living room balcony, another push and here she is, half way out! Legs and back were dangling out but the rest of her body was still inside. My next contraction took longer than expected. My baby was just floating there, very calm and relaxed. Me too the same, we knew that everything was ok. She didn’t even move, just floated there. I trust her and she trust me. It was after a minute when I hear the Doctor say: NOW, PUSH HARD and I did. and there she is!!!! All out.  She did it! she just knew her way out __
Rodrigo place her on my chest. OMG what a moment !!! She had eyes wide open and was so alert. She looked at us. She knew. She was the most beautiful baby ever 🙂  
We couldn’t believe what just happened. It was a miracle!Me and Vasili kissed each other, amazed and bewildered. I remember Graciela telling me to talk to the baby , and I did… and I kissed her, we were all so happy !!! 
I started breastfeeding her right away…she just knew how. After a while sitting in the pool, Vasili cut the umbilical cord. 
After a little while in the pool, he gave Aliana(my  to Graciella for tests. She was 3.200 kilos (around 7 pounds) and 9/10 on the Apgar score. Dr. Aybar check on me, everything good! No tears, no stiches.  
I took a quick shower, laid down in my bed and they brought my beautiful baby girl Aliana to me. My mum made sure to bring me plenty of water and Graciela showed me how to breastfeed. I just stay there with Aliana skin to skin, I think all night long, while everybody else, Drs included, were having a late dinner at 3am in our dining room! Next day, Doctor Aybar and Graciella came by to check up on us. Everything was perfect! _
Coming to Panama was the best decision we ever made!!!! The journey was wonderful thanks to all the nice people who met and gave us so much  help and support!  
I encourage all the women out there to trust their feelings, to believe in themselves and to nature!!! _

Tessie Kalafatidou 

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The most important pause in the life

17 Thursday Apr 2014

Posted by partonaturalpanama in ABOUT US

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The Birth Pause: Unhurrying the Moment of Meeting
The birth pause, very simply, is a slowing of the moment when a mother and baby first meet. This can occur in many ways, but we are loving what happens when a midwife or doctor simply guides the baby down where he is born, allowing the mother the extraordinary moment of discovery where she can really see and explore her baby before she gathers her just-born child into her arms.
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The Birth Pause

If a ‘pregnant pause’ is a breath held in a story, a moment’s stillness where we linger between what has been told and what is yet to be told, then what we are calling a ‘birth pause’ might be thought of as a breath at the moment of birth: a place to linger, suspended briefly between what has just happened – the mighty work of birth, and what is to come – the unfolding of the new human life that has been placed in your care. When you pause at birth you are in a sense stopping to catch the moment of arrival, yours as much as your baby’s.

What is this “birth pause?” you ask your midwife.

A baby is guided down at birth

Well, practically speaking, instead of delivering your baby directly to your chest, she will simply guide your baby down where he is born. He will land gently on soft pads in a warm pool of amniotic fluid. He will stretch out his arms and expand his lungs for those first sweet gulps of air. You will likely take a breath yourself and gather yourself together after the huge effort of birth. You will then probably turn your full attention to this newly-born child lying in front of you. You will be the one to welcome your child as you touch his hands, arms, legs, belly. When you are ready, you will be the one to wrap your hands around his torso and bring him up to your chest. The moment of birth itself will be held by this pause, a pause in which you and your child first find each other on the other side of birth.

A mother sees and touches her baby for the first time

The first touch

Perhaps it makes sense to you that you will be able to see your baby much more clearly at the moment of birth if he is below you than if he is delivered straight to your chest. But won’t you be sort of overwhelmed at the moment of birth for all this looking and studying, you wonder? Maybe you’ll need a moment to collect yourself?

A mother who has just birthed
her baby takes a moment
Very true. You may need just such a moment. And that is one of the beauties of a baby guided down at birth. When a baby is birthed down, and no one hurries your baby onto your chest, you will very naturally have your moment for the stunned relief of delivering your baby. This part of the birth process will be accorded its own respect. A woman will exhale from the work of birth before she begins to inhale the presence of her child and her new identity as a mother.

Now ready, they turn their full
attention to the extraordinary
moment in which they
meet their baby
Indeed, your midwife knows that when a baby is delivered directly to a woman’s chest, many women are in fact somewhat overwhelmed when they finish the work of birth and attempt to take in their baby in the very same moment. As a witness to the birth process and perhaps a mother herself, your midwife knows that the words and phrases that describe many mothers’ very first moment after giving birth include a stunned kind of relief, bewilderment, and shock. Of course you are eager to see your baby at long last, but you are still very right brain. The tears your midwife most often sees at the time of birth are the father’s. You are not there yet. But then, like a cruise ship changing course, coming now into port, your attention shifts. There is a coming back, a return, a shifting of focus to this new child who is also experiencing his own coming into port. This changing of course will happen at more of a clip for some women than for others. But it is with this turn of attention that the high begins to swell, and it will continue to swell over hours and days, weeks and months, parenting effort after parenting effort, until one day it is the tidal wave of love that you have for your child.

Meeting their daughter just after she is born

Meeting their son moments after he is born

Seeing her daughter for the first time
When a baby is delivered immediately onto a woman’s chest there will be plenty of time to study your child’s face and body, absorb his presence and digest your new state of being in the hours and days to come. But perhaps with a simple shift in business as usual, we can pause at the moment of birth … slow this first trip that your baby makes to your body … and allow what midwife Karen Strange calls the “natural sequence of birth” to unfold.

Picking up her daughter for the first time

Picking up her daughter for the first time
Karen describes the sequence of birth as a sort of blueprint for what happens when we do not disturb birth. She speaks of it as one of Connection—mother and baby connected in pregnancy; Rupture—the moment of separation at birth; Rest—the pause as the baby lies before its mother, the mother seeing and touching her baby for the first time; and Repair—the trip the baby makes to the breast, thus completing the sequence of birth. Karen says, “We all carry this blueprint within us. When we follow it, it turns on the brain in a certain way. It is amazing!”

With the Rest, or ‘pause,’ there is no rush to get the baby onto your chest. “This pause,” says Karen Strange, “allows the mother to integrate this moment of transition”. You sigh with the completion of your labor and turn your now-ready attention to the next deliberate moment, the moment in which you discover your baby. With your baby below you, not yet on your chest, you can really see your child. You study him. You touch him and then finally gather him in your arms.

A baby crawls to the breast

When this sequence is uninterrupted, neither is there a rush to get the baby to latch on the part of eager helpers. There is a tender, gentle time as you rest from your own hard work of birth where your baby, when ready, begins his search, as all mammals will do, for the breast. You help him as needed, but give him the time and opportunity to exercise this age-old, instinct-driven ability to find your breast. In fact, your midwife has seen how beneficial it is for a baby to be allowed to take the lead in breastfeeding in the special hours after birth (and beyond!), something that is dramatically shifting many parents’ experience of breastfeeding.

A cuddle completes the sequence
But just as your midwife is now appreciating what occurs when we respect a baby’s ability to find its mother at birth, she and others are learning a respect for and understanding of our own abilities as women to find our babies at birth. When we do not rush through the moment of birth, but honor the pause that marks the center of this sequence, what happens seems to be nothing less than a paradigm shift of equal significance. For you are not only finding your baby, you are finding yourself as a mother, finding your way into a new state of being.

For more on this, see “Waiting to Inhale: How to Unhurry the Moment of Birth,” Journal of Perinatal Education.
Mary Esther Malloy

Birthing Room

24 Friday Jan 2014

Posted by partonaturalpanama in ABOUT US, HOME BIRTHING, HOSPITAL BIRTHING, NATURAL BIRTHING

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Free birth

Free birth

Expulsion Unit/ Expulsion Ward

It is incredibly interesting to see how many mothers and expectant moms have become more and more interested in defending their rights; in particular the right to give birth in the manner they prefer and feel more comfortable with.

Each day they contact us and motivate us! They always give us useful and interesting ideas.
One of them, Eliana, told us that we should suggest to the hospital that has named their labor and delivery unit the “Expulsion Unit” to change that name to the “Birthing Unit”. We thought her suggestion was fantastic.

Unfortunately, the problem in our country is that the attention to child birth is more serious than just a simple name that you could give the Labor and Delivery Unit.
All maternity areas in panama’s public and private hospitals are cold, full of medical gadgets and artificial lighting, with the same background music that has been used for the past 40 years y managed by personnel who in most cases are cold, distant and authoritarian.

For example, none of the public hospitals in Panama allows a mother giving birth to have a birthing partner during labor and delivery.

In private hospitals a birthing partner is allowed, but with tons of rules and limitations. In most cases, those birthing partners feel stressed because they know hospital personnel doesn’t really want them there.

The scenario itself is always the same, the pregnant woman about to give birth on a bed and when she is about to give birth, they apply an enema to clean her bowels!
She is connected to an IV so she can receive an infusion of synthetic Oxytocin.

A fetal monitor is permanently strapped to her belly with two belts that keep the monitor in place so that the nurse or doctor can monitor the baby’s heart rate from a distance (in essence losing any human contact).

The expectant mother cannot stand up. She cannot eat nor drink anything.

If the woman wishes to urine or have a bowel movement, they place a cold metal or plastic bedpan under her hips …

Vaginal exams are conducted with excessive frequency, without even consulting with the woman in labor or discussing with her the need (or not) to conduct this exam at any given moment.

In private clinics, they suggest with enormous insistence that the mother accept an epidural, which immobilizes her even more and once the epidural is administered, they connect even more monitors to her, for example, the electrocardiograph sensors and the blood pressure meter remain permanently in place on her other “free” arm.

The epidural is a “cocktail” of drugs that adds to the synthetic oxytocin already in her bloodstream.

To pressure the mother to “request” the epidural, in each bedroom of the labor and delivery unit of some private hospital, they have a huge pain scale. The nurse will walk in the bedroom frequently, without even knocking, to ask the mother to point to the face that best describe the pain she is feeling. If the pain is “Severe to Worst Possible”, the nurse then calls the doctor so they can suggest the epidural.

Quite frequently the doctor helps the mother rupture membranes…

And in the middle of all this madness, if she is lucky to escape a C-Section, she is rolled into the “Expulsion Unit” on a wheelchair!!!

There, she is examined frequently. And they continue to press down on her belly to “accelerate” the birthing process.

Almost always they will perform an episiotomy. As soon as the baby is born, they cut the umbilical cord take the newborn away from the mother to conduct an Apgar assessment (which can be performed on her belly) on what they like to call a reanimation crib (recovery crib).

They speed up the process of placenta expulsion, which causes intense pain and increased bleeding.

Currently, in any part of the civilized world, the reality is completely different. I saw this personally, for example, in Germany in the city of Heidelberg.
Things are completely different there.

During the pregnancy, every woman visits the place where she will give birth with her entire family.
She is given birthing options such as a water birth or a big cozy bedroom that doesn’t feel like she is in the hospital.

She will be in this big bedroom during labor, delivery and post-delivery. She is released after two days. The new mother is given support with nursing and bonding in the first hours of the newborns life.

Mother and newborn stay together all the time, without any interruptions.

During active labor a mother is allowed to walk, sit and lean on ropes that were especially installed to help her during the last moments of delivery. She can eat, drink, take a shower and go to the bathroom.

When she is ready to give birth, the bed where she has been during labor becomes the delivery bed.
Then they bring in the medical equipment that will be needed to give the mother and the newborn the care required… The reality is that the medical equipment was always there but placed discreetly and not entirely visible in order to keep the mother focused in labor and not causing her any unnecessary stress.

The rooms have adjustable lighting and the mother can opt to have background music or not. Hospital personnel cannot come and go in her bedroom as they please. They have limited access to ensure the mother isn’t distracted nor interrupted.

They even worry about the tone of voice used when they are walking inside the labor and birthing area or bedroom.

In the moment of giving birth, the mother can choose whatever position she desires. For example, squatting if she feels safer and more comfortable.

The midwife or doula must adapt to the birthing the position the mother chooses.

So we reach the following conclusion:

We do not even need the Labor and Delivery Unit!
Of course, in the meantime, changing the name from Expulsion Unit to the Labor and Delivery is more appropriate!

Dr.Rodrigo Aybar
Dra. Graciela A. de Aybar

Reflections

26 Tuesday Feb 2013

Posted by partonaturalpanama in ABOUT US, HOME BIRTHING, HOSPITAL BIRTHING, NATURAL BIRTHING, NEWS, STORIES

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Why we speak about natural delivery in our Blog ?

Why we decided to be in contact with pregnant women around the world ?

The main reason is because Panama is a little country in Latinamerica , with the same reality of the rest of the world in Maternity Care.

In our publics hospitals the cesarean section’s rate arises 45%. In private hospital the situation in worse: 85%!

In the last ten years the rate of maternal mortality increased in alarming way.

The increase of cesarean sections, had not improve the neonatal healthiness. In opposite we have more preterm children and more chronic diseases like asthma, allergic and visual disorders.

The birthing process is considered a disease, and not a natural, biological and physiological event.

In our country when a low risk pregnant woman arrive to the hospital in labor, immediately she receive ” treatment ” like she were sick.
The team prohibits her to eat or drink even water.

She cannot walk.

They fasten in her body during all the delivery process a Fetal Monitor.

The physician and nurse team, begin always the application of intravenous Pitocin.

She receive a countless vaginal “evaluations “.

These are some of the reasons why my wife and me began three years ago a frontal struggle to change this reality in Panama.

In general we can be happy, because the women response has been marvelous .

We are changing the way to receive our children.

In our Blog, we will speak a lot and continuously about all these topics .

Dra. Graciela A. De Aybar
Dr. Rodrigo Aybar

Irene

Irene

All together

All together

Natural Birth

22 Friday Feb 2013

Posted by partonaturalpanama in ABOUT US, LINK

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You can read too:

http://www.partonaturalpanama.com

About Us

13 Wednesday Feb 2013

Posted by partonaturalpanama in ABOUT US

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Tags

Doula, Gynaecology, Home birth, Neonatal nursing, Panama, Panama city, Pediatrics, Pregnancy, Water brth

About us

Dra. Graciela

Dra. Graciela

Dr. Rodrigo

Dr. Rodrigo

 

We are two Obstetricians and Gynecologists with a wide experience in warm and humanistic way in pregnancy care and delivery.

We are the only ones in the Panama Republic performing home births and also in pools.

Our goal is a profound respect for the process of birth as a natural, cultural and familiar experience.

We work with a high level team, which include Pediatricians, Neonatal physicians and Doulas with the mission to be near with the future mother and her baby,during all the pregnancy and delivery process as well as in postnatal and breastfeeding phases.

The delivery can take place, at home, in water or in any Hospital of Panama city.

You can contact us:

E-Mail: aybar_anhel@yahoo.com.ar

Dra. Graciela Anhel de Aybar cellphone: (507) 66148895

Dr. Rodrigo Aybar cellphone: (507) 66143787

Our Clinic:

Centro Médico Nacional
Av. Justo Arosemena and Calle 38
5th Floor N° 504
Bellavista

(507) 2275444
Panama city

Recent Posts

  • Reírse o ponerse a llorar.
  • La llegada de Adrian Ignacio…Mi parto en agua
  • Tessie’s Testimony
  • The most important pause in the life
  • Priscilla teaching Biology

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