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birthpanama

~ Pregnancy & Birth in Panama

birthpanama

Category Archives: HOSPITAL BIRTHING

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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Priscilla teaching Biology

02 Sunday Feb 2014

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

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TeachingPriscilla’s Biology class

During the month of January, we received an amazing guest: Priscilla Kramer.

Priscilla is a young North-American Midwife who studied and who is currently working in the State of Florida (USA).

She is levelheaded, intelligent, capable and well prepared. She has been involved in a lot of Natural Water births, home births and births at birthing centers in the USA.

With her at our side, we were able to perform a few deliveries at the Caja de Seguro Social (Panama’s Public Health System’s Hospital) and they were wonderful and caused huge impact in the Labor and Delivery Unit’s personnel, doctors, nurses and aides. The happier ones were the mothers that had the privilege of being assisted by Priscilla and experienced a gentler birth.

In future blog’s entries we’ll continue sharing the enriching experience we lived together.

Today, for example, I’m going to share with you one of these experiences.

Mason was born a few days ago, Sheila’s third son. Graciela and I have assisted her in all her children’s births: José, Ria and now Mason.

This last child was also born in water and at home, as did Ria.

It was a beautiful and gentle birth like the previous ones.

The children stayed with their father Joe during labor and arrived a few minutes after Mason’s birth.

As if it were the most natural thing in this world, they walked to their mother’s and brother’s side. There was only peace and happiness in the room.

After the placenta was expelled, Priscilla was able to answer all of Jose’s (the older brother) questions regarding how the placenta, this human and mammal organ, works.

Priscilla showed them every detail. Vessels, umbilical cord, cotyledon and placental membranes…

It was an unforgettable biology class for Sheila’s and Joe’s children.

When I live these kinds of experiences I realize that Panama’s has a long road ahead to learn about things so simple and life changing as the birth of a child into this world.

We would like to say: Thank you Priscilla for your sensitivity and lessons that we will never forget.

Dr. Rodrigo Aybar
Dra. Graciela A de Aybar

The most important organ

The most important organ

Microbioma

01 Saturday Feb 2014

Posted by partonaturalpanama in HOME BIRTHING, HOSPITAL BIRTHING, LINK, WATERBIRTH

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http://www.indiegogo.com/projects/microbirth

The placenta and the umbilical Cord

01 Saturday Feb 2014

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

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The most important organ

The most important organ

The placenta and the umbilical Cord.

When we talk to a future mom, we try to answer all her concerns, which is a continual process throughout her entire pregnancy. We do not limit the questions she can ask. The purpose is for the expectant mom to know we are there for her and we will always answer any concerns she may have.

One of the aspects that are generally hard for the future mother to understand is the placenta and umbilical cord. What they are made of, how they work and their role during the pregnancy and during labor and delivery.

We recognize how difficult it can be for a future mother to understand the role of the placenta and the umbilical cord. Once the placenta is expelled (afterbirth) along with the umbilical cord, we show it to the mother. At that point she is surprised, and with her eyes wide open and great satisfaction, she then understands what this very important organ is made of.

During ultrasounds, we often take advantage of the visuals to talk with expectant moms about the importance of the placenta, umbilical cord and membranes. During the entire pregnancy a woman shouldn’t have more than 3 ultrasounds (1 each trimester).
It is a perfect opportunity to clear any doubts.

Future moms are particularly concerned about the umbilical cord. Often scared that “something could happen” with it during the pregnancy or during childbirth. With great fear and quite insistently they ask about the possibility of a nuchal cord, known as the umbilical cord wrapped around the child’s neck.

We will try to explain some important factors:

The placenta is an extraordinary vascular organ. It is everything for the baby meaning that it supports hormonal, metabolic, respiratory, protective and immunological functions, and many more.
We want to point out two important elements that reach the baby via the mother through the placenta and the umbilical cord. Those are the Glucose (energy and food) and Oxygen (breathing) molecules.
Without these two elements human life is basically impossible.
The blood that comes from the placenta to the baby comes from two umbilical arteries along the cord. The blood that returns from the baby to the mother travels through a single umbilical vein.
The umbilical cord is soft and elastic and very resistant. It floats in the amniotic fluid and surrounds the baby.
When the baby moves and as he grows, often he will press against it often.

What does it feel like, what happens to the fetus/baby when the umbilical cord is pressed or squeezed?
The answer is quite simple: He is left without air/ oxygen to breathe, without food (glucose). The same happens with an adult if you cover their mouths and nose and isn’t allowed to breathe.

How does the fetus/baby react when this happens?

The answer is also simple, he tries to get out, to move and “escape” from that dangerous and uncomfortable situation.
This is a vital exercise: compressing the umbilical cord, moving, getting out of danger. The baby does this thousands of times prior to birth. Really, permanently! In other terms, the baby isn’t dumb; he knows he has to do this. This vital exercise while in the womb will help him/her for life.

The baby’s Fetal Heart Rate (FHR), meaning the amount of heartbeats from the baby’s heart is quite stable. It fluctuates between 120 to 160 beats per minute. It is easy to find and listen to with a Doppler placed directly on the mother’s womb.

If the umbilical cord is pressed, what happens to the FHR? That answer is also obvious: The Fetal Heart rate drops drastically and a bradycardia occurs (slow heart rate), meaning the amount of beats per minute of the heart diminishes. It can drop to 60 – 80 bpm (beats per minute).

If the baby is uncomfortable it moves, changes position, moves a limb and rotates a little. They are perfectly prepared and programmed to face constant adversity during the pregnancy and during labor so they permanently prepare for it.

During the third and last trimester, slowly, another event interferes periodically with the process of a body delivering blood to the placenta and the umbilical cord. During the last trimester the mother will start feeling Braxton Hicks until eventually she feels real contractions.

A true breathing exercise that prepares the child for birth.
What happens?

The answer isn’t complicated: the uterus is a powerful muscle. When it contracts, it tightens and blood vessels close (the lumen the blood vessel collapses) and blood doesn’t reach the baby.

As the pregnancy progresses, the length and frequency of the contractions changes and during labor they happen every 3 minutes and can last up to 40 to 50 seconds and they are more intense.

Something similar to what happens to an adult when their heads are submerged under water for 40 to 50 seconds and only give them two seconds to breathe before plunging them again happens to the baby.
How does the baby react to this experience?

Logically this situations causes the baby stress which releases huge amounts of adrenaline and noradrenaline which alerts it and activates mechanisms that allow him to adapt which then allows him to face adversity.
In other words, uterine contractions are nature’s mechanism that prepares the baby for life outside of the uterus.

It is an extraordinary breathing exercise prior to birth.
Then, what should the birthing partner do during the pregnancy and birth?
What we do when a natural birth happens, we motivate the mother to move.

We allow her to change positions as many times as she desires. She can move freely and should avoid laying down all the time.
Offer her soft foods and liquids during labor and delivery.

Avoid binding the mother or any type things that could restrict her movements such as IV’s and fetal monitors.
The child tells the mother when they are uncomfortable with a position and asks the mom to move. Meaning, when the child feels asphyxiated briefly, it does things such as kick, move the head, rotates for the mother to change and be allowed to move out of that uncomfortable feeling that comes from lack of breathe.

Avoid the use of synthetic Oxytocin that produces intense and frequent contractions of the uterus and do not allow the mother or child to rest during delivery.
Allow the mother’s oxytocin to do the job. It enters the mother’s bloodstream naturally and not continuously how it happens when administered via an IV.

Avoid rupturing amniotic sac as much as possible or completely avoid it. That way the amniotic fluid cushions the pressure that the uterus could have on the umbilical cord.

When the baby is born: do not cut the umbilical cord immediately and do it when it stops beating or pulsating spontaneously a few minutes after birth.

If any degree of pressure had been placed on the umbilical cord in the last few minutes of birth, delaying clipping the umbilical cord until it has stopped pulsating allows for the compensatory tachycardia (fetal heart rate speeds up – FHR) compensate for “lost time” and send the child the Oxygen and Glucose molecules the child direly requires at birth (FHR increases to 180 BPM).
The placenta revives the baby after birth.
Finally, allow the placenta, the umbilical cord and related membranes to be expelled softly, by itself without any unnecessary maneuvers which ensure that it remains intact and we avoid further discomforts for the mother who just completed such an incredible task and we avoid interrupting both mother and child that spiritual moment of their lives.

To show it (the placenta) so that the mom can better understand and see this very important organ that managed to nourish her child during the course of the pregnancy.

Dr. Rodrigo Aybar
Dra. Graciela de Aybar

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

Marijke once again.

10 Monday Jun 2013

Posted by partonaturalpanama in HOME BIRTHING, HOSPITAL BIRTHING, NATURAL BIRTHING, STORIES, WATERBIRTH

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Marijke once again.

A little over two years ago, her daughter Jiske was born. It was an unforgettable experience.

Now Marijke had an impact on us once again, with her sweet personality extremely sensitive and secure.

This second birth of Marijke in water was calm.

Graciela and I were with Marijke and Joris that day. Truthfully it was wonderful to see them together throughout all the labor that we didn’t wanted to interrupt them. They would relax, listen to music and caress each other. Later on she asked to get into the pool and there they continued in the intimacy of her maternity.

It was an easy and sweet birth. Janne was born as beautiful as her sister and parents.

A couple of days later Marijke wrote to us:

Dear Rodrigo & Graciela,

I’m sitting on my bed feeding Janne. Her name is Janne, I believe we forgot to tell you at the night she was born. And I’m so grateful that our beautiful girl is healthy and happy. You must know that I’m even so grateful to you. What a beautiful day it was, as soon as Graciela walked through our door my first contractions diminished and got a rhythm, both Janne and I knew that now everything was going to be just fine. I was alert during the whole birthing process, knowing each second from start to finish, so different than from Jiske’s birth. But again a very quiet, peaceful experience. Thank you for making this possible! Thank you for being here in Panama, for your warmth, your guts, expertise and common sense and just being you.

I will keep on spreading the word of your good work here, where I can I would love to help you gain more and more recognition of your practices. And when we ever leave Panama, I will never forget you! I want you to know how grateful I am to you both!

I wish you a beautiful Christmas and so many more beautiful births.

Lots of love

Marijke, Joris, Jiske and Janne!

Episiotomy Always?

10 Monday Jun 2013

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

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Is Episiotomy necessary?

When a future mother goes to the beginning of her prenatal control, she always asks about the episiotomy.  In Panama it is known as “stinging” or “cutting”.  It is a real torment.  To feel that it’s obligatory in order to have a natural birth, the doctor has to cut the vulva and the perineum!

The answer is NO!

Medicine based on evidence, which means that after multiple studies with large groups of populations, recommends clearly not performing a routine episiotomy in any birth.

Every woman knows what they have to do for her not to get hurt.  The only thing we do is discuss during pregnancy how does she have to let the head and the body of the baby out, slowly so that she doesn’t have any lacerations.  Surprisingly they all make it. And it’s not even hard.

 The last time I did an episiotomy was 12 years ago and personally I attend births every day.

If a tearing or laceration is produced, it is always going to be less than a cut with a scissor that is very anti natural and painful.  Little lacerations in the vaginal membrane may be produced, that most of the times doesn’t require any stitching, because the vaginal tissue it’s extremely noble and heals wonderfully.  The pain after birth it is enormously greater if an episiotomy was performed in comparison with the lacerations that may occur.  Also the risk of an infection it is significantly smaller and the sexual life doesn’t suffer any changes of any kind to the women who hadn’t had and episiotomy performed.

So the answer is NO. It isn’t necessary to perform a routine episiotomy and it’s scarcely the situations when it’s necessary to do it, independently of the existence of previous births or not.

Dr. Rodrigo Aybar

Technology and Natural Childbirth

03 Sunday Mar 2013

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

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Technology and Natural Childbirth

Delyleth

The delivery process is a biological event, common in all the mammals. It has not direct relationship with the neo cortex activity in human being. This process is regulated by more ancients structures in our Central Nervous System, in the evolutive’s point of view.

The beginning of the delivery process, is a result of a very complicated biological events in which play a roll both: the mother and her child. The more significant moment is the huge augment of the Oxytocin hormone in mother’s body, the so called love’s hormone .

During the childbirth process, the mother needs to avoid external connections with her neo cortical structures to let the low cortical structures work without interference and in harmony . The labor does not depends of mother’s volition .

The mother in labor needs silence. She needs a bit of light. She needs to eat and ingest liquids in low and frequents quantities. She needs a nearly and warmly presence of the persons that will be near her during all the delivery process, only in case she requires some support and help. She needs a deep respect of her intimacy .

During the seventies it was being a technological boom. Appeared sonograms , foetal monitors, intravenous infusions pumps, Epidural Anesthesia , digital beds, blood’s pressure monitors, transports incubators, new medicaments …

It had being added a lot of new professionals in the delivery room:

Neonatologists, Perinatal Gynecologists , Anesthesiologists. Each of these specialists need some nurse and technicians support in the room.

So suddenly the reality inside the delivery room,changed completely for the mother and her child. Around her 4-6-8 more people !!!

Each of these persons are there to make something . In other words,after the moment the future mother arrives to the Obstetrical Unity in any Hospital, the nurse puts her an intravenous needle and some minutes later begin a cascade of aggressive medical interventions.

For example :

If the team put a fetal monitor fastened in mother’s body, she cannot walk.
If an epidural analgesic intervention is planned, the future mother cannot eat or drink nothing… And so consecutively …

I can not loss the opportunity to comment, that all of these in-necessaries interventions mean a huge money cost for the mother and her family, for the State and for all the society.

All of these medical equipment are useful only in case we really need them. This is very rare in the total quantity of deliveries around the world. The low risk pregnancy represents the 85-90% of all the pregnancies.

Our task consists precisely to avoid it use , giving the mother and her child the space and necessary peace for the development of an harmonious , physiological and peaceful event,in relationship with the unique features of each delivery process.

This is our challenge . This is our goal. To it we give all our wisdom and love.

Dr. Rodrigo Aybar
Dra. Graciela A. de Aybar

Irene

Irene

Reflections

26 Tuesday Feb 2013

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

≈ Leave a comment

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

Documentation

25 Monday Feb 2013

Posted by partonaturalpanama in DOCUMENTATION, HOME BIRTHING, HOSPITAL BIRTHING

≈ Leave a comment

The Panamanian authority which have the responsibility to register each birth in Panama Republic is the Tribunal Electoral.

The main section is located in Panama City and there are sections in each Province.

When the birth occurs in any Hospital, inside the hospital’s building there is a Tribunal Electoral office to inscribe the birth.

When the birth occurs at home, the parents go directly to the Tribunal Electoral representation with the needed documents. Normally whe write a letter with all the birth’s details, and go together with the parents to the Tribunal’s office and register the newborn.

The Panamanian authorities provide the birth certificate, 10 days later.

Dr. Rodrigo Aybar
Dra. Graciela A.de Aybar

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