Technology and Natural Childbirth

Technology and Natural Childbirth


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




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



All together

All together


Natural Birth:
Our Blog in English:

Bebés y más

Gentle Birth Choices (healing Arts Press Rochester Vermont,2005) by Barbara Harper, R.N.

The Functions of the Orgasms, by Michel Odent

Birth and Breastfeeding: Rediscovering the needs of women during pregnancy and childbirth, by Michel Odent

The Water Birth Book (Thorsons 2004) by Janet Balaskas.

Parir en Libertad (Grijalbo 2007) por Raquel Schlallman

Childbirth Connection


Yoga Prenatal con Sara Zomer:

Spiritual Midwifery (Book Publishing Company 2002) by Ina May Gaskin

Ina Mae and Graciela

Ina Mae and Graciela

Ina Mae Gaskin

Ina Mae Gaskin


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 Aybar




, , , ,

Sandra arrived from New York city. She came with her husband John and her children.She arrived to Panama in her 39th week pregnancy. She wanted to have a panamenian son or daughter and still more: to have a home and water birth. And it was so. The day she was in her 42th week was born her beautiful daughter, Azela.

A few times in our life we were present in such a beautiful birth. Character and Sandra´s personality are really unique. All was smile and joy. All was naturalness and a deep connection and communication with her body and her daughter. She came in to the birth pool and in some minutes she even had a break and relaxed sleeping in the pool. Niki, Graciela, John and me were unable to avoid our emotion and gladness in these unforgettable moments.

We only say: Thank you…. Sandra !!!!

Dr. Rodrigo Aybar





Uninterrupted Mother-Baby Tie

Uninterrupted Mother-Son Tie Part I

One of the most important missions during a natural delivery consists in to make sure the close contact between the mother and her newborn.

Just immediately after the birth, even before the moment when we cut the umbilical cord, begins their mutual relationship which will be decisive to them during all the life.

Is absolutely necessary to create the conditions and give peace to the mother. The silence is crucial, not much light and to provide the initial contact.

The baby is placed softly just he birth, still humid on the naked mother´s belly. Immediately begins their visual and physical contact between them.
Both, believe me, talk! The newborn babbles and converses with her mother.

They touch and caress each other. We invite the mother and her couple to dry the baby, maintaining him or her always in direct contact with her belly, skin to skin. This contact assures the transfer by irradiation of the high mother´s temperature to the baby, saving him stress and energy so important for his initial adaptation.

After a couple of minutes, when the umbilical cord stops their beats, we proceed to cut it. This procedure is absolutely imperceptible to both of them: the baby and her mother.

Once we cut the umbilical cord is easier to the mother to approach the baby and place him (her) on her chest, which in women is endowed with a very high temperature and the newborn can easily hear the mother´s heart beats, which will bring him security and peace for all his life.

Mother´s heart beats strong and quickly due to her recently ended big effort.
We encourage the mother to speak with her baby, to dry him and to approach him to her breasts.

The newborn do not need to suck up yet. He sucks a bit and enjoys. He feels her mother´s odor which is for him so familiar, as well as he (she) listen her mother´s and father´s voice so well-known to him (her).

All these events should happen in silence. We should keep the deepest respect to them in these so decisive minutes.

While all these moments are happening, we make a courteous and watchful look, observing the baby´s adaptation process to the extra uterine life. We are located in some distance of them.

With these quiet moments, some minutes later arrive the moment of the placental birthing. The placenta appears softly.
We show the placenta always to the parents. This act give her the possibility to better understand and to visualize the internal ambient in which was her baby before the birth.

We ask her some minutes and make carefully and meticulous baby´s examination.

This procedure do make the Pediatrician or we, maintaining always the newborn in skin to skin contact with her belly. We take advantage of this moment to clean, to cut and fix the clamp of the remainder umbilical cord. After a few days the clamp and the remainder cord will fall.

We ask the mother her permission to weigh the baby, taking care of her continuous glance to him.

We make a carefully placental inspection being sure of her complete integrity as well as the well uterine retraction.

Occasionally we must  suture some lacerations and normally we make it with local anesthesia in some minutes with the baby preferably in mother´s hands.
Al these events normally take some 20-30 minutes.

After we clean the mother gently we propose her to rest in this intimate ambient, preferably with mild light in her room together with her child. During these first two hours we must be sure about the suitable womb retraction and the beginning of the breast feeding.

This can be the appropriate moment in which the rest of the family congratulate the mother and meet the child.

This is the real task we think about in each birth. We can say that always results marvelous!

Dr. Rodrigo Aybar
Dra. Graciela A. de Aybar

Johana, Emerson y Aldair

Johana, Emerson y Aldair

First contact

First contact


Uninterrupted  Mother-Son tie.  Part II

In the first section of this narration, we commented about the crucial importance, for the mother and her child, of the uninterrupted link between them during the first hours after the child´s birth.

Who accompany the mothers and their children should be very carefully and respectfully in such relationship that begins between them immediately after the birth, trying to do nothing to interfere or interrupt this tie so crucial for both of them.

We only support with a thoughtful and alert look, from some distance and through it we can easily identify any change or deviation of the natural or normal process, such that merit some minimal correction.

The arrive of the rest of the family to congratulate the mother and know the child should be gradual, short, joyful, trying to not distract them from such so important link between the mother and her child.

In home deliveries the task for us is easy: The mother and her newborn are in their home! For both we repeat: Is their home, their ambient. For both is familiar.

All flows easily. Both will be this day and the next days in the parent´s bedroom. There and very near will be the bassinet. It will be near them their bathroom.

The newborn will have his clothes. The mother will can dress his child with the clothes such she, with love and patience, selected for this moment. The bassinet will have surely an embroidery blanket for one of the grandmothers!

All this and much more, give us the possibility to obtain an intimate ambient, so essential for them and for their mutual understanding.

The human being is a mammal. For the mammals the direct contact with the baby´s body, skin to skin, is indispensable and determinant for their development. It would be babies with different character and personality:  Some of them would like to be virtually all day “pasted” to the mother, others not so. The most important is to adapt to their needs.

The first breast feedings days are not easy. They require patience and calm and the most important a lot of intimacy between the mother and her baby.

Another very different reality occurs when the birthing it produced in a Panamanian Hospital:  State or Private Hospital!

For us Obstetricians and Pediatricians the task is much more complicated. We must say: almost titanic!


1-    Some minutes after the birth the newborn is detached from her mother and transferred in a transportable incubator! in another floor of the building. The nurses promise the mother “to carry” the baby to her room that is located in other floor three, four hours later!

2-    When they give the baby to the mother, the hospital personal  “allow” the mother be with her baby maximal  two-three hours with the idea to carry the newborn once again to the Rooming In , “to watch over” him until the next turn!

3-    During all this time a lot of members of the hospital´s team, like nurses, assistants come in to the mother´s room frequently, during the days of her permanence in the hospital, during the day and at night, measuring her body temperature, pulse, etc.

In the Rooming In, they assure the mother that the baby don´t receive any artificial milk. They explain that occasional they give them some “serum” (water with sugar). The result is absolutely discouraging: The baby arrives to the mother´s room asleep, without hunger. She try to breast feed him and nothing: “he do not want”, “he do not like my milk”. I “ do  not produce milk”: These are the unanimous mother´s protests!

The baby became nervous, because she is stressfully.

4-    When at the end of their permanence in the hospital and they return to their home, the hospital give away them some artificial tins milk if the baby need because the mother milk production is not enough!

In our country there are only three States Hospital with the UNICEF´s designation: “Children Friends Hospital”. That means: In these hospitals is prohibited the use of feeding bottle for infants and exclusively breast feeding.

Only to give one example: In Sweden, one of the best healthcare lands of the world, all the Maternity Care Hospitals have the United Nations recognition through the UNICEF of “Children Friends Hospitals”.

We believe and are anyway confident that in our country the things are changing. The woman and their families are asking for.

Although still timidly, in some Hospitals of Panama City there are some changes and they are discussing how to make them.

In our mother´s honor and their children invite them to continue in this direction!

Dr. Rodrigo Aybar
Dra. Graciela A. de Aybar




Marijke wrote 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!


Marijke la foto(25)

About Us


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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:


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

(507) 2275444
Panama city