Recently I was interviewed on BFM 89.9 in their "Careers Unusual" segment about my job as a Doula. I guess its an unusual job - seeing as there are less than a handful of certified doulas here in Malaysia. I was excited to be on air, because there really is so much misconception about what a Doula actually is among doctors, nurses, hospitals and the general public.

Some think we are there to make medical decisions for the mother. This is completely untrue. We are non-medically trained professionals who provide emotional and physical support to the family throughout labour and birth.

We actually have quite a tough job - because on the one hand, we are employed by the mother and father, yet on the other hand we are in the hospital premises and in the delivery suite. So its really important to work well with the labour ward staff. The staff - nurses AND doctors - can view us as a threat if they don't understand what our role is.

And lately Pantia Bangsar has issued a directive for mothers wanting a doula at her birth to sign a notice of understanding which states the role of a doula at birth is questionable at best and "risky". 

Although the Ministry of Health has come up with the latest Mother Friendly Guidelines "Program Mesra Ibu" that clearly states mothers should have continuous support throughout labour and birth by a birth companion - be it her husband or a doula. It seems this is merely lip service. Many government hospitals still do not allow even husbands to be present with the birthing mother during labour and birth.

Some other misconceptions include:
Q1. Are doulas governed by a regulatory body?
A: We obtain training from the certifying body e.g DONA/ CBE/ AMANI and we are required to re-certify every year. This body is independent.

Q2. Do we attend homebirths?
A: Some do - but I don't anymore. Some certifying bodies e.g. DONA do not condone their doulas attending unassisted births

Q3. Are doulas employed by the mother or by the hospital?
A: We are independent and employed by the family, and therefore have to a duty to protect her space during labour and birth and do what is necessary in the labour room for mother to achieve the birth she wants - such as advocate for her choices.
HOWEVER we cannot completely disregard the hospital staff. In fact its very important for us to develop a good working relationship with them. This can sometimes be tricky to know when to advocate for mother and when to be flexible considering the individual circumstances.

Q4. Do doulas provide information to the family?
A: Yes definitely. We can provide the family with research and evidence-based information to enable the family to make an informed choice.

Anyway, have a listen to this podcast. It may shed some light on what the role of a doula is.

And please comment if you've any feedback or questions :)

I’m still reeling with oxytocin from a recent birth. It was a beautiful VBAC waterbirth!! I can't blog about it until I get permission from the mother. So I'm going to talk about my experience instead! haha..

This was my FIRST time doula-ing at Pantai Cheras. The hospital just began to offer waterbirths a couple of months ago. And this was the first time their delivery suite ever had an official doula present at a birth! So I was excited, but wasn't exactly sure what to expect – especially from the staff.  I had heard the waterbirth room was small... but really mothers have birthed in small buckets before..lol..so I wasn’t too concerned about that.

The mother was doing beautifully all throughout her labour and went to hospital only when it got really intense. So when we arrived at the hospital she was already in her ZONE - quiet, focusing inwards.

The environment in the delivery suite was rather busy and noisy - staff talking on the phone and to each other, rushing in and out of rooms. Just outside the waterbirthing room was a desk with a phone, so everytime the phone rang, we could hear it. The door to the room was a glass foldable door and not sound proof, so if it wasn't completely closed, we could hear the sounds of the nurses talking outside.

There was a flurry of activity as the mother entered the birthing room and tried to settle in. The pool was about a third way filled, but mom couldn't wait and immediately got in.  There were a number of nurses entering and leaving the room trying to fill up the pool and get the water to be the right temperature. To do this they had to drain some cool water out of the pool using a pump and fill it with hot water which they had to get from a thermopot outside of the room (in addition to hot water from a hose attached to the waterheater). So there were staff going in and out of the room frequently. The pool is a LaBassine pool, so it took some time to fill.

The nurses were trying to get the CTG machine strapped on to mother’s abdomen and at just the right spot to be able to get a good reading. This was a wireless CTG machine - the FIRST ever being used in Malaysia as far as I know. The nurses tried to get mother to lie back, but she couldn't. The only comfortable position for her was leaning forward onto the side of the pool. At one point, there were three nurses hovering around the mother - one trying to drain water from the pool, and another two adjusting the CTG machine on mother's tummy.  Mother shifted uncomfortably and was visibly annoyed. I felt slightly helpless at this point - should I say something? I didn't think it was a good idea to say anything just yet because we had just arrived, and I didn't want to turn the staff off working with doulas ever again. Lol. So instead, I focused my efforts on mother and trying to get her into her zone again with massages and hypnosis. I silently prayed that the fuss would soon settle.

After several subtle attempts by me to get the nurses to leave the room and quiet down and close the door, the activity died down and it was quiet at last.  Father joined us after some administrative work and the two of us worked to make Mom as comfortable as possible, and protect her space.

Every so often the CTG machine would beep and disturb the silence. I was SO grateful for this GREAT tool that enables mother to move around freely in the tub, but at the same time, I was cursing it under my breath!! I knew though that it was important for the staff to get a good 20-minute strip reading especially with a VBAC Mom, so I just had to bite my lip and hoped Mom could endure the hassle just a little bit longer. It took quite awhile to get it at exactly at the right spot, and even then the reading would only last a few minutes before the trace went off again.

I can't give too much away about the birth story (hope the mother writes her story soon!) but Dr Tan arrived after a few hours. She did one final adjustment to the CTG and it stuck! Hah! (Dr’s touch ;) )

Mom was left alone for a few more hours, and before long, baby finally made her slippery entrance into the pool and was placed onto Mom’s chest. Tears and words of joy all round! Mom was incredulous!

It really was a beautiful birth - the star of the show of course was mother - and I really can't wait for her to write her birth story. But as far as the staff at Pantia Cheras is concerned - they were really great! Two thumbs up for effort – most definitely!! They had never really been exposed to a doula and other requirements of HypnoBirthing mothers apart from taking the lead from Dr Tan (who is a HypnoBirthing Practitioner herself) ..but they had positive attitude about supporting the mother and father, and this speaks volumes. 

Pantai Cheras had 6 waterbirths prior to this one, but I was glad and relieved that the staff accepted and acknowledged my presence and my role and were willing to cooperate!  Of course things could have been much better with staff being more respectful of the mother's needs for privacy, quiet and getting informed consent before carrying out things like taking her temperature or taking her blood pressure, etc., but this can all be learnt in time.


Dr Tan really has to be given most credit. She really is one of those rare ObGyns who is willing to stick up for what is right, rather than what the system dictates, and because of this many mothers have been able to enjoy undisturbed births in medicalised settings.

I’m excited for mothers who will birth in the future- especially for mothers who will birth in Pantai Cheras. With more training of staff on the needs of HypnoBirthing/ natural birth mothers, I can see much improvement in catering to natural birth mamas.. and who knows, maybe one day Pantai Cheras will be a hub for natural birth mamas to go to. And there are already plans for training in the near future!!

So in short, I HIGHLY recommend considering waterbirth @ Pantai Cheras :)

BUT of course, as with all other hospital births, the mother herself has to be extremely mentally and emotionally prepared. This mother ROCKED her birth and I'm sure many more mothers will in the future inshaallah, with the growing awareness about natural birth.

Its been some time since I made an entry into this blog. Last year was an eventful year. I attended many beautiful, amazing births and witnessed not only babies being welcomed gently into the world but strong empowered families being born :) I felt blessed to be a part of such significant and intimate life events.

Then in Ramadhan last year, two events happened to me that brought this feeling to a screeching halt. I won't go into the details here, but at one of the births, I arrived after baby was born and mom was lying in a pool of her own blood barely moving. I told the father to call the ambulance and luckily the ambulance came in time, and mom received a transfusion. In another birth, mom's placenta wouldn't expel, and the mother almost lost her uterus. Prior to this, I had witnessed about 15 -20 labour & births - most of them unassisted at home. All of them turned out well. I had heard of a few cases of babies who died in unassisted births in the Klang Valley prior to this. I was, needless to say, affected by these stories, but not nearly as deeply affected as I was by these two incidents that happened in front of my eyes. These two incidents made me think long and hard about what I was doing.

Of course it was awe-inspiring to witness mothers & fathers transform into empowered parents & babies being welcomed gently into the world, surrounded by love; but at the same time, I had to ask myself what I would do if a tragedy occurred while I was there. Would I be able to live with myself if that mother died, or if the other mother lost her uterus? ...And the answer would be an unequivocal no. 

Usually after the baby is born, without fail, the mother or father would turn to me and say "Thank you!" - the two words I was never comfortable hearing at a birth - knowing full well I didn't deserve an ounce of credit. I would smile back and say "Oh but I didn't do anything". The more I reflected on this, the more I realized that no matter how prepared the mother & father are for an unassisted birth, my being at the birth would inadvertently create a sense of dependence on me, no matter how small... not so much when things went right, but definitely when things go awry. I have heard the phrase "we would just feel more comfortable if someone experienced is around" said to me all too often. 

I realized that if I were to continue to attend these births, I would be providing a false sense of security to the parents - which would be unfair for both the parents AND myself. Personally, I LOVE homebirth, and I would probably birth at home if ever I have another baby, BUT as a Childbirth Educator, I'm concerned about how my words can influence families' birth decisions. My role is merely to provide information and help families make informed decisions. Ultimately it is the families who must empower themselves by owning and taking responsibility for their own decisions. Regardless of whether UCs are safe or not (countless deaths happen in hospitals too), I decided I could not continue to act in a capacity that is beyond my scope, by attending unassisted births. 

I NEVER deserved the credit for when things go amazingly well, and similarly I could not bear the responsibility for when things go wrong. "You know, there is a reason it is called UNassisted birth", said a colleague to me... and for the first time, I understood what it meant.

Immediately after those two incidents, I related the stories of those mothers to my colleagues in the birth community and in not so many words pre-empted them. Surprisingly, or perhaps not surprisingly, they were unfazed. Ironically, a couple of months later, a mother in the Klang Valley died while having an unassisted birth, and the month following that, another mother died.

The Gentle Birthing Group came under alot of flak by the medical community, although none of the admins were part of either of those two births/ deaths. We issued a statement saying we do not advocate UC, but still we were blamed. The truth is GBG had never been a UC group. And UC stories had been circulating in Malaysia long before GBG came into existence. The GBG has always respected & supported women's choice of where and with whom to birth, and it has focused its efforts on increasing awareness and improving birth options in Malaysia. But because it is the only public platform on facebook promoting gentle birth, it was singled out as being responsible for spreading dangerous ideas.

It is an unfortunate situation that here in Malaysia there is a sore lack of natural birthing options. I completely understand the very difficult position of birthing families here in Malaysia. I myself was in that position before and remember feeling completely disempowered with the lack of options available. It should NEVER be the case that birthing families are forced to chose between two very black or white options (medicalized, mechanized birth in a hospital OR unassisted birth), simply because there is a lack of proper care and options. I dream of a day when families in Malaysia will have the option to birth at a birthing centre with midwives and have midwife-assisted or doctor-assisted homebirths ; and this I believe is the direction to focus on, moving forward.

Since I made the decision to stop attending unassisted births, I've attended a few hospital births and they've truly been eye-opening. I believe mothers who birth at the hospitals need Doulas/ birthing companions more so than the mothers who birth at home! There is so much more going on in the hospital that can interrupt the natural flow of labour & birth. And the Doula has a crucial role to play in protecting the mother's space and supporting the Dad while both of them work to welcome their baby gently into the world. 

I also intend to concentrate on improving birth in hospitals/ birth centres. There are still millions of mothers who birth in government hospitals and THIS is truly where change needs to happen. I pray that Allah puts barakah in my work and guides me to the right path.

To all the families whose births I attended in the past, thank you for including me in such a significant, intimate time of your lives.. truly the power was ALL YOURS (with the permission of the Almighty) and I will cherish those memories forever! No matter where or with whom you birth - the difference is IN YOU! 

Ultimately it is the family's right to decide where & with whom to birth, and this I will always respect. 

Last week I had the privilege of attending a hospital birth for a young first-time mom. Mom texted me in the early morning at about 5am and said the surges are getting closer. At 8am Mom said the surges were 4 minutes apart and they'd been like that for over 2 hours. I arrived at 9am and they were getting ready to go to the hospital. Mom had just lost some of her uterine seal (mucous plug). She was not sure about going to the hospital, but her mother (whose house she was living in) was concerned at the sight of the blood and advised her to go in.

So Mom, Dad and mother's younger sister made their way to the hospital while I followed closely behind. Once at the hospital, we hung out at the hospital cafetaria as Mom had a sandwich for breakfast still unsure of whether she should check herself in, and how she was going to do it. A couple of months before, Mom had a vaginal exam performed on her by her doctor and it was clearly a very traumatic incident for her. So she wanted to avoid a vaginal exam at all costs. Its clear she still carries the trauma with her. In the last couple of months I had tried to talk the couple into changing doctors (as it was very clear the doctor was not pro-natural birth), but Dad's mother was the director in this hospital and the couple felt they owed it to her to take her advise.

I tell Mom that she can get a CTG (electronic fetal monitoring) done – just to give her mother peace of mind - and she can go home after that if she wants.

We sat in the cafetaria for close to an hour just chatting and eating, in between Mom's surges. Mom chatted and giggled in between surges, but when a surge came, she would close her eyes and relax her body and breathe through them. We took turns holding her hands during a surge in the middle of the cafetaria, and people must've been wondering what we were doing! Dad's mother arrives at about 10.30 am and the conversation takes a slightly more formal tone. Dad's mother and I chat for a while and we find out that we know the same people in the birth and breastfeeding community and she is at ease slightly, that this strange person is not going to put strange ideas into her kids' heads! She advises Mom to register and get a CTG done without having a vaginal exam (It helps to have a mother who is Director of a hospital!).

So Mom goes to have a CTG at about 11am. I leave at this point because I have to send my daughter for her class. At 12.30 I get a text from Mom saying her surges are more intense and so I go to the hospital and reach about an hour later. 

Mom is in the labour ward with Dad. Her surges are clearly more intense, longer and very close together.

“Very good!” I say. She doesn't respond. She is so focused.

She asks Dad to massage her back. She is uncomfortable in any position. Finally she lays down on her side. I take over from Dad and massage her lower back.

Dhikr... “Allah!”.. Mom cries.


Mom's mother and younger sister come into the room and hold her hand. Younger sister tears up seeing her sister in such a state. Grandmother gives Mom words of encouragement. The whole family is lovingly supporting Mom. What love!!

“Rasa macam nak berak” Mom says.

I keep quiet and continue to press Mom's back... heh, maybe baby'll come soon here, I think to myself.


But Grandmother notices how close the surges are to each other and calls nurse to check on Mom. Mom refuses a vaginal exam. So the nurse pushes her to the delivery room as the surges are intense and close together. In the delivery suite, Mom musters every ounce of energy to tell the nurses that she wants me in there too. The nurses are put-off, saying “Only one person – either Dad or doula”. But Dad tells me to just stay there and I continue to apply pressure to Mom's lower back. 

Mom lays on her side and nurse does another CTG. Once the nurses see I'm quite harmless, they are more relaxed. Dad happened to bring in the Amani textbook with him; and one of the senior nurses flips through it and is actually very interested. She asks me where I trained and asks me whether we have a birth centre! I chat with her for awhile and she leaves us alone.

Grandmother, Dad, Aunty and I are alone in the room with Mom. Mom changes position to a modified all-fours position - kneeling on the bed, resting her upper body on the inclined bed-head. When a surges comes she'd say “Tekan!” and I get on the bed and press hard on her lower back. It gives her obvious relief. Dad is at Mom's head reading Qur'an and zikr to her. Mom grips his arms tightly through the surges.

We all chat and joke around. Grandmother has had six babies herself and has much wise words to say and comfort to give to Mom. Her jokes lighten the mood and bring calm to Mom.

Mom's surges seem to slow down.. and I'm thinking baby might be near. I pray baby comes soon while everything is quiet and calm.

At one point, Mom goes into a monologue “Allah ampunkanlah dosa Farah. Farah banyak berdosa. Farah tak sanggup masuk neraka” (Allah please forgive me. I have sinned much. I can't bear your Hellfire”.... I can't help but tear up slightly at hearing this..

She goes on, “Abang, maafkan Farah ye. Ana (her younger sister) maafkan Farah ye. Ibu, maafkan Farah ye” We are quiet and making our own silent du'as (prayers).

“Kenapa baby tak nak keluar ni?” Mom asks, exhausted.

“Babies do things in their own time” Grandmother and I say, smiling at each other.

“Tell her its ok to come out” I whisper.

Mom talks quietly to baby.

After sometime, nurse comes in and wants to do another CTG. “Kalau kita tak buat VE, tak tau setakat mana dah bukak.. Kalau dah bukak sepenuhnya kita boleh tunggu 1 jam sahaja sampai baby keluar, takut baby distress”. I scowl inwardly and pray baby comes soon.

Nurse asks Mom to lie on her side, so she can do the CTG. Mom refuses “Tak nak!”


Grandmother tries to get Mom to listen to nurse, but Mom shakes her head. 

Mom apologises to the nurse, “Sorry ye, tapi saya tak nak!”


Grandmother asks me “Is it OK to be in this position? Shouldn't she be lying down?”

“Well, it depends on her – what she feels.” I turn to Mom, “Farah, are you OK in this position? Do you want to lay on your side?”

“No I want to be in this position!” Mom says firmly.

I smile inwardly, so proud of her. Grandmother realizes I've made my point, and is quiet.


Mom is emitting pushing sounds, although we tell her to breathe. And the nurse is getting very uncomfortable at this point. She calls in another nurse and they are standing by the side of the bed, looking on at me still applying pressure to Mom's lower back.

At one point, she looks at mother's perineum and baby's head is slightly visible. She rushes to phone the doctor to inform her.

She comes back into the room and again says to Mom, “Kalau tak baring, macam mana kita nak sambut baby”. 

Mom says “Tak pe, Kak Nadine boleh buat” (!! oops). I smile at the nurse and say “Ayah dia boleh sambut” and motion for Dad to come to the perineum.

When she hears me say this, the nurse runs out of the room in panic. She gets on the phone with the doctor. Within minutes, the lights are switched on and the doctor arrives with a small army of nurses, all of them decked in scrubs and gloves!

Oops! bad move on my part...sigh..

The doctor takes one look at me applying pressure to Mom's lower back and says “What's this??” 
She turns to Grandmother and says “We cannot have this. If you want this, you should have chosen a homebirth!”

Here we go, I thought.

Grandmother doesn't know how to react. “I'm torn at the moment”... I can sympathise with Grandmother who I'm sure is torn between listening to the hospital and respecting her daughter's wishes. Allah bless her for staying calm.

Dad quickly gets on the phone with his mother, the Director. And tells her that his wife is comfortable in that position and should not be made to be in a position where she is not comfortable. He passes the phone to the doctor. After the doctor and his mom talk, the doctor passes the phone to Dad. She tells him "I've told your mother that we have to do what is right and she agreed."

At this point, baby's head is bulging and almost crowning! (Alhamdulillah!) So I move out of the way, near to Mom's head and motion to Dad and also doctor to come close to receive the baby. I tell Mom baby is almost here! In just a few seconds, Mom has a big surge and pushes and baby is born in a couple of surges!

Alhamdulillah!

I have no idea who received baby, though there was a "plop!" and from Mom's expression I knew baby was out. (It was between Dad and doctor who received baby). "Baby's here! You did it!" I tell Mom. 

Mom cries relief “Ya Allah!”

All the six nurses are looking at the baby, while doctor is not sure of what to do. Mom just birthed on a semi all-fours position and baby is on the bed. Doctor is fixed to the spot not really doing anything. One nurse (the one who asked me if I have a birth centre earlier) then asks “How does she take her baby?”

So I tell Mom to lift her leg and turn over. Mom does so, all the while screaming with delight “Ya Allah, betul ke ni??!!”

She is so full with emotion, incredulous that she had just birthed her baby. "Betulke baby dah sampai?!!"


MasyaAllah...a beautiful moment!!

Dad and Grandmother are in tears!

And the shocked nurses and doctor also get swept in the moment and start smiling.

Baby is passed to Mom and put on her chest “Ya Allah!” Mom keeps saying with sheer Joy!

The cord is clamped after a few minutes. Baby has some fluid and the doctor somehow persuades Mom to consent to suctioning baby. Then doctor asks Mom if she wants pitocin to expel the placenta. “No!” Mom says. So doctor massages uterus and placenta comes out soon after.

Doctor examines perineum “Minimum second degree tear” she exclaims, “Do you want me to stitch?”

“No!” says Mom adamantly again. (I'm beaming with pride!)

Doctor resigns herself “OK" she smiles "..unnconventional.. but ok”. She bids farewell to the family (and even me!) and the family is left to bond.

I leave shortly after feeling very proud of the Mother and Father that they called the shots in their baby's birth. And so happy it all worked out well. However, I'm unsure about how the nurses and doctor's attitudes towards doulas has changed after the birth... but I pray its for the better.

Mabrook to the new parents! You overcame the odds even with a non-supportive doctor and got the birth that you wanted.




May little Khansa grow up to be solehah and the coolness of your eyes!

I recently attended a hospital birth a few weeks ago. The mother was having her second child. In her first birth, she was induced and the pain was so unbearable she couldn't remember much about the whole birth. This time around she wanted a better experience. 

A few days before she birthed she wanted to see me to release her fears with hypnosis. She felt she was still nervous and anxious about the “pain” she would be feeling. But the day she planned to see me, she started bleeding and went in to see her doctor. Her doctor advised her to be warded, so she stayed overnight at the hospital. Her surges were irregular on and off, and her labour really wasn't progressing. The next morning she signed AOR forms to release herself from the hospital. I saw her before noon and together, we did a fear release, while mother was experiencing intermittent surges. “I feel my surges have picked up now that I'm out of the hospital” she smiled.

She went home to rest and about 5 in the evening I got a call saying she is in hospital because the surges were more intense. She said she had a second bout of bleeding and she was grunting. I rushed off but it took almost an hour and a half to reach the hospital Pusrawi in KL because of peak-hour traffic. When I arrived, mom was doing beautifully, standing and leaning forward on the side of the bed. Dad was rubbing her back. She looked at me “The surges feel different. They feel like they are pushing downwards”.

“That's good” I said.

“Can I push?”

“Try breathing baby out”

She got onto all-fours for a while on the floor, and then felt like standing again. She stood leaning against a high-table and swayed her hips gently from side-to-side. Standing like this seemed to be her preferred position.

Eyes-closed. Quietly breathing. Head in her hands.

Sips of water. Small bites of dates.

Throughout the few hours that she laboured there – only one nurse came in to ask her how she was doing. Other than that, Mom was left to labour with Dad and me. The doctor was attending to a surgical birth in another hospital and was due to see her by midnight.

Dad and I took turns to say Maghrib prayers and be with Mom. Mom tried sitting on the chair, all-fours on the floor, on the bed and standing. It was getting to a point where nothing worked. “Zikr” I said.

There was a point when she was leaning against the wall with hubby embracing her. Not a few minutes passed and she felt she needed to change positions again.

“Do you want to go to the toilet?” I asked.

“Yes.” 

She made it to the toilet and spent quite some time there, relieved to be able to clear her bowels. 

“Tak boleh. Ada lagi. I want an enema” she said.

I thought it was most likely the baby, but said, “Are you sure?”

“Yes. Call the nurse", she insisted.

So I called the nurse, and the nurse came. “Boleh saya tolong puan?” the nurse peaked in the toilet.

“Nak enema”

“Tak boleh. Kita tak boleh bagi sebarang je. Kita kena check pintu rahim bukak besar mana dulu.”

“Ok”, Mom said, agreeing to the vaginal exam.

Slowly Mom walked to the bed. “Kena baring ke?”

“Lagi elok kalau baring”

So with much difficulty she lay down, and the midwife did a vaginal exam. "10cm!" she claimed. The midwife had a motherly, gentle mannerism.

“Bila saya boleh ambik enema ni?” asked Mom.

“Tak boleh bagi enema. Tu baby! Nanti saya panggil doktor”. The midwife rushed to call the doctor, and chaos ensued, nurses calling out to each other, “Fully dilated!”

Dad was so excited. “Baby is almost here sayang”, he smiled at Mom.

Mom got on her knees on the bed and leaned against the head of the bed that was put upright.

Soon after, baby's head could be seen.

“Baby's almost here” I whispered to mom. “Breathe him out”

The midwife came back into the room and put on her scrubs. She looked extremely uncomfortable, standing at a corner of the room, fidgeting with her scrubs and gloves. She was looking at the baby's head start to crown but seemed to be rooted to the spot! She probably had never witnessed an all-fours birth before this.

I motioned for Dad to come receive his baby.

Dad came. And midwife finally moved closer to Mom.

Baby's head crowned and was born. Midwife held out her gloved hands but looked visibly panicked. “Tekan butang!”, she told me (Call the other nurses!)....Now where IS that butang...hmmm...

With a couple more surges baby was born into both Dad's and midwife's hands.

“Alhamdulillah!” 

Mom smiled and breathed a sigh of relief. Dad looked wildly ecstatic.

Midiwife was still unsure of what to do. She told Dad to hold the baby for awhile. She went to the scrub station and came back with clamps! In a swift motion she milked and clamped the cord. I nudged Dad and glared at her, but it was too late. She seemed to want to take control of the situation.. do something!... but just not sure of what to do.

I told Mom to lift her left leg and turn her body over so she could sit down. Dad passed baby to Mom. Mom was SO happy to hold her baby!!

I usually leave the couple to bond with their baby at this point, but I felt I needed to stay because the midwife was fussing over her.

Doctor came in at that point. “Baby is out already” midwife told her “Good!” She was relaxed, greeted the parents and went to check on Mom.

She apologised because she had another birth to attend and chatted with Mom and Dad for awhile. She told the midwife that the parents requested for delayed cord clamping. The midwife gave the excuse that the cord was too short (!)

I took pictures of the loving family – big smiles on their faces. Baby was just so alert and taking in his surroundings. “His name is Arif” Mom told everyone, proudly beaming.


Mom asked for some private time, but doctor was worried that Mom was bleeding a lot from the tear, so she had to suture Mom immediately. No pitocin was given as Mom had requested for a natural third stage, but doctor was worried by the amount of blood she was losing and was telling baby to nurse. 

MasyaAllah, as far as hospital births go, it was a pretty good birth. The doctor and nurses have to be commended for their treatment of the mother and baby, overall. They were respectful of Mom and Dad's wishes. Mom only got one VE, and was left to labour alone most of the time. Alhamdulillah and mabrook to the mother and father for preparing well for the arrival of their child! May Arif be the coolness of your eyes!

I'm so excited to finally find the time to sit and blog about this beautiful birth. About a month ago I attended an unassisted birth of a young mother and father. This was their third baby, and masyaAllah they have such a cute little family. 
A few days before she birthed, Mom was PMing me and ready to birth her baby. At 42weeks and 1 day, I received a text from her in the morning saying she started feeling her surges. I had a class that day and a talk by Ibu Robin in the afternoon. 

After class I rushed to her house. Apparently, the night before she felt intense surges after she nursed her second boy. She didn't get much sleep and was tired. She was doing well though; breathing beautifully through her surges. Her surges were long, but irregular. I stayed for a while during which she ate some lunch, then she told me to go to the talk as she felt it was still some time to go. I suggested for her to rest, and then to try going on hands-and-knees to help baby get into a more encouraging position. I left for the talk, but didn't stay long as her hubby texted to come around 4pm. 
I went to see her and when I entered the room, I noted the scent of amniotic fluid in the air. Mom was doing beautifully - relaxed and doing slow breathing through her surges, lying semi-reclined on the bed. 
She was starting to lose her patience though. "When is baby going to come?" 
"Sometimes babies have a mind of their own" I said. 
She half-smiled.

There was one point when Mom stood up and leaned forward against her husband and started to sway her hips from side-to-side. Her husband was supporting her and kissing her and holding her, and they were in a little dance together moving baby down and out.

Probably the most memorable part of the birth was when Dad kept doing light touch massage up and down Mom's arms and talking in a little girl's voice - meant to mimic their three  year-old daughter. "Nuha works", Mom whispered.. and so Dad continued to do all the impressions of their daughter, Nuha, in all situations imaginable. "Mama, Nuha ada dress!", "Its a dinosaur!". I smiled at the dedication of this couple to each other and their determination to have the most peaceful birth. "Please Allah make it easy for them," I silently prayed.

Mom then went into the toilet and cleared her bowels. After awhile she got up and went into the room and squatted at the foot of the bed. Her instinct was telling her to squat the baby out... some primal noises coming from her.. Soon she became tired. And so she moved to the bed. Dad was there by her side every step of the way - telling her he's there for her, massaging her, wiping the sweat from her face.

Not long after, Mom began to voice her doubts "I don't think I can do this"; "They'll have drugs at the hospital"

Dad and I looked at each other.

"It seems very close" I said.

"I want to go to the hospital!" she said.

"Ok, the best thing is you might birth in the car... shall we get you dressed?"

Mom seemed to change her mind at the mention of getting dressed.

Azan Maghrib was heard, and a peaceful feeling filled the room. Dad and I took turn to say our prayers and be with Mom.

Mom was starting to grunt and make guttural sounds that filled the room. Dad and I held each of Mom's legs up during the surges, as the expulsive surges were taking over her body.


Silence... Calm... Dad lovingly holding Mom while Mom gave into her body's urges.

"I can see the head!" Dad said incredulously with a big grin.

"Really??" Mom said, not believing.

"He's got curly hair!" I smiled.

"Aghhhh!" One last primal sound from Mom and baby's head slowly crowned and was born.

Dad looked at his baby's head being born in sheer awe.

And then another "aggghhh!" and the body rotated to allow the shoulders to come through.

Baby had a nuchal cord. With the next surge, baby's body came out only slightly further and the cord became tighter. So I motioned to Dad to unwind the cord, and when he did, baby started to sputter.

One last surge and baby's body was out.

"Alhamdulillah!" Mom said, visibly relieved.

Dad received baby and slowly put baby on Mom's chest. 

A big smile on Mom and Dad's faces as they gazed at their new baby. Mom looking so refreshed and ecstatic! ...quite the opposite from just a few minutes before ;). 

I left the family alone to bond and enjoy their special moment.

They were chatting when I returned, and I could sense the feeling of pride, gratefulness and joy! 

Alhamdulillah! Allah is the best of architects! A family is born again :)

The placenta came not long after when Mom sat on the toilet bowl. We fed Mom dates and honey so that she would regain some of the energy she expended.

I left feeling warm and fuzzy..

"Thank you Nadine. I don't know what would have happened if you weren't there" came a text from Dad after I had left. I chuckled to myself. I find it so funny when couples say this to me.. because I know I didn't do anything.

Mabrook to the amazing mother, father and baby team who did so beautifully! Nik Umar is so lucky to have such wonderful parents such as yourselves. May he be anak solehah and be the coolness of your eyes. Ameen.

Note: I do not promote unassisted cildbirth. This family decided they wanted an unassisted childbirth because they believed that it was the best for them. They are well-researched and informed and they made and informed decision. They were going to birth unassisted anyway, whether anyone was with them or not. I was just a companion.

Last week was probably THE busiest week of the year for me and the rest of the committee of The Gentle Birthing Group!

There was a huge Internatioal Conference called Women Deliver, held once every three years, that was held in Kuala Lumpur Convention Centre. It attracted thousands of participants from all over the world including government leaders, policymakers and NGO representatives from organizations such as UN and WHO. Internationally renowned figures such as Melinda Gates, Chelsea Clinton and Queen Mary of Denmark gave speeches at the conference; and also eminent figures in the birth world, such as Debra Pascali-Bonaro, Robbie Davis-Floyd and Ibu Robin Lim.

The weekend just before the conference, BIB Malaysia hosted the 2nd International Birth Without Borders (BWB) Conference, in which Robbie Davis-Floyd (meidcal anthropologist) and Debra Pascali-Bonaro (Birth Activist, Doula and chair of the International MotherBaby Childbirth Organization) were the main speakers. These are two prominent figures in the birth world and I was SO excited and SO grateful to be able to meet with both of them.

I myself was invited to present at a Forum during the Birth Without Borders Conference, as a representative of the Gentle Birthing Group Malaysia, and to represent the collective voice of Malaysian mothers. Other panelists included Consultant ObGyn, Dr Noraini from Sunway Medical Centre and Consultant ObGyn, Dr Haliza from Hospital Kuala Lumpur. I felt honoured and grateful to be invited to present amongst eminent figures at such an important conference.

In my presentation I showed video clips of mothers from the Gentle Birthing Group (GBG) telling their birth stories in their own words. Their stories told of how they were ill-treated during their births or given inaccurate information or how they were pressured into accepting unnecessary interventions. As these were first-hand accounts of mothers' experiences in birth, it did a good jon in informing the audience that many mothers are unhappy about the way they are treated in Malaysian hospitals during their births.

I thought it must be a difficult message to see, if I were a nurse or doctor, but it certainly had to be done. At first, the audience was silent and I noted an air of defensiveness from the other panelists, but as soon as I and the other members of the Gentle Birthing Group, who were seated in the audience, made it clear that we want to work together with the Ministry of Health and actually be part of the solution, the tone of the discussions became much less defensive and more productive all round. The conclusion was that medical professionals cannot turn a deaf ear to what mothers have to say, and so all parties agreed that it is in mothers and babies' interests that all parties work together in the spirit of mutual understanding for the health and safety of mothers and babies.

The whole Conference was charged with oxytocin, as the main speakers, Debra Pascali-Bonaro and Robbie Davis-Floyd, told it like it is to an audience full of medical professionals – how routine hospital procedures (much of which are still parcticed in Malaysian hospitals) impede the chances of the mother to experience a natural birth by a great amount; how many of them are actually NOT based on scientific evidence; how many other motives drive Obstetricians – including legal issues, conveniene and money. Each of the speakers brought to the conference their own strengths - Debra focused on the International MotherBaby Childbirth Initiative and the importance of doulas at birth, while Robbie Davis-Floyd talked from an anthropological perspective about childbirth and why we have gotten to the point we're at today. I found her talk about the difference between Technocratic, Humanistic and Holistic models of birth simply fascinating! And when she talked about power issues in birth and the centuries-old power struggle between man (Obstetrician) and woman (midwife and mother), the whole room (well, mostly the birth activists) gave her a standing ovation! Obstetrical medicine is a very recent phenomenon. Only in the past few hundred years, have men encroached upon the domain of childbirth, a historically female event – where females attended births and provided emotional support (midwives and doulas) to the mother. Fascinating! 

We were able to network with many parties and we definitely made headway in following-up with our relationship with the Ministry of Health. The GBG was invited by Dr Ravichandran, the head of the Obstetrical and Gynaecological Society of Malaysia, to work together with OGSM and Ministry of Health in improving birth in Malaysia. So this was a HUGE step forward for the GBG in our birth activism activities. I met midwives and nurses from Klinik Kesihatan who said "you know we have had a few women who birthed at home unassisted - at first we were against them, but now we realize we have to listen to them" ! :) These were good midwives who are just carrying out their jobs to the best of their abilities and to the best of their knowledge. The concept of Gentle Birth and HypnoBirthing were all new to them... they were curious! You could see it in their eyes!.. And many were willing to listen :)

I left the conference with a renewed vigour and a sense of awe by the work that these two strong amazing women do and how they contribute to the collective wealth and health of women and babies all over the world. My colleagues and I from the Gentle Birthing Group laughed, hugged and shed quite a few tears because it was so refreshing to be at a conference where the truth was spoken out loud and birth workers, mothers and medical professionals all gathered in the interests of mothers and babies! The conference only re-affirmed my belief in my work as a birth activist, and showed me that there is a MUCH bigger purpose for doing the work I do..It's not JUST birth. It has repercussions for women, babies and whole societies, nations and future generations in years to come.

Immediately after the BWB conference, was the Women Deliver Conference where key figures from renowned institutions across the world came together. We were fortunate to attend and listen to such important people speak such as Francis, the president of the International Confederation of Midwives, Queen Mary of Denmark, and other eminent figures talk about the state of women and girls all around the world today. Ibu Robin Lim (CNN Hero of the Year) also was invited to speak. It was a great opportunity for me and my colleagues from the Gentle Birthing Group to network with relevant organizations to put forth our cause. I met many wonderful people there who I hope to be in touch with for future projects with the GBG. The conference itself I thought was alright. I did learn quite alot. However, the entrance fees was very high and it was definitely not affordable to independent midwives who work the most with mothers and babies. Many ministries from around the world sent representatives, and there were many Obstetricians there, but the main theme I felt was still about institutionalizing birth - about getting women to the hospital and "adequate care" and reducing maternal mortality, etc - but as Robin Lim poignantly pointed out - there was nothing about food quality - and about addressing malnutrition in countries. How can we talk about gentle birth, when mothers are malnourished?? Its not possible. There really should have been more talks addressing the causes of undernourishment of women and children leading to dangerous complications and deaths. However, it was good that the International Confederation of Midwives were represented and were able to put forth their case. Debra also put forth her case for Respectful Maternity Care. Hopefully all these issues will be taken into consideration when the next Millennium Development Goals are drawn up in 2015.

After the conference, we spent half a day with Debra and Ibu Robin just chatting! The day after that, the GBG hosted a talk where Ibu Robin addressed a crowd of about 40 mothers and fathers at Chayo Studio before she went home to Bali. I was only able to stay for the first half of the talk, but it was full of love, hugs and tears of happiness :)

It was such a memorable 10 days. I am so grateful and feel so blessed that everything worked out well – and I was so grateful I managed to squeeze in an intensive HypnoBirthing class and also attend a beautiful homebirth (more about that later;) !

Alhamdulillah! Feeling very blessed! And now, returning from a 5-day vacation with my girls, I'm excited to get back into gear! Allah make it easy for me and bless our work and give us barakah in the work we do to make birth better for mothers and babies in Malaysia. Ameen.

MashaAllah , SubhanAllah. I still smile to myself thinking of the events of this past Saturday. I was privileged to attend a home unassisted birth of a first time mother. I had missed a few births in the past few months because of home commitments and other issues, but somehow this birth was perfect timing. In fact, I was supposed to have a class that morning, but the mother had to cancel because she was not feeling well.

I got up in the morning thinking it would be an uneventful day, relaxing with my kids. My phone had gone flat in the night and so I charged it and got this mama's SMS at 7am, when she had already texted me at 6am. I rushed to get my kids fed and left them at my mother's house. Her husband was texting me to hurry as he was excited:) "No stop in surges for last 30 mins. Sorry to rush you".

When I got there, mom was on all-fours on her bed riding her surges. Rocking her body back and forth in silence. Her waters had released at 4am and apparently she had wanted to drive herself from her mother's house to her house to birth, but her husband didn't allow it. *chuckle*

I knelt by her to let her know I was there. She acknowledged my presence and returned to attending to her surges. She was quiet, breathing through her surges. She would occasionally scrunch her eyebrows and her fists and moan. 

We reminded her to relax and release the tension in her body. "How do I do that?" she asked. "Smile" I ventured. And soon enough she started to relax.

"I'm comfortable in this position but my hands are tired". So we piled a heap of pillows against the headboard of the bed and she leaned on it, slightly elevated. This seemed to be her position of choice.

Her surges started to patter out and not long after, the tip of baby's head could be seen. Dad was excited by the sight and rushed to get towels. Mom's sister arrived to give support. Mom was still on all-fours breathing and smiling between surges. 


"But every time I relax I can feel his head go back in".  

"That's fine", we said smiling quietly, excited at this point. 

A few relaxing surges later, baby's head slowly emerged, almost all the way.. and then stopped just at the lips, like a turtle-neck sweater that didn't come down all the way.

Time stood still. 

Dad steadied his hands under baby's head.

"Mancungnya hidung dia!" 

Dad and aunty couldn't contain their excitement.

Another smile from mom..

After a couple more surges, baby slithered out wearing his cord around his wrist and with his hands against his chest... as if making du'a :) SubhanAllah.

Dad received baby, and after mom turned around and sat back down, Dad put baby on her chest.

What a beautiful moment.

We helped mom take her shirt off for skin-to-skin with baby. Then her sister and I left the room to let the new family bond and enjoy their magical moment together.

The mother was ecstatic and incredulous. Baby was alert and taking in his new world with bright eyes. They were both tired and enjoyed a good sleep. I left soon after and learned that the placenta came a few hours after that. 

Mother went to the clinic at night and got a few stitches (which she didn't appreciate) and was so happy and grateful for her beautiful birth and baby.

Alhamdulillah ala kullihaal! What awesomeness HE creates everyday in birth, through the simplest yet most profound moments.

I don't usually blog about the births I attend, because its the family's story to tell and not mine.. but it would be a shame not to share the sheer awesomeness of it.. plus mom gave permission.. hehe.

Congratulations and Mabrook to the amazing mother and father! May your son be the coolness of your eyes, and may you live to tell this wonderful tale to his children :)


Note: I do not promote unassisted cildbirth. This family decided they wanted an unassisted childbirth because they believed that it was the best for them. They are well-researched and informed and they made and informed decision. They were going to birth unassisted anyway, whether anyone was with them or not. I was just a companion.

Just recently one of the moms in my class related what her doctor told her when she asked if her baby could delay getting a Vitamin K shot at birth. The doctor told a story of a mom under his care who refused to immunize her newborn with Vitamin K and the child suffered brain hemorrhage as a result, and his skull had to be drilled into for operative surgery. 
I was surprised at this, not of the story, but of the fact that her doctor told it to this mother with such vividness and detail. 

For all intents and purposes, the mother was trying to make an informed decision about her baby's well-being. By telling her the story the doctor was not helping her make an informed decision. In fact, he was scaring her into complying with hospital practices. What he should have done was given her information about the benefits and risks of Vitamin K injection at birth, (This is a good one for example http://drbenkim.com/vitamin-K-shot-baby.html) and if he really needed, he could have mentioned he had seen cases of brain hemorrhage before. But to tell the story the way he did, it was clear he was trying to scare her. It is downright unprofessional, and something no doctor should do. In any case, it would be the pediatrician's jurisdiction when it comes to newborn immunization, not an ObGyn. 

When I was pregnant with my first, I would be ready with a long list of questions to ask my ObGyn at each antenatal appointment- about whether I could birth in different positions, about whether I'd be given enemas, episiotomies on routine, about her induction practices, etc.. But every time I tried to bring up the topic with her, she'd hush me with a wave of her hand and start throwing me statistics about deaths in births. She'd say things like "Did you know, every year, 7 babies die in childbirth?" ... and I would be left re-considering what I was asking of her, whether it really was too much to ask. I have since learned that it is definitely not too much to ask. In fact, I didn't ask enough. I should have insisted she make known her c-section rates (she also waved this question off with a vague "well it depends, sometimes 20%, sometimes 50%" ??!?), her induction rates, her episiotomy rates, and many more. And I was also in a system that supported this kind of disclosure (in Australia its mandatory that doctors and hospitals be transparent about these data).

My point is, scaring pregnant women by telling them stories of maternal or infant death or injury is an extremely unprofessional and irresponsible way for doctors to get women to do what they want you to do. Under no circumstances should a doctor resort to these scare tactics if he is a true professional... because this can have devastating effects on the psyche of the mother. In many cases the mother is left feeling unsure and insecure about her body's ability to birth naturally.

Families have a right to make informed decisions about their baby's births and care in the immediate post partum period. Sadly this is NOT supported in many hospitals or with many doctors in Malaysia today. Many doctors will order prenatal tests, prescribe drugs without bothering to explain to parents about why they think this is needed or bother even getting their consent.

Before families make decisions, remember you have the right to know "BRAIN": - 
 B - What are the benefits of a particular procedure?
 R - What are the risks involved?
 A - Are there any alternative courses of action/ options that we can explore / consider?
 I - What is my gut instinct?
 N - What if I don't do anything and let nature take its course?

And you also have the right to a second opinion. 

The more families make known their request for less biased, more accurate, evidence-based and complete information, the more the maternal health community will take note and perhaps some improvement can come about. 

Yay! Really excited that an article of mine got published in OnIslam.net!

Here's the link http://www.onislam.net/english/family/moms-and-dads/457732-childbirth-gentle-initiation-into-motherhood-.html