Catherine O’Brien, YOU Magazine. 13 June 2004
While the ‘too post to push’ debate rages on, some celebrities have brought natural birth back into fashion with the help of a very special doctor.
The state of pregnancy may be as old as humankind itself, but that has never stopped it being susceptible to trends. How we choose to give birth says much about who we are, which is why the elective caesareans of Victoria Beckham and Elizabeth Hurley dominated the ‘too posh to push’ debate. However, not all those who can afford to book their delivery date in much the same way they would fix a leg-waxing appointment do so. Some – and they include Kate Moss, Elle Macpherson, Lady Helen Taylor, Sadie Frost, Gwyneth Paltrow and Sharleen Spiteri – follow up their positive pregnancy test with a call to Dr Gowri Motha. In fact, Dr Motha was on hand when Gwyneth Paltrow recently gave birth to Apple.
A private obstetrician, Dr Motha is architect of the Gentle Birth Method – a pioneering programme for those who understand that if they want to give birth as naturally as possible, they are going to have to work at it. So far, Dr Motha has only been guru of choice to those within striking distance of her London clinics. The publication this month of her book promises to change all that.
Softly spoken and with her rounded frame dressed for comfort rather than to impress, Dr Motha is the antithesis of some of the high-profile and high-maintenance mothers-to-be that she deals with. She exudes calm, but is also reassuringly direct.
‘Gentle doesn’t mean painless,’ she warns. ‘But it is worth remembering that childbirth is what our bodies are best at.’
Now 54, Dr Motha grew up in Sri Lanka and it is in her childhood there that much of her teaching is rooted. Her mother was a full-time mother, her father a GP and paediatrician; Dr Motha’s first experience of childbirth was the arrival of her brother Hami when she was four. ‘My father delivered him in between playing cards on the verandah,’ she recalls. ‘In Sri Lanka, natural birth is the norm.’ She remembers throughout her childhood, going to her father’s surgery after school and occasionally being allowed to listen to a baby’s heartbeat in a pregnant patient’s womb.
For her, a career in medicine was preordained. She studied in Bangalore and then spent almost a decade working in hospitals around India. ‘I remember in Madras how the poorest of the poor would come and give birth with ease, and yet those on the private wing often struggled. I soon realised that intervention was not always the best way.’
Dr Motha was 30 when she came to England, securing a post as an obstetrician/gynaecologist at Whipps Cross Hospital in East London. At first, she was
impressed by the Western approach, ‘the cleanliness, the monitoring, the way the woman’s voice was heard, so that if she wanted pain relief it was there for her’. The more she talked to mothers, however, the more she became convinced that she was working in a regime of ‘crisis management’, where doctors were fearful of complications and litigation and patients were ill-prepared and emotionally out of control. According to Dr Motha, fear is one of the greatest barriers to having a gentle birth because it releases the ‘fight or flight’ hormone adrenalin. This has a constrictive effect on the body, causing tightening of the muscles and even going so far as to stop the cervix from opening. Too often, by the time she was called upon, there was little she could do except administer the epidural and apply the forceps. ‘The mothers would then consider themselves a terrible failure -and that saddened me, because every birth should be a personal triumph.’
In 1987, she met Michel Odent, the French obstetrician and founding father of the modern-day water birth. She was so inspired by his work that she spent £1,500 of her own money on a birthing pool for the maternity unit at Whipps Cross. ‘Some of the midwives thought that I had lost my marbles,’ she smiles. ‘But they also knew I was a safe obstetrician.’
It was to be her first step towards finding alternative approaches to childbirth that could work alongside, rather than in place of, conventional medical treatment. She started self-hypnosis classes and welcomed two reflexologists who volunteered their services in her antenatal clinic. She also made a point, whenever she encountered a woman who had a good birth, of asking her how she had managed her pregnancy. ‘I wanted to know about their diet, exercise, mental attitude. I knew mental stress translated into physical stress and that any woman was likely to have complications if her anxieties could not be allayed.’
In 1993, Dr Motha left her NHS post to develop her own portfolio of holistic treatments. She studied craniosacral therapy, reflexology and visualisation techniques, and began her own clinic from her home in South Woodford, Essex. Her Gentle Birth Method has taken 15 years to evolve and is based on the fundamental premise that women must ready themselves for childbirth. ‘I have always been bemused by the fact that pregnant women spend longer preparing the nursery for the baby than their bodies for birth,’ she says. ‘Labour is like a marathon. It is not something you just turn up and do on the day – you have to train for it. Your body has to be conditioned, ready and at its peak.’
The inescapable truth, Dr Motha points out, is that big babies and overweight mothers lead to a higher incidence of complicated births, which is why the first part of the Gentle Birth Method focuses on diet. Mothers are expected to follow key nutritional guidelines – no wheat, no sugar, no bananas (mucus producing), no grapes or mango (too sugary), two litres of water a day, no carbonated drinks (they deplete calcium from your system) and limited caffeine (water retentive). Foods to enjoy include chicken, occasionally lamb, fish (except tuna due to high levels of mercury found in its flesh), brown rice, oats, parsnips, lentils, pears (lots of calcium), pineapples (good for digestion), any vegetable in season, but potatoes, aubergines and raw salads in moderation. Far from eating for two, Dr Motha stipulates that the expectant mother needs only an extra 200 calories a day – the equivalent of a bowl of cereal – and that she should not put on more than 20lb over nine months. ‘If there is one thing that characterises all the mothers who follow my programme, it is that they are light on their feet,’ she says proudly.
Their nimbleness is aided by an exercise programme, introduced from the second trimester, which includes daily yoga and walking to build stamina, and twice-weekly swimming to help with foetal positioning.
But physical preparation is only one element of the Gentle Birth Method. For many mothers, becoming mentally and emotionally attuned to giving birth is the bigger hurdle. In a course of four classes, Dr Motha demonstrates how women can overcome their fears through visualisation and self-hypnosis. She advocates regular massage and reflexology, and explains the secrets of cervical dilation – the quickest way to achieving the necessary 10cm, she says, is through deep-muscle relaxation, a technique she teaches to improve blood flow to the whole body, particularly the cervix and uterus.
Dr Motha has not had children herself. ‘My father was very much an Asian father. He told me that if I was going to be a doctor, I must not get married – and I never have. For a while, I was sad about it, but I know that I would not be able to work the way I do if I had a family – and my work is everything to me.’
She sees some 250 patients a year- of whom only a small contingent are well known. ‘The truth about the celebrities who come to me is that they want to be treated as normal people,’ she says. A crucial element of her work might be described as prenatal counselling. In India and Sri Lanka, she points out, it is accepted that a pregnant woman needs a lot of care. ‘She will go to her mother’s house at 32 weeks and will stay there until 40 days after the birth and in that time, she will have regular visits from a massage therapist. ‘ Conversely, some of the women she sees in the UK expect to be working almost until the onset of labour. ‘I tell them to slow down.’ She suggests going in an hour later to work and coming home an hour earlier, or alternatively trying to arrange a day off midweek. ‘Having a baby can be a harsh challenge for modern women because they are so used to being independent money earners. Psychologically, it can be very damaging if they feel they are letting go of that independence. I help them to realise that allowing yourself to be looked after is not a sign of weakness.’
The results of the Gentle Birth Method speak for themselves – 90 per cent of births by vaginal delivery, compared with a national average of 79 per cent; 3.4 per cent episiotomies, compared with 15 per cent nationally; an epidural rate of 17 per cent- almost half the national average. Those who do the programme can, if they want to, book Dr Motha to be at the birth – she attends, on average, two deliveries a month for a fee of around £1,000, although she charges less for those who cannot afford to pay the full cost. Queen Charlotte’s Hospital, London, one of the country’s foremost maternity hospitals, is about to launch a research project on her work.
The difference between Dr Motha and some other birthing gurus is that her teaching is underpinned by solid medical training. Having seen an estimated 50,000 expectant mothers throughout her career, she claims to be able to tell, within moments of meeting them, those who will have problems. ‘I look at their skin – texture, their stomach distension; I place a hand on their shoulder and I can feel mental stress and water retention. I don’t tell them, because that would be negative conditioning, but I drop hints. A caesarean for some women is unavoidable.’ Nor does she recommend that any woman endures more than eight hours of strong labour without an epidural. ‘There is always going to be a need for intervention -and why suffer?’
Gentle Birth Method by Dr Gowri Motha and Karen Swan-MacLeod is published by Thorsons on 21 June 2004.
YOU Magazien, 13 June/2004