Gently Does It… the natural waterbirth pioneer

press-dolphinsCarolyn Burdet
Kindred Spirit, September/October 2004

Dr Gowri Motha pioneered waterbirths in NHS hospitals, buying the first ever water birth pool in 1987 out of her own pocket for the NHS London hospital where she was an obstetrician. Her dream is to open a centre where women can give birth with dolphins. Carolyn Burdet is inspired by the holistic Gentle Birth Method.

Giving birth is the most natural thing in the world – yet this rite of passage can be a shocking and brutal experience for mother and baby.

As an obstetrician at a London teaching hospital, Dr Gowri Motha despaired of the number of times where her medical expertise was a last resort – being called in an emergency to perform invasive forceps deliveries on terrified mothers when a baby got ‘stuck’ during a laborious labour. Rather than heralding this life-saving medical intervention as progress, she says, ‘Hospitals tend to turn birth into an organised, sanitised affair over which the professionals, rather than mothers have control.’

To ease these traumatic labours, she bought the first ever pool at an NHS London hospital in 1987 and asked the midwives to let her know if any mother was interested in a water birth. It is now a government directive for waterbirth pools to be available in birthing suites.

Noting the ease with which labouring women squat and give birth in the paddy fields, compared with the painful and laborious experience of many Western women in childbirth, she concluded that the stressful, sedentary modern lifestyle and sugary diet provide clues to the problem and that preparation, inside and out, was the key.

‘I have always been bemused by the fact that women spend longer preparing the nursery for the baby than our bodies for childbirth,’ she says.

Dr Motha now runs a holistic antenatal clinic. The Gentle Birth Method is offered privately as a comprehensive antenatal programme at Viveka (which Madonna has attended for fertility advice) and at her own clinic, the Jeyarani Centre in north London, and for the birth itself at the gently exclusive St John and Elizabeth Hospital, alongside natural birth exponent Yehudi Gordon. Here her patients have included glamorously fit and healthy role model mums, Elle Macpherson and Gwyneth Paltrow.

Coaching for childbirth

Gowri Motha is committed to helping women to give birth as naturally as possible, devising an antenatal programme of massage, reflexology, cranio-sacral bodywork, detoxifying ayurvedic herbs to tone the womb and ayurvedic massage oils to soften the pelvic tissues, and self-hypnosis techniques, to prepare women physically and psychologically for giving birth. A Kindred Spirit reader, Gowri also emphasises the spiritual journey of bringing a baby into the world, even chanting mantras in her fertility clinic. She gives Reiki healing and massage and has a hands-on approach with her patients, though she hesitates to call herself a ‘doula’ – the fashionable term for a natural birthing midwife. ‘The word means slave,’ she says laughing gently. ‘I prefer to see myself as a birthing coach.’

The Jeyarani (meaning ‘triumphant queen’) antenatal preparation programme is fairly rigorous, with regular bodywork treatments and a restrictive diet that limits sugar, wheat and gluten, which congests the body’s tissues and lead to bigger babies, which can get stuck in the final stages of childbirth.

‘Some mothers find the programme a bit of a shock,’ she says. ‘Often their pregnancy has made them less active and more self-indulgent with their diet. There is a steep curve. I ask you to start doing gentle daily exercise, restrict your diet, take herbal supplements and have physical treatments.’

The preparation of gentle yoga stretches and bodywork treatments culminates in massage – inside and out – to loosen the tissues in the pelvic area.

‘We want your uterus to be as toned as your leg or stomach muscles, we want the muscles in your pelvis to become so soft that your pelvic cavity becomes wider, we want your cervix to be decongested.’

She reasons that most women are used to watching their diet, so rather than ‘letting themselves go’ during pregnancy, they should be motivated to keep up the regime to achieve peak fitness for giving birth.

‘The difficulty is that you can’t see the changes,’ Dr Motha acknowledges. ‘Stomach crunches give you a noticeably flat tummy at the gym, but you can’t see how well the ayurvedic herbs are toning your uterus. Your motivation and reward is a short, gentle birth and it can be yours if you build up your birth fitness steadily.’

Motha’s mothers

To anyone who has experienced the fluctuating energy levels and strained ligaments of pregnancy, the prospect of stepping up exercise is daunting, and despite the recipes for tasty chicken, spicy vegetable dishes and apricot desserts, restricting a diet already limited by nausea at the sight or smell of so many foods, when a biscuit causes so little olfactory offence, is quite a commitment. But there’s no doubt that her enabling encouragement inspires confidence in your innate natural ability to give birth. Dr Motha is an unusual obstetrician but she insists she is not a maverick, citing her reputation as a sound medical practitioner. Having been an obstetrician and fertility specialist in the NHS, and then a GP in Hackney, Dr Motha’s philosophy has gradually filtered through the health service. Her pioneering Gentle Birth programme is on offer on the NHS at Queen Charlotte’s hospital in north London.

Dr Motha’s advice and encouragement is available to everyone in her new book, The Gentle Birth Method, which guides women through the programme month by month.

Reflexology is effective in turning babies from breech position and naturally inducing overdue babies, and there are confidence-inspiring cases of using a shower as invigorating hydrotherapy to resume contractions after uterine inertia threatened to require invasive procedures. But the most remarkable aspect of the programme is her psychological coaching, with self-hypnosis sessions, tapes and CDs to strengthen mental focus and encourage women to relax so labour progresses without anxiety. The book includes visualisation scripts for couples to read aloud before and during the birth.

The spiritually holding aspects of gentle birth method are reassuring but the Jeyarani programme is not simply a feel good therapy for fashionable mums – the programme’s remarkable results and statistics speak for themselves.

After following the programme of bodywork treatments, low sugar diet, ayurvedic herbs, and perineal massage to soften the tissues, labour is typically six hours instead of 18-36 hours, less than one per cent of women have an episiotomy and only three per cent need any stitches. A third of women in general have an epidural spinal block, which reduces the sensation of contractions and increases the incidence of invasive procedures, with 15 per cent having episiotomies for forceps deliveries.

The government recently issued new guidelines after concerns that 25 per cent of births are caesareans; indeed Dr Motha’s colleagues in London hospitals report an emergency Caesarean rate as high as 40 to 60 per cent in first time mothers. Over 90 per cent of Dr Motha’s antenatal patients give birth naturally and only nine per cent need a Caesarean for medical complications.

Dolphins as underwater midwives

Dr Motha has helped with more than 500 waterbirths in hospital, but facilitating a birth with dolphins was her all-time triumph. Six pregnant women, a medical team and massage therapists flew out to the resort of Eilat to give birth with dolphins in the Red Sea helping women to have a tranquil labour.

The trip was meticulously planned, with Dr Motha, an anaesthetist and another obstetrician in attendance. A shark-proof, glass-bottomed birthing pool was specially built, with the seawater filtered and heated to body temperature to make it safe and hygienic to give birth in.

‘We didn’t take any risks,’ says Dr Motha. ‘I had emergency resuscitation equipment with me, in case medical assistance was needed.’

But the Israeli authorities banned the plan after health inspectors ruled it could expose mothers and babies to infections. Swimming with the dolphins leading up to giving birth was an experience they’ll never forget, but only one woman gave birth with the dolphins. Sarah Evans ignored the official ruling. When she went into labour at midnight, she walked down to the beach to have her baby in the glass-bottomed pool in the Dolphin Reef sanctuary. Sarah did visualisations as the reef’s six dolphins swam around her. The baby was born within three hours, her husband Jonathan cut the umbilical cord and half an hour after giving birth, they walked back up the beach to the hotel with their healthy newborn son, Samuel. Dr Motha says: ‘That was the calmest newborn baby I have ever seen. Women feel safe when they’re in the water with dolphins. Swimming with them enables a prospective mother to be in touch with joy, which is the essence to birth.’

For Sarah it was an elating experience. ‘Giving birth in the Red Sea with the dolphins was the most wonderful experience of my life, ‘ she says. ‘I was in complete control and didn’t feel under any pressure to perform, as you do in a hospital. It happened so quickly, and I wasn’t in any pain. The dolphins came close – but not too close. It felt like they wanted their presence to be known, but didn’t want to be intrusive.’ Dr Motha believes dolphins use ultrasound to sense if a woman is pregnant and can help her give birth without pain by sending underwater sonar messages.

The trip was resource-intensive – the birthing pool alone cost $20,000 but the fact that one woman gave birth with dolphins made the trip worthwhile.

‘It was a very carefully thought-out project,’ Dr Motha explains. ‘Everything has to be done in a clinically controlled way. The water has to be filtered and heated to body temperature to make it safe to give birth in. The location needs to be somewhere with warm seas where dolphins swim regularly. And the birthing pool even has to be shark-proof- we don’t want the blood to attract sharks!

‘I receive calls and emails from women all over the world requesting a dolphin birth. It is my dream to have a dolphin birthing centre. I think a lot of women would be interested. But it is very expensive to do. If someone came forward with the funding it is something I would love to do. Maybe some day we’ll be able to open a dolphin birthing centre and offer this in the Maldives or Bali, Australia, or maybe in Mexico.’

Now in her forties, after devoting her working life to making birth a beautifully natural event for hundreds of mothers, Dr Motha has been ‘too busy’ to have any babies herself, and though she’s delighted to see water-births become widely available, she is unconcerned about whether people have heard of her or associate her pioneering methods with the Jeyarani Centre as her advice spreads into mainstream hospital use.

As someone who introduced waterpools to NHS hospitals where they are now offered in almost every birthing suite around the country, and seen so many of the techniques of her gentle birthing method become mainstream, her dream of enabling women to give birth with dolphins is sure to be come reality someday soon.

WAVES OF CONTRACTIONS – ANDREA

Although I’d visualised the baby’s head dropping deep into my pelvis, I didn’t recognise the start of proper contractions. I felt energised all day. Driving home I perceived the period-like pains as Braxton-Hicks (weak practice contractions). Climbing into bed at midnight I nodded off. By 1.30am the strength of my contractions woke me, and I ran a bath. I felt very excited – this was definitely it. Back in bed I dozed in and out of sleep. The midwife arrived at 6am and was amazed, as this was my first child, that I was already 3cm dilated. ‘My goodness’ she said ‘your cervix is so thin’. Of course it was – I had spent the last 13 weeks telling it to be thin. The second midwife arrived at 7.30am – I was 7cm dilated.

Nigel and the midwives massaged my back as I buried by head in the pillows in a trance-like state between contractions, off in my safe place. I thought of each contraction as a wave crashing onto a beach. AS the waves crashed there was tremendous force, but the beautiful sensation of the water flowing away and seeping back out to sea made it all worthwhile. After each one ebbed away, I felt an amazing sense of peace. Then my waters broke. I started to push. Two or three contractions later baby Jade slipped out.

VISUALISING A SAFE PLACE

Visualisation of a safe place is your best tool for managing contractions. It’s a mental distraction technique that reduces the amount of pain the brain registers and allows your body to work efficiently. The brain may be limited to your body, but the mind is not. It spans the universe and can fly away from a situation, be playful, consoling, or switched off.

To build a picture of mental retreat, I start by asking the mother to imagine a place where she remembers feeling truly relaxed. For many, this is a holiday memory – stretched out on a sandy beach at sunset or lying under a tree in a garden, singling in a hammock. Then fill in the gaps of your dreamscape. How does the sun feel on your tummy? If you’re by the sea you may be able to taste salt in the air, or the essence of flowers in a garden. Your inner eye can see a peaceful garden, bringing into view all the things you love – the soft tickly grass, birds swooping and singing. Listen to the noises of the garden; it soothes your brain. Soak in the strength of being with a circle of trees, protected and cool.

The early hours of your birthing day can be spent visualising your garden. This feeling of peace that you create will balance your hormones and activate your parasympathetic nervous system, assisting the opening of your cervix. The balance of your sympathetic and parasympathetic nervous systems will ensure your baby feels calm, and as a result the mother will feel calm and confident too. When the baby feels relaxed it’s brain secretes hormones and endorphins that command the mother’s hypothalamus to excrete the birthing hormone, oxytocin. The placenta releases hormones that transform the cervix and surrounding tissue to a softly set jelly from 38 weeks onwards.

See your hypothalamus a shimmering blue lagoon. A cool, clam hypothalamus will send calming influences to the whole of your body, helping your uterus to work efficiently.

Kindred Spirit, September/October 2004

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