Islamic Birthing (2): Assisted Birth vs. Unassisted Birth | Janet Kozak

Maryam’s Birth Story

WHEN WE LOOK to the story of Maryam (Mary, mother of ¢Îsa/Jesus) we find that she was first and foremost a women of piety and respect. We learn that her life was dedicated to the service of Allah by her mother who was blessed with a righteous, purified and blessed child in spite of the fact that Maryam’s father was in his old age and it had been believed that his wife was barren.

It is mentioned in Tafsîr ibn Kathîr that Maryam’s mother dedicated her child, Maryam, to the service of the Masjid of the Sacred House in Jerusalem. Many in the family similarly had been called to serve in that way. Maryam was also well-known for her remarkable acts of worship, devotion, and perseverance.

When she was tested with the news of her pregnancy (Sûrat Maryam, 19:19)—though still a virgin—she bore the trial of it with perseverance and patience (Sûrat Maryam, 19:20). When it finally came time to deliver her son, she moved out and away from her tribe and from her fellow villagers, to be alone in her labor and supplications. (Sûrat Maryam, 19:22), as she had done earlier before the miracle of her pregnancy (Sûrat Maryam, 19:16).

Guidance from the Story of Maryam’s Labor

Maryam ate well in her pregnancy. It’s reported that every time her guardian Zakariyyah came to her, she was found to be supplied with a variety of foods, some, arguably out of season or somehow miraculously placed with her. Otherwise Zakariyyah would not have questioned her thus:

…Every time that he entered [her] chamber to see her, he found her supplied with sustenance. He said: ‘O Mary! Whence [comes] this to you?’ She said: ‘From Allah: for Allah provides sustenance to whom He pleases without measure.’ [Sûrat Âl ¢Imrân, 3:37]

Pregnancy is not a time to be restrictive in one’s diet. An abundance of fruits, vegetables, grains, meats and legumes is essential for a healthy pregnancy, a healthy baby, and a complication-free pregnancy and birth. Malnutrition during pregnancy is to be avoided at all costs because not only does it cause harm to the mother–-it also causes irreparable harm to the developing baby, as well. Unfortunately, malnutrition in pregnancy can result in abnormal development, low birth weight, and other weaknesses-–leaving the infant more at risk to contract infectious diseases after birth. Malnutrition can also compromise the mother’s ability to successfully birth her child with strength and vigor-–and in extreme cases can result in conditions like painful stigmatizing conditions like obstetric fistulas.

From Maryam’s birth story we also learn that it is not only allowed, but encouraged, to eat and drink during labor (something many hospitals won’t permit). Allah specifically gave Maryam a spring of cool water to drink from and encouraged her to eat the dates she was able to shake from the tree above her (Sûrat Maryam, 19:24-26).

Incidentally, studies from Jordan and Iran have found that dates consumed before and during labor not only shorten the labor process, but can lessen post-partum hemorrhaging as well 9 – in addition to being an excellent source of calories for an exhaustively laboring woman.

From Maryam’s example we learn that moving around (as opposed to laying on a hospital bed–which closes the pelvic outlet), also known as “active birth,” is the preferred activity in labor. Additionally,  a standing, kneeling, or squatting position, which Maryam ostensibly needed to be in when she grabbed the palm tree towards her–is an optimal position to maximize the effect of gravity and the work of the contracting uterus.

From the recount of Maryam’s birth we also learn that there will come a time in the labor when the mother feels she just can’t go on. In that climatic moment Mary exclaimed: Oh, I wish I had died before this and was in oblivion, forgotten [Sûrat Maryam, 19:23]. We learn that this heightened emotional state is completely normal and not a sign of anything that needs to be fixed. However, if experienced helpers are there assisting in the birth, then laboring women can be coached through it.

Maryam provides the most excellent example of a woman trusting her natural instinct and taking the steps needed to have the safest, fastest, and most effective labor and birth experience.

RETURNING TO A MORE NATURAL BIRTH PROCESS

Range of Birthing Choices

In their searches for less traumatic and more empowering births, many Muslim women may find a variety of options and coaches to suit their individual needs. These helper-aids and alternative [to hospital] locations can include: midwives/ doulas, designated birth spaces (like birthing centers or water-birthing centers);

and even various forms of  the home-birth experience, with or without other guides and assistants present.

To guide you through the choices, here is a breakdown, with brief definitions, histories, and explanations of the various active care-giving roles and responsibilities.

Doulas – Non-medical Birth Attendants

The word doula is a Greek word meaning “women’s servant.” Millennia of women serving women during childbirth and throughout the postpartum period have proven that support from other women has a positive impact on the process of labor. Doulas can offer emotional, physical, and informational support throughout pregnancy and delivery. They also act as an advocate for the mother when she is unable to speak for herself.

Doulas support mothers who are expecting a child, are experiencing labor, or have recently given birth.  A doula’s purpose is to help create a safe, memorable, and empowering birthing experience. Doulas may also sometimes be referred to as labor companions, labor support specialists, birth professionals, birth assistants, or labor assistants. There are also antepartum doulas and postpartum doulas.

While doulas do not provide any type of medical care, they are deeply knowledgeable about the emotional and physiological aspects of labor and delivery. They usually help prepare mothers for the marathon of labor by making themselves available to answer questions, addressing fears or concerns, sharing books and other resources, and helping mothers draft their birth plans.

Doulas can be instrumental in helping their clients gain better understanding of any potential procedures, or complications of pregnancy or delivery. Doulas are ideally in constant and close proximity to the mother during labor and delivery to encourage partner participation, reassure the mother, and provide comfort. Their assistance can also come in the form of non-medicinal pain relief techniques including; guided breathing, relaxation methods, massage, belly and back support, gentle cues to try other laboring positions, and reminders to eat and drink for strength and stamina.

A doula acts as an advocate for the mother, encouraging, reminding and helping her fulfill specific desired outcomes that she might have for her birth. The ultimate goal of a doula is to help the mother experience a positive and safe birth. Many labor doulas will also spend some time, after the birth, helping mothers begin the breastfeeding process and will encourage bonding between the new baby and other family members.

Doulas may or may not be certified, and may or may not belong to any number of professional organizations. Because they are practicing as support-persons during pregnancy, labor and birth, they are not, by law, required to gain certification–as they are also not, by law, allowed to perform any “medical procedures” or to recommend treatments or care. Their role is to support and educate, letting mothers and families make their own informed decisions.

There are many professional organizations from which to search for trained doulas including; AMANI Birth, DONA International, CAPPA, and dozens of other regional certificating organizations.

There are documented benefits of having a doula present during labor. With the support of a doula, women:

  • are far less likely to have pain relief medications administered
  • are far less likely to have a caesarean (delivery in which the mother’s abdomen and womb are surgically opened)
  • are far less likely to have an instrumental vaginal birth

Thus, they have reported having an overall more positive childbirth experience.10

Women with a birth team that includes a doula also

  • have shorter labors
  • are less likely to use analgesia
  • are less likely to have a baby with a low 5-minute Apgar score (https://en.wikipedia.org/wiki/Apgar_score).

These are all positive outcomes that translate into reduced risks of serious complications for both mother and child.

The Husband’s Role

A doula’s role is not intended to take the place of husbands in labor. Doulas are there to complement and enhance the whole experience. Today, more and more husbands are actually choosing to take an active role in the birth process. However, sometimes due to personal or cultural inhibitions, husbands may prefer to be nearby to observe the delivery, or offer additional emotional support, without having to act as labor coach.

The husband, from an Islamic standpoint, has a degree of protection over his wife and children.11 A husband needs to understand that he can’t properly and fully protect, help, and care for his wife and unborn child if he is not in the room for the delivery at the critical moments, nor when he is ignorant about the natural process of labor and birth. Just as a husband (hopefully) wouldn’t go into a used car lot to buy a car completely uneducated about the basic mechanics of a properly functioning car, similarly, a man should not fail to undertake the much more important task of educating himself about pregnancy, labor, and child-rearing with as much, or more, enthusiasm and solemnity.

The husband needs to understand the normal process of labor and birth so that he can make sound decisions and judgments if needed–especially if his wife becomes fatigued, injured, or unable to make the best decisions–as pregnancy and labor progress.

Midwives – Trained Labor Professionals

Midwives are the historical and traditional care providers for mothers and infants. Midwives possess expertise and skills in teaching women how to maintain healthy pregnancies, assisting women with their birth experience, and supporting women with recovery during the postpartum period. Midwives deliver individualized care plans that are unique to each woman’s physical, emotional, spiritual, and cultural needs. Midwifery is woman-centered and an empowering model of maternity care that is utilized in all of the countries of the world including countries with some of the best maternal and infant outcomes such as the Netherlands, the United Kingdom and Canada.

Midwives in the United States

There are approximately 15,000 practicing midwives in the United States. Midwives are known to practice in private homes, private clinics, birth centers, and in hospitals. In most countries, midwives are the primary health care providers for maternity care and women’s health care. However, in the USA only slightly more than 10% of births are attended by midwives. Countries that employ midwives as the primary health care providers are also the countries where mothers and infants outcomes are at their best. The United States has a higher infant mortality rate than any of the other 27 top-ranking wealthy countries, according to a September, 2014 report from the Centers for Disease Control. A baby born in the U.S. is nearly three times as likely to die during her first year of life as one born in Finland or Japan–due in part to a lack of in-home nurse visits in the crucial early years that other countries offer to more of their citizens.

Midwives Nurture Relationships with Women

Midwives put great value in developing trusting, working relationships with the women and families they serve and strive to create a relationship of open communication. In the process of developing their relationships, midwives may provide personalized and all-inclusive care, meeting a mother and child’s needs on many levels. They may counsel on matters related to preconception, pregnancy, labor, birth, postpartum, and beyond. Many midwives provide primary health care, gynecological care, and follow-up care of the normal newborn as well. Some midwives will also prescribe medications including family planning and contraceptive methods.

As trained medical professionals they are able to conduct comprehensive physical exams and order laboratory, screening, and other diagnostic tests. Midwives may also provide wide-ranging health care education and counseling on important issues and decisions by engaging in shared decision-making with the women and families they serve.

… We continue, inshâ’Allah, in Part 3 with more on birthing choices…

 

 

 

Written By

Janet Kozak, is an award-winning artist, designer, author, activist, and educator. Her articles, artwork, and interviews have been featured in The Huffington Post, Azizah Magazine, Aquila Style, SISTERS Magazine, Islamic Art & Architecture and more. She is currently working on collaborations with leading artists around the globe and a creating a series of collages addressing domestic violence in Muslim communities. Her lecture topic Financial Abuse: The Reason We Stay will was presented at the 2nd International Conference on Women Empowerment in Karachi, Pakistan. When not art-making or helping clients with content marketing, she can be found lending her talents to a variety of non-profit organizations.

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