More than half of India’s babies are delivered using a Ceaserean section procedure – the recommended percentage is 10-15%. For women from all socio-economic backgrounds, the commercialization of childbirth makes it a process fraught with risks and exploitation.
One organisation wants to change this by changing how childbirth is carried out. The Bangalore Birth Network (BBN) believes that childbirth needs to be supported rather than managed, and should not be treated as a high-risk condition that is over-medicalised at every step.
Meghana Naidu, Director of Operations, says,
“Childbirth needs a safe and supported system for the mother’s body to do what it is naturally equipped to do.”
BBN reaches out to all groups of women: from those who are computer-savvy and English-speaking, to those who belong to disadvantaged socio-economic groups. Meghana says they all face different problems, ranging from being made to change hospitals during active labour, to not having access to doctors.
In addition to these women, BBN also engages the healthcare system around childbirth. Doctors, nurses, hospital administrations and birth professionals such as doulas—non-medical birth companions and supporters—and lactation consultants are all part of the network.
One milestone BBN had while engaging with the system was the training programme they organised during World Breastfeeding Week, the first week of August. The training programme taught 150 nursing students skills related to lactation support, including soft skills. BBN targeted students because sensitivity on these issues is easier to build when the trainees are young. For most women, BBN says, nurses provide the only lactation support available. The programme ran for two years and was well-received by the hospital administration as well as the students.
Born out of a need
BBN developed out of a small volunteer group of women that was started in 2007. These women realised that there was not enough conversation happening around childbirth issues. Thus the co-founders included a midwife, a doula, and a birth educator among others. They wanted to create a space that would transform childbirth for women irrespective of their background or identity.
Counselling for better births
BBN runs a direct phone line for one-on-one counselling. This phone line receives a wide variety of calls – women trying for a second pregnancy, women anxious about giving birth vaginally after having a C-section their first time, expectant mothers looking to avoid unnecessary ultrasounds. BBN provides recommendations on doctors and hospitals best suited to the particular caller’s needs, based on a wide range of feedback it has collected over the years. Its recommendations don’t guarantee a perfect childbirth experience, but they aim to make people better placed to make their own childbirth decisions.
The original intention to set up BBN – starting a conversation around childbirth – is today being carried out over social media. Through a combination of evidence that BBN puts out, and other women sharing their stories over the network, women are able to find the confidence to not quietly submit to disrespectful care.
Preventing abuse during childbirth
While there is over-medicalisation of childbirth at one end of the socio-economic spectrum, the other end faces more basic challenges. A large proportion of women do not end up giving birth in hospitals. Meghana says, “It is important to think about why women don’t want to give birth in hospitals. Even well-off expectant mothers face abuse and exploitation at hospitals sometimes; imagine how bad it can get for a poor woman.”
A year-and-a-half ago, BBN was approached by a woman who had been following their work closely. This woman was Janhavi Nilekani, one of the largest shareholders in Infosys, and today a student at Harvard. Janhavi provided seed funding that allowed BBN to change from a volunteer organisation to a structured NGO.
Along with hurdles
Meghana feels that there is a lack of support system for NGOs in India. “Other countries have strong peer support networks that allow NGOs to share thoughts, resources and expertise. In India, several NGOs function, but there is no comprehensive, central support system for these organisations,” she says, “Besides, there is an inherent mistrust of NGOs. People need to realise that NGOs do some commendable, acutely necessary work.”
Looking to the future
BBN, Meghana says, keeps going back to two basic principles of childbirth while deciding strategy. “Respectful care and informed decision-making are the fundamentals on which maternal healthcare needs to be built. Informed decision-making means treating every mother as a unique person with her own sets of characteristics, and including the mother and family in decision-making. Not every decision is the doctor’s alone to make.”
In the next five years, BBN has many goals to fulfill. It wants to build a legion of birth professionals; it wants to provide mothers with more choices, apart from just hospitals; it wants to see more birthing centres come up.
“Ultimately,” Meghana says, “although we work in Bengaluru, these issues are common across the country. And we really want to create a positive birth movement for women everywhere.”