Dr. Vijaya Krishnan – Championing Natural Birthing In India
Five years ago, I birthed my son naturally at Dr. Vijaya Krishnan’s Healthy Mother Sanctum Natural Birth Center in Hyderabad. At that time, The Sanctum was within the premises of JJ Hospital – a tiny pod compared to the independent, sprawling and beautiful center that it’s become now. My birthing experience was empowering and tender, and I have always hoped that more mothers would give this kind of ‘Warrior Queen’ #naturalbirthing a shot.
Dr. Vijaya Krishnan - the lady in red
Today, I’ve invited Dr. Vijaya Krishnan to spread her light and share more about her work & how natural birthing can be a life-changing experience for mothers and babies.
Hello! Thank you for taking time out to join us at www.GorgeousGirlsGoGreen.com, an online magazine for women about natural wellness & green living.
C. Please tell us about what you do.
V. Thank for this opportunity to talk about the work that we do. I am a Certified Professional Midwife, and along with my husband, own and run a Natural Birth Center in Hyderabad, India.
C. How did you decide on this vocation & what has your journey been like (from training to setting up at JJ Hospital to setting up your own center)?
V. I have been a clinician for more than 25 years now. But, the journey to Midwifery started after the birth of my own 2 sons. My first son was born by an emergency C-section. That was a much needed C-section, and it saved his life. However, there was a part of me which so wanted a natural birth, and so when I got pregnant again, I asked my doctor about having a normal delivery this time around. We were in the US then, and my doctor was one of the few doctors there, who was into helping women have a VBAC (Vaginal birth after Cesarean Section). And, I had a very empowering VBAC birth. As I prepared for this birth, I had turned to Lamaze and got to know the amazing benefits of birth preparation. With my boys still young, I started teaching Lamaze classes informally from my home, and that would be the start to my career change to becoming a Midwife!
Meantime, we shifted back to India. And, as a part of my research project, I started to talk to women in a big corporate hospital in Hyderabad, about what information they were receiving regarding childbirth. The answer astounded me – ZERO. Women would wait for hours to “see” their care provider, who then would really not “see” them. A scan done. Medicines prescribed, scans prescribed. And no talk about what birth entails, not only that, not many of their questions would be answered, and they would go back home with more questions than answers, and perhaps more fear! From here, they had already outsourced their body to their care provider, and of course C-section rates, were sky high!
That was late 2007. We started with Lamaze classes to educate and empower women and their families about choices in childbirth, and also to help dispel myths about pregnancy and birth. While we had started teaching classes independently. In 2008, I came to know about Dr. Jayanthi Reddy and met with her. She was very much into promoting Lamaze classes, and also wanted to do something about her C-section rates, which were nearly 83% at that time. We still wanted our classes to remain independent, so that we could teach the true Lamaze healthy birth practices, so we just rented space from them at her hospital to teach classes. However, 80-90% of those who took those classes landed up with unnecessary interventions and C-sections, as they went back into the same medical system!
Slowly, parents started asking us, where they could get to experience the kind of birth practices that we talked about. This spurred us on, and by end of 2008, we started talks with Dr. Jayanthi to see if we could start a Midwife-led Birth Center. This would be the first of its kind Birth Center in India. It would be based on a Collaborative Model of Care – giving the Mother the best of two worlds. It would be a Midwife-owned, Midwife-Led Birth Center, but it would come with the Safety net offered by on site back obstetric infrastructure and services, in case of a true emergency! That would not only lead to women getting safe, respectful maternity care, and excellent natural birth outcomes, but would also give her the continuity of care that made her feel safe, even if there was an emergency. This was a revolutionary concept at that time. No one in India had heard about independent Midwife-Led Birth Center, with this kind of collaboration! So, in April 2009, we opened our door – The Sanctum @ JJ Hospital was born.
Our statistics speak for itself. Since then, we have 93% Natural birth rates. Due to our Collabortive Model of care, we serve not only the average low risk pregnant woman, but also women with gestational diabetes, gestational hypertension, twins, breech, and many other women with complex needs. Our VBAC success rates stand at 96% (No, once a Cesarean, most definitely does not mean a repeat cesarean!). We have even helped mothers with 2 previous C-sections, have natural births. Waterbirths are routine at our Birth Center, the very first waterbirth happened in 2009, when everyone else was questioning or unaware of the benefits of this gentle birth practice!
We continued teaching Lamaze classes, and we also became the first Lamaze Accredited Program in the country to teach other childbirth educators, so that they could emepower women across India. Today, most of India’s Lamaze Certified Childbirth Educators are alumini of our Healthy Mother Lamaze Accredited Childbirth Educator Program.
We also realized that women needed support in the postpartum phase. To help them we started a peer support system – this would become the Healthy Mother Breastfeeding Support Network. Today it serves 1000s of women in the sensitive immediate postpartum phase, but also is a wonderful peer support system in their motherhood journeys.
As we grew, one more important thing happened. Dr. Jayanthi started incorporating some of our birth practices in her practice, and her C-section rate today stands at 53% (from a high of 80% in 2009)! Slowly and steadily, we have helped make changes to not only her practice, but to all others in our community as well!
The Sanctum Natural Birth Center, Hyderabad
Finally, as we outgrew our space, we moved into our freestanding birth center in November of 2016. This is India’s first free standing Autonomous, Midwife-Led Birth Center – The Sanctum Natural Birth Center – with emergency infrastructure on site. With our now partner, Dr. Jayanthi Reddy, we have established this birth center, to have all professionals on call – We have OBGyns, Anesthesiologists, Physicians, Pediatricians on call 24x7. We also have a Level 1 NICU on site, and we run a pediatric clinic as well. Our Gyneacologists run a complete women–centric practice treating infertility, and other gynecological issues from adolescence to menopause.
Our Midwifery practice provides holistic care to women from preconception, antenatal check ups to labor and birth, and postpartum care, lactation counseling, we help women with a particular focus on wellness.
In terms of Wellness services, we provide end-to-end wellness services to Women. Lamaze childbirth classes, prenatal yoga, prenatal aerobics, postnatal weightloss, postnatal abdominal strengthening programs, lactation counseling, prenatal and postnatal massage services, to infant massage training programs, to Women’s only physiotherapy services, we provide every one of these services tailor made to individual needs!
C. What is the entire philosophy behind natural birthing and how does Healthy Mother facilitate this for moms today?
V. We, at The Sanctum Natural Birth Center, believe that Birth IS SACRED. We believe a woman has the right to choose the manner in which she wants to give birth safely, and be fully involved in the decision making process. We believe women’s bodies have the innate wisdom to give birth naturally, without unnecessary interventions, if they are supported by trained knowledgeable Midwives whose only interest is the well being of mother and baby. We believe that Mothers know how to give birth, and babies know how to be born, and that if mother are supported, encouraged and monitored as needed, she will be able to birth her baby with peace, privacy and dignity, if there is no real medical emergency, which happens only rarely. We believe trained, INDEPENDENT MIDWIVES are the best advocates for moms, babies and their families, and are experts in the Science of Normal Birth.
Midwives care for the physical and emotional well being of expecting mothers, and are the single most steadfast, round the clock source of counsel, support, encouragement and knowledgeable care during pregnancy, childbirth, new motherhood and beyond.
The Scientific Midwifery Model of Care practiced at The Sanctum is testimony to the fact that we have the highest rate of natural births in the country. This practice is rooted in the best scientific, evidence-based research and practice, which is recommended by public health institutions such as World Health Organization. We are the pioneers of this model of care in India and only among a handful of such Birthing Centers across the world. We consider the mother as the center of our care universe and are available for her at all times, during day or night, 365 days in a year. In addition to the mother’s physical well being our midwives take great care to ensure her emotional, psychological and social support system and counsel, discuss and advise on any matter that mother may need help in. Our Midwifery care focuses on the promotion of health and the development of individual responsibility. Our Midwives take time to listen to women; we believe that childbearing is normal and that a woman and her family should create the birth experience that will be meaningful to them.
C. Can you share a few real life stories and snippets about natural birthing and how it’s a rare joy in today’s world?
V. Every birth that I have had the honor to attend is special! So it is very hard to point out to just a few. But let me give it a shot
- The VBAC birth where it was progressing super slowly, when we asked the Mamma to walk the corridors, she spontaneously broke into a Balle-balle dance between strong, hard contractions
- The Waterbirth where the mother, started chanting “Om Namo Bhagavate Vasudevaya” as she gently let her baby out into the water
- The moment of Birth where the Mother – an Emergency Room Physician herself, and battling to have a natural birth at 41 weeks and 3 days, despite Pregnancy Induced Hypertension – meets her daughter and says “Hello. I knew you were gorgeous, but not this gorgeous. Thank you for supporting me in my quest to have you naturally”
- The strong Mamma, whose husband was in the Middle East, and she working long and hard for a VBAC over 2 days. Never, never giving up, at one point, she takes a shower, comes out and applies “Ittar” all over her, and says innocently amidst strong labor contractions – “ I am trying to see, if perhaps my baby will be enticed by nice smells, to come out and meet me” – She looked so ethereal and beautiful and vulnerable and strong, all at once. And, yes some hours later, had her much wanted VBAC birth, skyping in her husband to meet their baby
- And finally, a strong, strong Mamma who worked so hard to have her baby girl after the C-section births of her two older boys. She at the moment of birth, smiling ear to ear, as my tears pour – saying “ I am finally victorious. My body works, and my woman (meaning her little girl) finally made me a woman”
- I dedicate this section to every mom who has labored to have their baby! You are all strong, amazing, powerful Mammas!
C. What are the challenges in this work?
V. Many. Round the clock being on call. Sleep wake hours have no meaning. Family functions, friends and parties come second to laboring moms needs. It is a lot of sacrifice. But holding space for women to help them have the best start to their families, is important not only for this generation, but for many generations to come. As they say, peace on earth, begins with birth!
Also, India is in dire need of professional midwives. And the Government must recognize Midwifery as a separate and independent profession, giving it licensure. Without this, Midwifery still remains as a less-understood profession. Not only this, we are losing mothers and babies daily. If there is a midwife for every woman, we could easily decrease our maternal mortality and morbidity statistics to one third of its current number immediately. This is a big challenge – to provide compassionate, respectful and safe maternity care, we just do not have enough qualified professional midwives in India.
Parents with their brand new baby at The Sanctum
C. How do you think that natural birthing is an empowering experience vis-à-vis a standard labor room/ opted C-sec experience?
V. When a mother is respected, given choices, supported 24x7, she owns her birth! It is that simple. Pizzas get delivered, not babies! However, in the labor room, the woman is made to lie down on the bed, unable to move. She finds herself in pain – when she moves, she is able to manage her pain better, and allows gravity to assist the movement of her baby down the birth canal. She is made to undergo multiple internal exams, which increase her pain and discomfort. There is no privacy. The doctor and nurses are in-charge of her birth. She is told to “co-operate”, whereas, it is actually the care provider who should be cooperating with her, to help her achieve a safe birth. She is told to push – whereas, she should be the one to say, “I feel like pushing now.” She is given a cut at the vagina mandatorily – whereas, this should be a very rare procedure. Medicines and drips and epidurals are given to her. Even if she does have a vaginal birth, most times, someone pushes with full force at the top of her belly, routinely – whereas actually, this should be only done in an emergency.
As soon as the baby is born, the cord is cut and the baby separated and put in a warmer – whereas actually, the pulsating cord carries almost 1/3 rd more blood to the baby, should it be left unsevered until it pulses. The baby should actually be on mother, skin-to-skin, so as to facilitate better thermal regulation, bonding and early breastfeeding, and to stimulate its own good microbiome. Lastly, feeling spent from all the procedures done to her, the mother feels, tired, listless, and powerless – whereas, she should be feeling a “high”, fully powerful, joyous, and capable – a memory she will potentially cherish for the rest of her lifetime! A medicated, intervened “normal” delivery on the labor table, is nothing that resembles to a powerful natural birth experience.
As far as an opted C-section, each to their own. However, there are tremendous bodies of research now, which point out that babies who are born by planned C-sections have not only the immediate increased risks of respiratory and digestive disorders, but also long term increased risks of compromised immunological systems, lower math skills (especially when born near term, 37-39 weeks), as well as increased risks of autism when medicines like Pitocin are used to induce the mother routinely. For the mother too, it carries increased risk – It is a major abdominal surgery. Short term risks of increased blood loss, infections, and readmissions apart, there are long term risks like miscarriages, ectopic pregnancies, placental attachment abnormalities. The fact is that it is a life saving surgery, and should be used as such. However, when used flippantly, or because of unnecessary fear, a mother’s risk of dying from a C-section, is thrice the risk during a natural birth. It is our moral and ethical responsibility as care providers to inform a healthy low-risk mother of all the pros and cons of having a major abdominal surgery!
C. If a mom-to-be comes to Healthy Mother for a natural birth, what is the experience like, right from the time she begins consulting/check-ups to the birth and after?
V. Our Antenatal Checkups are more of a Conversation between family members. We believe expecting couples must be given adequate time to express their concerns in a manner they are most comfortable with, and that we, as care providers must LISTEN with empathy and honesty. We believe it is our honor and privilege that couples choose us to be their care givers during one of the most important phases of their lives.
Therefore, our Antenatal Checkups last for more than an hour…… or as long as couples find assurance and answers to their most pressing questions. We avoid unnecessary tests and interventions during checkups. Emphasis is on good counseling, paying attention to moms physical as well as emotional health, her relationships around her and overall holistic well being, in addition to the progress of her pregnancy and growth of her baby.
While we use appropriate technology as required, we are not slaves of technology. We do not subject moms to numerous tests throughout their pregnancy, as in other places – rather, we believe in unobstrusive means of testing, often feeling baby’s size, growth with our hands and estimating to high degree of accuracy. At The Sanctum, The Mother is the most important person and we make sure that she and her baby receive the best care possible, and where she, as much as we, is a part of the care and decision making process.
The emphasis is on Holistic Care which improves birth outcomes. We provide parents with unbiased, education counselling through our Lamaze classes, which many couples say were “the game-changer”!! We chave a laser focus on Nutrition and Exercise on an individualized basis.
Another important thing: Throughout their pregnancy, moms receive care and counseling from the Same team of midwives. This promotes familiarity, trust, and closeness between moms and families and their care providers, which helps a great deal during labor and birth.
During Labor and Birth: All our nurses are cross trained to provide doula services (24X7 labor support). They, along with the midwives, provide emotional and physical support and encouragement until the baby is born. Fathers are also an integral part of this support system, and they too get to experience the birth of their baby! And, the mother births where she wishes, in the position and place that her body guides her to be in – Waterbirth or on the land, she is the “queen” of the birthing room, that day!
Postbirth: This seamless continuity of care, means that our team is there in the first hours post-birth, ensuring safety for mother and baby, but also plays a huge role into helping the mom transition into her role as a new mother. Breastfeeding help is immediate and continuous – No one gets discharged, without the Mother being able to confidently breastfeed. This translates into us having 100% Breastfeeding rates at discharge, 1 week and 6 weeks postpartum! And, when the mother comes to us at 6 week postpartum we counsel about child spacing options, as well as help her slowly achieve her exercise, fitness and weight loss goals!
C. Would you like to add anything?
V. No, I think I have said enough :-).
But, then a last word –
Birthing Women have the right to a beautiful birth experience. And, as Midwives, we are honored to provide that care and accompany them in their birth journey - with kindness, empathy and love!
To know more about Dr. Vijaya Krishnan’s natural birthing center, contact:
Healthy Mother Wellness & Care
The Sanctum, Natural Birth Center: 72071 68666 (M-F 9am - 5pm);