The joy and hardship of birth

BALI—The Nusa Dua area of this island is the site of the International Conference on Family Planning (ICFP), which formally opened Monday (Jan. 25) with a keynote address by Indonesian President Joko Widodo.

Held every other year since 2009, the ICFP has, in the words of the organizers, “brought together the family planning community to share best practices, celebrate successes, and chart a course forward.” Theme for this year’s conference is “Global Commitments, Local Actions,” fusing the twin goals of the movement: getting the world’s governments, international institutions and multilateral agencies to commit both resources and political will to push the family planning agenda forward; and then translating these into local policies, programs and services.

It is also—in the words of Beth Schlachter, executive director of FP 2020 (which aims to reach an additional 100 million women and girls worldwide with family planning services and supplies)—a means to put family planning back into the limelight of world attention and official priorities.

Since the early 1990s, said Schlachter, huge chunks of the budget worldwide for reproductive health services have gone to address the HIV/AIDS crisis. As a consequence, family planning programs stagnated and in some countries, progress has even backslid. With the HIV/AIDS situation stabilizing in some countries (but not in the Philippines which is experiencing a resurgence of the disease), the world can now focus on spreading the message that family planning promotes the rights of women and children and improves their lives.

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By some sort of serendipity, I managed to stumble upon a TV documentary on my first night here about the births of four babies in different parts of the world: the United States, France, Cameroon and India.

As expected the scenarios highlighted the differences in the experiences of mothers and babies who went through the birthing experience in settings vastly different from one another. The mother in the United States gave birth, by caesarian section, to twin girls, attended by an obstetrician/gynecologist and a nurse/anesthesiologist, both of them male. In France, a midwife attended to the birth, but she had to call on a doctor to assist with a pair of forceps when the infant stalled in the birth canal. In India, the mother was brought to a Catholic hospital and attended to by a nun/matron. It took more than 10 hours for the baby to be delivered, with the husband and mother nervously fidgeting outside the delivery room. In Cameroon, the birth was presided over by a village midwife in a village birthing center with the most rudimentary of facilities. To weigh the infant—the eighth in line in the family—the midwife had to weigh herself first and then weigh herself again while carrying the infant.

But what struck me most were the commonalities in all four birth experiences: the anxiety and nervousness of the mothers, the easy air of competence that surrounded those assisting at the births, and their efforts to ease the women through their pain and uncertainty, and then the joy that surrounded the arrival of the babies. The Indian father was ecstatic at the birth of his son, vowing to make the world better for him. Would he have felt the same if he were holding a daughter?

Cushy or rudimentary, technologically advanced or pitifully simple, whatever the circumstance, the experience of pregnancy and birth is much the same. Would that every mother giving birth do so without fear of death or disability. And would that every baby born is wanted, desired and loved!

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On our first day in Bali, our group of women journalists, gathered by the Population Reference Bureau, joined other journos on a field visit to Yayasan Rama Sesana (YRS), a nonprofit, nongovernment sexual and reproductive health clinic located in Pasar Badung, Bali’s biggest traditional market.

Here, on the fourth floor of the structure, the YRS provides women, men and young people medical services and education sessions ranging from prenatal care, family planning and counseling, breast and cervical cancer prevention, and STIs, including HIV/AIDS.

Dr. Luk Putri Upudisari, known as “Dr. Sari” to her staff and clients, described the YRS as “like my second home,” seeing the clinic as a means to reach out to low-income Balinese women by giving them access to information and affordable health services. Founded in 1999, YRS serves an average of 520 clients a month, while mobile clinics reach an additional 120.

Why the focus on women? Because, said Dr. Sari, “women have less education, less income, less power and less time.” In a way, locating YRS in a big public market is bringing reproductive health services to where the women are, since the market is not just a place to find and buy foodstuff and household necessities, but also to meet with other women and exchange information and keep up-to-date on each other’s lives.

That morning, there was an education session going on and we found women standing in front of the group wearing aprons on which were imprinted diagrams of the reproductive system. The atmosphere was carefree, but the women seemed caught up in the lesson. Trusting women with information doesn’t just empower them, it can save their lives.

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CORRECTION. In last Sunday’s column, I wrote that both Ninoy Aquino and Sen. Juan Ponce Enrile belonged to the fraternity Upsilon Sigma Phi. I was wrong. Enrile is a member of Sigma Rho, and apparently I managed to offend both Upsilonians and Sigma Rhoans in the process. My apologies to them.

Forgive the senior moment. The other Upsilonian I was referring to was no less than the late dictator Ferdinand Marcos, which makes the irony I was going for even more dramatic.