September 27, 2002

Birth in Bangkok

Hello from Thailand! Yesterday was a last-minute-getting-ready day and then travelling the 9 hours to Bangkok. I am having a few days here before heading off to the UK for a huge round of workshops (13 on all) and three conference appearances over the next 5 weeks. I’ll keep you posted on the current scene in the UK as I trek about to Scotland (twice), Ireland, Wales and many points in Britain.

During these few days in Bangkok I will have a chance to catch up with my close friends Melanie and Tanist Habanananda. Tanit is a Thai obstetrician and a crusading pioneer in this country for normal birth. Mel is a British childbirth educator who has been a major influence here as well. Together they established the first (and only) Birth Centre in Thailand at the Samitivej Hospital almost 20 years ago and this unit has a proud record of water births, normal births, great breastfeeding rates etc. It has also been a showcase for how birth can be as opposed to the very high rates of interventions that are part of the birth scene everywhere else in this country.

For women in most of South East Asia, births are managed in a very medicalised way, a legacy of old style US birth practice that has never been updated. Virtually 100% of women will experience shaves, enemas, lithotomy and episiotomy, labour alone in a shared room with little or no privacy and give birth in stirrups in a multi bedded 2nd stage area. There is no concept of midwifery care and birth is managed by a team of obstetric nurses who follow the doctors orders. Concepts such as consumerism in health care, choice as part of care, informed consent and woman-centred care are virtually unknown and not part of the culture in these countries.

Dr Tanit had his obstetric education in the UK (many doctors here learned their skills in the US) where he was exposed to quite different ways of doing things. He and Mel also had home births for their children and have read widely and seen many normal births. Many expat women in Bangkok seek our Dr Tanit’s care because he has a low interventions rate (3% caesarean section rate!) and encourages active birth. He is well known amongst medical circles here, often speaking to colleagues, and I’ve seen him demonstrate in their own hospitals with their clients how births can be achieved easily when off the bed.

I first met these wonderful people in the UK when Mel came to a workshop I presented in London in 1996 with a Thai nurse, Supriya Boonyagate, who was interested in birth. They had a great time and invited me to stop over in Bangkok and speak to the obstetricians on my way home. This I did, with success, and after that a very close bond has developed between us all. I have since facilitated many workshops in Thailand and my book Preparing for Birth is about to be released in Thai version. We travelled together to the big Humanisation of Birth Conference in Brazil in 2000 where we were speakers and have holidays together when we can. Mel and Tanit spend part of every year in the UK and the rest in Bangkok - an enviable lifestyle!

I’ll write some more about their work with the Childbirth and Breastfeeding Foundation of Thailand tomorrow, but today I am going to spend time lounging by the pool in the most sensational tropical garden paradise in the heart of Bangkok. An oasis in time and place.

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