Water and Birth in Mumbai

This is the story of our son’s birth from the perspective of my husband, Robert D Stephens. 

18 May 2016

This is a story of water and birth.

Bombay has always struggled with water. Getting clean water in, and getting dirty water out – these basics have proven the bane of millions for more than three centuries. An 1852 document entitled “Report on the Water Supply of Bombay City” details nearly a dozens infrastructure plans proposed to solve the cities water problems. The vast majority of proposals, and certainly all of the schemes that were executed, relied on some form of imported mechanics from Europe – the latest and greatest of a finite man’s imagination – and an efficient system for moving a precious resource from one point to another. But what if, in the race for efficiency (and profit), the value of the unseen, the spiritual, and the value of individual ideals is washed away?

We shall return to the water shortly (even if the water shall not return to us).

Bombay is struggling with birth. When we found out Tina was pregnant, we searched for midwives in Mumbai. Surely, in a city of 20 million people, there would be a few dozen midwives? We found 3. And last night, in a kiddie swimming pool in the living room of our 500 square foot rented flat, we welcomed Kairav Stephens into the world after 19 hours of labour. Unfortunately, the midwives will be leaving Mumbai by the end of this July which means, to the best of our knowledge, Kairav will have been the last Mumbai homebirth assisted by midwives for the forseeable future. And what a farewell it was!

Kairav and Tina began their journey together yesterday at 4.30 am. Gentle to moderate surges welcomed the early morning sunrise, and by 5 am Tina was having surges every 15 to 20 minutes. Kairav was on the move.

So, coming back…..10.30 am midwife arrives. I’m ready to go. I’m ready to hear Tina talk about the surges she is having. Common….lets goo….!!!!! Midwife comes in, sits on the couch, and says “You know, I know a couple that lives the next building over, I think y’all would make really great friends…he or she does X,Y,Z…” and she goes on to explain their jobs and interests, while I hear “blah blah blah blah blah.” Excuse me….We have better things to talk about!

But of course, like a good and experienced midwife, she is setting a pace, she is supporting the natural setting in which Tina has aspired to give birth. I’m ready to fire the rocketship and take off for the sprint. The midwife is drinking lots of fluids for the marathon. I mentally realize my flaw and release gratitude hormones throughout my body for having such wise care providers. What better way to live out one of the most meaningful days of ones’ life.

We did, after 15 minutes, get around to talking about the surges. Midwife madam listens, nods, and then says, OK, sounds good. Give me a call if you need anything, I’ll be at home. And off she goes.

In the midst of our midwife chat, a prospective cook arrives. Tina loves cooking. She has a huge mancrush on Michael Pollan (me = jealous…..jealous….jealous…..) And I love that because in addition to eating good food, it means Tina has really fixed me up in terms of my nutrition. I don’t get sick near as much as I used to. And generally, I feel better in my physical being. Perhaps it is because of Tina’s love for good wholesome (as much organic as possible) food, that Kairav is, thus far, chak-a-chak healthy. No internal checkups, no ultrasounds, no medical supplements. Just good wholesome food for years before conceiving, good food during pregnancy, and cast iron cookingware. Tina’s iron levels were HUGE…. over 12 or something like that – as a layman I understood that to be HUGE.

So the cook arrives. We like her. We chat. We finalize salary. When can you start? Right now? Yes….right now. Great! Thanks so much. And into the kitchen she goes. Little did we know, had she not come that morning, we would not have had such lovely food to eat that afternoon and today, when we needed it the most. Thank you God for your providing for us, and knowing every detail of our lives!

Midwife leaves. Cook cooks. Tina surges. Mucus plug comes out. I hold her. I press her back. I let her know that she is doing wonderfully. Tina is an introvert, and I’m a moderate extrovert who is discovering and accentuating my introverted qualities thanks to Tina, so that means we find joy in whispering to one another. Others often tell us to speak up, but we just speak very gently. So now is the time, we whisper. To calm the intensity of surges, and to also prepare for Kairav’s arrival. We want Kairav to enter a world very similar to the womb…quiet (well, most of the time) and dim. We want Kairav’s transition to be gentle. Life is tough, especially when you are a little person.

Midwife returns at 6.00 pm. Tina has been surging for about 13 hours now. Intensity picks up, and duration between surges decreases. Labour is progressing. Blood pressures are checked. Fetal Heart rate is checked. All is first class – chak-a-chak. Kairav is barrelling down.

We discuss and determine it is time to break out the kiddie pool. I lay cushiony cloths on the floor, followed by a rubber mat which will protect the cushions from being stained by the colours of life giving fluids. I inflate the pool, we are good to go. Now the Water. The water. We discussed water a lot. This was Tina’s only road-block to a home birth. The amount of water it would take to fill up the kiddie pool. In a country suffering from a drought, was it appropriate to use so much water for one person? This is one of the many things I love about Tina. She believes that loving your neighbour is not limited to being nice to them, but extends to realizing that every decision you make, every way in which you use resources affects your neighbour. The types of things we buy (plastic versus natural material), the types of trash we generate, and the way we use natural resources – it all has a very DIRECT impact on our neighbor – near and far. After much discussion, we determine that, given the limited number of times this event will come, it is responsible to use water for a home birth.

The filling starts. Lots of tap water with buckets of hot water. At 7 pm the door bell rings. Who in the world could that be? The second midwife (she had arrive around 6.30 pm) opens the door…she hands me a piece of paper. A society notice…it reads: “Due to drought conditions throughout Maharashtra, the BMC will be limiting water supply to the city. Water Cut will be in effect from 11 pm – 6.00 am, starting today.” Wow. Bombay, you never cease to amaze me. Had the water cut been one day before, or Kairav, one day later, the whole plan would have fallen apart. Thank you God again for delighting in every detail of our lives, way beyond what we can imagine.

By 8 pm the pool is full. Temperature is set. Surges are getting stronger. Tina is moaning louder. She gets into the pool….Ahhhhh…. it feels good she says. We go through a number of surges in the pool. Midwives check fetal heart rate again…they have to place the monitor lower to catch the heart. Kairav is moving down. One of the midwives presses on Tina’s back while I am getting some more hot water for the pool. Tina loves the back press from the midwife so we switch jobs for a while. I pour water on Tina’s back while the midwife puts good pressure on Tina’s lower back. She would do this for the next 3 hours, for every surge. How she managed I have no idea – exhausting!

The pot does the job of giving Tina some much needed rest. Now time for a new position with the midwives around (only Tina and I could fit in our bathroom). We move to the bedroom. Tina is on the bed, on all fours. Her water bag bursts while I am in the kitchen managing water – I was storing up water for the evening because I knew that after 11 pm we would not have any water – and if it was not planned now, we would have a problem. The bag breaks, and falls onto an incontinence pad we had placed on the bed. Just a few months before my grandma had given us the incontinence pads – which she had bought for my grandfather who was dying and whose body could not control his motions. The reusable pads initially intended to be used for someone leaving life now became part of the journey of new life. And fit beautifully in with Tina’s values of using resources as responsibly as possible, even and especially in the little things.

The bag breaks. Surges intensify further. Tina starts saying she can’t go on. I whisper that she can, and that she will be seeing Monksky soon (our nickname for Kairav). Tina feels down to see if she can feel the head – no such success, and she starts become discouraged. Nothing is happening (so she felt). What to do? She wants to go back into the pool. She gets back in. Surges intensify. It is now time for transition. The stage in labour where women are convinced they CANNOT do it. Tina says it at least 5 times. The midwives say “but you ARE doing it.” And they are right. Kairav is moving down. Further and further. The midwives recommend that Tina transitions from breathing with the surges to pushing with the surges. Tina would later tell me that, during this stage of pushing, she felt as if her whole body would be split in two. It is a feeling of absolute vulnerability. Tina knows there is no choice but to push on. She puts her head down and pushes surge after surge. There appears to be no progress. Tina screams with each surge.

Then, at 11.50, the midwife says “Oh my, there’s your baby!” The head and an arm is out. This was the hiccup. Kairav was not content on just bringing his head out first and then shoulders and then lower body…Kai Kai wanted to wave to everyone simultaneously, so just decided to make it a little bit more complicated for Mama – arm and head coming out together! By this stage, Tina knows she and Kairav are almost there. During the last bit of surges I remember thinking to myself that birth is a mysterious and powerful experience. There has to be a special bond which is forged, perhaps in the unseen places (spiritual?), between two people when they go through such an experience together.

At 11.54pm Kairav Stephens comes fully out and is quickly grasped by Mama, Tina Nandi Stephens, and held in her arms. The lights are very low, and we whisper to Kairav. He is exploring his new surroundings – what a world it is. It is silent. It is dark. Is this Bombay? Really? So peaceful? So quiet?

I would hold Kairav shortly thereafter (after I cut the cord – which was done after it stopped pulsating). He would take the opportunity to plaster my boxers and my stomach with Meconium, the first poop – a black tar like substance which is really really difficult to clean!

One of the midwives would sleep on our living room floor after all the day’s events (actually, under the same spot where Kairav was born), and spend the morning with us – checking vitals, guiding on feeding, and most importantly, just being present to love and support as needed.

This morning the cook came again …….. she was a bit stunned. What?!?! How?!?! The Doctor let you out of the hospital so fast?….oh golly, where do we begin…. with chicken curry of course……..(and whatever happens, do NOT tell the cook that the bag of frozen something in the freezer is the placenta – there is a good chance she may not come back!)

The water supply of Bombay teaches us the limitations of mechanical solutions made by finite men. Birth itself is a solution of infinite capabilities, not the problem. May we all learn to encourage women to seek and discover this truth.

Glossary:

Homebirth: a birth that takes place at home.

Kairav: boy’s name meaning “born of water.”

Surge: another name for a contraction – does not have a negative connotation as some women find the word “contraction” to have.

About the family:

Tina Nandi Stephens is a full-time Mama. She is also a photographer www.borninbombay.org and www.tinanandi.com . In addition to taking care of Kairav and her husband, she is also working with Birth India (www.birthindia.org) to help plan the Human Rights In Childbirth Conference, to be held in Mumbai in February 2017.

Robert Stephens is a Principal at RMA Architects (www.RMAarchitects.com) He recently started an instagram account to document his collection of aerial photography and archival books of Indian cities – you can follow him @UrbsIndis.

Kairav Stephens is a full time baby. He and his family are based in Bombay.

Mumbai Midwife has been active in Bombay since 2007. They are leaving Mumbai this July 2016, but hope to be back in due time. You can followup them on Twitter and Facebook:

Our supporting obstetrician was available to serve us should the need for her skill set arise. This is a unique setup of Midwives and an Obstetrician partnering together – it would be wonderful to see such a collaboration happen in a systematic manner throughout India (and why not the world as well). Perhaps one day…