Birth Community

Who Doesn't Like Babies?
by Avalon Moore

How interested would you be in kicking back and watching a movie if I were to tell you that it:

A) is a documentary,
B) has no dialogue (and the scraps of spoken language that can be heard aren't subtitled),
C) is not narrated, and
D) will last for more than an hour ?

Are you making this face right now? (Photo credit: Martin Burns)

Some of you might already be hooked--and some of you might be feeling your 'fight-or-flight' instinct kicking in nice and strong. But before those of you who belong to this second group give in to the overwhelming desire to flee, take a deep breath and read on. It's possible that you may yet change your minds.

The four main subjects of this film are, in and of themselves, a pretty strong draw. Who are they? Their names are Ponijao, Mari, Hattie and Bayar, and they all have one thing in common--and this one thing, without any effort on their part, makes them pretty damn likeable right from the get-go. In fact, you would probably like them at first sight. Just watch one of them yawn and (if you're at all like me) you'll feel a big rush of warm-and-fuzzy affection.

It's not this guy. (Photo credit: EverbodysDracula)

Why? The answer is in the film's title--Babies. In amidst the sharply contrasting backdrops of Tokyo's sky-scrapers, Namibia's village huts, the sweeping landscape of Mongolia, and the familiarity of the American urban scene, we watch as four babies navigate the first year of their lives. Director Thomas Balmes brings us right into the intimacy of family life: Mari's mother, in Japan, stroking her big round belly before Mari is born; in her Namibian village, Ponijao's mother holding her tiny newborn daughter in her hands; Bayar lying swaddled in a crib next to his exhausted mother in her hospital bed in Mongolia; Hattie and her mother lying so peacefully together in bed in San Francisco, mother stroking sleeping baby's belly. From their beginnings, the camera rarely strays from the four main characters, and we watch as in their vastly different environments they each go through the things that all babies go through (that we have all gone through)--the process of figuring out our own bodies and abilities, and the way the world around us works.

And how could you not? (Photo credit: Wikipedia)

An essential part of this film's beauty is its complete absorption in its subjects. The camera frame often stays focused directly on the baby's expressive face throughout a scene (for example, when Bayar's mother is angrily scolding him for making a mess, we don't see her, but we do see his uncomprehending eyes looking up at her, or when Hattie is meticulously peeling a banana in order to eat it, her dad--who is taking the peels she offers to him one by one--is just out of view). As viewers, while watching these four babies so closely, we come to share their perspective--and I found that the 'baby' way of understanding things sometimes made more sense than the 'adult' way did.

When Mari goes to the zoo for the first time and screams in terror when confronted with the close proximity of a gorilla and a tiger, I found myself thinking, 'Well, how reasonable of her. Why would she enjoy being within mauling distance of vicious predators?' When Hattie's mother brings her into the hot tub and Hattie is considerably freaked out, it suddenly seems clear that it should be disturbing to be dunked into overwhelmingly hot, loudly bubbling water.

Really now, who wouldn't scream? (Photo credit: GavinBell)

Now, even if you aren't the kind to be conquered by mere adorability--if the prospect of watching babies be babies for 75 minutes doesn't thrill you--the film's cultural aspects might still be sufficient bait to draw you in. In each of the four very different environments, Babies allows its viewers to witness the intimate details that constitute parenthood and early childhood within those cultures. There are touching moments of familiarity that transcend the geographical distances (the scenes of each of them crawling--that identical motion--across the ground in such different places; the way in which a loving parent coos to their baby). There are also moments of striking opposition. At one point in the film, the camera cuts between scenes of Hattie's father, in San Francisco, vacuuming the floor around her and then de-linting her, and Ponijao, the Namibian baby, sitting at her mother's feet, playing unimpeded in the sandy dirt, finding a bone, and then putting it into her mouth and sucking on it with curiosity.

This way of cutting between opposite approaches to parenthood (in this instance, the protective American model versus the much-less-so Namibian version) has the effect of redefining each, in relation to the other. Interestingly, I found that it made Hattie's father come across as the more extreme and bizarre parent in his behaviour--his North American concerns about maintaining sterile surroundings for his child appear odd and over-protective when compared with the complete lack of these worries in Ponijao's mother (especially since her baby seems just as happy and healthy as his does).

This, perhaps, is where Babies' most impressive quality lies: in its ability to take us as viewers and show us our own culture through entirely fresh eyes. When we see Bayar, in Mongolia, crawling between the legs of cows (with those big heavy hooves) and emerging completely unhurt and unworried, we are forced to wonder whether babies might be more resilient than we give them credit for in Western culture--that maybe we go too far, here, in our concerns over an infant's fragility and vulnerability.

Babies gives us a new point of view (Photo credit: starbooze)

Seeing the ways in which all four babies (especially Ponijao and Bayar, whose experiences in Namibia and Mongolia are less familiar to Canadian viewers) confront the world around them and venture happily into the unknown shows us the possibilities inherent in all of us, at the point where we are most elastic, adaptable and open. Watching each of them as they learn to babble, learn to crawl, and eventually learn to walk, we take part in their little sorrows and joys, and in the human universality of all of their defeats and triumphs. While watching Babies, it is as if we get to go back to being babies--to experience the beginning of life all over again, to see the world and everything in it as something fresh, strange and new.

Photo credit: SanShoot

So, even if you find the idea of a non-talking, un-narrated documentary to be somewhat daunting, keep in mind that this is not your run-of-the-mill documentary. It is an experience of four different countries and lifestyles, it is a warm basket full of warm-and-fuzzy baby moments, it is a hilarious look at the quirks and humour involved in human behaviour, and it is a new way of looking at the world and our own culture. So whether or not you are a person who loves babies, you still might love Babies.

Choices in Childbirth : Why They Should Exist
(But Don't) in Quebec Today

by Avalon Moore

Photo credit: The Jordan Collective

This past summer if you were in or around Montreal, or even if you were elsewhere in Canada, you may have heard about Heather Mattingsley, the Montreal mother who was asked by the province of Quebec to take a maternity test to prove that her newborn infant was in fact her own child. The government refused to issue a birth certificate until they felt certain of the newborn's parenthood. Heather Mattingsley's daughter was six months old by the time her existence was legally recognized by the province.

Why was Mattingsley's claim to her child so disputed by the government? It all came down to her choice of health care providers.

Like 25 % of women in Quebec, Heather Mattingsley wanted to have a midwife, and not a doctor, present at her child's birth. However, she found, as 80 % of women looking for a midwife in Montreal do, that the waiting lists at Montreal's two birthing centres were too long to accommodate her. In order to get the type of care that she wanted, Mattingsley turned to the network of underground midwifery, and hired an unregistered midwife. To get a birth certificate in Quebec, it was necessary at that time to have a doctor or a registered midwife attest to the birth; as Mattingsley could not get access to a legal midwife, and had made the choice not to have a doctor, neither was present at the birth, and Mattingsley could not obtain a birth certificate for her baby.

Since Heather Mattingsley's case, Quebec has attended to the surface cause of the problem, but not to the root issue. The requirements for obtaining a birth certificate have been changed (now, one needs only two signed statements of witnesses to the birth not related to the child), but a woman who wants access to the care of a registered midwife in Montreal still only has a 1/5 chance of getting it.

Photo credit: ChepeNicoli

The key word is registered. There isn't, at the moment, a significant lack of university-educated and well-trained midwives in Quebec; in fact, the 15 annual graduates of Quebec's only midwifery program, at l'Université de Québec à Trois Rivières, have severe difficulty in finding full-time employment upon graduation.

This means that both sides are losing: expectant mothers who want a midwife-supervised birth are unable to have one, and midwives who have spent years studying and attending births in order to be able to practice their profession cannot do so. It doesn't seem to make sense.

The barrier is actually fairly straightforward. There is a deficiency, not in the demand of mothers or in the supply of midwives, but in the number of birthing centres in the province. In Quebec, it is illegal for midwives to practice independently, and therefore birthing centres are an essential requirement for midwifery professionals who wish to practice their trade legally within the province. The lack thereof causes many midwives to seek work outside of Quebec (for example in Ontario, where midwifery is more established), or to turn to underground midwifery.

Obstetrical care is the other available option, however there is also a shortage of obstetricians in the province. One year ago in Le Soleil it was reported that the Association of Obstetricians and Gynaecologists of Quebec was too understaffed to adequately respond to the needs of the pregnant women of the province, and that the problem would only worsen over the next few years as many doctors reach retirement.

Photo credit: Voxphoto

The development of midwifery care in Quebec seems to be an obvious solution to this problem, as midwives could fill the gap left by a lack of obstetrics professionals. Additionally, while obstetricians are an important resource during the birthing process in order to deal with high-risk births and emergency situations, midwives put forward the case that for normal, low-risk pregnancies, there is no reason to turn primarily to hospital care. In fact, a Statistics Canada survey conducted in 2006 found that women who gave birth with a midwife were more satisfied with their birth experience than women who gave birth under the care of doctors and nurses.

One complaint which has been levelled against hospitalized birth is the pressure which is exercised within the hospital environment to medicalize the birthing process. Claudia Faille, the president of Regroupement Les Sages-Femmes du Québec commented during a CBC Radio interview that obstetrical care during pregnancy is the equivalent of seeing a pneumonia specialist for a cold. In the hospital environment, medical interventions are often used to treat what would otherwise be safe and natural childbirth processes.

One example of this tendency is the considerably high rate of caesarean births in Canada. The World Health Organisation recommends that the rate of C-sections should not exceed 10-15 %, and yet in Canada this percentage was at 17 % in 1995, and had risen to 23 % by 2003. In 2006, more than one in four (26 %) of all babies in Canada were born by caesarean. Giving birth by C-section is a serious surgery which involves varying lengths of recovery time and the possibility of risks and complications. According to a study done in 2006, three quarters of births in Canada involve medical intervention of one form or another (which could include inductions, C-sections, epidurals, etc.). While this form of childbirth has become part of the standard initial approach in Canadian hospitals, it is an experience which many women wish to avoid.

Photo credit: José Goulâo

Midwifery's stance is to treat childbirth as natural, and to resort to medical interventions only when it becomes absolutely necessary.

One quarter of women in Quebec would choose to approach childbirth in this fashion, with the help of a midwife, if they could. Yves Bolduc, the Minister of Health and Social Services, has been accused by the midwifery community of proceeding too slowly in the development of new birthing centres, which would allow all of those women to give birth in the manner and at the location of their choosing. In 2008, the provincial government announced a plan to build 13 new birthing centres by 2018, and to increase the percentage of women treated by midwives to 10 %; however, only 2 new birthing centres have in fact been opened in the four years since this promise was made (there is a total of 13 birthing centres in the province), and midwives care for only 2-3 % of women.

This past May, Bolduc announced his intention of accelerating the development of birthing centres, by changing the manner in which the projects would be financed (the previous system caused massive delays). He acknowledged that women should have access to the care of midwives if they would like it, and that they should be free to give birth in the location of their choosing.

Photo credit: Trevor Bair

For the women who are now pregnant in Montreal and elsewhere in Quebec, and who hope to give birth under the supervision of a midwife, these promises (though optimistic for the future) will not be fulfilled in time to give them the service which they want, and which they have a right to have. Many of these women may turn to the underground network of unregistered midwives for help, as Heather Mattingsley did, and others may be forced, against their wishes and by necessity, into hospital care.

When care by midwives has been shown through studies to be a reasonable, and even a preferable, alternative to obstetrical care, it is unfortunate that after 13 years of provincial regulation it still remains out of reach for most women in Quebec today. The rising demand for midwifery care and the overburdened state of obstetricians both call for the same solution, and that is the active creation of birthing centres. Even if the promises made by the government are actually fulfilled, the work to continue the development and support of midwifery in the province will be ongoing. If this issue is given the attention that it deserves, then over the next few years, perhaps more women will gain the ability to make their own choices in how their bodies are treated, and how their children are brought into the world.

Photo credit: sabianmaggy

A lot can be accomplished by spreading awareness. If the need for access to midwifery care becomes more widely known and accepted, and if the reasons for this need are better understood, the chance of obtaining adequate results from the government will increase.

Please feel free to spread the word by sharing this article (you can do so by using the 'Share Us' widgets at the top right of this page).

You can read in more detail about the information in this article by following the links below:

The Gazette: "Quebec eases rules for women who give birth at home without licensed practitioner" October 5, 2011.

Open File: "Certificat de naissance: la directive qui soulage les parents" October 4, 2011.

CBC News: "Montreal family still fighting for birth certificate" August 26, 2011.

TVA Nouvelles: "Maisons de naissance: Les ressources manquent au Québec" August 17, 2011.

La Presse Canadienne: "Yves Bolduc revoit le mode de financement des maisons de naissance" May 5, 2011.

Le Soleil: "Crise en gynécologie: le PQ veut plus de sages-femmes" January 29, 2011.

La Presse: "Sages-femmes: diplômées sans emploi" January 28, 2011.

Le Nouvelliste: "L'UQTR forme le plus de sages-femmes possible malgré le manque d'emplois" January 28, 2011.

La Tribune: "Toute une cohorte de sages-femmes sans emploi" January 26, 2011.

La Presse: "Sages-femmes en chômage" January 19, 2011.

This Magazine: "How Canada's midwife shortage forces healthy mothers into hospitals" January 7, 2011.

Macleans: "A midwife crisis" November 20, 2008.

CBC News: "Women happier when babies delivered by midwives: Statscan survey" November 28, 2007.

World Health Organization: "Identifying barriers and facilitators towards implementing guidelines to reduce caesarean section rates in Quebec" October 2007.

Canwest News Service: "C-section rate in Canada continues upward trend" July 26, 2007.

Esmeralda Nadeau-Jasso: A Montréal Doula

Photo credit: - Trevor Blair

Originally from Calgary, over the last few years Esmeralda Nadeau-Jasso has made a home for herself here in Montréal, and has become deeply involved in different aspects of Montréal community life. We managed to find an hour of time which was not filled with her various projects and engagements, to sit down together at her kitchen table and have this interview.

Her living room was in the process of being painted yellow, and there was a sewing machine sitting on a little table in the middle of the semi-chaos, fabrics here and there around the apartment. The apartment itself was colourful, bright, and just a little hectic, much like Esmeralda herself. She has quite a balancing act going: she is a performer, a costume designer, a waitress, and a doula. It was this last part of her life that I focused on during our chat, curious to hear what kind of experience it is to become a doula in Montréal.

What, you might ask, is a doula? Esmeralda explained that it is "an emotional support throughout the birthing process" for the labouring mother--this support lasts "before the labour, during, and after labour," and can vary in scope, from "strictly emotional support," to help with positions during labour, massages, and breastfeeding advice.

"Even after the birth," Esmeralda explained, "it's still important to have that emotional support. And not everyone has friends and family who can attend their birth."

Esmeralda was initially introduced to the idea of becoming a doula through a friend's mother, who had been a doula herself and had become a postnatal care nurse. "Her mother was like, 'I think you'd make a good doula, and then she sent me to Rivka who was in charge of Montreal Birth Companions, so I took a little class with them, and that's how I started." The classes were once a week over a several week period, and covered many aspects of the labour process, including some medical information, and birthing positions and massages to soothe pain. After that, it was into the field. "I'd be a student doula and I'd go help with other doulas' births."

When I asked her if she had felt prepared when she attended her first birth, she exclaimed, "Oh God no, I was terrified!" Since she was attending as a student doula, there were other doulas present with her, and she didn't have to handle anything alone, but even so, assisting at a birth is an intimidating idea. "I didn't really know what to expect, but it was a really beautiful experience, and ever since then it's really marked me as a great experience," she said. "Any birth is really, for lack of better words, magical. There's so much going on, and in the end you get to hold a little baby that's fresh out of the oven... It's a really happy experience."

"The mother's excited, the father's excited...You know, oftentimes," she continued, laughing, "I find I'm more of a doula for the fathers involved than for the mothers--because usually the fathers are freaking out! Sometimes the mothers need more help, sometimes the fathers do."

On the struggle of being a young and childless doula (she is twenty-one), Esmeralda commented that, "Sometimes I find I'm really uncomfortable when I tell people my age, and they're like, '..Oh.' A lot of people assume that a doula or a midwife (...) would already have kids. And that's why it's good to know your stuff."

On that note, she added that "It's important to also be quite knowledgeable about all of the medical stuff, even if you're not doing any of the medical stuff. You really want your mother to have confidence in what you're doing."

"A lot of moms are at different stages than I am, and I'm obviously not there yet, and I don't plan to be in the near future, so it's a different place. And so sometimes they think that you won't be able to relate."

To this end, Esmeralda admitted that she does change the way that she dresses to help mothers feel more comfortable with her. "I just have to dress... not the way I've usually been dressing," she smiled.

I asked, "So do you tone it down, or what do you do?"

She burst out laughing. "Well I obviously have to tone it down a little! (...) You know, you definitely have to play up the part a little bit. Like I wouldn't be able to go there wearing my circus costumes. I would think that would be awesome, but I don't think everyone would appreciate me showing up in a one-piece with rainbows and stuff on it."

Because of all of the other things that she has going on, Esmeralda has continued mostly just doing volunteer births, though she has done a couple of paid ones. When asked about pricing, she said that "Three-fifty is like the cheapest, cheapest you would go, because you could be there for forty hours straight--so it's quite cheap for that amount of hours. (...) Then there's the pre-natals and the post-natals, and the getting around, and then there's also being always on call. So, three-fifty is like minimum-wage doula. But sometimes it's even lower than minimum wage doula." Doulas with many years of experience often charge more, anywhere from 1000 $ and up, which means that doulas are not always an accessible option, since it is not a service covered by health care.

Because of Esmeralda's busy lifestyle, she hasn't been able to be as dedicated to her doula work as she had originally planned. "I do a lot of other things, and I haven't quite found the time to make myself a website, get little cards, start handing them around. You have to do a lot of self-promotion, and I haven't found the time to do that yet."

Despite the trickiness of getting established as a doula with so many other things happening in her life, Esmeralda plans to stay active in the birth community. She has the eventual plan in mind of pursuing an education in midwifery (which she describes as her "dream job"), and until then, she will continue her volunteer doula work, in between her many other involvements, around Montréal.

"The entire birth experience itself is pretty amazing," she said, considering what she enjoys most about being a doula. "I like helping people, I really do. It makes me happy, (...) when someone is satisfied and is like, 'You know, I'm really happy you were there, I'm really glad you were able to do this.' (...) They're really happy about you being around, and that's a really rewarding experience. I guess it's a reward in itself, just to help others and to see other people be fulfilled."

If you are interested in having Esmeralda as a doula, or would like to contact her, you can reach her by email at [email protected]

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