Hi everyone! I wanted to follow-up on my "OR Experience" post with one that talks about birthing practices in the Philippines since I believe it's a little bit different than what is done in the US. First off, I was a little bit confused and intrigued that almost all births occur in the OR. Back in the US, I volunteered on a Family Birthing Unit where most births occurred in the patient's room where family members could be present to support the mother. Even the hospitals in Hawaii have a separate birthing unit for women to give birth. I found it most interesting that family members, as well as the woman's partner, are not allowed to be present during the birth. Even after birth, there isn't much contact between mother and baby and it could be hours before family members are allowed to see the mom or baby. Furthermore, epidural is rarely given for pain. There's a belief that the medication could reach the baby and cause harm. However, sedation is given after birth during suturing. Only during c-sections is anesthesia given (thankfully). For c-sections, the incision is most commonly horizontal instead of the more common vertical incision done in the US. The surgeon simply said they do it like that because it's faster, easier, and the surgeons aren't trained to do it any other way. The scar is larger and more noticeable, but the surgeons have to work with how they've been trained.
Once the baby is born, vital signs are obtained, the baby is cleaned, and then sent to PACU. The newborn is often left alone in PACU and vaccines and the screening tests are done at a later date. I have yet to take obstetrics, but it seems like they are much less hands-off and not as concerned about monitoring the baby after birth. The baby usually has no identification and there really are no preventative measures in place to prevent kidnapping. Often, the nurses are willing to hand-off the baby to whoever comes into the unit, assuming they are taking the baby to the proper place. I even witnessed a pediatrician put a newborn on its stomach in hopes that it would stop crying. Also, even though the Philippines is a predominately Catholic country, circumcisions aren't done until the child reaches adolescents. I happened to recently read an article that highlighted circumcisions in the Philippines. For the most part, if a family is unable to afford a circumcision procedure with anesthesia and pain management, there are clinics set up in local gymnasiums or gathering places where healthcare providers complete the procedure at a discounted rate. However, the procedure is done without anesthesia or pain management (ouch!!). The boys simply bite down on some leather or clothe and bear the procedure. The boys look at it as a sign of maturity and "becoming a man."
Based on recommendations by the World Health Organization, the Filipino government has been trying to promote breast feeding throughout the country. Justifiable, breast feeding has been shown to have added benefits that formula cannot provide. Plus, formula can be extremely expensive. Cabrini promotes breast feeding soon after birth, and doesn't even have formula to provide for the mother. If the mother wants to use formula, she would have to bring her own from home. For the most part, many mothers chose breast feeding over formula anyways.
In Hawaii, I also studied Filipino culture and birthing practices. I learned that there's a high maternal mortality rate in the Philippines due to the absence of professional birthing attendants and inability to handle complications. Despite researching this, I have not experienced this firsthand. Cabrini is a well equipped medical center that takes labor/delivery very seriously. They also cater to wealthier individuals who have had access to prenatal care. Perhaps the more rural and poorer areas of the Philippines experience higher maternal mortality rates. There are also many superstitions surrounding pregnancy and birth that I researched in Hawaii that are ever present in Filipino culture, and that I've experienced at Cabrini. For example, heavy lifting or jumping up and down, stepping over a rope, and wearing scarves/necklaces could cause the umbilical cord to wrap around the babies neck. Wearing high heels could cause cleft lift and hats should be worn during pregnancy to protect from dew that could harm the baby. Eating eggplants during pregnancy could cause a darker-skinned baby and a woman shouldn't bathe for 2 weeks after birth (reason unknown). It's fascinating how these beliefs have been around for centuries and still permeate the culture. Despite modern technology and education, people still believe in these practices. It goes to show how much Filipino's respect the views of their ancestors and desire to carry on their beliefs.