I traveled to Cuzco to do a feature different from most news stories. This was to be a project of several days that would give me the chance to photograph in depth without the usual rush to file my pictures. The story was about vertical birthing in a public clinic on the poor outskirts of Cuzco.
Cuzco is a spectacular city full of Incan ruins and history, and it turned out that this was the week of Corpus Christi during which the Catholic faithful parade their saints in procession, under an impressive full moon.
Birthing is a subject capable of overwhelming anyone, even a photographer like me used to maintaining a distance from most subjects. It was impossible not to feel empathy towards these women who in their agony waited patiently alone for their turn to give birth, without taking anything to stop the pain.
The fact of me being a woman and a mother too was like an invitation into their world, even though I had never felt the same pain of birth that they were feeling. They always asked me if I had a child, and that opened the door for me.
On the second day of the story, an obstetrician named Guido told me that this was the night of a full moon, and that there would be many births so I should stay overnight. He was right. I was fortunate to witness four births that night. Just being there was a privilege, as well as an exhausting and hallucinating experience. These births are natural, without anesthesia. The pre-labor room, where the women endure the pains before actually giving birth, is really a chamber of terror in which the women scream out their pain, lying on the floor or pacing. They suffer, endure and survive in spite of not receiving anything for the pain.
They stand, the babies cry out as they are born, and the exhausted mothers make room for the next to take her turn.
Many times I just hung up my camera to console one of them and give her my hand during the contractions - things that I would normally never do…It was impossible not to.
The third woman of the night was Mary Luz, a 21-year-old single mother. The father of her baby had been killed in a traffic accident on Christmas day. This was her first child and she spent hours in the pre-labor room, crying and very nervous. In the labor room things became complicated when she tried to give birth standing, with great difficulty.
They tried lying her down on a bed to cut her perineum because she wouldn’t dilate enough to allow more than the head to be seen. Amidst an atmosphere of butchery, with the blunt instruments that wouldn’t cut and the lack of anesthesia, there was a blackout. The clinic had neither candles nor flashlights, not to mention a generator. Guido, the obstetrician, very calmly requested a light of any kind, even if it was from a cell phone.
Apart from Mary Luz and myself, inside the labor room there was the obstetrician, a male nurse and a woman nurse, and they didn’t have anything to light with. I took out my Blackberry and offered it to illuminate the mother. I tried to take pictures but there was too little light and the obstetrician couldn’t see to cut the perineum. I turned on the screen of my Canon 5D camera and I got as close as possible, offering just enough light for them to cut. I had been recruited. I spent the rest of the birth helping, following orders to aim the light here and there. Nothing worked for them to cut, not even the blunt scissors. The baby wouldn’t appear and the minutes seemed like hours. Mary Luz screamed and screamed. The blood meant nothing to me compared to the anxiety of wanting to see her baby born.
At last the baby appeared and the first screams flooded the room. We could only hear the baby crying, against a background of darkness and silence. Then, with one hand I illuminated a nurse as she cleaned the baby, and with the other hand I gave light to the obstetrician as he removed the placenta. I was still helping.
Finally, others entered with candles and it looked like the Corpus Christi procession.
It would have made a wonderful photo, but I was still assisting the nurse with the baby and was barely able to take a couple of pictures before the lights came back on. That was when I realized that I was trembling and had my robe covered with blood. I remained next to the mother, consoling her as she cried while they stitched her up.
The blood was not an issue for me. I’ve seen a lot of blood related to death in my work, but this was a story full of life that reached deep into my soul.
The next day, after photographing a few more births, I went to the Cuzco Cathedral, an imposing ancient church, and went inside to find thousands of saints still illuminated from the previous night’s Corpus Christi celebration. I kneeled on a pew and when an un-tuned organ began to play along with a Quechua chorus, I covered my face and cried an ocean of tears.
I followed the mothers during the next few days and the story ended in their homes. These people gave me more than what I gave them. I had only planned to take pictures, but they invited me into their houses, gave me food and beverage, and had me hold their babies. I ended up the last afternoon sitting on the bedside of Viviana, conversing with her family and feeling as if I was in my own home.
It’s for stories like these that I became a photographer.
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This way of birthing does the most for the emotional well-being of the baby. The experience of pain is not to feel pity for these women, but to admire them. This women needs to be accompanied by her relatives in order to feel more security and the pain will be less, also.
- Posted by YolandaDear Mariana,
Wonderful, wonderful journalism, compassion and presentation. I am a homebirth midwife and a doula trainer. I’ve helped women with natural childbirth for over 25 years. Birth is hard work. There is a difference between pain and suffering. Of course we want to ease suffering, prevent suffering. The mother in your audio slide show said she was “afraid of the pain, oh well.”
Her “oh well” shows how she acknowledged pain and then set about her work.
I have been honored to help women 15-46 who have faced their fear of pain and chosen natural, supported birth. More women here have the kind of support that was given by the nurse student in your audio slideshow (some of the same pics are here).
Please, readers, realize that these women are not birthing in their own environment, and that adds stress; that risk of maternal death also has to be emotionally born in labor, there more than here in the US, and death in the hospital is a fear as well especially since hospital birth is newer there.
Your blog, Mariana, is such an intimate unfolding of your night’s experience. Ending with your tears in the Cathedral was so moving and, having once been in a Catherdral in the Yucatan, I had a little bit of what that image may have been. Thank you, so much.
I followed the link to reuters and you through the blog at OrgasmicBirth.com portraying a film that shows an entirely different view of natural childbirth. One that I have also been witness to.
Gail Tully, CPM
- Posted by Gail TullyMariana, amazing pictures and story, congratulations!
It is possible to, sometimes even brilliantly, document a fraction of the life of others, but it is almost impossible not to get somehow and unintentionally, involved and that is what makes the difference in your pictures.
The day we stop caring for what we see and experience, we will lose it all. To feel great empathy, the urge to reach out and being able to share with others is what empowers us as photographers and makes us grow as human beings. This is precisely what makes our profession so very different from other jobs.
Stories like these make me proud of being a photographer and having the opportunity to work with one like you.
- Posted by Claudia DautThey way you described pain during these birth experiences is so typical of an uninformed, ignorant American. (And this is not to say these women could not have had better support, however…) Pain in childbirth is constructive. It isn’t telling you something is wrong, it is telling you how to move your baby to get it out. Taking away the pain, no matter what means you use, is introducing risk to the baby and the mother. Should pain relief be available? YES. Of course. But it should be used judiciously after other comfort measure have been tried. And the woman must know the risks she is introducing to a natural, normal health process (for 80-90% of women).
Please read my essay about birth at http://www.myspace.com/normalchildbirth.
There is also a list of links to become more informed about the subject. And this author obviuosly needs some education regarding interventions during birth.
- Posted by AdrianeAs a certified and home birth midife for over 20 yrs, I am still shaking my head , becasue most all women if left to there own choice will give birth squating or standing or hands and knees.
It is only in american hospitals that vertical birthing is so “pushed” on women.
Hospitals, that follow the american way of birthing are not helping women.
Inductions, c-sections, forceps are are very dangerous. With all the modern medical tools used for labor and delivery ,the amerian stats have not changed in 30+ yrs.
The reason most women die in childbirth in most countries is lack of prenatal care and good nutrition.
Technology will not improve maternal or infant mortality.
Good food, sanitation,and education will.
I have delivered over 1500 babies at home in a number of countries. Vertical birthing is the norm!
Glad that Peru is discovering the old ways are most times the best when it comes to birthing postions.
America has not “discovered” this as yet ! Will they ever?
Gail Johnson
- Posted by Gail Johnson CPMKuddos for Reuters and this serie of articles ,videos and photos, encouraging non invasive methods to improve perinatal mortality is one of the soundest things to do… I am not condemning technology, (I actually work with South American Pregnant ladies in the Atlanta Area) but I am seeing too many abusive and non justified interventions on this populations pretending to save them..
- Posted by Regine MArtonI intentionally gave birth, in sterile, medication filled, technology ridden America, in very much the same way these women did. I LIKE giving birth. It is hard, hard work, but it is empowering, liberating, and spiritual for me.
Immigrants from Latin America frequently choose to birth similarly when given the option of the American model. It’s good stuff and (when things are clean and sterile) unmedicated, vertical birth is actually the safest method, as well as the easiest recovery.
I am a huge wimp. I am no martyr. I had natural, vertical childbirth because it was safest and most comfortable. Labor was hard (labor does actually mean work) and sometimes I moaned in feeling something so powerful, but it was never agony and it was not a hardship. I would’ve been heartbroken to need technology or medication.
Those are wonderful photographs and I’m sure it was a moving experience, but I think you’re projecting a lot of your own cultural birth biases onto women who may be experiencing this far differently than you describe.
- Posted by JessicaAs a pregnant woman and as someone who has given birth without drugs twice before, these images are striking…a reminder of the pain we go through and the joy we have afterwards. It makes me look forward to this new baby while dreading those last few hours.
- Posted by EricaI agree that the majority of women don’t NEED pain relief but without a support person and being among strangers, it could be terrifying. And obviously, these facilities need generators and some types of pain relief. Cutting into people over and over without pain relief and not getting results is horrifying. Yes, we did the same thing in the Civil war and people survived but no one asks for that kind of experience!
We should keep the things from the past that work well…vertical birthing, natural pain relievers, etc. while trying to save lives and horrors by finding a way to get the NECESSARY equipment, drugs, and medical clinics that so many people lack.
Mariana, how can I say this?
- Posted by Diana NgilaThat’s some real stuff right there… the joy of being a mother, great but the pain of getting there…hmmmm, another story but worth it all the same i guess. Deep stuff
Beautiful pics and moving story. As a labor nurse I know the sounds of the birthing room and what you are hearing there is what happens here in the heartland, but we force them onto their backs, push their legs back and humiliate them by exposing them to their families.
- Posted by CindyA birth without drugs is usually a birth with less complications.I hope these birth houses help with the maternal mortality rates, another way to help would be training midwives and letting them use life saving drugs like pitocin when needed. Or antibiotics. We use them with no thought to cost here in America.
this is a wonderful article, i cannot wait to give birth and have my own child. I used to want to adopt but giving birth to life is something else!
- Posted by nianneMariana,
- Posted by Vivek PrakashThanks so much for the touching story, I was so moved reading it. And thank you for bringing this story to the world, it reminds me that truthful, compassionate journalism still has a role to play in a world of spin.
Beautiful article
To those criticizing Ama, C-sections can be very very traumatic. Anyone who has seen one knows that. It’s not just a surgery, it’s a physically rough way for a child to be pulled out of a body. I had my child naturally with a midwife and doula and even with the 1st degree rips (had stiches too by my doctor with no medicine)would not have traded it for a c-section. What she means by “forced” is that there are many unnecessary c-sections done in the united states, not the elected ones. More than any other developed country and increasing because they’re faster and to insurance companies time is money. I personally know many women who still feel scarred from their c-sections whether it’s in a fancy hospital or not. When you’re in the heat of labor, have been laboring for 10 hours and someone says “you need a c-section” a mother is not going to argue and many have found out after that in fact, they didn’t. It’s a different for of brutality, mentally perhaps.
Birth is a very intense, painful, and joyful experience. When it’s tampered with in any way through lack of proper medical care or lack of people who realize the sanctity of the experience, it leaves deep emotional ridges. Please show compassion.
- Posted by MGiving birth/life is not easy…but notice the smiles on those holding their infants when the birthing process is completed. Perhaps, as we’re told, they have forgotten the pain. I did after each of my six children.
- Posted by HulananniThis is outstanding reportage, both for the quality of the pictures and text, and for the compassion shown. Exactly the kind of work that inspires other photographers and definitely the kind of story that made us want to do this job in the first place. Thank you for sharing the lives and struggles of these brave, generous women. -Finbarr
- Posted by Finbarr O'ReillyIt was hard for me to view these photos without immediately thinking about what they said about the way the women were being cared for, but I also want to say that the photos themselves are beautiful and really give a sense for what this birthing place was like, and what it must have been like to witness these ordinary yet extraordinary moments in the lives of the women and their families.
- Posted by sI’ll admit this is a bit off topic, but — to the person who commented about c-sections always being a choice — if you pick up a copy of “Pushed” by Jennifer Block, you can see descriptions of several documented cases where women were legally forced (through court orders) to have cesareans, or where women stated out loud that they did not consent to a cesarean but were given one anyway. Also, while cesareans may technically be a choice in a lot of cases, women are often given incorrect information (your baby is too big, your pelvis is too small, etc.). They trust their doctors and have a cesarean, only to find with their future babies that they can in fact vaginally birth babies bigger than the ones they were told they couldn’t birth the first time. Choice is one thing, but informed choice is entirely another, and that is something that is often lacking in maternity care. i guess my point here is that women all over the world (including here in the US) do not always have the opportunity to make informed choices about how and where to birth.
- Posted by sarasorry…Here is the story:
http://www.reuters.com/news/globalcovera ge/verticalbirthing
- Posted by Mariana BazoThank you for your comments. Here you can see the full story.
http://blogs.reuters.com/photo/2008/07/1 2/old-birthing-in-the-new-world/
In the blog I just write from the perspective of a photograph in one place. Definitely it is better for mothers in rural areas for Peru, giving birth in hospitals like this that respect their traditions, because the other choice is do it at home which is more dangerous.
- Posted by Mariana BazoThe theme of pain caught my attention as an outsider… but for the mothers it is natural of course.
mariana