Singapore is known for its stringent policies in the effort to keep everyone safe and in order. The culture spreads into the birth world - which is seen as a medical event as opposed to a beautiful, natural event that should be left to unfold.
This may not seem like a big deal. However, interfering with a mother's wishes and instincts have been known to cause mental health issues and trauma which interferes with a mother's ability to mother. The effects of the lack of emotional presence of a new mother is known to carry on in a baby into adulthood. You can see what this might mean for the future generation. A lot of harm.
If you understand birth as a natural passage (as opposed to a sterile laboratory event) to release the right supporting hormones for motherhood, you will begin to understand the importance of this ceremonial process of labour and birth.
Normal Birth in Singapore
A normal birth in Singapore happens in a cold hospital, tied down to an uncomfortable bed, baby's heart rate and contractions continuously monitored, with intermittent vaginal checks, bright lights. If by any chance this woman is able to progress despite the surroundings and lack of comforts, she is being told to turn around onto the bed and be on her back for the pushing, perhaps cut in her vagina (hello incontinence!) and then told to purple push until a baby is born.
The cord is cut quickly, depriving the baby of the extra blood needed to surge and expand the organs the baby wasn't using in the womb - like the kidneys. Babies cry with the shocking entry and taken away from the only woman who can make the baby feel safe. Onto the bed with the heater and rubbed furiously of its vernix. Dressed, weighed, poked while screaming in distress.
The management of the placenta is active.....and the honouring of the organ that has kept your baby alive and well is non-existent. It's 'dirty'.
And this is a straight forward birth. Due to the narrow definition of Normal in Singapore, you will be pressured to augment your birth, pumping you with synthetic hormones, induce your baby at 38 weeks or even just go for a c-section because your hips are 'too tiny'.
Not every birth goes this way... most births do. No one raises an eyebrow if this birth story is told. It is just one of the things a woman needs to endure to have a bub in her arms. We don't want to but our evolutionary need to procreate instils in us a desire that will overcome this 'normal' suffering.
So what is Normal birth?
The truth is - there isn't really a strict definition of normal. There is such a wide range of normal that most doctors in Singapore cannot accept. There are variations of normal from when you give birth, to how the baby is positioned, to how quickly you dilate, to the positions you want to be in, to the sounds you want to make...everything is a variation of normal.
There may be instances a mother needs medical assistance and this is where it is truly top class in Singapore. However, in any other case, it can be highly traumatic.
What it may be like else where.
Caregivers and the environment:
Unfortunately, unlike in other 1st world countries like Australia, neither birth centres nor midwife led births are an option. All births here are accompanied by an Obstetrician (well trained in surgery nonetheless). Whereas in other countries, only the ones who are really unwell would need an obstetrician.
If you're healthy and your baby is healthy, you would likely go the midwife route in say, Australia.
Birth Centre births in Australia are practically free. You will have a comfy double bed, and tub to labour in... and all these natural birth tools to bring comfort. Midwives sometimes act as doulas as well but it is always best to have your own, chosen one whom you feel comfortable with.
The environment is so important. A study of 5418 planned home births by CPM found that only 12% transferred to hospital of which only 4.7% asked for epidural. Only 3.7% needed a c-section compared to the 40% c-section rate we have in Singapore. No mothers died. Maternal satisfaction was high at 97%.
Home births are an option here but are costly - given the equipment etc that one has to procure and since the laws around midwife attended births are iffy, most look to the one and only Dr Lai who would attend. This is an option however and can be discussed if you PM me.
Just for the sake of covering all options... I will mention this. The other option is a Free or unassisted Birth which no doula bound by the rules of the Doula of Singapore Association will attend. Doulas of Singapore have done so much to ensure the presence of doulas at hospitals (a fragile process) and keep their doulas in check. So much fear around. They are a beautiful, lovely bunch and I appreciate their work in Singapore.
I know of doulas who are not bound by membership....but by their ethics and need to serve women and their babies.
Most women in Singapore mistakenly believe that they will need medical help bringing their baby into the world. They know they will need help but the only assistance that they really need is in providing the environment for them to do their thing. So the support is in other forms - emotional, physical, mental and spiritual.
The assistance most mothers need are in what they call 'alternative' forms. Which is strange given that these physical, emotional, mental and spiritual assistance is actually PRIMARY.
How to mitigate the risks of having your birth turn into a shit show?
Luckily there are some angels in Singapore who managed to progressed in their views of birth despite having a medical background. A doctor who supports a natural childbirth is not one who thinks natural childbirth is only about birth through the vagina. This is your first most important step in Singapore and I cannot stress how important it is.
How to choose your Doctor in Singapore
The doctors all doulas love in Singapore are:
Dr Paul Tseng - TMC
Dr Lai Fon Min - Gleneagles
Some other Doctors are a little more strict and can give a little bit more leeway but their belief in a natural birth is still...shaky. I appreciate the doctors who are expanding their faith a little more into this area. It is scary - with all potential litigation and what ifs and their own fearful programming. (Even doulas can be fear ridden which can interfere in your birth so perhaps... this is something you might want to investigate.)
Choosing your hospital to give birth in Singapore
Naturally, I believe that hospitals that do not allow doulas think that women are not deserving of consistent comfort and support; hence their policy. They will state that they have had doulas who crossed the line in the past by being argumentative (threatening the hospital's staff's ability to force their decisions on their clients) or by being unsafe. As with any population, there will be cases that crosses the 'no can do' line. No one kills off an entire population because of a few threats. Right?
Wait...oh,
Hospitals that are currently allowing doulas:
Thomson Medical Center (my personal favourite)
Gleneagles
NUH
Mt Elizabeth Novena
Why you need a natural birth education Singapore even with a doula.
Doulas in Singapore are under strict rules not to interfere with the process. So we rely on your readiness and knowledge to make decisions. This is unlike in other countries where some hospitals are okay with the doula voicing out for their clients.
A wise person said if you don't know your options, you have none.
So it is wise to know birth and know your options.
If it is a good birth you want, try a Hypnobirthing course, Lamaze course or Bradley course. You might even want to attend an ecstatic birth course. Whatever it is....what you expose yourself to matter. Most antenatal classes leave you feeling more scared, more clueless about natural birth but with more knowledge about the various forms of pain relief and augmentation available to you.