The Geography of Birth

The Geography of Birth

The land I walk on, was born from the sea; rising up as the waters receded, leaving a rich, fertile place where rivers emerged from mountains.  Surrounded  on all three sides by the ocean, it is blessed with all forms of sea life and a clear view of the horizon where other lands also grow and shift with the changing climate.  

Small bands of people from Africa, left their land hundreds of thousands of years before these stories take place.  Women, in small communities, crossed the Red Sea into present day Yemen.  From there, with intelligence and cooperation, followed the coastlines and rivers to populate the whole of earth.   As they made their way they settled, hunted, fished, learned new technologies and developed new ways of living. They also formed families and had babies.   These babies, in turn, grew up and had babies of their own. Some people stayed and created semi- permanent  communities while others continued to explore new lands and make the slow ,perhaps a mile a year, migration towards what we now know as South East Asia. 

The geography of birth explores the patterns and processes that helped women give birth safely in the context of their landscape and cultural experience.  It examines how women adapted to change, used natural resources, shared information and cared for the young.   The birth practices of most humans was tied to the landscape they lived within.  Much of what we know about the migratory patterns of humans is from the study of archeology.   Today we can learn through the sharing of stories.

Archeologists, who study the bones of  ancient people, report that there are almost no signs of babies being buried inside a mother’s pelvis and few burials of mothers and babies together.  They consider that if there had been significant problems with childbirth, there would have been more mothers and babies born together but there is little evidence of this.   This along with the vast evidence of the human ability to populate the earth, helps us to believe that birth was and is inherently a normal and safe part of the human experience.   In the Geography of Birth we look at outside influences; those people or events that changed birth practices and how they impacted the safety of women and babies.

The first evidence of these modern, human ancestors in SE Asia. were found in a cave in present day Laos; people who lived hunted and gathered the food of the rich peninsula.

Archaeologists believe that some people, following the coastlines went to Australia.  Others pushed up to China and others remained in present day India.   For most of these 200,000 years, people lived in small tribes and bands following migratory animals and seasonal crops.  There is no part of human migration in which women were not giving birth.  There is no historical event, war or act of genocide that was not also accompanied by women giving birth.

Like many people everywhere, the people of Southeast Asia developed a desire and ability to make permanent structures, grow crops and domesticate animals.  They developed pottery and iron works and sophisticated systems of working with stone and wood.  As these systems became more sophisticated, the people spent more time in permanent villages.  These villages grew larger and over time turned into city-states.  Meanwhile people were navigating and continuing their exploration of the coastlines and seas.  People from the north, south and east came to the land to settle and trade.  Some, who came to trade, never returned home. They married and stayed bringing new thought systems, technologies and beliefs.

During this time, in every place on earth, people believed in some form of earth based spirituality in which the natural world is filled with spirit. The rivers, the sea, the trees, the mountains, the flowers and the sky were all deeply connected to a force that slowly becomes known as God.  Just as small city-states began to develop, so did larger, more structured religions.   Hinduism would make its way to SE Asia from India.  The Chinese would bring Confucianism and Nepal would give them Buddha Later the French and Spanish would bring Christianity.  

What was once small bands of people roaming one landscape; free to hunt, gather and fish as they needed became a land divided into kingdoms and dynasties that often followed former tribal routes. Their formation and decline was often closely linked to the landscape and their use and misuse of natural resources.   Rulers joined forces with the world’s great religions to create monarchies linked to God and heaven. Societies that had enjoyed equalitarian life styles became divided into rich and poor; ruler and slave.   Empires such as the Khmer and Cham became prominent and then declined.

The Chinese pushed down from the North, as smaller tribes worked to survive and consolidate their resources.  The Europeans made their way too around the globe and set out to colonize many lands including SE  Asia. People who had once had power over their own futures were forced to work to create great wealth for colonial powers.  What had been one peninsula of free roaming people was divided into Vietnam. Cambodia, Thailand, Laos and Burma.  Their borders would be determined by treaties made in Paris.

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A version of this story can be told all over the world as people, countries, religions and ethnic groups fought for survival, wealth and power.  The deaths of millions of mothers and babies was and is a consequence of  greed and a desire for power.   I am assured, by the women, I interviewed that childbirth was far less the cause of death than political and economic warfare waged on innocent people.

There is no way to wage a political, economic or religious war without hurting and killing mothers and babies.   The woman who first walked out of Africa is our common genetic mother. Some call her our Mitochondrial Eve.  I feel confident that the first band of people that left Africa, did so out of a love for their children and a wish to secure a better future for them.   It is the same reason my son set out on a boat across the South China Sea and why my daughter walked through landmines to reach Thailand.

We honor all the women of the world, when we take care of one another and the amazing, bountiful land that has taken care of us for all these generations.  I love listening to the stories of the oldest midwives left on earth.  I want to know, how they survived war and famine and an ever-changing society.    I  believe they have the power to teach me the vast lessons of graciousness. 

I will try to paint for you, my unknown reader, the stories of birth I have collected in a backdrop of geography, archeology, history and religion.   I feel my way along the shores of my own uncharted territory; following streams within the ever-changing seasons of my life, using birth and midwives as the star in the dark night as my guide.

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My Journey Continues...to Southeast Asia

An Introduction

In 1980, my family grew to include children who had fled the conflict in Southeast Asia.   They made their way to refugee camps in Thailand and Indonesia by foot and by boat and then as, orphans and unaccompanied minors, they arrived aour house in Portland, Oregon.  I was thirty-two years old, pregnant and already a mother to two young boys.  My husband was in medical school.  We felt that love could accomplish all things and were children ourselves of the idealism of our generation.  Our old wooden house would burst to overflowing as we faced, unprepared, the joys and challenges of bringing young people into our community who were sick, frightened, homesick and lonely.  

Thirty-three years later, I made a trip to Vietnam and Cambodia with two of those now grown children. I had been to Cambodia twice before with my daughter but it was my first visit to Vietnam.  I had volunteered as a midwife in Haiti and Gahanna and wanted to spend some part of my trip with midwives.  They had grown up with a midwife- mother and knew this to be my particular and peculiar passion. 

I was interested in how Vietnam and Cambodia’s midwives had managed through bombs, famine, genocide and years of conflict.  I wanted to know how they became midwives and who helped them along the way.  I wanted to know how their new governments had made the transition from war to peace while improving the maternal and newborn mortality rates of women and children.   I wanted to know the situations in which my own children were born; of the practices and women who helped them take their first breath and survive.

I had wanted to offer the midwives of my children’s countries some small gift and so

before leaving, I had decided to offer training in newborn resuscitation through Helping Babies Breathe.  I packed training materials and 40 ambubags to give to local birth centers.  My children helped me to make contact with many local clinics and others I found through NGO’s working in the countries.   Through them I gave many workshops, observed birth in a variety of settings and had an opportunity to meet many midwives. 

I had become a midwife in the post  Vietnam war years, when many of us struggled to create a way of life that would eliminate the causes of war.  During this time, we formed food co-ops, schools, community gardens, and some of us were drawn to birth.  I was working in Head Start and saw the harm of drug and alcohol use on the unborn child.  I saw the need for parenting to begin long before my four- year old classroom.   A co-worker asked if I would go to her teen age daughters birth classes and birth.  It was my very first birth and I sensed then that in that place I could find, for myself, the moment where heaven and earth touched.   After so much conflict from war, the civil rights movement and protest I felt a possibility of healing and peace.

I began my journey, as a midwife, slowly but without hesitation.   In Cambodia, a midwife told me she was woken by a dream that told her to go and help a neighbor in labor.  We are all perhaps, offered these dreams but it is often hard to get out of bed and follow them.

This is how it was for me, both as a midwife and as a mother.  Once I knew that children from the refugee camps needed homes and families there was really never any turning back.   Once I began to listen to the story of birth there was no choice but to listen.

While women in my country were making connections between war and corporate control over every part of our lives, the women in Vietnam and Cambodia were struggling to heal their communities and their families.   Over and over again the women and the midwives told me that it was not birth that killed them or their children but war and famine.  Most women had many children during this time and all, that I spoke with, lost several to starvation and a lack of basic medical care.  I was reminded over and over again how deeply war impacts women and children and their ability to survive and protect one another. 

In these stories, I try to capture the impact of war but also the resiliency and courage with which women preserved their families and their communities.   As the guide in My Lai said, “It is hard for your generation of Americans to come to Vietnam.”  It was often very painful and full of heartbreaking memories.  Coming face to face with the lasting harm of Agent Orange on newborns left me sobbing with embarrassed, powerless, pent up tears.

Years ago, I had stood in silent vigils  asking for the war to end.  It felt right, no matter how difficult, that I make this vigil and stand beside the women and midwives of Cambodia and Vietnam.  I tried to feel peace and to let my heart, so broken by the actions of my own much loved country, heal. 

I am forever thankful to my children’s families who fed me, introduced me to older midwives and helped me find my way from place to place.   For all the cups of tea, laughter and nights spent sleeping together I am grateful.  To all the midwives of the world who deliver each and every baby with a silent prayer for peace in their hearts.  For all women who deserve to give birth in peace and to raise their children with enough food, a free education, health care and a clean environment.

A photo of my children who came from Cambodia and Vietnam as adults.