Midwifery is an ancient profession; however, with the advancement of obstetrics, midwives have been marginalized all over the world. In the United States, midwives once trained through apprenticeship and practiced within their own communities. With the rapid growth of the field of obstetrics and movement of birth into hospitals during the 20th century, professional midwives in the U.S. today only attend ~10% of births, even while they are considered to be advanced primary health care providers on par with Advanced Nurse Practitioners.

In India, the traditional midwife or dai attended births in people’s homes. Today, the largest group of midwives are community health workers known as anganwadi or ASHA workers who undertake the gargantuan task of providing primary, antenatal, postpartum and pediatric care in rural areas. While there are options for nurses to train to attend births under OBGYNs, there is no option for professional training in midwifery. As a result, there are only a handful of Indian midwives who are able to practice independently in India. Two of them who are both U.S. trained CPMs (Certified Professional Midwives) have opened impressive birth centers — the Birth Village in Kochi, Kerala, and the Sanctum Birth Center in Hyderabad, Telangana.

The Sanctum Birth Center

I first visited the Sanctum Birth Center in 2018 and met Vijaya Krishnan, the midwife and owner. She had a doctorate in physical therapy prior to training as a midwife. I spent a month teaching prenatal yoga classes at Sanctum. When I started my own midwifery training, Sanctum was at the top of my clinical training list. Vijaya ma’am was gracious in accepting me as a student and extremely patient in navigating all the paperwork that was involved in getting my placement finalized, given that I was pursuing my midwifery degree through a U.S.-based institution.

The Sanctum Birth Center is categorized as a hospital, as Indian regulations for birth centers do not exist. It is located in a commercial complex, sharing a building with a supermarket and a night club! The center has six birthing rooms with birthing tubs, a double bed with an extra cot, bedside tables, a closet for storage and for necessary medications and supplies, an armchair, a chair without armrests, several stools of different heights, birthing balls, rebozos and an adjoining bathroom with a shower. There are appointment rooms, an operating theater, storage for IV stands, a sterilization area, oxygen tanks and nitrous oxide. The hospital is a Level 1 NICU facility and can do phototherapy as well. Newborn babies are only transferred to the nearby full-scope NICU if they need 24/7 observation or one-on-one pediatric care.

The center is owned and led by midwife Vijaya Krishnan who, in turn, has hired four affiliated OBGYNs who offer first-trimester care, back-up labor and birth care, perform C-sections when needed and consult on more complicated medical conditions that require collaborative care. An affiliated pediatrician offers pediatric care and is on call to assess newborns after each birth. An anesthesiologist is available on call to perform spinals or epidurals when necessary. The center is staffed 24/7 by nurses who work in pairs in shifts ranging from 6 to 12 hours.

As C-section rates have increased in India, clients who come to the birth center come specifically looking for a natural birth, with many seeking a water birth as well. In clinical circles, the term “natural birth” has largely fallen out of use and has been replaced with physiological birth. This change in nomenclature has taken place in order to validate all types of birth and not label surgery or other interventions as “unnatural”; however, even as language changes, clients continue to express their desires for a “natural” or “normal” birth, by which they largely mean a vaginal birth without interventions.

Antenatal Care

All clients are required to attend prenatal yoga, walk at least 40 minutes a day, eat a nutritious healthy diet and attend childbirth education classes (at which families are welcome!). As a result, hopefully, by the time their labor comes, they are physically and mentally prepared for birth, and solid partner and family support in place.

Diabetes and gestational diabetes are prevalent in the Indian population. In the U.S., I have seen GDM managed via standard protocols of testing using the one-step method; recommendations for diet, exercise and possibly medications; and finally induction at 38 weeks. I suspect it is managed similarly in hospitals in India as well; however, in the birth center, care is individualized.

In some cases, diabetes may present in the first trimester with an elevated A1c, while in others, GDM is noticed around 26 to 28 weeks with a 2-hour OGTT. Those with controlled diabetes and no other health complications may be accepted as clients, while those with uncontrolled values have higher risks, may not be good candidates for a birth center and are thus referred to a hospital. The birth center also takes care to classify people who are borderline GDM for whom only one value from their OGTT may have been slightly elevated.

First, lifestyle changes are recommended with a low-carbohydrate, high-protein diet personalized depending on each person’s 3-day diet diary, along with recommendations for walking after each meal for 30 minutes and practicing daily yoga. Follow-up fasting and postprandial values are drawn two weeks later, accompanied by regular check-ins to see if the diet and exercise routines are actually being followed. Almost always, if followed consistently, blood sugar values come down and are well controlled. If the values continue to be well controlled, often induction is not recommended until 41 weeks as long as macrosomia and poly/oligohydramnios are not of concern.

While those with hypertension are referred to hospital care, clients who have elevated hemoglobin in the second trimester, or those who have high-resistance umbilical arterial blood flow in their doppler and might be at risk for gestational hypertension are given a course of baby aspirin and their blood pressures are monitored closely. If gestational hypertension does occur, collaborative care with the OBGYN is started and medications are proscribed until induction is appropriate. In the few cases of gestational hypertension I saw during my time at Sanctum, all had vaginal births following the induction protocol.

The combination of a higher-than-average BMI and lower levels of physican activity meant that many clients have weak abdominal muscles that led to posterior positions or ROA/T positions, identified through leopold’s maneuvers. If at 36 weeks, and especially after 38 weeks, spinning babies positions (for example, side-lying hip release, forward-leaning inversion and cat/cow) are strongly encouraged and demonstrated within the antenatal visit.

People coming to the center from other parts of India have an initial virtual appointment and follow-up with local care providers where they reside before arriving in Hyderabad at 35 to 36 weeks. Most families rent a service apartment and stay until two weeks postpartum. I met people coming from as far away as Dubai, Singapore, Assam, Nasik, Chennai and Bangalore. There is also no obvious “type” of person who seeks care at Sanctum. The clientele are extremely diverse and hail from a range of different places, belong to multiple ethnicities and religions and are from a wide range of socio-economic classes.

Pain Relief

Everyone who comes to the birth center is advised that the facility only offers epidurals in case surgery is required, and it is extremely rare for an epidural to be employed for pain management during labor at the center. In fact, the rooms do not have the option for an epidural to be placed; one can only be placed in the operating room theater. As a result, people who come to birth at the center do not keep the option of an epidural in their mind as a backup method for pain relief. Pain relief is available from sterile water injections, hydrotherapy (bath or shower), hot water packs, birth ball, breathing and relaxation techniques, massage and comfort touch and one-on-one labor support and encouragement.

Labor

While at Sanctum, I witnessed several vaginal births which would almost certainly have resulted in Cesarean sections in most other birthing contexts. In particular, these were labors that stalled or took a long time to progress. This could happen in pre-labor or early labor at 2cm, between 5 cm to 7cm or even during pushing. Often the underlying cause was malposition, although occasionally it could be owing to a larger-sized baby.

Cervical checks are very minimally administered; however, when performed, more information than just dilation / station / effacement is gathered. Occasionally, a cervix swells and starts to close to one side; other times, it may continue to remain posterior; there may be an anterior or posterior lip; or it might be a baby with an asynclitic or posterior position.

Almost always, maternal positioning techniques are employed. These include doing the side-lying hip release for three contractions on each side, the forward leaning inversion for three contractions, five rounds of pancake flips (exaggerated side lying on each side, cat/cow, open knee chest), abdominal lift and tuck, walking, side lunges with the birth ball, rebozo sifting and full squats or time on the toilet seat. Often, this takes a couple of hours and is done by the nurses or the midwife. The commitment to positioning is extremely rigorous with the type of intensity you would see in a CrossFit class! The difference these interventions can make is often startling, with some people going from 6 cm to 9 cm within half an hour, or from 6 cm to head out in 3 hours.

When it seems like cervical dilation is not progressing as it should even with good contractions, a 2 ml IV dose of Drotin (Drotaverine Hydrochloride) is administered during a contraction to help speed up labors. Drotaverine Hydrochloride is not approved by the FDA; however, it has very few side effects. The evidence on it is of low quality, however, there is a suggestion that it could help shorten the length of labor, and further studies are needed. It is an antispasmodic medication that works on smooth muscle tissue, and therefore has an effect on the cervix. It may be repeated every half hour. We had a particular case where the birthing person had SROM at 38 weeks with light meconium. Once contractions began (within 24 hours) she progressed to 2.5cm, but then stalled for another 24 hours. At about 28 hours she was 6cm, but when the FHR had a few bradycardic episodes, Drotin was administered and the side lying hip release was done on both sides. She quickly progressed to 9.5cm within a half hour and was able to push the baby out in another hour.

Induction

Inductions at Sanctum are approached very cautiously. First, there is a lot of patience in recognizing when birth needs to be imminent as opposed to opting for expectant management (patiently waiting for labor to take its course). As mentioned before, if all is well, clients are counseled to wait for labor until 42 weeks.

Another significant difference is the manner in which inductions are managed. All clients are counseled at the first visit that in most cases, it is safe to wait until 42 weeks for labor to start. If an induction becomes necessary, but not urgent (as might be the case for gestational diabetes or ruptured membranes), natural induction methods are employed first.

The protocol to naturally induce labor involves an entire day of intermittent nipple stimulation and walking at the center. The birthing person arrives with their partner first thing in the morning and spends the entire day at the center, often until 9pm. They start with half an hour of nipple stimulation via breast pump (3 minutes on each side) followed by half an hour of walking and climbing stairs sideways (there are 7 floors in the building), and then a half hour of rest. Homeopathic medications are used; however, much like with the use of herbs, there is an art to the use of homeopathy. The most commonly used homeopathics are Belladonna, in difficult labors when the uterus or cervix remains rigid; Sepia, when the birthing person is tired from a difficult labor; Pulsatilla, to help transition from false labor to true labor; Gelsemium, for weakness and exhaustion or a long labor from a posterior presentation; and Rescue Remedy to combat exhaustion.

This protocol is repeated for 2 days, and most of the time labor starts on its own. Most often, contractions begin within 2 days, following which labor may progress on its own, or medical induction techniques (cervical gel if the cervix is still not softening and dilated, or synthetic oxytocin if dilation is about 3 to 4 cm) may be started if necessary.

If oxytocin is used, it is started at a very low dose (8 to 10 drops / min) and the fetal heart rate is checked every 15 minutes. Positional changes are continued even with augmentation, and all the pain relief techniques are employed as well. Synthetic oxytocin is rarely used when meconium is present or with those trying for a VBAC owing to the recognition that such medication might add additional stress to a fetus or uterus in more delicate situations.

Monitoring

Clients at Sanctum are recommended to get three ultrasound scans during pregnancy: the NT scan in the first trimester, the complete anatomy scan in the second trimester, and a growth scan at 36 weeks. Additional scans are only employed if there is a need for follow-up. Because scans can be unreliable, if an anomaly is present in the scan, there is thorough assessment to see if other parameters such as discrepancies in fundal height warrant further intervention.

At all antenatal visits and during labor, intermittent auscultation is employed. If necessary and appropriate, a 20-minute NST is completed anytime fetal wellbeing reassurance is needed. NSTs are conducted daily after rupture of membranes, if low fetal movement is reported, or after cervical softeners are inserted, but rarely used otherwise.

Water Births

There are a few criteria that are taken into consideration for people choosing to labor, or give birth in water. They should be low-risk; have a good FHR without any decels, intact membranes or membranes that have not been ruptured for more than 12 hours; and should not be at risk for PPH or shoulder dystocia. Unless water is being used in a prodromal early labor for relaxation, the contraction pattern has to be steady and strong enough to continue to progress when immersed.

The tub is filled enough so that the belly can be immersed and is around 100 degrees fahrenheit. Hydration is extremely important when in water, and intermittent auscultation with a doppler is continued. If any of the above conditions are not met, the midwife will ask the laboring person to exit the tub as any complication or concern that would make management more difficult in the water should be managed out of the tub. During the birth, the pelvis must be submerged in water. When the baby is born into the water, it is quickly placed skin to skin, and warmed with the towel. If there is no excessive bleeding, the placenta is birthed in the water as well! The sign of excess bleeding is if there is so much blood that you cannot see the bottom of the tub.

The water births are some of the most peaceful births that I have witnessed. People birthing in water appear to me more relaxed and often not just happy, but elated from the experience!

Breech

If a baby is in a breech position at 32 weeks, Spinning Babies techniques are taught and encouraged to be continued at home. This includes performing the side-lying hip release on both sides for 5 to 7 minutes followed by the forward leaning inversion and cat /cow a few times a day. If at 37 weeks, the baby still has not turned head down, an external cephalic version is attempted.

I witnessed a few ECV attempts, where first the Spinning Babies series was performed; then the pregnant person was cocooned in three rebozos and gently moved from side to side; and finally, the ECV was attempted slowly with fetal heart checks in-between and soft communication with the baby. Often if the baby is in a mood to kick and move, that can be a good sign for a successful version.

The first three ECVs that I witnessed were not successful, but for one client, it was repeated again at 39 weeks and succeeded then! This second-time parent went on to have a vaginal birth. For those whose ECVs are not successful, and who are good candidates, a vaginal breech birth is offered. I witnessed labor for a parent whose ECV was not successful and chose to attempt a breech birth. She was counseled on the risks and benefits and signed a breech birth release. Her labor began spontaneously around 39 weeks with spontaneous rupture of membranes. She then had contractions that got her to 6 cm, but then stalled for 10 to 12 hours. As augmentation wasn’t recommended, and while the FHR remained stable, a decision to perform a C-section was taken. The stalled labor was seen as a sign that either baby or body were not in a good place to continue to attempt a breech birth.

VBAC

Telangana, the state in which Hyderabad is located, has the highest C-section rate in India. In private hospitals, the rate ranges from 60 to 90% (and from 30 to 40% in government hospitals). While many surgeries are by maternal request so as to schedule the birth for an “auspicious” time, skills and patience for physiologic and vaginal birth are also waning among practitioners. At the birth center, about one-third of the clientele are attempting a VBAC, and many travel from across the country so as to have that option.

When clients talk about their surgeries, their stories of unnecessary C-sections, lack of information or consent, and suffering verbal and physical abuse are extremely painful, and many are in tears as they recount their experiences. Just from charts, it is often clear that people were either bullied into inducing before their due dates or told their baby was “too large” or that it would be dangerous to wait even an hour after spontaneous rupture of membranes.

At the initial visit, after assessing whether a trial of labor after C-section might be appropriate, the risks and benefits are explained. Specifically, it is emphasized that while the center has an 85% success rate, there is a chance that a repeat surgery may be necessary. The biggest risk — that of uterine rupture — is explained, and the fact is shared that it may occur in 3 to 5 out of 1000 people trying for a VBAC. It is also explained that the only test for uterine rupture is a trial of labor, and that the signs of fetal heart rate changes, unusual bleeding or scar pain could be signs of separation.

The biggest challenge for VBAC clients is long labors from malpositioned babies due to weak abdominals. While diet, exercise and yoga are encouraged, all the same positioning techniques are employed to aid better positioning and faster labors. Since synthetic oxytocin is not used for VBAC clients, natural methods of induction are employed extensively. The only repeat C-sections that I witnessed were either due to extremely poor fetal movement followed by a concerning BPP on ultrasound, or due to adhesions from the previous surgery that did not allow the lower uterine segment to stretch as needed. Most successful VBACs were similar to primary physiological births, and some even had successful water births.

Episiotomy

Medio-lateral episiotomies are done when there is a need to get the baby out quickly or if the second stage has been extremely long and the baby is low enough. A few examples follow of what I have seen. In one case, an episiotomy was performed where the second stage was 6 hours, with no change for about 2 hours. Baby was at 0 station, caput at +2. While fetal heart tones were reassuring, the birthing person was absolutely exhausted from a long labor and pushing so an episiotomy was performed.

The second time I witnessed an episiotomy was in the case of a VBAC with a 5-day labor; while fetal heart tones were reassuring, she had GDM and was on insulin (her blood glucose was being tested regularly through labor to modify insulin as needed) and her levels spiked to 220 (even after insulin) when she had been pushing for 3 hours and baby was at +1. Because of the risk for hypoglycemia to the baby, an episiotomy was performed to help speed birth of the baby.

The third episiotomy I witnessed was for a birthing person who received an epidural after 12 hours of labor; the epidural was disconnected to help her push but during pushing the fetal heart tones were dropping to the 70s and so an episiotomy was performed to help birth the baby.

Consent is always obtained and lidocaine was used prior for all three episiotomies. Thankfully, all the babies did well after birth! So far no one has had an extended postpartum stay due to an episiotomy; however, the standard stay postpartum at this birth center is a night or two, which is longer than typically seen in birth centers in the U.S.

In case of emergencies

An OB is always either at the center or on call to be at the center as soon as required if necessary. Most of the time, they are called for a third or fourth degree tear and occasionally for surgery. An anesthesiologist is also available on call and comes in if surgery is necessary. The center’s pediatrician or the pediatric team from the nearby hospital is always present for the birth or to check the baby shortly thereafter.

Having an on-call system for providers means that early recognition of labor or fetal problems is imperative, even though OBs can generally be from call to incision within 30 minutes. Thankfully, as Vijaya ma’am says, “You don’t go from healthy to unhealthy in the blink of an eye. We typically have some time to react.” So if the fetal heart rate is not reassuring, thick meconium is present, or it seems like there is a chance for a shoulder dystocia from a larger baby, or if the birthing person has hypertension or gestational diabetes with symptoms during labor, the team is called early and kept ready just in case.

Postpartum

Most parents stay at the birth center for a day or two after birth. Nurses help with skin-to-skin and breastfeeding within the first hour, and continuously every couple hours as needed. Sometimes, the baby continues to breastfeed while suturing or surgical closure takes place. Vitals are monitored for the parent and baby, and visitors are welcome during the day. A pull-out cot is available in addition to the double bed.

For those who have had episiotomies or second-degree tears, infrared heat therapy is done to enable faster healing. The dry infrared heat stimulates blood flow, and, in particular, stimulates fibroblasts to aid in rebuilding collagen. The therapy is completed twice a day for three days with the birthing person sitting in front of the heat for about 10 minutes each time.

Parents are also encouraged to purchase a sitz bath, to immerse the perineum in warm water, and to apply Betadine a couple of times a day, as well as to avoid sitting cross-legged. The protocol seems to work well, as only those who failed to follow it had slower healing from what I witnessed.

Parents might return to the center for phototherapy within the first weeks if newborn jaundice is present or for breastfeeding support, while follow-up postpartum visits are at one week and six weeks postpartum; however, because the center has an integrated pediatrics practice, parents can also address any postpartum concerns at the one-month and other newborn visits.

Breastfeeding

In addition to continuous lactation support from the nurses, a lactation counselor visits all clients on day one post-birth. For low-risk people who do not have any colostrum within 48 hours after a physiological birth, Domperidone may be used to stimulate lactation. It is dosed at 10 mg three or four times per day, along with pumping to stimulate production every 3 hours. The baby is formula fed until milk is produced. The dose is kept for about 10 days after which it is slowly weaned off.

I have seen it used twice, both in parents who did not have any breast changes in pregnancy and where insufficient glandular tissue was suspected. In both cases, milk was produced within 48 to 72 hours of starting the medication, and combination feeding was done until the infant regained birth weight. If the infant continues to gain weight well, slowly the formula is weaned first, and then Domperidone is weaned. The infant then continues breastfeeding and pumped milk feeding until they are eventually able to exclusively breastfeed by 3 weeks or so. This approach took a village, a lot of support and immense dedication from the parents but was wonderful to see succeed!

Domperidone is not approved by the FDA in the U.S. due to risk of cardiac arrhythmias and QT prolongation. When it is used in India, it is only used in people without cardiac issues, and the risks of the medication, its side effects (dizziness, palpitations, syncope or seizures), and when to seek emergency care are clearly explained.

For babies that have a tongue or lip tie, parents are referred to a pediatric physician who specializes in releasing ties. Parents prep with a few days of exercises before the release, and follow up with the exercises after the procedure as well to maintain separation.

Conclusion

The Sanctum Birth Center is an excellent model of a midwifery-led birth center. It proves that midwifery care is extremely successful in creating good outcomes, with extremely high satisfaction for clients. If only we had more centers like this to universally offer midwifery and birth center care to everyone who desired such an option.

Neelu Shruti

Founder, Love Child Yoga

The challenge of giving birth in the current times is to nourish your self-confidence about your body and baby, and let nature lead the way.

I often think and reflect on the births that I attend. Why is it that for some women, the process of giving birth is a conversation of her body with her baby, which takes on a spiritual quality? Why is it that for others, the entire process gets overridden with fear? Pain — and the ability to manage it — is then only a small aspect. A very important aspect, but a small one.

Here are some things which I feel impact the quality of the birth experience:

How we live today: So much chatter! Social media, so much digital information at our fingertips. But so little time spent with ourselves, downloading information that your own body is giving you. If you have an ache, instead of seeing what it could be signalling, you run to Google which could scare the life out of you. But Google cannot feel what is going on in your body and how, for the most part, the intelligence of the body is to automatically seek out comfort.

Quick fix relief for everything: Pop a pill. If not, run to the doctor, who will most likely tell you to take a pill and get yourself some bedrest. Now, sometimes, both the pill and the rest maybe needed. But by scaring yourself or wanting to immediately anesthetise yourself to any discomfort, you have lost the ability to sit with yourself, comfort yourself, and listen to your body’s signals.

Living in Crisis Mode: For the most part, many of us live in crisis mode. Constantly multitasking and trying to be the “best” at everything we do. As we live, so we birth. Birth can then take on a crisis mode as well. Something that needs to be tackled and completed. But with as little discomfort as possible. The truth is you can prepare all you want, but you have to be able to be in non-crisis mode. Let your body do the work of slowly letting your baby out.

Family: While we expect that family will wait on us, encourage us, and help us during the time of birth, sometimes the exact opposite happens. Family does help for sure, but for the most part instead of waiting on the process to unfold, everyone is waiting for the family’s baby!! Nothing wrong with the excitement and the anticipation. Everything is wrong with looking at birth as a project that needs to be completed. And in that way, the pressure is on the laboring mother, who has enough to deal with already. She is then waiting on the family!!! And, has to perhaps explain that it is okay. How can birth progress smoothly in these circumstances? Who has the onus of waiting on whom?

The current maternity care system: Which believes that the mother has to be saved and rescued from her own body which has been sending millennia-old signals to birth her baby. These signals have been encoded in the mother’s body since the first baby was born. And by wanting to “help” labor progress along, in a particular fashion that has been ordained expedient, we are directing the body to move out of its wisdom of biology. Sure mothers and babies need to be monitored and around 15 to 20% benefit from being saved, with all the technology and modern medicine. But 80% needing a major abdominal surgery? Or 90% being augmented with medications? This “saving” of all women from their own bodies, now becomes the new narrative, which further erodes the confidence of the mother in her own body and ability to give birth.

More fear = More pain = Longer labor = More stress on the MotherBaby = More interventions = Self fulfilling prophecy “Women need to be saved in/from childbirth!!

So back to the original question: What helps some women experience childbirth as a transcendental experience?

Not just childbirth classes – which give information about labor, coping skills, breathing, exercises, what to avoid. But, still with all of that information and practicing and reflecting and meditating about what you need both internally and externally to help go through labor in a peaceful manner

Not just Birth Stories that you read on this page & others – While they are very important to increase the conversations around birth being a positive event, only relying on them is like expecting to wake up in a candle-lit room, with a smile, with a baby in your lap, WITHOUT going through the discomfort and pain. No one can be in comfort and give birth. You will need to step out of your comfort zone and step into the unknown realm, then you can experience the spiritual nature of birth!

Not just Pain, But Also Pleasure – Feeling the contractions, recognising the magnificent pressures of bearing down, feeling your baby move down the birth canal, feeling tired yet exhilarated as you say “The baby is coming” These are nature’s design to elevate childbirth as an experience that the mother and baby both get imprinted for a lifetime. The cascade of hormones, love, connection, touch, smell, feel – all were designed not only to make you survive, but thrive!!

Control – We cannot control birth! It is that simple. We can prepare, yes. But not control. Mismatched expectations can lead to labor slowing down or feeling more painful. When the woman stops trying to control, but surrenders and opens out her heart to the pain, the sensations, the nausea, the shivering, the peeing, the pooing, the sweating, the roaring, the moaning, the groaning, the whining, the silence, the tiredness – however her birth might unfold – she opens herself up to receiving her baby, her way. This permanently alters her way of existing!

When we stop looking at birth as a linear process and understand that birth is as circular as life is, we will all empower the mother to experience birth as a transcendental experience!

Most cultures around the world have an innate understanding of the vulnerability of a new mother and the need for her to be cared for and nurtured to recover from growing and birthing her baby. Innate postpartum care emphasizes the following pillars of postpartum wellness in the “45 day lying in period”:

1. Rest
2. Nutrition – Every community in India has their own specific postpartum diet they use – some foods restricted, others encouraged
3. Massage – Belly massage, leg massages and belly binding
4. Warmth – Not to get exposed to cold, hot baths, therapeutic steams have been culturally used in India for generations
5. Family/Community – Comes together to both help the new mother and celebrate the new baby

While each community has its traditions and its roots in both the art and the messages of benefits passed on from generation to generation, there are some very powerful rituals across the world, which seem to help the mother’s recovery in the sensitive postpartum period.

Closing of the bones is one such postpartum healing ceremony. Created to nurture the mother after her passage through giving birth, and her journey into motherhood, it is setting of a sacred space, and way to nurture her physically and emotionally as she goes about her enormous work of motherhood.

Having its roots in Ecuador and Mexico, I learnt this amazing technique from two amazing teachers, Mirjam de Keijzer and Thea van Tuyl – both expert doulas, and who teach the art and science of Rebozo (a Mexican shawl) use across the world.  When they performed the ritual on me,  I felt like I could let go, it was a magical, almost other worldly experience.

Many women find that when they have given birth they feel ‘broken open’.  The body, mind and spirit have to open and let go from a deep place to bring a new soul into the world. We open ourselves to the most dramatic life experience and sometimes traumatic experience.

The pelvis is a complicated piece of engineering, with bone, muscles, ligaments, tendons and fascia helping both stabilise the body and allow for motion.

Emotionally, the pelvis is the home of the second chakra, “Svadhisthana”, which is closely associated with emotions and with the unconscious. The hip muscles are programmed to be easily activated for “fight, flight or freeze” response. When the body suffers a trauma, our instinctual reflex is to clench these deep muscles. The problem is, we don’t let go. These unresolved emotions and trauma can be felt upon the hips as adrenalin crystals, that are released during the massage.

During pregnancy, the hips, open, becoming wider and wider to accommodate the growing baby, and prepare the body for birth.  It is vitally important to help the hips close post birth, otherwise, mothers suffer from pelvic instability as a result, and they “leak energy”.

The closing the bones treatment involves the use of a traditional shawl called a “Manta” or a “Rebozo”, to rock and articulate the mother’s hips, followed by a complex abdominal and pelvic girdle massage using a warming oil, and then finished by tightly wrapping the cloth around the woman’s hips.  Receiving this massage and ceremony after the first 40 days postbirth (once the lochia has ceased), stimulates blood flow which in turn; cleans, renews, moves fluids, balances hormones, stimulates the immune system, and helps tone muscles and tissues. In addition, it helps pop and release the ‘fight/flight/freeze’ adrenaline crystals in the hips, thus promoting emotional release, which allow for the mother to set foot into her present of mothering her baby with ease and calm.

Various hand massage techniques are utilised, using oil around the pubic bones, belly and around the hips, helping to draw the woman’s energy back to her creative centre, her womb. The Rebozo is then used for closing the hip bones by a method of wrapping.

Beyond the physical aspect of closing the bones, there is a spiritual aspect to the massage, which provides a safe space/ritual for the mother to feel nurtured and release emotions associated with the birth and motherhood.

The Closing of the Bones Ceremony is designed for mothers from postpartum and beyond. The ceremony is open to all mothers at any time who wish to find some closure for themselves no matter how old your child is.  Most women find it most beneficial between 6 to 12 weeks postpartum.

In a warm and quiet room, a sacred healing space is created for this ceremony. Lights are dimmed if possible, a mat and some blankets are placed on the floor, there is soft music playing. When the woman to be blessed is ready, we start with some energy cleansing and then she lies on a mat on the floor.

With the help of a Rebozo, the hips of the woman that have widened and open to accommodate the growing baby and to give birth are gently rocked and pulled back into place. The gentle rocking  movement,  has a soothing effect. We are also honoring the work these hips had to go through to bring a new life into the world.

Some warm oil is applied all over the skin of the belly and a gentle massage begins. The movements are rhythmic and relaxing, bringing the energy of the woman back to her center. We are lovingly taking care of this area where a baby grew. Both giver and receiver acknowledge this great achievement.

For the last part of the ceremony, a woman’s body is tightly wrapped using five rebozos. We wrap and honor different parts of her body—feet, knees, hips, shoulders, head. The woman is then left to rest as we hold this sacred space for her. Some energy work can be done to bring her back to center, balance her energy and relax her.

Closing the Bones is a practice that can be transformational for any postpartum mama–whether you are 3 days or 30 years postpartum–who is looking to find more peace within.  This is a profoundly powerful tool, which acknowledges the immense challenges a woman has undergone in pregnancy and childbirth, and assists in bringing her spirit back into her body. Women who are honored in this way, experience a sense of calm and grounding.  Our hope is that more women , will learn about this wonderful practice, and participate in a Closing the Bones ritual after birthing.

If you are interested in this powerful, ancient, ritual to make your mind/body/spirit strong and balanced in the postpartum period, with Dr. Vijaya Krishnan, please call 72071 68666 for booking an appointment and mention “Postpartum Care Ritual”. Or fill out the form on the right and Submit to us.

Have more questions about your pregnancy or post pregnancy? Go to our #SanctumFAQs page where most common questions are answered. In case you have a specific question which you don’t find here please fill out the form on the right and we will get back to you within 24 hours.

We would be glad to advise you via a Skype Consultation. Let us know if you are interested and we will send you the relevant details.

For continued support and advice from Dr Vijaya subscribe for membership to our WellMom Community. You will recieve periodic updates on a variety of topics relevant to you which you can use to educate yourself and put into action. In addition, Dr Vijaya will be available to talk to you about any specific issue either physical or emotional, relating to Preconception, Pregnancy, Birth, Postpartum, Newborn and Infant Care and general Womens Health. We are your trusted advisor, care provider, friend and advocate from preconception to birth, postpartum and beyond.

Do write to us for for any information you need.

With awe, sharing this picture from a birth we just attended.

GDM Mamma. Came to us for care at around 30 weeks, having gained enormous weight and sugars out of control. We worked hard to course correct, and with super-excellent adherence to diet and exercise, she brought both her sugars, and weight under control.

Working her way through #PrenatalYoga #LamazeClasses and #PrenatalAerobics, she became stronger and more confident, as she headed towards her due month.

Today – 39 weeks and 6 days:
Working hard in labor, with grace, patience and so much power, she rocked her birth, and have birth to her baby boy, just a couple hours ago

Amazing work, Mamma! Congratulations

What more can a Midwife want? The smiles say it all !

Before sharing my story of delivering our second baby, I would say that it’s a boon for Hyderabadi women to have #TheSanctum here.

“Nature has designed women’s body to give natural birth” This is the first sentence Vijaya mam and Crystal told me on the first day of my consultation and I remembered this throughout my pregnancy.

We had trouble conceiving, also suffered two spontaneous miscarriages, fed up with mounting hospital files and the drugs I was taking, I quit my job and we changed our lifestyle, slowly but surely. My health parameters clearly picked up and I delivered a baby boy in 2017. But with an unnecessary C- section supposedly owing to “cord around neck” and “low amniotic fluid” conditions. When we look back now, with the knowledge imparted by Sanctum, we simply feel being cheated. Not a day goes by without this feeling, my husband asks me to take succor from the following saying attributed to Confucius “We have two lives, and the second begins when we realize we only have one.”

Another pain point in my first pregnancy, was prescription of HcG, it’s a very painful oil injection which had to be done weekly, it was given for no reason other than it being a precious pregnancy, Crystal asked “were you given information about pros and cons” when we brought this up with her later. Even though my contractions started on positive note, they fell on deaf years of our doctors’ pressure. I was totally disappointed with c-section and it took three months for me to come out of this depression.

This is how corporate hospitals operate and the only anti-dote to this is “Knowledge” and “Bold Action”.

I conceived again in 2019, by this time we found our rhythm in the natural lifestyle and I fully trusted the wisdom of my body to the extent, I didn’t even confirm my pregnancy with tests, till three months and I was keen in trying natural birth this time(a.k.a VBAC, vaginal birth after C-Section). The Sanctum was suggested by a friend from our natural lifestyle groups. First consultation itself I was totally satisfied and loaded with lot of confidence that I am in a right place and this confidence & contentment stayed with me till the end of my pregnancy.

Can you believe? There were two scans and two hemoglobin(hb) level checks, and 2 post lunch sugar checks, throughout this pregnancy?

Lamaze classes armed us with the specific knowledge of process & history of childbirth and prepared us mentally for the VBAC. This where we learnt all the below commonly held beliefs are lies peddled by modern day hospitals.
● 1st time C-Section = 2nd time C-Section
● Cord around neck = C- Section
● Low Amniotic Fluid = C- Section
● Fetus passing motion (Meconium) = Immediate C-Section
● Baby in breach/posterior position = C-Section
Lamaze Instructor Rama, herself a VBAC mom at Sanctum, shared her experience in the first class, and increased my confidence in trying towards natural birth.

#PrenatalYoga classes were very helpful in preparing my body for the birth, number of exercises were suggested which helped to this end. ‍‍
Yoga Instructor Sanjana was very good, I remembered her soothing voice throughout my contractions in managing my pain. She also shared many tips and supported me a lot whenever I asked her questions in turning posterior baby to anterior.

#PrenatalAerobics class instructor Udaya, made it clear that pain will be there, and no one can bypass it, if the intent is for a natural birth. She said single word: Just be calm and manage the pain.

My EDD was Jan 30. My labor has started on night of 3rd Feb (40th week, 4th day) after a long walk the previous day in KBR park. I managed myself till 4th Feb evening. Then I revealed it to my husband. By that time mucus plug has released several times. Then I called Kiran in the evening and said that my contractions are 5 mints apart lasting for 40 seconds. She suggested to wait for them to last for 60 seconds then come to Centre. My contractions caused heavy back pain which can’t be put in words.

Finally, 5th Feb morning I went to Sanctum around 6am. My husband and I went without disclosing to any our relatives, we left our 2.5 years old son with my mother, who arrived on the same day. Kiran observed my contractions and as they were 5 mins apart lasting for 50 secs. She said she need not check the dilation, but when she checked and found dilation was 4cm upon my insistence and she said that she can feel the baby’s head, and suggested me to go home. But return journey back home in car appeared unsurmountable with the back pain and we stayed put at the center. I was walking and doing squats for some time and was in sleeping managing back pain with hot pack for the next 5 hours and hot showers in between. Then I overheard soothing voice of Vijaya mam and Crystal, they came in and found I was dilated around 6 to 7cm.

Sister Vijaya made me do head bending, lying on my knees for 5 contractions, lunges for 5 mins in the lobby, managing the backup with squats by holding the window(put in place for the same purpose). Soon I felt an urge to push and my waters broke, I started pushing. Crystal managed my pushing phase along with sisters Vijaya, Saroja. I cannot forget their encouraging/coaching/soothing voices in getting me to push. This part of labor lasted for an hour and 15 mins. The moment baby came out my backpain ceased (wisdom of human body).

Finally, about my husband who was calm and just supporting me all the way in labor, made our big day a successful one. He was my ultimate strength and support all over my pregnancy in managing my diet and elder son. Total 9 months I was alone without any elders’ support, and managing the household things without maid. Sweeping and mopping the floor, washing clothes till before day of delivery, walking for more than 70 mins, yoga everyday made my body more flexible in facing the big day.

My sincere thanks to Vijaya mam(her mesmerizing words and voice), crystal (down to earth attitude), Kiran, Sisters Vijaya ,Saroja, Sukeertha(Vbac mom in Sanctum), aayammas two Manjulas and Alivelu, receptionists Mounica (she recognizes my voice over phone), Radhika and security (whom my son also remembers) made my big day successful. Basically, it’s like a hospital (we don’t call it a hospital it’s a birth center or simply The Center) set in olden days where everyone recognizes you with your name.

We decided to do our best in promoting The Sanctum model of care. No one should feel that I missed Sanctum during my delivery like I felt. Only Birth Center doesn’t require to carry our list of files and scans reports.

I am pleased & proud (and feel like I have awakened the tigress in me, exactly as Vijaya mam said) to have a Sanctum baby (Vbac) without any interventions and as it is intended to be by nature.

I’ve become a sensation among our friends and relatives for avoiding the C-section and thanks Sanctum for that.

As soon as I came to know that I was pregnant, I wanted to have a normal delivery. We searched for hospitals which does normal deliveries, from one of my cousins got to know about #TheSanctum.

I did lot of research seen so many videos of Dr. Vijaya Krishnan garu, We booked our first appointment at Sanctum – I wanted to have my consultation with Dr. Vijaya only, but she wasn't available that day, so we visited Crystal, she spent good amount of time and asked all the details. We felt good and we wanted to continue with our care at The Sanctum.

Appointments were going well – but during 16th week, I got severe pain on right side of my back, stomach and hip. I immediately called and went to the Center. Dr. Vijaya Lakshmi visited and gave injection for pain relief. By afternoon I felt better and had discussion with Vijaya Lakshmi doctor, she said its not normal pain and maybe it is kidney stone. I was worried even my husband isn't with me, he was outstation for his work. After abdominal scan test we got to know that I had right ovarian cyst and its quite big in size! After hearing this, first thing I had in my mind is whether I can have normal delivery or not? I immediately messaged Dr. Vijaya Krishnan saying I have right ovarian cyst, she asked me to take appointment when she is available. I took appointment and I met Dr. Vijaya garu. She is so inspiring, just a simple talk makes you calm and settled. I got to know that cyst is not at all problematic for normal delivery I just need to bear the pain whenever I get pain throughout pregnancy. Pain is the least thing I worried about at that moment because my concentration is only on normal delivery.

Then at 26 weeks, my cyst pain came back with double impact and I was admitted at Sanctum for a day and on Dr Vijaya's advice, I moved to JJ Hospital – there I got to know that the pain is due to minor intestinal infection. I was there for 3 more days until the infection is reduced, so as the pain.

From then on, we are extremely cautious regarding my diet and food intake. I have cut down all the junk and outside food, even though I had less outside food prior to this, I decided to completely stop it as I'm not ready for that kind of pain again.

Yet again, cyst pains bothered me at times, and I had to manage them with pain killers and apt sleeping positions.

Sometimes I gained too much weight, and Dr. Vijaya garu used to warn me and I worked on getting my weight stable and maintain it within limit.

At 35 weeks, I was admitted at Sanctum – this time due to high fever, I suffered all night, even with all the meds and baby heartbeat was also going up. Dr. Vijaya garu called and suggested a doctor at Apollo Hospital, as she doesn't want to take any risks.

I got admitted at Apollo, I was completely on IV fluids, and from one of blood tests we got to know that I have Chikungunya. We were shocked and immediately called Dr. Vijaya garu and asked whether baby will have any impact of this fever and she said it doesn't affect baby, as long as the fever is well managed, and I take rest and recover, as it is third trimester. We thought everything will be normal once fever comes down.

But God already planned something for us, suddenly the cyst pain came back. I started crying like anything, this time the pain is not subsiding even with pain killers. The Gynecologist in Apollo wanted to check the cyst and, she wanted growth and doppler scan to be done to check how the baby is doing.
I took the suggested scan and by evening Gynecologist came with reports and said you need immediate C-Section to bring the baby out, I was completely blank for a moment and asked her why, she said oxygen flow to baby is less. We need to give injection for baby's lungs to mature!
I was not at all ready for this, at this point I am like I don't want any doctor to treat me – I wanted to be under the care of Sanctum and Vijaya garu. I immediately called Vijaya garu and told her the same, she asked me for reports. She checked them and told that reports are neither normal nor that worst either. And, immediate surgery is not at all required. And she consulted with Dr Jayanthi regarding my case, and asked me to get discharged from there immediately if fever is reduced, and go to JJ Hospital to be under Dr. Jayanthi's care.

We got discharged within an hour, came home had food and got admitted in JJ hospital the same night as per Dr. Vijaya garu advice. From then our travel with Dr. Vijaya and Dr. Jayanthi is unforgettable!! We got every question answered at each stage till my delivery.

We stayed 4 days at JJ hospital with alternate day scans. Doppler scan results are good, but baby's growth is reduced, amniotic fluid is reduced to 5 AFI. We panicked that oxygen flow may not be enough for baby and could be risk to both of us. My husband even went to Dr. Jayanthi garu and asked her to perform C-section for me as he didn't want to take any chance. But she talked him through, convinced him that it hasn't got that bad and we can still wait for few days. With proper diet and care we can maintain the AFI level without going down any further and there is still chance for normal delivery. Only then we got discharged from JJ, but Dr. Jayanthi suggested growth scan once in a week and CTG every alternate day.

I met Dr. Vijaya garu next day, we discussed all the possibilities, we decided to closely monitor baby and wait at least 37 weeks complete. We thought every day after 37 weeks is bonus for us. We came out from room booked next appointment and about to leave from Sanctum, Dr. Vijaya garu came by holding my chin and looking into my eyes said "I won't be available October 1st week, even if I am not there for your delivery I will see your baby once I come. But my gut feeling is you will go into labor in a good position".

From then I have rapidly increased my fluid intake, I took anything and everything that was good for Amniotic fluid growth, right from L-Arginine sachets to Sweet lime juice to coconut water to all water rich veggies and fruits. I was so determined to get my AFI levels up even though doctor told increasing the level at this stage is highly unlikely and all we can do it is maintaining it at same level or may + or – 1.

Next growth and doppler scan at Abhishek scan center, flow to baby is good but BPP score is 5 out of 8 and fluid in the same level (5.1). For next appointment Crystal was available, she said we will wait one week and will go for induction. I thought in my mind induced labor is better option than C-Section. Both me and my husband were happy that there is a less chance for C-section now.

Next scan: Same BPP score and same fluid levels (5.5), Dr. Vijaya garu is back to Hyderabad for next appointment. We showed scan report to her she said will wait for one more week. I asked her why we can't wait till 40 weeks by closely monitoring, she said we can't wait for a longer time – BPP score is 5 and it means baby may not be comfortable inside and wants to come out. Every appointment is so informative like this.

Next Scan: No one expected this, amniotic fluid is adequate (8.5 AFI) and baby BPP score is 8 out of 8. I was the happiest person in the world at that moment, we shared reports Dr. Vijaya garu. She replied saying "Is that the same baby and same doctor?" :p

She said no further scans and no CTGs needed, come for regular appointments!! We will wait for your labor to start by itself. Now everything is normal, I had increased my walking to 2 hours, duck walks, basic yoga but didn't join aerobics because I recently suffered with chikungunya and too much of physical stress is not recommended for a while.

Early labor:
14th October: Very less Stomach and back pain, at 5AM mucus plug discharged. Informed the same to Dr. Vijaya garu at 10AM, she said good pre labor, come to aerobics. I went to aerobics immediately, I started doing and taking contractions in between. It was so fun, I felt I should've joined before. I was so excited and kept on asking Udaya what's the next exercise. Udaya told me it will be easier for you if you are like this in the labor as well.

15th October: Irregular contractions with less pain, continued the same complete day.

16th October: By early morning contractions became close and intense, we reached to center. Kiran listened to my contractions and said still in early labor. We went home, I had warm bath and my contractions continued till 9.30 and then stopped.
Contractions were back by noon with more intensity but no regular interval at all. During this time my husband used to rub on my back and did slow massages, it was very helpful to manage the contraction. I was little worried as labor isn't progressing, pain was getting intense but still irregular. Almost at 8.30 pm contraction are 5min to 8min, we informed the same to Crystal and reached the Center. She listened to my contraction and said you are still in early labor. We planned to go home and come again once the contractions are close.

Active Labor:
Meanwhile Crystal called up Dr. Vijaya garu and informed the details. Dr. Vijaya garu suggested few exercises, I completed all those under Crystal's guidance and started duck walks (worked well in my case to start labor and to progress labor) with the help of Saroja sister. Crystal then listened to my contractions came to us and said probably you are in active labor she suggested stair climb and few more exercises. I did exercises during contractions and took rest in between. I asked Saroja akka not to leave me until I deliver baby. :p

The D-day:
17th October: Crystal visited me around 6 am in the morning, contractions are still 4 to 5 min apart. She suggested to get into water tub for relief. I felt relaxed in water tub, till 10.30AM I was in water tub only. Pushing urge started at 10.30AM Vijaya sister was with me. I was trying in different positions, went to toilet seat. Baby is coming down to certain point and going up again.

After some time Dr. Vijaya into action, she came into the room with lots of positivity and energy, maybe I picked some from her at this point! She started to encourage me with all her cheering, making me remember all my struggle and reminding me that it is going to end soon, and it made me believe that I can do it now!! During pushes she was continuously asking me to "Give me the maximum you can do" and her referring to me as a "tigress" whenever I gather my energy to go for next push – it was really motivating. After each push she used to tell 'Great work' and these made me to put more effort for next push. Between pushes, my husband was feeding me chocolates, ORS water and whatever that gives instant energy, and I was eating all of them without thinking about what I was doing.

After a couple of hours of pushing, cheering and eating, our baby was out at 3 PM – ending 15 hour long active labor!! Final push was quick, whole baby came out in a second and Dr. Vijaya immediately took the baby out and kept on me. We had skin contact and I finally got to hold my baby.

From start of pregnancy, everyone used to say you will have baby boy, but we strongly desired for baby girl. But every time when we discuss about baby we used to say as "he" because we don't want to get disappointed if it is a baby boy. After the baby was out and I was holding her and looking at her awestruck, Dr. Vijaya checked the baby's gender and told that it's a baby girl. Both me and my husband shouted out loud in happiness. We are blessed with a cute baby girl, all healthy and pink.

I fed her within an hour, and they let my husband cut the umbilical cord. Doctor told me that I can eat anything I want for 2 days as the first milk will be available for 2 days and what I eat has no impact on baby gassiness etc, but lots of impact on getting good quality milk in. I immediately ordered my favorite fries from McDonald's and pani puri which I have been craving for a long time.

The doctor at Apollo had suggested me to go in for a C-section on 17th September, and I delivered baby on 17th October and it's a normal delivery!! Exactly one-month difference, in this one month my baby has become full term and no cuts on my stomach. This itself validates that we took a correct decision in choosing our care provider. Lamaze classes helped us in gaining the knowledge, we got all the available options and we needed to decide the best option for us.

Instead of saying I delivered a baby, I would like to say that WE delivered a baby. I got such a huge support from my husband throughout pregnancy in all the situations – be it a cyst pain, fever, low hemoglobin levels, labor. Daily he used to walk with me about an hour, gave massages every night, attended all the classes for labor support with me.

I want to talk about postpartum care as well, until you feel confident in feeding you will not get discharged from Sanctum. We learnt many things in postpartum period. Now my feeding is going well, baby is reaching all milestones on time. Feeding my baby is the happiest job for me, I feel so warm and satisfied when my baby looks into my eyes while feeding her. All these are happening just because of Sanctum team.

Even now we visit Sanctum for our baby's regular checkup with Dr. Pradeep. He's very professional, handles the baby very well and suggests what to do for baby's growth and extremely patient in answering all our questions, even the stupidest ones.

I would like to thank Dr. Jayanthi Reddy, Crystal, Kiran, Dr. Vijaya Lakshmi, Saroja Sister, Vijaya Kumari Sister, Sukeertha Sister, Ramya, Sangeetha and both the aayamma's. I became friends with all the Sisters as I was admitted many times at Sanctum. :p

A special thanks to Dr. Vijaya Krishnan, she can inspire anyone on the Earth. She is very particular and doesn't take any chances. I wish her and Sanctum very good luck and I perfectly refer Sanctum to anyone who is reading this for an opinion or suggestion.

All the pregnant ladies out there, you may feel tensed about the baby and wellness when something unexpected thing comes your way. I advise you not to worry, stay confident and don't miss your routine. Remember that your body is ready for it and you have a good care provider who you can go to. Everything will be fine in the end.

I have been following the Healthy Mother page for over two years now, and although I had a relatively natural birth experience the first time, it wasn’t gentle or respectful – there was last minute forced drips, and other interventions. All this left me wishing that I had the chance to have my first baby at the Sanctum.

When I learnt that I was pregnant with my second child, I started religiously following the Sanctum’s posts – Birth stories, Videos and Resources. It was positively empowering to access the right information, which reinforced my belief in keeping medical interventions as low as possible.

Travelling to Hyderabad was not an option for us…So, after months of literally studying the Sanctum’s posts (thanks to which, I continued strength training, squatting, with weights upto 20 kgs throughout pregnancy, till week 38), I scheduled a Skype Call with Dr. Vijaya.

Although I had excellent OBGYNs at the clinic I went to in Chennai, I needed more support. What a call that was! The one hour I spent with Dr. Vijaya was positively reassuring – she had read my email that had all the test results, history of the pregnancy etc; twice! I asked all my questions, got helpful answers – Dr. Vijaya helped me prepare for what conventional clinical deliveries may be like, what to ask my care providers, where to insist and where to let go. Simple advice like, taking a favourite pillow to the clinic and reminding you to rest, recover went a long way in feeling comfortable and calm during labour. Basically, she tutored me on how to birth as naturally as possible in a conventional clinic. A really “silly” breathing technique, pursing your lips down and blowing out air was such an effective pain management tip!

Have you seen the video where Dr. Vijaya talks about “due dates”? I watched it twice after my due date came and went. It calmed me down when everyone else was getting antsy. I was confident when I told my OBGYN that we should wait, and I was lucky to have a doctor who did wait for a whole week! But when I had to get admitted, I confess I was getting nervous and sent a quick message to Dr. Vijaya. She wrote back with such warmth and encouragement, that it gave me fresh courage! Then, after 18 hours of labour, no epidural or gas, baby arrived and what a great thing it is to trust the baby and follow baby’s cues!

Thank you, Dr. Vijaya – not just for the Skype consult, but for the great page that you run which is full of excellent resources. Birthing with love, and not fear – is indeed a wonderful thing.

I have known Sanctum from the past two plus years passively, as my best childhood buddy – who is no less than a sibling to me – had opted to deliver at #TheSanctum after she had faced nightmare experiences in her initial months of checkups at private hospitals in Bangalore, who scared her not to get off the bed etc etc. But once she found The Sanctum, and spoke to Vijaya Mam, she was much, much relieved, happy, and from then started to enjoy her pregnancy; And, finally she delivered at The Sanctum! After knowing about the birthing process at Sanctum, I decided that if I ever plan a baby, I wi give birth at Sanctum only, because in this commercial world, a natural birthing process also has become so challenging. In such case, undergoing care at The Sanctum is no less than a blessing.

And yeah now comes my journey.. I was in Gujarat as my husband worked there when I conceived my first baby in Jan 2019. In my third month, we thought its time to contact Sanctum i.e., Vijaya Ma'am. I already knew by then the model of care and how Vijaya Ma'am and the entire team helps throughout the labor as I have seen two of my closest people deliver their babies there. Even my husband knew it all and he was pretty confident, but it is a totally different experience when you are having your own baby, so I wanted my husband also to speak to Ma'am once and have his doubts cleared . So we scheduled a skype consult with Ma'am..That skype consult was less a consult and more of an eyeopener for us about many things and how beautiful a pregnancy can be instead of too many restrictions and too much immobility. Ma'am was very open about everything and patient enough to answer our questions and no where in a hurry to end the call, and I must mention that she had not slept through the previous night as she had to attend a new born who was not well and the very next morning she was ready to talk to us with the same energy and patience, by which we were totally convinced we are in safe hands of care! I used to update her regularly with my scan reports, and we moved to Delhi too, I was in touch by phone/whatsapp.

I came down to Hyderabad to my mom's place in July, which was my 7th month, and the very next day I had joined lamaze classes at Sanctum..
#LamazeClasses were so helpful as we were told about every small thing related to pregnancy, labor, and every minute detail, and it was an open platform for questions n answers, and even practically showing us through role plays, and all what a labor really means and how a partner plays an important role throughout the process..Though my husband couldnt attend the classes as he was working n Delhi, I used to brief him after the class.

Together we were being prepared for the big day. I personally was very much impressed and touched by the basic concept of Sanctum, involving husbands in the whole process especially in the labor room which is the rarest thing to happen in Indian hospitals. No one actually realizes what it really feels and means to have your partner beside you while you are birthing the little one whom you both have created!

So I was done with my Lamaze classes, I was doing my yoga and exercises taught in lamaze classes and was walking and remained active .. Weeks were progressing, baby's position was fine and touchwood everything else was going fine without any complications. My due date was 27th Sep and my husband had come down on the 20 th Sep and we were waiting with fingers crossed when will it all start n how is it going to be.

Big Day:
On Sep 24th morning at 6 a.m., I woke up out of my bed to realize I was having a gush of fluid leaking out, I wanted to be sure so checked myself and was almost sure it was my bag of water. I woke my husband up and told him calmly I think my water broke call Vijaya Mam.. He called her and she asked me the symptoms and asked me to calm down and eat well and relax and as I had no contractions at all, she asked me to wait for it and once come in the noon for a checkup.

At around 3:30 p.m. we had gone for a checkup and had a CTG done. After an hour I was able to feel contractions which were 20 mins apart. We went back home and relaxed and planned to come when contractions progressed..I tried to eat, but could not eat much and I tried to sleep by 8 p.m., but by then my contraction frequency decreased to 10 minutes apart, with heavy contractions.. We called mam at around 11 p.m. to inform. She told me to take a nice hot water shower and relax and told my husband to note down the contractions and inform her after half an hour. After the shower, contractions were fluctuating between 5 and 7 minutes but they were strong contractions.

We informed Vijaya Mam at 12 a.m. and she told us to come to the center. It was raining and we drove to the center and Kiran and Vijaya Mam were there. Mam had to leave as she was leaving for Mumbai that morning, but she stayed back to check on me. Kiran and Mam were checking on my contractions and the fetal heartbeat was fine, but I had slight fever and necessary IV was given and fever came down and my comtractions were progressing, but were not consistent so we waited and Mam had to leave..She gave her magical hug and left wishing us good luck.

My contractions slowly progressed at around 3 a.m. and I was doing squats and lunges and all possible exercises with the immense support of my husband, Kiran, and sister Vijayakumari. They kept me hydrated throughout n my husband was feeding me every now and then to boost my energy.

At around 10 a.m., I was fully dilated and they could see my little one's hair strands but my pushing phase was a little long and tough, but throughout I could see was a positive atmosphere and such good vibes and not even a pinch of tiredness or any kind of discouraging behaviors from anyone. Especially Kiran.. she was there with me from midnight 1 a.m till I delivered that afternoon 1:30 p.m!! All I could hear in the room was "you can do it ..try.. relax..take ur time.. dont worry we are there to support you". Finally at 1:30 p.m., our little one was in our hands.

Labor is stressful, painful, exhausting, a rebirth for the mother, especially when its a natural birth, but with a team like The Sanctum, the experience becomes a wonderful memory for lifetime! Most importantly, experiencing the whole thing with your partner in the labor room, holding your hand throughout and passively experiencing equal amount of stress and pain though not physically, definitely mentally, doubles your energy and make you feel – Yes, WE can do it TOGETHER! No words can actually describe that feeling. Every member of the team is so warm and welcoming right from Vijaya Krishnan Mam, Crystal, Kiran, Security, Mounika, Radhika Mam, Sisters Vijayakumari, Sangeeta, Sukeerta, Ramya, and Ayammas Manjula and Alivelu

We cannot thank each and every staff of The Sanctum who made our journey of birthing such a beautiful experience. The Sanctum is like a home for us, and the team is no less than a family member

I am Sushma Gujjula. Yes, I am a short Mamma, who is not even 5′ in height (4’10” to be exact), and I had a C-section the first time.

I am a working woman, and I continued my job even after 36 weeks complete! Except me and my family, everyone worried about me! All my colleagues suggested that I go on leave and take rest! Some would counsel (without my asking them!) “Why are you struggling for normal delivery, which is an impossible thing for a mother with previous C section?” Sometimes, I used to feel low, discouraged by their words.

But. .But..But… Immediately I used to get boosted up by “The Sanctum” ..With their energy booster words and encouragement, I continued my job till 39 weeks +….Till the day I started getting contractions, I continued my job!

“HATS OFF & THANKS TO SANCTUM”

Thank you, for the Yoga classes by Sanjana. Your amazing breathing techniques helped me a lot during labor. Thanks, Sanjana

Thanks for the Lamaze Classes. These classes are really mandatory for every mom and dad. They help in achieving mental strength. Counseling classes by Udaya are really excellent..I am one best example for that!! I had a lot of fear of pain – But, I Did It!!! It is both shocking and amazing to me!! Thank you, Udaya

Thanks for the Aerobics Classes. Usually, we think we should not strain ourselves in pregnancy, especially after Week 36. Everybody prefers to take rest. But here at The Sanctum, it is different. Everyone enjoys, moves, squats, dances, and stretches their endurance – and enjoys the Aerobics Classes. It should be experienced, it cannot be explained! This different and amazing prenatal aerobics is totally worth every minute of the workout!! Thanks again, Udaya

Thank you Crystal and Kiran. Your smiling welcome into the consultation room, makes us comfortable in asking and getting our doubts cleared

Special thanks to the dynamic lady behind this excellent team. The Captain of the ship – Vijaya Krishnan – for gifting us a lifetime memory of bringing our baby into our arms, and witnessing our baby’s birth. You empowered us, encouraged us, and helped us in bringing our dream into reality. Without you, I could not have delivered a 3.1 kg baby girl, through a perfectly natural birth! Thank you Madam, for adding me into the list of successful VBAC mothers!!.

Thank you, Team Sanctum

Yours lovingly,
Sushma Ravi