“You have the right to have the best experience ever,” Melina Brufman, a doula living and working in Buenos Aires, says of giving birth.
Although, women here in Argentina who are eager to give birth vaginally without unnecessary interventions may feel as though the odds are stacked against them. The government enacted the national Parto Respetado (Respected Birth) law in 2004 — ensuring women the right to birth following the natural biological process, without any unnecessary medicinal or surgical interventions to accelerate the process. But concerns that obstetricians increasingly push cesarean sections on pregnant women out of convenience and to reap higher compensation persist.
Nearly half of all births in Argentina (45 percent) are now by cesarean section — three times higher than the World Health Organization’s (Organización Mundial de la Salud) “ideal” medically necessary rate of 10-15 percent. And within the country’s private medical centers, the average c-section rate has risen to 67 percent, according to a study released in 2019 by the local organization Parir y Nacer.
“The [birthing] style that they developed here is just a style,” Melina said. Women eager to give birth vaginally without unnecessary interventions can succeed — by finding the right support team and committing to staying in control of the entire process.
As a mother of two, Melina learned this first hand. While she birthed both of her children vaginally here in Buenos Aires, she had two very different experiences.
Her first “was a very traditional birth with a lot of interventions,” she said. “It was fine, but deep inside I knew that some of the things were not necessary.”
After processing her feelings around the birth and participating in her first doula training course, Melina took a completely different approach to preparing for the birth of her second child. With more information and resources, she planned a home birth with two midwives and a doula. And the birth experience was a sea change.
“It was like being born again myself,” she said. “Everything turned in my life
Melina (top center) leading a meditation.
Now as a doula herself, accompanying women and their partners through pregnancy, birth and the postpartum period over the past four years, Melina says the most important part of her job is empathizing and sharing information.
She meets with her clients about once a month to discuss what they’re going through and is on call to talk through concerns that arise in between. Throughout the pregnancy she can help expecting women find the right obstetrician and birth team, work through difficult emotions that arise and determine their deep desires for the birth.
To arrive at those deep desires, Melina says part of the process can involve dissecting their fears. “When you can separate your fears, you understand what part of those fears are yours, what part of those fears are from stories you’ve heard, your background and your own sexual history … ,” she explained.
Once her clients are fully aware of the birth experiences they’re seeking, Melina can then help them work toward realizing those desires. That can include helping to write — and defend — the birth plan (plan de parto).
“Sometimes you need to negotiate with the doctors,” she explained. “To be able to express yourself, you need to be very confident in the information that you have. You need to be very confident about what you want and why. Why is that better for you than other things?”
Melina — who previously traveled the world as a professional tango dancer — also leads yoga and spherodynamics (esferodinamia) classes with the yoga ball for prenatal women and postnatal women and their babies. The gentle movement classes encourage a mind-body connection and give pregnant women practical tools for working through labor with a yoga ball, she said.
There’s no doubt that current COVID-19 precautions have impacted the way doulas can interface with their clients. One-on-one meetings and group movement classes are currently done virtually, and doulas aren’t allowed to accompany women as they labor in local medical centers. But Melina assures that she can still accompany women in-person for as long as they labor at home.
Overall, Melina’s top advice for women seeking a vaginal birth without unnecessary interventions here in Buenos Aires: build the right support team.
“We need to take the whole experience in our hands. Building the team, it requires commitment from you,” she said. “ … what you need is to open the questions to the other person to realize if it’s really the person that you want to become your doctor.”
Ask around for obstetrician recommendations, research each one in online forums, ask your chosen obstetrician lots of questions, and don’t be afraid to seek second, third or even tenth opinions throughout the pregnancy, she added.
“It is fundamental to have the right people there for you.”