Vanessa Sykes and the Bolivian Birth Revolution

Globally, the number of babies born through caesarean section (C-section) almost doubled between 2000 and 2015 -- from 12% to 21% of all births -- according to a Series of three papers published in The Lancet and launched at the International Federation of Gynecology and Obstetrics (FIGO) World Congress in Brazil. In Brazil, particularly high levels of C-section use were seen in women who were highly educated, compared with less educated women (54.4% of births vs 19.4%). “It’s quite worrying,” said Silvana Granada, one of the lead childbirth researchers at Brazil’s Oswaldo Cruz Foundation (Fiocruz). According to Granada, as many as 70% of women first say they want a natural birth. But this “reverses” as they reach the end of their pregnancies, with the majority voicing preference for caesarean sections. César Eduardo Fernandes, president of the Brazilian Federation of Gynecology and Obstetrics Associations, said social and cultural factors influence women’s choices when it comes to vaginal birth versus caesarean sections. “In Brazil, there’s a belief that normal childbirth is something the poor do,” he said. Medical labor practices in Brazil have done little to change this belief as the study revealed Brazilian doctors still often bind women to their beds and forbid them from walking around, or leave them without food or drink during labor.

The labor practices of the often-overlooked country of Bolivia are similar. Vanessa Sykes learned this when she was pregnant with her daughter, Isabella. Sykes, a Canadian expat living in Santa Cruz de le Tierra with her Bolivian partner, says, “I wanted a vaginal birth,” she says, “and to women outside Bolivia, this seems like a given, but in Bolivia, women are kept out of the birthing process.” Sykes refused to be excluded even though she, “had a difficult time finding a doctor to honor my wish.” She found a Bolivian doctor who, “listened actively” to her desires after changing physicians four times.

This doctor provided Sykes with a satisfactory birth although she points out, “it could have been better.” She recalls how the nurses insisted she take off her grandmother’s homemade socks on the day of Isabella’s birth as they rolled her into the delivery room. She says, “They wanted me in the hospital garb which is not necessary for a natural birth. I was able to convince her that I could keep my socks, but I had to fight for that. I found it funny I had to argue with the women to keep my socks.” Sykes says her birth could have been improved if an advocate had been at her side. She laughs, “A woman fully dilated is a loving woman next to her side who knows what you need even if she didn’t know what she needs.”

Sykes decided to become one of these women who are referred to as doulas. Doulas, according to Dona International, are a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible. Sykes became the first doula in Santa Cruz Bolivia after completing her doula training at Doula Canada. She organized Vanessa Sykes Birthing Services are her training with the desire to educate others. She has added additional skills to her tool belt since opening her business. She says, I am a la maze educator, a lactation counselor and last year I went to Brazil to learn about spinning babies which are different exercise women can introduce while pregnant to help with the birthing process.” Sykes Birthing services provides monthly workshops regarding these topics. Sykes says these workshops have had a rippling effect and she has noticed an increase in demand.

Sykes hopes her efforts influence the conversation regarding birthing practices in Bolivia. She says Bolivia doesn’t have reliable statistics, but it is estimated that the C-Section rate in Bolivian pubic hospitals is 40% to 60% while private hospitals have an estimated 95% C-Section rate. Sykes says, “Lots of factors drive thi. Economics a big one. It is believed having a C-Section shows prosperity. You were able to pay for the surgery so natural birth is for poor people. This is a myth.” Sykes and her Birthing Services hope to dispel this myth, so Bolivian women no longer have to be victim to the global caesarean section epidemic, which is hinders women’s choice.