Sunday, February 15, 2009

Eduador's vertical maternity ward

In an effort to lower maternal and infant mortality rates, one Ecuadorian hospital has implemented a "vertical maternity ward" in which traditional practices--including upright or "vertical" birth, medicinal teas, bathing & massage during labor, and indigenous spiritual rites--are encouraged. Read more about it in the article 'Gravity Birth' Pulls Women to Ecuador Hospital. Some excerpts from the article:
Gravity is the invisible midwife in indigenous birthing rituals, says Rosa Colta, a traditional midwife and intercultural health promoter in Otavalo, a town in the Andean highlands of Ecuador.

For that reason a maternity ward in the dimly lit hospital of San Luis de Otavalo calls to mind a small yoga or ballet studio.

Six horizontal bars covered in colorful rope hang on the back wall, forming a gradient, or "chakana," in Kichwa, the dialect of the Quechua language spoken here.

In a room right around the corner from the hospital's emergency room, laboring women move down the chakana's rungs during delivery, transitioning from almost standing before contractions, to kneeling with their palms on the lowest rung, back curled like a cat, posterior high and ready for birth.

The practitioners believe the downward abdominal pressure as a woman moves down the steps or switches from standing to squatting helps push the child out and speeds up dilation of her cervix.

Part of a model effort to lower maternal and infant mortality and attract more women to hospital deliveries, San Luis de Otavalo is the first public hospital in Ecuador to provide a so-called vertical maternity ward that connects indigenous birthing practices with access to modern medicine. The ward opened in April 2008.

"It was a hard fight for us to get into the hospital and care for women with our ancestral wisdom and practices, with our teas and waters, our sacred cleansing rites," says Colta. "Everyone has bad energy. But we shoo it out at birth."

I particularly enjoyed this gynecologist's commentary about vertical versus horizontal birth:

Pedro Luna, the chief gynecologist at the ward, attributes the speed of ... vertical deliveries to the use of a natural position. "Vertical birth-delivery, adapted by the Kichwa tradition, is a natural and instinctive process that makes physiological sense," says Luna. "Horizontal birth is an occidental practice brought by the conquistadors with zero medical logic."

First chosen mostly by indigenous women, vertical births are becoming more common among mestizas as well. Vertical births have also lowered the hospital's cesarean rate from 18% to 8%.


  1. Cool. Reminds me of this article about neighboring Peru...

  2. Thanks for the link; I'd read that article about Peru a while back but couldn't find it.

  3. wow! from 18 to 8! that's awesome.

  4. Neato! And MAN what an awesome C-section rate. The U.S. could learn a lot from Ecuador!

  5. I just had a birth in October this way (vertical). Whole process was less than 3 hours and AMAZING!!!

  6. Rixa: I am really happy the folks in Equador are able to bring this into the hospital. In order to convince folks here that it might improve outcomes, we would have to do a study with numbers. And use good math technique. I will check out the site. I hope they are quanitfying their stuff with good math. Because if so, I can present that to folks at my Hospital. Our c-section rate is atrocious.

    I cannot fault the Obs alone. Many of the Midwives and Nurses are quick to jump on the C-section band wagon. And of course, no one wants to be sued.

    Maternity care at my hospital is in a huge stage of distress. Many Docs and Midwives have left. I have to ask myself, "Who is going to take care of the pregnant women of the future?"

    I think it is great that the hospital and the community could come to an understanding and get the job done.

  7. This is so basic and obvious that my first reaction was "duh"...but then I thought about the hospital births Ive had and the homebirth I had and how different (duh again) the labors were.

    The laying down in bed that was omnipresent in the hospital was completly non existent at home. There was no worse pain than to be on my back, I endured it for about 15 seconds, once, during my home labor for an agreed-to cervical check and truly, truly thought I would die

    I hope that really, really soon this basic acceptance of gravity in conjunction with women's needs will be incorporated into todays American hospitals.

    But this is a big step and I am happy to hear about it.

  8. Great post! I linked to you and wrote about this on my blog.

  9. Perfect post for your new blog title.

  10. awesome. vertical birth (parto verticale) is a law in Peru, but very few women in Cusco hospitals actually birth that way; if they do it's usually not on purpose. here's hoping for some positive neighborly influence!


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