The Baby Arrived at a Natural Birth Centre

“I didn’t want to have another caesarean section (C-section) unless absolutely necessary,” Neethu explained when I asked why she chose to give birth to her second child in a natural birth centre. As a major surgical procedure, the C-section carries the risk of intraoperative problems (such as anaesthesia, uterocervical, and bladder lacerations) and postoperative complications (such as pelvic infections, sepsis, and urinary infections).

I had met Neethu during my PhD fieldwork at one of the three birth centres where I conducted ethnographic data collection. Like most of my respondents, Neethu had had a vaginal birth after C-section (VBAC) at a natural birth centre in Hyderabad. The birth centre, one of the very few in India, is notable for its collaborative care approach to childbirth where, in case of an emergency, obstetric care is provided. A birth at a natural birth centre, relatively uncommon and recent phenomenon in India, and only a handful of births take place in such centres. In India, the norm for childbirth is in an institutionalised hospital-based birth under the care of an obstetrician. The government supports and encourages hospital-based births because of reduced risks. But pregnant women like Neethu choose the natural birth centre to try for a “normal” delivery after a C-section, as there is a common belief that “once a C-section, always a C-section.” Some upper-class, well-to-do women prefer to give birth at a natural birth centre to escape the negative experiences they have had giving birth in hospitals. These experiences vary from not having their questions answered, to labour inductions being performed without their consent, and unjustifiable and unnecessary C-section deliveries. The increasing number of C-section deliveries in India is adequate evidence of this.