One at a time
How to make the world a better place? Simple, says midwife Robin Lim. Provide gentle hands at birth from a midwife and mother figure. Michael Andrews experiences the energy of a woman with a calling to accomplish “some small thing, every single day” – and a quest to infuse our first moments of life with maternal love. Photos by Damon von Lawner.
I’M sitting in the open foyer at the Bumi Sehat Clinic in Ubud and Robin Lim has just burst out of her office en route to one of the delivery rooms. I’m immediately struck by her piercing black eyes and her long dark hair – along with a demeanor that is positively ebullient. There is something fresh and crisp radiating from this midwife of 18 years, who is also a mother of eight and grandmother of two. Previously anticipating a brush with a soft-spoken New Age type – more typical of Bali’s Western caregivers – I was caught off-guard by a directness that wouldn’t be out of step in Robin’s native city, New York.
I had been waiting for an hour and our interview had yet to begin. Instead, I had been caught between a seemingly endless queue of expectant mothers awaiting check-ups and a couple who circled the waiting room joyously holding their newborn child. With a curtness bordering the fine line between playful sarcasm and brusque honesty, Robin Lim spoke her first words to me. “You’re still on hold,” she said. “Mothers before journalists.” She turned for the door, stopped quickly to introduce herself and explained the delay – a baby was about to be born.
As a single man in his mid-thirties who had just spent an hour in the maternal atmosphere of a birthing clinic, I felt the need for a breather. I started up from the couch, asking Robin if an hour would suffice. She shot back: “Why not stay right here and feel and experience the energy of this birth?” The invitation stopped me in my tracks…the energy of a birth? Makes sense, I thought – it’s a tiny three or four kg explosion of new life on the planet, someone who could turn out to be a future President of the United States or perhaps, more poignantly, a beloved and loving grandfather. ‘Birth energy’ was a completely alien idea to me, and the first of many new concepts that I was to encounter through this extraordinary woman. It would also be the first time the word ‘placenta’ crossed my lips, and after studying it, I discovered that the term is strikingly appropriate – from the Latin, meaning cake.
Robin ducked into the delivery room to join two Balinese midwives, Ibu Agung Mas and Ibu Dewa, who would be ‘catching the baby’. Due to Indonesia’s strict foreign employment standards (which protect the jobs of the indigenous population) a Westerner is not permitted to do the actual work here. Robin’s focus is primarily to manage and run the clinic, to teach, and to facilitate. She considers herself the “protective mother and adviser to the Bumi Sehat Medical Team”.
At 53 years old, and with about as varied an ethnic background as one can have, Robin is a mixture of East and West, Old and New World. Her father was part German, Irish and Native American and her mother was Filipino-Chinese. Aside from her roles of midwife, mother and grandmother, she’s also a published author and poet, an environmentalist and a humanitarian who was recognized with the Arthur Lange Humanitarian Award in 2006. Operating three clinics – one in Aceh in the northwest tip of Sumatra, one in Haiti, and her centre in Nyuh Kuning village (next to Ubud), which is also a short 30-second walk from her home. The clinic here is named Bumi Sehat, which is Indonesian for “Healthy World”.
The clinic, which employs 30 Indonesian workers, (nine of whom are midwives) and engages many international volunteers, facilitates an average of almost two births per day, nearly 600 each year. It also provides prenatal clinics, pediatric baby clinics as well as treatments in acupuncture and the energy work of Reiki. It’s a place where all are welcome. Musician Michael Franti can be found hanging out here on his trips to Bali. Franti is a big supporter of Robin’s, devoting not only his money and his music towards the cause, but also his time.
Indonesian rock star Oppie Andaresta caused a commotion when she had her baby boy delivered here, with the clinic besieged by teenaged girls. In a move that surprised even Robin, Oppie welcomed her fans to pop their heads into the birthing room within an hour after childbirth to show them all that she was breast-feeding. Elizabeth Gilbert, author of the bestselling novel Eat, Pray, Love has a special section on her website about the clinic, calling it “a special haven…that operates on a shoestring budget” where “Balinese Muslim women (a not-always-embraced minority) are sure to always be treated with respect and kindness.” She wonders whether or not Robin ever sleeps and requests of anyone planning a trip to Bali to drop off an extra suitcase of blankets or toothbrushes if they aren’t able to make a monetary donation.
Robin and a team of midwives founded the clinics in Aceh and Haiti as a direct humanitarian response to the international emergencies that occurred following the 2004 earthquake in the Indian Ocean (and subsequent tsunami) and the 2009 earthquake in Haiti. Once the initial media buzz of these events had died down and most of the NGOs had packed up their respective operations, these clinics found themselves scrambling for money to fund ongoing operations – so far, they have been able to continue running them on a shoestring budget. Franti and Gilbert aside, the core of their funding comes from regular people making consistent, but very small contributions.
Robin was a ground-zero witness to the horrible aftermath of the 2004 tsunami in Aceh where, in the span of an hour, 250,000 people perished and half a million lost their homes, businesses and livelihoods. Likewise, she just spent a month in earthquake-ravaged Haiti, and will return there again in September. The horrifying memories of these catastrophes and their respective aftermaths remain so deeply ingrained that they still cause her – and her tough-as-nails persona – to weep uncontrollably. To get through such difficult and inherently emotional situations, Robin focuses strictly on her work and her lifelong devotion – to make the world a better place, one birth at a time. Her de facto motto is to accomplish “some small thing, every single day”, she says. “If we look at the big picture, we can be paralyzed, so I focus on the potential for peace right in front of me at the very moment.”
In Robin’s view, human nativity – especially those occurring in particularly traumatic or stressful deliveries – have the potential for long-lasting negative consequences. On a personal level, she believes that these nascent experiences, though largely unremembered, can have a lifelong impact on how each of our earthly existences plays out. On a macro level, Robin feels that numerous traumatic births have the ability to negatively influence societies for generations.
As with other Balinese midwives, Robin is known simply as Ibu, meaning mother. She feels that the precious first moments of birth represent every new soul’s introduction into the world as the single most important place to begin to make it a better place. If we get this right from the get-go, she believes, future citizens on this planet might have a chance to foster healthy loving relations with each other and to experience such oft-repeated catch phrases as “world peace” and “respect for humanity and the environment”. As the hackneyed expressions of Dale Carnegie tomes and dandruff shampoo commercials go: “We never get a second chance to make a first impression.” This phrase is particularly relevant to Robin’s embrace of her perceived meet-and-greet role as earthly stewardess, believing that each incoming new human being should be welcomed likewise by a midwife trained in the art of compassion and care, instead of isolation and trauma, which can be symptomatic of hospital births.
Of course, fine restaurants employing impeccably trained maitre d’s, department stores filling entrances with perfume offerings, and any company rolling out a new product with an expensive marketing campaign can embrace the value of a good “lead-in”. It’s no small wonder as to why our newest members to the planet – our youngest consumers, customers, and future scientists, lawyers, inventors and financiers, not to mention mothers and fathers – are not treated with the same warm-and-fuzzy welcomes as those epitomized in Western society by the likes of Super Bowl commercials or costume-clad Disneyland greeters. Young minds have always been known as impressionable, and our minds are never younger or more impressionable than the moment we’re born.
Some members of the Western medical community would disagree. The idea that a traumatic or overtly clinical birth could foster long-standing personality problems has not yet hit their radar screens, and it’s unlikely to do so anytime soon. In the US, the focus is on the logistics of a successful delivery, with institutions like the American Medical Association and the American College of Obstetricians and Gynecologists remaining steadfast in their assertions that obstetricians provide better maternal and infant healthcare than midwives. Hospitals often complain that practicing midwives operate in a grey area – mostly unregulated and with lack of oversight from a governing body. They feel they’re also an open target of midwives who speak out against their perceived injustices, yet they are still there for midwives to fall back on during emergency situations – where problematic births may threaten the lives of mother and/or infant. A hospital will never refuse a person in a critical condition.
Backlash against midwifery is nothing new and has its roots in a 1484 document by Pope Innocent VII, with the claim: “Midwives cause the greatest damage (of all witchcraft).” By the 19th century, the medical community commonly regarded the practice as “a relic of barbarism”, as a medical journal of the time referred to it. Today, such negative perception is much less common in Europe, where 70 percent of babies (whether in hospital or home) are born in the presence of a midwife, as compared to seven percent in the United States.
One of the handful of voices that have been pushing for more research, studies and scientific insight into the matter is Obstetrician and Gynecologist Dr. Michel Odent. He’s been doing extensive research into the studies on the physiology of birth and the effects of the hormone Oxytocin, which he refers to as the “love hormone”. Having supervised over 15,000 births since 1953, the 80-year-old Dr. Odent is still looking youthful and spry, as his recently posted YouTube videos and our spirited e-mail correspondence would attest. As a surgeon in Paris during the ’50s, he began to witness hospital birthing procedures first-hand. By the ’70s, Dr. Odent began to push for more home-style hospital birth rooms and was the first to publish in medical journals an avocation of the advantages of birthing pools and the benefits of breastfeeding in the first hour following childbirth. Since then, Odent has published 12 books on a diverse amount of topics regarding birth and newborns.
Dr. Odent is “convinced that those first moments after childhood, which can never occur again, are critical to mother-child bonding”. Feelings of love (factoring prominently in the mother-child connection) “are particularly strong immediately after birth”. This is the instant, he says, “when a woman is supposed to reach the highest levels of Oxytocin that she will ever experience”.
Oxytocin, part of what Odent also refers to as “the cocktail of love hormones”, is not only critical to initial human bonding, but essential for contractions of the uterus; making for easier delivery and subsequent smooth release of the placenta. Adrenaline, which appears in the presence of perceived danger, begins to enter our bloodstream even when we are aware that we are being observed. Adrenaline also acts as the main inhibitor of Oxytocin. “An inappropriate birth environment and a talkative birth attendant can increase the chance of a laboring woman seizing and panicking, which can result in unnecessary intervention,” cautions Odent. While the secretion of adrenal glands can lead to disruptions for humans mothers, it serves a useful purpose in the wild. A mammal about to give birth in a situation of danger benefits greatly from adrenaline to freeze the birthing process and to provide the necessary energy for fight or flight until the mother can secure a safe place to continue with the birth.
The more disruptive the environment, the greater the possibility of pretension – which leads to the increased likelihood of difficult births. Sports psychologists are incredibly valued for their ability to get ballplayers ‘in the zone’ – which, for the layperson, means to stop thinking and become naturally in tune with what is happening. Dr. Odent explains that this activity in the Neo-Cortex part of our brain is particularly relevant in women giving birth (and athletes trying to hit a curveball, for that matter). When intellectually stimulated with direct questions and heady talk, it becomes harder for women to achieve a smooth delivery.
Dr. Odent reports that “interruptions in the birthing process have led to more interventions” such as C-sections, and through this process something very valuable can be lost. For example, with monkeys that give birth by C-section, there is no acknowledgement by the mother of the baby – for the baby to survive it must then be raised by humans. In a University of California study of 4,269 male subjects born in the same Danish hospital, it was found that the main risk factor for being a violent criminal by the age of 18 was “the association of birth complications, together with early birth separation from or rejection by the mother”. Similar empirical studies have linked birth interventions and complications to autism, asthma and anorexia.
Dr. Odent observes that “societies have dramatically disturbed the birth process for thousands of years” – which, he believes, has fostered aggression among certain civilizations and enabled them to dominate nature and other human groups. It seems to be a self-replicating cycle – hostile, successful societies fostering truculent births that produce aggressive humans.
To counteract this, he urges the promotion of a protective mother figure – a strong female guardian knowledgeable about the natural processes to defend the space that the fetus needs to indicate when it is ready to be born, instead of it being over-ridden and ejected in the spirit of efficiency. Science can now show that even in the last few days of a fetus in a womb, finishing touches can be put on the baby’s growth that may not later occur. Although it’s a widely accepted practice in corporate farming, let’s say, to pick bananas at bitter green and let them ripen on the shelf, it may not work for humans. A baby’s lungs, heart and brain are much more time sensitive in maturation – making the birthing process, and the baby’s own indication of readiness, more critical to human potential than originally speculated.
Dr. Odent’s conclusion is simple. “The best environment for an easy and fast birth is when there is nobody around the laboring woman, apart for an experienced and silent midwife who is perceived as a mother figure.” That role of the protective mother is the role that Robin Lim and her staff take seriously with each incoming pregnant woman. “Robin is a legend,” is how Dr. Odent concluded our email correspondence, stating that one of his projects “is to visit Robin one day in Bali, on her own territory, instead of always meeting her at conferences”.
Ibu Robin’s work in striving to foster the healthiest and most psychologically sound babies has meant that she’s had to butt up against countless issues and controversies on increasingly varied fronts. One of these has been the influence of corporations on the food supply and what she says has led to “full belly poverty”. In Third World nations, she says, one of the most dangerous threats to pregnant mothers has been the replacement of traditional rice varieties grown for thousands of years with variety IR-8 and later IR-36, also called Miracle Rice.
It’s a simple case of quantity over quality. IR-36 and similar strains, which are staples here in Indonesia, have little value other than as empty carbohydrates, and their production also requires a greater use of fertilizer and pesticides. The commercial benefits are obvious – two harvests a year from the same land as opposed to the traditional one, with much higher yields per harvest – and the surprise addition that it can be stored forever without danger of being eaten by rats. The rats seem to be unable to recognize it as food, and have been found, when desperate, to eat the paper containers but leave the miracle rice untouched. What it means for regular people when ingesting this essentially nutritionless food is a sugar spike in insulin levels which can lead to stored fat and eventually a risk for Type-2 diabetes. What it translates to for mothers-to-be, whose diets consist mainly of this rice without many proteins and greens, is a high risk of hemorrhaging after childbirth. It hasn’t been lung cancer, nor heart disease, nor automobile accidents or even terrorist attacks that rank the number one leading cause of death for Indonesian woman in recent years – it’s been bleeding to death after childbirth.
Another obstacle to Robin’s work in creating healthy babies has been the medical community’s promotion of infant formula feeding over breast-feeding. “Even malnourished mothers can produce enough quality breast milk to feed their babies well,” Robin says, and she has seen it firsthand. The World Health Organization recommends that babies survive solely on breast milk for the first six months after birth. She notes the societal and environmental advantages to breast milk over formula – namely, the packaging, shipping and cleanup of hundreds of millions of empty formula tin cans. However, there is one huge over-riding problem surrounding breast milk which she says can’t be resolved for companies – “there’s no money to be made on it”.
Breast-feeding is a practice that has continued to decline in Third World countries, for various reasons. Insecurity has been a major problem for doctors in developing countries who have been schooled by Western methods. It’s made them more susceptible to authority figures, some maintain, including corporations pushing the powered milk. In Indonesia, Robin tells me that a child is “300 times more likely to die within the first year if it does not feed from mother’s milk”. It’s something that’s going to take a lot of courage from doctors here if they are to learn to trust their own instincts again after their Western education and not, as the saying goes, “throw the baby out with the bathwater”.
Robin trusts her own instincts. For her, the natural arts are “a waiting game” – of assisting nature and knowing exactly when to intervene, never forgetting that “nature is calling the shots”. She also seems to use her motherly instincts to keep her staff incredibly happy and well-motivated. Robin’s charismatic nature and her willingness to lead by example impel her staff to work hard in this endless campaign of assisting new life into this world. Jacinta Knell, a volunteer from Australia, told me: “Robin is quite inspiring and is able to draw people in – an amazing gift.” She seems to possess a great sense of humor as well. Jacinta and Robin’s valued assistant, Ayu, recounted a time when they were threading beads to make a necklace as a gift for a new mother on their staff, but were having great difficultly in securing the thick string through the tiny bead holes. Robin came across their missteps and remarked with a sly smile: “You girls are very good at helping to take things out, but not very good at putting things back in.”
Ayu, who loves working at the clinic, admires Robin “for her big heart”. In speaking with others in and around Ubud, it is obvious that Robin is viewed as larger than life. “She’s one of those saintly figures,” confides a longtime Bali resident who wished to be unnamed, he said, because of Robin’s “Mother Teresa-like reputation”. Like the documentary based on her work, Guerilla Midwife, there is a side to her, he went on, that can be quite graphic and provocative in person, and this can come across as off-putting in a way that borders on “self-righteousness…to get others to fervently join their cause”. (The film, which was presented at the Cannes Independent Film Festival, is itself quite explicit and shocking for the uninitiated – including as it does scenes of babies’ heads popping out of vaginas with repeated references to miracle rice and breast-feeding.) He recounted a story of a party at which the film was premiered in Bali. It began, he said, “with a neo-hippie chick citing New Age babble and singing Joni Mitchell-like laments of injustice in the universe,” the audience being told that Robin would be late because of a last-minute delivery. When Robin did finally appear looking “weary”, he reported her as saying: “I wanted to take a shower before I came but was forced to rush here with my clothes soaked with amniotic fluid and blood because I just delivered my third baby today.” Although stating that he has “great empathy for her work and her sacrifice”, her speech, which this Bali resident likened to mirroring the film itself, was in his opinion “designed to instill feelings of guilt”.
For someone with such as strong personality as Robin’s, battling desperately to find operating budgets for her clinics for disadvantaged people, it’s understandable that she is going to get in some people’s faces in her attempt to wake people up to her realities. Far more difficult than delivering healthy babies, Robin tells me, is another part of her work. “The hardest challenge is fundraising,” she says. Whereas I personally know friends in North America who think nothing of spending two thousand dollars to have plastic testicles placed in their neutered dog, citing reasons of giving their male pet more confidence after its sexual organ removal, I don’t know too many people who are actively looking to support a midwife clinic in Indonesia. It’s a struggle she deals with daily.
For Robin, this calling had its beginnings in her “first sex education class in high school at 14 years old,” she says. “I got very excited about sexual reproduction, and I still am! Just think about it – we make babies from scratch, with a little love and some lust and a miracle, an entire human being gets born. It’s ancient and it works so well. And it’s not just human births that hold her fascination. She recalled to me how, on a trip to Maui, she “witnessed humpback whales giving birth. The mother would come to a protected cove with an elder female whale – a leviathan midwife!” Through this experience she came to believe that humans are not the only mammals who have midwives. “Female monkeys also know that they must get far away from male monkeys when they give birth, so that the birth will not be disturbed.”
As I continued to sit outside the birthing room at Bumi Sehat, I began to hear grunts and moans coming from inside. The door then gently opened and closed. It was Devin Bramhall, an American volunteer. She had stepped out of the room due to a spell of light-headedness and explained that this was only the second birth she had witnessed.
At 27 years old, Devin decided to leave her job in Boston working at an Internet start-up, put all her belongings into storage and come to Bali as the assistant volunteer coordinator. With the encouragement of her mother, a midwife who has worked with the clinic for four years helping to run the volunteer program and co-found the newest clinic in Haiti, Devin prepared for many things, but had never suspected she’d end up this close to the process. “A big part of Robin’s gift,” she says, is “to encourage those around her to open their minds up to new experiences.” In her first birth, Robin had instructed Devin to gently stroke the mother, using the soothing qualities of human touch to help the woman to relax. This birth also marked Devin’s so-called “baptism” – a sudden projectile of amniotic fluid from the mother splattered across the room and onto her legs and feet. Her biggest surprise with it was “that it didn’t gross me out”. Rather, she explained, it just felt like a normal part of the life process.
There was something else that had caught Devin by surprise during that first birth – just how little machinery was used to bring the baby into the world. “The woman lay on a bed completely void of equipment, surrounded by her husband, three midwives, me and some rags to clean up her fluids. Even after the birth, there were remarkably few tools required to complete the process: a metal basin for the placenta, scissors, stitches and one needle’s worth of medicine administered before the stitches.”
Devin admitted to me that today’s birth was much more intense than the first one she had attended, calling the energy in the room “thick and stifling”, which had apparently served to push Devin out the door, but not yet the baby out of the womb. She took some deep breaths and then went back in. Sitting on the couch for what seemed to me only a very short period of time, I heard a quiet cry – a small confirmation that the earth’s population of roughly 6.8 billion had been increased by one. It’s another baby that Robin says she might “recognize years later”. She confided in me that sometimes she’ll walk down the street and, even though she hasn’t been with the child since the day they were born, and now they may even be 16 years old, she can still recognize their face, which she says, “doesn’t change”.
A few minutes after the cry, Robin emerged from the room smiling. She appeared much more relaxed. It was evident to me that her tough facade which I had glimpsed earlier was a barrier that she called upon to protect the sacred space that mothers need in achieving an easy birth. It’s a measured mix of strength and tenderness that I suspect must come with the territory of supporting thousands of mothers over the years. In fact she’s seen so many thousands of births that she wouldn’t even give me a number, saying that, if she did, it would appear “as if she was lying”.
While Robin washed up, she asked me to poke my head into the next room over and say hello to the couple I had seen earlier circling with their baby in their arms. This woman appeared so incredibly fresh and bright that my initial thought was that she must have given birth a few days prior. Robin told me it had happened only in the afternoon of the previous day. Not quite believing this, I had to confirm for myself – the couple smiled and said it was true. My other experiences with new mothers had taken place in hospitals where visiting friends’ wives had given birth the previous day. I recall seeing those women looking exhausted, worn-out, and then being told that they would be kept in the hospital for several more nights. This beaming Balinese woman who sat in front of me instead looked as though she had just come back from a week lounging in Bora Bora. Could this be the aftermath of her experiencing a natural Oxytocin high, unimpeded by an epidural or other injections?
“When one has Oxytocin-rich experiences, our perception of the world changes,” Robin tells me. “The trees appear greener, we can really hear the birds singing, food tastes more delicious. This is the platform for jumping into gratitude.” There are also other ways than giving birth to get this type of blast, she says. “A heart-to-heart talk with another person or a good hug, or making love, or sharing a meal with a friend, or just smelling a flower.” All of which, according to her, builds more love hormone receptors in our bodies, with “the experience of love building in us an increased capacity to appreciate love”.
It’s the opportunity to be around this kind of insight that brings in busloads of young midwifery graduates to the Bumi Sehat Clinic, “sent by their teachers to learn to infuse their future midwifery care-giving with love”. Here they are exposed to Robin’s formula on the love that a midwife must posses – “Respect for nature together with respect for culture plus a solid foundation in medical science.”
Her experiences have led her to a Zen-like philosophy on life that she sums up with a favorite saying of the midwife who delivered her fourth child. “We know what we know,” translating into what, for Robin, is an unconditional and loving acceptance of our own personal stage of development and respect and non-judgment for where others currently are. In Robin’s own take on acquiring a loving acceptance of all that is in the world, she reminds herself by repeating the words: “Is, is.” This is indeed living a life where nature calls the shots. She tells me: “The big carrot on the stick, enlightenment, as it is called, is perhaps only that, the tiny moment when one first feels agape (unconditional love for all). It is so simple, that people might not even realize they are enlightened.”
A little later Robin invites me to say a quick hello to the woman at whose birth I had been asked to ‘take in the energy’. Walking into the rooms here at the clinic I notice that they look much more like a simple bedroom, devoid of beeping machines, not in the least like stepping into a hospital ward. This brand new mother of one hour, also a Balinese villager, was breast-feeding her baby as her husband sat next to her. She looked happy, content and again, surprisingly fresh.
It seems that it’s true, as Robin has been quoted, that “the poorest women can enjoy the most beautiful birthing experiences, which not even the most expensive clinic could offer”. I’m reminded of an oft-used expression that actresses at award shows have been known to say: “If this film could help just one person, it would have all been worth it.” Well, this year at Robin’s three clinics, 1,400 babies will receive a tender and healthy welcoming to planet earth.
And if Dr. Odent is in fact correct in his observation that “humanity is at a turning point, when all our deep-rooted prenatal beliefs and rituals are losing their evolutionary advantages…and it’s time for humanity to invent a new strategy for survival” around learning the energy of love – it makes one consider what the world could potentially be like if there ever comes a time when a good percentage of the estimated 135 million babies that are born every year are welcomed with such compassion, intelligence and love as they are by Robin Lim and her team at Bumi Sehat. That’s a whole lot of potential natural birth energy to usher in a new way of living in this world.
However, more than just a chic, urbanesque gudang for Eastern morsels, Mama San’s loft bar quietly teems with cocktail connoisseurs, amateurs and those who are still in training. As with the ground floor below, the décor oozes old world with new world charm. The boudoir lighting is highly flattering – sets the stage for a fun take on how to ‘mix’ and be remembered. Choice is king, with a wide range of tipples both ancient and modern. Martini’s come with a dropper of Dry Vermouth giving this classic a conversational twist. The Moscow Mules arrive in shiny, brass, footless chalices, while the humble clay drinking pot pays homage to Cambodia and its road to recovery. The Bloody Mary, a Yak must have, was still undergoing a fabulous Mama San makeover as I write. Now that, amongst every thing else currently in the Mama San pipeline, (and there are rather fabulous things afoot) is something we also look forward to. 
