Book review: The Heart in the Womb by Dr Amali Lokugamage

Claria Yoga_book review

Intuition versus Education – 

Book: The Heart in the Womb

A thought-provoking book written by Dr Amali Lokugamage, an Obstetrician who, despite her medical training and years of practising in the profession, chose a home birth over a hospitalised birth for her own delivery.

Throughout her pregnancy, she sensed a very strong bond between her baby and herself, feeling that she was able to pick up on communication coming from him. She spent time exploring the natural philosophies of pregnancy and childbirth practised by Birthlight and the Gentle Birth Method, and over time drew a number of conclusions about how society has moved into a fear-driven, medicalised, de-humanising way of managing pregnancy and labour, thereby rejecting the fact that women, their bodies, minds, inner selves and consciousness “know” exactly what to do without medical intervention. The preventative, risk-mitigating approach used by doctors interferes with the mother’s natural rhythm. Their assumption that all pregnancies are risky has led women to lose all confidence in their innate abilities to manage pregnancy and childbirth, causing widespread fear associated with what is in fact a most natural, beautiful and divine process.

Modern-Day Pregnancy

She shares a few examples illustrating where she feels that society today has lost all connection with the natural rhythm of pregnancy and childbirth:

  • During pregnancy, most women tend to carry on working, running around and doing what they’ve always been doing, instead of slowing down, going within and nurturing themselves and their baby. As discussed by the author, the body is naturally programmed to trigger a period of nurturing, today called “pregnancy brain”, which is only the body’s natural and necessary response to pregnancy to help keep the expectant mother in a calmer, less anxious state.
  • There are countless medical practices that come with managing a pregnancy. However, Dr Lokugamage shows that certain medical practices are unnecessary or may even be detrimental – to name but a few:
    • Use of electronic foetal monitoring
    • Routine use of antibiotics
    • Unnecessary delivery by caesarean section
    • Use of epidurals or systemic opioids that can lead to adverse breast-feeding effects
    • Medicalised and pharmaceutical recourses for dealing with common pregnancy issues such as gestational diabetes, morning sickness and pelvic girdle dysfunction
  • Antenatal consultations now rely excessively on reports, biochemistry or technology, to the detriment of hands-on medicine
  • Midwives in hospital have been turned towards a risk-averse, protocol-driven system, when in fact the more natural midwifery model minimises unnecessary intervention during labour

An Expectant Mother’s Inner Wisdom

The author explores a number of interesting points about an expectant mother’s natural ability and inner wisdom – for example:

  • Expectant mothers can and should trust what their intuition is telling them
  • An underlying communication exists between mother and baby, and can be accessed when the mother is given space just to be
  • A woman’s body enters a natural rhythm when labour begins, a rhythm that the mother should be allowed to access without distractions, interruptions, noise and stress, that are typically present in a hospital environment, and that interfere with the body’s natural triggers (ie. the production of pulsatile oxytocin, the relaxation needed to allow the tissue of the pelvis to stretch, etc.)

In the book, Dr Lokugamage discusses the proven success of much gentler and more intuitive models such as the Gentle Birth Method or Birthlight principles:

  • When adequate peripartum support is available, the mother is more easily able to tap into her body’s natural ability
  • “Breathing the baby out” using sounds to help open up the pelvis is a much gentler method than pushing and forcing during delivery
  • The use of complementary therapies such as hypnotherapy, yoga and massage help in all aspects of pregnancy and delivery
  • From a nutrition stand-point, more awareness around diet can help women to achieve normal birth
  • Creating the optimum environment for labour helps to ensure that the mother’s birthing wisdom is allowed to prevail (private, soft, homely, comfortable)

In Summary

Dr Lokugamage is trying to increase awareness around the need to reduce the current fear-based reality of pregnancy, lead people to adopting the philosophy of mothering and nurturing the mother, and give women back the confidence to trust their bodies’ natural ability to birth. She hasn’t dismissed the importance of having access to the medical system in the event of emergencies. However, she has highlighted how following more natural paths would help to reduce the problems and risks currently associated with pregnancy and labour. Moving away from a de-humanising, logic-based, medicalised pregnancy and labour process, to a more inwardly connected, intuitive process contributes to better bonding between mother and baby, less likely development of problems such as post-partum depression, and better confidence with child rearing.

Things are changing. Hypno-birthing, yoga, acupuncture, home birthing and other alternative methods are now becoming more readily accepted and encouraged in pregnancy and childbirth. But there is still a long way to go to getting women to regain confidence and have faith in their body’s natural ability to birth.

This book was a real eye-opener for me. I haven’t yet been blessed with the opportunity to become pregnant and eventually give birth. However, when I do, Dr Lokugamage’s experience will make me think twice about how I want to manage my pregnancy and delivery. I would like to be given the space and confidence to embrace my inner divinity, balance and wisdom, and give my body and mind the chance to access the powers that they are naturally programmed with to manage the miracle of pregnancy and childbirth.

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