The tiny trailblazer and his joyous parents are back home amidst these trying times. Not named yet, as Kshanikadevi Rupesinghe and Mevan Peiris wish to see his personality before bestowing a name and did not want to know the gender of their first baby before birth, he will however go down in the annals of [...]

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The newborn making waves

The baby boy born to Kshanika and Mevan on Good Friday is the first planned water birth in a hospital setting in Sri Lanka
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Relief and joy: Kshanika, Mevan and baby. Pix by Sanuri Fernando (Ninewells)

The tiny trailblazer and his joyous parents are back home amidst these trying times.

Not named yet, as Kshanikadevi Rupesinghe and Mevan Peiris wish to see his personality before bestowing a name and did not want to know the gender of their first baby before birth, he will however go down in the annals of Sri Lanka as unique.

For, he is the first to be delivered in a planned water-birth in a hospital setting in the country on Friday, April 10.

“Soon after he was born, the baby wasn’t crying. He was calm as he was thinking that he was still in the womb,” says Kshanika creating an image of kneeling in the comforting waters of the birthing tub in the ‘Moon Suite’ at Ninewells Hospital down Kirimandala Mawatha, Narahenpita, holding onto Mevan’s hands during the delivery.

Of course, lots of photographs followed as she held him close and the umbilical-cord clamping was delayed as done in water-births, allowing the mother’s blood to keep flowing to the newborn until its pulsating stopped.

Next Kshanika sat on the edge of the tub, cuddling her baby to her chest and then stepped out of the tub, helped by Mevan and the healthcare team which had been around to assist her, onto a bed where the placenta was delivered and she inhaled some laughing gas (combination of oxygen and nitrous oxide) to take away the pain when her Consultant Obstetrician & Gynaecologist,
Dr. Probhodana Ranaweera, stitched up the birth canal tears.

“No medication did I take until that time, from the time the contractions started at about 6.30 that morning to the time of delivery,” says Kshanika.

Smiles all round: The entire medical team with Mevan, Kshanika and baby. Second from left is midwife Rennie Boreham and standing fourth from left is Dr Probhodana Ranaweera

All along Mevan was at her side, holding her hand, offering her water or king coconut to keep her hydrated and as the contractions became more intense and painful firstly rubbing her lower back and then seating her in the bathroom and holding a hand-shower over her, in a session that lasted nearly 45 minutes and later taking her through the inhalation and exhalation paces during the water-birth itself.

The staff, meanwhile, kept checking the heartbeats of both mother and baby.

“A water-birth is different to a normal delivery on a hospital bed. My baby’s head began crowning at 3.59 in the afternoon and his body slipped out with the contraction that followed three minutes later at 4.02,” she says, going into detail how a midwife who has much experience in water-births flown down from the United Kingdom (UK), Rennie Boreham, guided the couple through the whole process.

For Mevan and Kshanika the week brought about a double celebration – the arrival of their firstborn and Mevan who is Head of Operations of PickMe Food being included in the ‘30 Under 30 List’ of the prestigious international business magazine Forbes.

The week of the baby’s birth was extremely busy for the couple, with Kshanika continuing her work as a Chartered Architect attached to Hyundai Engineering & Construction which is handling the massive Cinnamon Life project.

“Before curfew was clamped I was working an 11-hour day which included site-visits after donning construction helmet and boots. My work continued even while at home,” says Kshanika.

All their belongings were in boxes as they were planning to shift from their present house to another home. The baby’s things too was not ready, “no cot, no cradle…nothing” as they thought they had time and many people had promised to gift them or lend them stuff.

Just before the curfew, while Mevan was caught up in heavy work, Kshanika had driven around and got a bag ready with nappies and a few of her maternity clothes.

The curfew also put paid to their attempts to meet and have a chat with the midwife, instead long conversations they had on the phone with Rennie encouraging Kshanika to continue the yoga breathing practices she had begun when she took to Kandyan dancing as a girl. She was also a good swimmer.

Both were working at a hectic pace and Mevan says their lifestyle was in “zombie mode”.

As they were on the verge of moving, they had no food stocks and had to borrow from their landlady. Maundy Thursday, the day before the birth, they watched the Christian service on TV and Kshanika made pol-rotti for dinner, finding that there was flour enough for just four which she told Mevan to have, while she had a soup and salad.

And the baby did decide to come early, laughs Kshanika, recalling that before their marriage she had seen a YouTube video on ‘The birth of Sloane’ by Natasha Hance which riveted her attention. It was about water-birthing and she thought that she too would like to go down that pathway.

When they married and she conceived, Mevan however, was skeptical and had many queries about the possibility of the baby drowning. It seemed “non-negotiable”. Sheepishly, she asked Dr. Ranaweera at their first consultation and he was open to the idea, suggesting that they check out the facilities being done up at Ninewells Hospital.

Dr. Ranaweera, meanwhile, had been fascinated with the concept of water-birthing – which was solely handled by a well-experienced and skilled midwife – during his post-graduate training in the UK.

This is a well-established and routine birthing process in the UK for low-risk expectant mothers, it is understood.

“Water-birthing is in keeping with the concept of positive childbirth promoted by the World Health Organization (WHO) under which expectant mothers have a choice. It has many advantages and studies have shown that water-birthing reduces pain and cuts out the need for pain relief medication because such relief comes through breathing techniques and the water itself,” he says when contacted by the Sunday Times, pointing out that it was also found to reduce the duration of labour, while reducing the bleeding after delivery.

There was also less need for an episiotomy (a surgical cut made at the opening of the vagina during childbirth) and mothers who delivered through water-birthing were found to have fewer perineal tears.

Many people question whether the baby would be affected by the water soon after birth, but remember that the baby is in an amniotic sac with fluid, he says.

There is also evidence that there is no increase in infection from the water for mother and baby, when comparing a water-birth and normal delivery, it is understood.

Dr. Ranaweera says that for the mother, the experience is positive and all about having a choice, moving away from the Sri Lankan mindset that a woman gives birth daha-duk vindala (with much pain). This helps the mother to enjoy the birth. This is another milestone in the maternal quality of care in Sri Lanka.

Echoing his views, Kshanika says she is happy to be a pioneer where the expectant mother is in control of the delivery and she hopes that more women would be empowered to make a choice on how they wish to deliver their babies.

For Kshanika and Mevan the water-birth of their firstborn is the fulfilment of a hope closest to their hearts and for Dr. Ranaweera it is a dream come true, while a tiny baby boy is establishing his own routine, oblivious that he has made obstetric history in Sri Lanka.

1990s: A baby is born in a tubful of water in a home in the hills
Tipped off by Dr. Probhodana Ranaweera that there had been a home water-birth in Sri Lanka before his time, we followed up and traced it to Obstetrician Prof. Jayantha Sirisena now living in New Zealand.

“It was a long time ago,” said Prof. Sirisena who was then attached to the Peradeniya Medical Faculty as a Senior Lecturer and Gynaecologist & Obstetrician at the Peradeniya Hospital.

A long-haired artist, Rahju, living about 10 km from Kandy had come with a friend of Prof. Sirisena’s and requested a water-birth for his wife. After reading the material available on such births which was not much, Prof. Sirisena had visited their home set amidst spectacular scenery, which could be accessed only in a four-wheel drive jeep and seen a fibreglass tub made ready for the birth. He had laid down certain conditions including the need for the jeep to be ready in case of an emergency.

It was at the height of the JVP troubles in 1988-89 when Prof. Sirisena was informed that Rahju’s wife was in labour. Rushing to a private hospital in Kandy, he had picked up the obstetric instruments and gone in his car, finding to his surprise that Rahju was on a motorcycle to take him to their home.

Watching and waiting for about three hours, Prof. Sirisena had not been “happy” with the baby’s heartbeat and insisted that they go to hospital. “The journey out was nerve-wracking. Rahju’s wife and I were ferried to my car in turns on the mo-bike as the jeep was not starting and then we drove down to the private hospital where I delivered a little girl,” recalls Prof. Sirisena.

It was a normal delivery not involving water.

A few years later, in the mid-1990s, Rahju had appeared again with the same request for their second child, whom Prof. Sirisena delivered in a tubful of warm water in their home in the hills.

“Mother and baby were fine,” says Prof. Sirisena, adding that the parents named their son, Ravana.

 

 

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