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Documenting birth

Phil Coomes | 16:34 UK time, Monday, 17 January 2011

Midwife Chioma Ochomma listens for a foetal heartbeat Lagos © Alice Proujansky

The birth of a child is undeniably an important moment in our lives, yet the experience varies depending on the location, culture and many other factors.

Photographer Alice Proujansky has been exploring the culture of birth for a number of years, initially as an artist but now as a freelance photographer who has worked for clients including the New York Times and Wall Street Journal.

Here Alice talks about her project and approach:

"In 2006 I was working as a teaching artist in an inner city school, saving up money for a trip to an under-resourced hospital in the Dominican Republic. Since then I've become a full-time freelance photographer, and I've continued the project by photographing collaborative care in Massachusetts, a midwifery-based practice in the Navajo Nation, and a Medecins Sans Frontieres (Doctors Without Borders) clinic in Lagos, Nigeria.
 
"Birth is a universal experience, but one that varies depending on birth attendants, access and culture. It can be frightening, difficult, powerful and beautiful.
 
A doctor and a medical intern deliver a baby by Caesarean section in the Dominican Republic. © Alice Proujansky

"My approach involves a lot of research. I read about rates of Caesarean and VBACs (Vaginal Birth After Caesarean), about maternal mortality and numbers of midwives, American Congress of Obstetricians and Gynaecologists recommendations and WHO (World Health Organisation) statistics, and then I find a way to get where I want to photograph.
 
"Access depends on the culture that I'm photographing. Navajo and Hopi people tended to be less willing to be photographed, while Nigerians often said 'snap me!' When I ask permission to photograph I explain my project if we speak the same language. If we don't, I find someone to translate for me or I point to my camera and lift up my eyebrows - it's pretty clear what I'm there for. It's important to be respectful and to know when to make jokes and when to be quiet, when to be forceful and when to disappear.
 
"I spend a lot of time waiting: for patients to arrive, for mothers who want to be photographed, and for labour to progress. I watch cop shows with families and joke around with nurses, I look for quiet pictures, and I eat snacks and write. It's hard to wait so much, but it's part of the work.
 
"It's an honour to see a baby's entrance into the world, and an inconceivable process every time. Intellectually I understand what's happening of course, but it's hard to grasp that suddenly there's a new human in the room, and the strength of the mothers and the knowledge of the birth attendants is often remarkable. One experience I really loved was drifting in and out of sleep in a chair next to a soon-to-be grandmother in Massachusetts, together with the expectant, resting family; working and waiting for the baby together.
 
"On the downside, some birth attendants are rude and dismissive to their patients, and I get angry when members of staff do not have the equipment and training that they need. Birth is a critical experience, but it doesn't need to be so dangerous. The first Cesarean section I saw was a little shocking - I hadn't seen an operation before and the hospital's sanitation was severely lacking - but I reminded myself that I was there to make pictures and tell a story.
 
"I shot with a Leica and black and white film in the Dominican Republic, and I've used Nikon SLRs for the rest of the project. Lighting conditions can be challenging: many times the rooms are dark and the patients and I don't want a flash disrupting everything, so I use a fast lens and look for available light. The majority of the project is photographic but I did add audio during my most recent trip, to Lagos."

This is an ongoing project that will in time develop into a fascinating document and one that will provide a visual glimpse of the varied experiences of mothers around the globe.

Here are a few more of Alice's pictures

Midwife Vivian Odionye hangs a solution for a labouring patient at the Aiyetoro Health Centre, Lagos © Alice Proujansky

Mothers wait for their newborns to be vaccinated at a Medecins Sans Frontieres (Doctors Without Borders) clinic at the Aiyetoro Health Centre in Nigeria © Alice Proujansky

A patient labours to deliver a stillborn baby in Nigeria © Alice Proujansky

Expectant parents read a pamphlet after an exam at the Women's Clinic in Tuba City, Arizona © Alice Proujansky

A patient with her newborn baby at the Hospital Juan Pablo Pina San Cristobal, Dominican Republic. © Alice Proujansky

You can see more of Alice's work and read about her experiences on her website.

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