January 18, 2021 • 39 mins
Pregnancy, childbirth and breastfeeding should be things that are universally understood around the world. But guess what... they're not. Societal conventions and traditions have created a disassociation between what is 'natural' and what is 'expected', leading to both cultural confusion and generational conflict.
In today's fascinating and eye-opening episode, we discuss these issues with Louise Roy, Director of Patient Support at Ferguson Women's Health in Shanghai. As a prenatal educator, labour doula, and lactation counsellor, Louise is perfectly placed to explain these historical trends, and analyse them within the context of the Chinese healthcare system.
The episode also includes a catch-up interview with Astrid POGHOSYAN from Season 01 Episode 04. (https://mosaicofchina.com/season-01-episode-04-astrid-poghosyan).
Chapters
00:00 - Trailer & Intro
01:05 - Part 1
26:09 - Part 2
32:12 - Outro
35:35 - Catch-Up Interview
Subscribe to the PREMIUM version, see the visuals, and/or follow the full transcript for this episode at https://mosaicofchina.com/season-02-episode-06-louise-roy.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
[Trailer]OF: Boobies. Boobies,
boobies. OK, already I'm blushing.LR: It's a little much.
[Intro]OF: Welcome to Mosaic of China,
a podcast about people who are making theirmark in China. I’m your host, Oscar Fuchs.
Today’s episode features another newguest without a connection to Season 01,
it’s Louise Roy, who is a women’s healthpractitioner in Shanghai. That might make
(00:27):
some people immediately reach for the offswitch, but believe me when I say this, and
I don’t care who you are - Chinese, non-Chinese,male, female, parent, non-parent - you will learn
something in this episode that will makeyou think differently. Oh, and stay to the
end for a catch up with Astrid Poghosyan, theArmenian violinist from Episode 04 of Season 01.
(00:48):
If you want to follow theimages that accompany the show,
please follow the @mosaicofchinaaccount on Instagram or Facebook,
or add me on WeChat using the ID (00:54):
mosaicofchina, and I’ll add you to the group there myself.
Are you ready? Are you looking at theimages? OK, then we’ll begin the show.
[Part 1]OF:
Thank you so much for coming, Louise.LR: You're very welcome,
I’m very happy to be here.OF: And let me get your title
right, because it's quite a long one,right? “Director of Patient Support,
(01:17):
Prenatal Educator, Lactation Counsellor…LR: I'm also the Director of Operations. So…
OF (01:23):
Oh, that’s easier. LR
OK. LR
Director of Operations, and it's Ferguson Health
LR (01:29):
Ferguson Health, exactly. OF
about what that means. But before we do, tell mewhat is the object that you have brought that in
some way represents your life in China?LR: I have brought my cervix.
OF (01:42):
Wow. LR
it's not the one actually inside of me.OF:
Oh gosh, OK.LR: It is a rainbow model
cervix made out of my children's Playfoam. Andthis is how I know that they will be in therapy
pretty quickly, because they look at me and say,“Mum, what do you making?” And I said “Well,
I'm making a rainbow cervix in various degrees ofdilation and effacement, darling”, and they say
(02:07):
“Oh, okay” and they just keep playing.OF: So explain what that is.
LR (02:12):
So this is a teaching tool. I have to show what happens to the cervix in the
process of labour.OF: Right.
And it goes from long and closed, to very, very, very thin and 10-centimetres dilated,
big enough for baby's head to get through.OF: Yes. That is such a strong visual aid
for what you're discussing, right?LR: It very much is, yeah. So I teach
(02:33):
prenatal classes - labour and delivery classes- to expecting parents, and they're coming to
learn about birth, and what birth is, becausewe're so far removed from it. We don't even
see animals giving birth anymore, let alone ourmothers and our siblings having babies, and our
neighbours having babies, we don't see it anymore.OF: OK, so what, in short, does your job entail?
Bellies, Babies and Boobies, is the shortest I can make it. Because it's bellies, it’s babies.
(03:00):
It’s boobies, because I'm a lactation consultant.
But on top of that, there's also a layer ofeverything else that we do for women's health.
So it can be contraception, it can be conceptioncounselling, it can be pregnancy loss and helping
someone through the worst days of their life.OF: Hmm. Well, we've crashed through a bunch
(03:22):
of taboos there in the first sentence,haven't we? Boobies. Boobies, boobies. OK,
already. I'm blushing.LR: It’s a little much.
OF (03:29):
Well, where shall we even start? So, childbirth seems to be one of those things
which is so imbued with tradition.LR: Sure.
Because in China, from what I know, there are many traditions about
childbirth, which people do adhere to still.LR: Yeah, and tradition is a hard thing to fight
against. And I personally don't fight againsttradition, but I fight for my clients to have
(03:55):
the most up-to-date, evidence-based informationand understanding. If they're doing something,
it's because they want to.OF: OK, so what are the
traditions then, here in China?LR: The confinement period traditions,
the timeframe after having a baby where it'sconsidered an appropriate amount of time to rest
(04:15):
and recover from the birth.OF: Right.
LR (04:17):
So in China, the first month is the most important. And
they will restrict bathing in general, goingout, certain foods - there’s whole menus
designed around what shouldn't beeaten - the list goes on, actually,
(04:38):
if you really look into it, it's quite complex.OF: Hmm. I've heard of these traditions, and I
do not know where it comes from. Do you know?LR: Yeah, you know, and a lot of the times it
seems crazy when you look at it on the surface,and someone says “What, she doesn't bathe for a
month?” I always say “Context is everything”.So if we look at somebody having a baby
(05:00):
500 years ago - even 100 years ago - typicallythey didn't have access to clean, safe water.
Water would have had so much bacteria in it forbathing, and that was fine in their everyday life.
But when a woman is postpartum - she's just hada baby, her body's a little run down, you know,
she’s tired, she may have a tear -having a bath sitting in dirty water,
(05:26):
you know, that's gonna be a bad thing.OF: That’s gonna be an infection, which is death.
Exactly. It's gonna be an infection. And that means death. So if you don't understand
what bacteria is, you're just goingto correlate, women who bathed after
birth got sick and died; women who didn'tsurvived. So don't bathe after birth. Once
you see that context, it makes a lot of sense.OF: It does. In fact, it makes me think, why don't
(05:50):
we in the West have the same correlation?LR: I guess we're just dumber.
OF (05:53):
Yeah, OK. Well, then let's go back to another one then, you were saying that
there are certain foods that you don't eat?LR: Mmm-hmm. Yeah, so there are certain foods
that will be more prescribed, but it'sa lot about the ‘format’ of the food,
if I could say that as much. As you can tell I'mnot a foodie… “I'd like the ‘Format Menu’ please.”
(06:15):
I mean, soup.OF: Ah.
LR (06:17):
So, soup is a huge one in the confinement period. Chicken and fish soup, particularly, are
really recommended. Why chicken and fish? Well,it makes sense, again. Chicken and fish are small,
and you know, you finish consuming it before itcould go off, in a time before refrigeration.
(06:39):
If you were to eat beef or pork, it's a biganimal, that the meat may not be so fresh.
OF (06:45):
Of course. LR
you're drinking a lot of water when you havesoup. And that's good because you're losing…
Hydration. LR
a lot of water after you have a baby. And thewater for drinking might not have been so clean
in the old times. But if it's made into a soup,it's boiled. And boiled water is much cleaner.
(07:08):
It's all falling into place. LR
OK. And now that we are in the modern age, we don't necessarily
need to worry about water being clean or not…LR: Yeah, our water is clean, our homes are
heated, we have safe food and drinking water.OF: But these traditions persist.
LR (07:25):
The traditions persist. So I just like people to know, if they're making choices, they’re
informed choices. They can choose to followthis diet. They can choose to eat a sandwich.
They can do what they want, solong as they have the information
to know why they're doing one way or another.OF: So will there be a case where there is a
(07:48):
younger mother, she's more modern, and she istrying to sneakily eat a sandwich, but her more
traditional mother will whack it out of her hand?LR: All the time.
OF (07:59):
Oh right. LR
mum goes outside, of she tells her mom "Can yougo do this” and then she sneaks into the shower to
have a shower. So it is a battle between families.The generational gaps can be really overwhelming.
Yes. And I'm guessing it's just the same as everywhere else, because the mother
(08:19):
has gone through it when she gavebirth, so she knows all about it. So
you can't really negotiate with her, can you?LR: Well, you'd think so. But actually,
the mother herself didn't take care of her ownbaby, her mother did. So traditionally the baby's
grandmother will take care of the baby. Sothe mother herself is focusing on resting
(08:41):
and recovering. So when her child has a baby, nowit's her job to take care of her grandchild. For
the first time ever she's taking care of a baby.OF: Because she didn't take care of her own baby.
LR (08:54):
She didn't take care of her own baby, her mother did. So we have also a lot of,
you know, it's hard to tell your mum“No”, in any country, in any culture.
But it's also a lot of education from ourpart, where we're talking to whole families
“This is how you bathe the baby, this is howyou burp the baby, this is how you breastfeed”.
(09:19):
Then we have… potentially they also have a 阿姨[āyí], a 月嫂 [yuèsǎo] actually is a baby nanny
for the confinement period. It's a particular job.And they go one month to one month to one month,
to different families…OF: A 月嫂 [yuèsǎo]?
月嫂 [Yuèsǎo], yeah. OF
the room when you're giving the advice?LR: Yes. So they're called as soon as the baby's
born, because they help take care of the baby inthe hospital. It's actually not necessary in the
(09:44):
private hospitals for them to be there, becausewe have nurses day and night to help with that.
But in public hospital, yeah your family takescare of you in the hospital. In an international
healthcare setting, we do have that flexibilityto choose what works from different cultures,
and we have families from all over the world.It gives us that that luxury, to the point where
(10:10):
I'm not sure how I could ever leave.OF: Yes, that's a good point, because you
could then go back to Australia, and then you'dhave a similar kind of entrenched mindset of how
they do things there.LR: Mmm-hmm.
OF (10:21):
Interesting. Yeah. And so, talking about this interface between
the international people that you see andthe local system, at what other points do you
interact with the local system?LR: So that's a really good question,
it’s a question that people ask us whenthey're choosing a healthcare system.
(10:42):
There are occasionally situations wherethe licensing of a private hospital isn't
comprehensive enough to cover very,very extreme medical conditions.
We haven't actually had to haveanyone deliver outside of our setting.
(11:06):
We've had, occasionally, babies have to transferto the high high level public hospitals.
Medically it's very sound, the NICU - neonatalintensive care - in China is very, very good,
well, in Shanghai, is where my experience is. Butthe culture of care is very different. And again,
(11:28):
that's context, right? So it's common in othercountries that if your baby is in the NICU,
you would still have access to the baby,you would still visit the baby, you would be
very much involved.OF: Of course, right?
LR (11:44):
Right, it makes sense. And this is what we come into thinking is ‘normal’.
We think that is the right way to run a NICU.And in the context of a NICU where you have
lower numbers, it's easily feasible. However, inShanghai, we're talking about hundreds of babies.
OF (12:07):
Oh I see. LR
24/25 weeks of gestation. Sothey're very, very vulnerable.
If you have people coming fromall over surrounding districts,
selling everything, spending everything they have,to get treatment for their babies, living in the
(12:30):
hospitals, living in streets around the hospital.OF: Oh, because they don't go back to
their hometowns. Yes, right,LR: No, because they're near
to the baby to talk with the baby’s doctors.They don't have money for Shanghai hotels.
Right. LR
If everyone came into the NICU,
(12:51):
it would be a public health disaster.OF: Right. Which is so interesting,
because pre-COVID, I may not have understoodthat. But now it's such an obvious petri dish
for spreading viruses and bacteria.LR: Uh-huh. To the most vulnerable
babies.OF: Yes.
LR (13:07):
In an ideal world, we would have five times more NICUs in Shanghai, five times more staff,
a system set up that allowed for more contact.OF: Right.
But that’s not happening now. OF
I mean, you can imagine that they willinvest, and it will improve day by day here.
Yeah. I think that even when we look at the changes in the NICU in the last 10 years,
(13:30):
they have been huge. They now have breastmilk donation banks, you do see the babies,
you do get to talk to the doctor at least.OF: So you did just mention breastfeeding.
Uh-huh. OF
one of your other areas of expertise.LR: Yeah, the boobies. Boob juice.
OF (13:46):
OK, I'm still giggling, I promise… LR
you can’t help yourself. Boob juice.OF: ‘Boob juice’! Let’s talk boob juice.
What are the issues around lactation? Becausethis is another thing where we seem to have got
so far away from what is natural, haven't we?LR: Gosh, yeah. We have this concept that
breastfeeding is so complicated, but nobody everthinks that the baby pig - and his mother - has
(14:13):
a complicated breastfeeding journey. Butfor humans, we have societal expectations
on women and babies that are inaccurate. And90% of the time, when somebody comes to me,
I have to explain to them how the situation wasnormal, not something that needed intervening on.
(14:36):
It's about going back to “What is normal? Whatis evolutionarily sound? How did we get here?”
How did we get here? LR
Like, where… What happened that we are so disassociated with the suckling pig?
LR (14:52):
It's such a big topic. It truly is such a big topic, but so many things all kinda converged at
the same time. Technology made formula…OF: Yes, the obsession with milk
formula here in China, that's a weird one.LR: Uh-huh, uh-huh. Yeah, and for a long time,
China hadn't signed an agreementthat would prevent the marketing
(15:18):
and advertising of baby formula.OF: Oh that's the reason.
Yeah. So most countries around the world have signed this particular
code - it's called ‘The Code’ in breastfeedingcircles - limiting direct marketing to parents,
and limiting what can be saidabout baby formula. Prior to that,
marketers could say “This is better for yourbaby”. Doctors could say “This is better for
(15:43):
your baby. Forget breast milk, that’s old news”.It's not legal here anymore. And it is really,
really, very much frowned upon,OF: Right. But it used to be something
which was more de rigueur a few years ago.LR: Exactly. A whole generation who skipped
the normal experience. In the rest of theworld, breastfeeding is no easier. Because
(16:04):
we've had years of mothers told “Don't coddle yourchildren”. And it changed the way people parented.
And breastfeeding was a part of that.OF: Right. So you're now on a mission to
re-educate us about breastfeeding, right?LR: I’m on a mission that people have
all the support and information they need,to make the best choices for them and their
(16:28):
babies. That's my goal. I don't really care ifyou breastfeed or not - which sounds strange
as a lactation consultant to say that - I carethat you had the information, and it was correct.
You weren't derailed, misguidedly or deliberately.OF: Interesting. And then, how do you translate
(16:49):
that sort of advocacy - that sort of advice-givingand consulting - to the actual birth process? Are
you there during the process, continuingto give advice, like, as it's happening?
So that's actually what a doula is? OF
So when you went through my titles earlier, you missed one, and that's I'm
a certified labour doula.OF: You’re a labour doula.
(17:09):
A doula. A companion through the process of birth. The doula will not direct your care,
they will say “Here's the situation; hereare your options; the pros and cons of each
of those options are…” and then the couplethemselves make the decision. It should be
(17:32):
like that in medical care, but it's often… you gosomewhere, and the doctor says “Take this pill”.
OF (17:36):
Yeah. LR
three different pills we could use”. They're goingon the track of “I know this one to be the best
for you. So I'm going to use this one for you”.OF: So you jump in there at that point,
and then give the options?LR: Well, our doctors tend
to be more in the role of…OF: Already on that way
LR (17:56):
Already on that way. OF
But if I were… and I used to have a childbirth support company. And I would go into hospital
settings all over Shanghai. And they could beeverything from local to the fanciest hospitals.
And it would be that the client had hired me toattend their delivery, not that I was hired by the
(18:19):
hospital to help the client. So I very much wasthere as somebody who was there for my client. But
not just throwing everything at this client, atthe risk of alienating the staff of the hospital.
It's a diplomacy between them. Otherwise,you'd never get to go back for the next client.
OF (18:39):
Give me an example then. LR
if a doctor were to be about to do somethingthat's irreversible. It might be a good choice.
But it's something that the client - the patient- should be involved in the decision making. So in
the past, I would see that this is about to happen- because I have the vantage point of seeing,
(19:05):
knowing the anatomy, knowing birth, knowing whathappens, knowing how it's done, knowing which
tool is going to do what thing - see it about tohappen to say “Excuse me, just a minute doctor”,
and then turn to the client andsay, “The doctor’s about to break
the water. Do you have any questions for them?”OF: “Oh, wow. Why is it specifically for this
(19:25):
procedure? Why not for alloperations, in that case?
LR (19:27):
It is a really good question, and informed consent is something that is a golden rule and
a gold standard in medical care, but it's notalways practised to the point where it could be.
OF (19:39):
Right. And I guess because this is a moment, which is so unique, I'm guessing that's
why this unique role of a doula has emerged.LR: Yeah, and I think that you can't have that
many staff around for other things, and peoplewouldn't be motivated for it. But for birth, it's
such a huge moment in your life.OF: Yeah. In my mind, I'm picturing,
(20:02):
then, there is the doctor, there is the midwife,there is a doula, like, it's a whole party.
LR (20:07):
It is. OF
Yeah. OF
is it always a joyous occasion, or you know,when are the situations where it's less joyous?
So, you know, birth has its highs and it's lows. So you have the birth that's beautifully
normal, everything's fine, baby’s healthy,mother’s healthy. And then you have times
where it's not so. You also have expectations.Traditionally, in China, a boy was desired.
OF (20:33):
Oh, of course. LR
the “It's a girl!” and, kind of, people go “Ah”.OF: Oh right. How funny, I didn't even think
about that. But of course it still happens.LR: It does, it’s much less in Shanghai.
Yes. Interesting. But I'm a bit confused. Like, you literally do the “It's a girl!”
(20:53):
thing. But nowadays, like, at scans you… Wait aminute, you're looking at me like I'm an idiot.
LR (20:57):
In China, you're not supposed to find the sex of the baby before the birth. The reveal
parties that people have in other countries,that’s not supposed to be happening in China.
OF (21:08):
Of course. LR
a long history in China of selecting which babyyou'll take to full term, based on the sex.
Yes. That’s interesting, it of course makes sense that you wouldn't tell
the parents about the gender of their child. ButI'm looking into your eyes, because your clients
(21:30):
would be a mix of Chinese and non-Chinese, right?But you still have to abide by the same rules.
LR (21:36):
The hospitals are bound to follow these rules. We have signs all over the hospital,
you don't ask the sex of the baby.OF: Oh, that's there, is it?
Mmm-hmm. OF
situations. So you know, at the beginning, whenyou did introduce the list of things that you do,
(21:57):
dealing with an outcome that is not expected, thatwouldn't just be about gender, of course. That
would be about the feasibility of the baby itself.LR: Yeah, exactly, so there… Miscarriage
is the first thing that most people thinkabout. Miscarriage is one in four. This is
primarily during the first trimester, thisis why people traditionally don't announce
(22:20):
they're pregnant until after the first trimester.Which is kind of sad, actually, to me, because
this is a time when you do need help and support,and it's incredibly taboo still to this day.
You know, we say most of those miscarriagesare happening in the first trimester,
(22:43):
then we have… sometimes this happens later
in the pregnancy. And of course, that’s… it'sheartbreaking at any time, but it's particularly
sad when you’ve felt a baby grow insideof you, and felt the movements, and had
plans and hopes, and this baby doesn't make it.OF: And this is part of the role of the doula, is
(23:08):
it? To manage the situation when this does happen.LR: Not every doula does this, but I have done
grief support training for parents with perinatalgrief situations. And it is something that
for someone, it's the worst day of theirlife. But if you can make it less ‘worse’,
(23:29):
then you've done something that's profound andlasting. In China, it’s if the baby doesn't make
it at any point, the family aren’t encouragedto have photos or clothes or hold the baby,
it's just whisked away as medical waste.OF: Medical waste.
Yeah. So even the concept of “This family wants to cremate
(23:50):
this baby, and they want the ashes back". It'slittle things, it doesn't sound like much,
but it changes everything. I'm thankful that I canbe a person who can make this situation better.
OF (24:05):
Wow. And how does that affect you? LR
quite a while, being very impacted emotionally.And I don't think you can do it without being
impacted emotionally. I will talk to a therapist,and I think anybody should in that situation.
(24:28):
You know, I find myself ‘go, go, go, go go’, andall of a sudden, something happens and I will
burst into tears, and it all comes out. Like,you can't push it away. You can push it down,
but you can't push it away. And it's good toget it out. Because you're very much in a very,
very, very raw situation. It's hard.OF: And in the same way, I can see why
it's such a privilege to share that withsomeone who is going through something so
(24:52):
similar. Like, you must have a bond withthe mother and the father at that time.
LR (24:56):
Forever. And you may not be a person they ever want to see again.
OF (25:00):
No. LR
that people really do take you into their family.These babies and these families live in my heart
forever, they really do. And it's very special.OF: Well, I am looking at the object you brought.
It is a colourful spiral of circleshere. And it's making me think, yes, we
(25:23):
did end that conversation on a very real butsad note. But the colourful circles in front
of me are reminding me that it's also happy.LR: It's thankfully, very few situations that
are so sad and so tragic. It's mostly, the highsare high and they're fantastic. And to be able
(25:44):
to have the privilege and the honour of joiningfamilies in this, on an almost daily basis, is
hard work, it’s exhausting, and it's fantastic.OF: Louise, this was not hard work or exhausting.
But it was fantastic. Thank you so much.LR: Thank you very much, it was really fun.
(26:04):
We now go on to Part 2. LR
[Part 2]OF: I think we're gonna
run a little bit long in the first half, becausewhat you said was so special. So let's try and
quick-fire our way through these there questions.LR: Quick fire. I’m Australian, I can't say
anything quickly. But let's try.OF: Question 1. What is
your favourite China-related fact?LR: Do you know what, my favourite China-related
(26:26):
fact comes from my now eight year old son who toldme that male pandas can do a handstand and then
pee. So that they can mark trees higher. Can youimagine a panda doing a handstand at all, and then
peeing, just so they can mark a tree higher?OF: Oh, wow.
LR (26:45):
That's not in the guidebooks, is it? OF
word or phrase in Chinese?LR: I think that actually 舒服 [shūfú]
is one of my favourite words.OF: Oh yeah.
舒服 [Shūfú] is just.. it sounds 舒服 [shūfú]. 舒服 [Shūfú] sounds 舒服 [shūfú]. And 不舒服 [búshūfú],
when I feel 不舒服 [búshūfú] it perfectly explains…like, I don't have to diagnose exactly what I'm
(27:05):
feeling right now, I just feel 不舒服 [búshūfú].OF: Can you explain what it means?
It feels uncomfortable. And 舒服 [shūfú] feels, you know, it just feels soft and nice
and comfortable and relaxing.OF: Yes. That's so… It does
sound cosy, 舒服 [shūfú].LR: It does, doesn’t it?
OF (27:19):
Yeah. What's your favourite destination within China?
LR (27:23):
I don't get to travel much - I think you probably hear that from a lot of people in
healthcare, I don't travel a lot becausebabies, babies, babies, they’re just born
all the time - but I really enjoyed visiting,years back, 峨眉山 [Éméishān] and 乐山 [Lèshān].
I liked 峨眉山 [Éméishān] particularly because itjust… I come from the Blue Mountains in Australia…
OF (27:42):
Nice. LR
laid-back mountain-y kind of thing.OF: Yes. LR: It was nice.
If you left China, what would you miss the most, and what would you miss the least?
LR (27:50):
Taobao. OF
It’s ‘most’ but I think my wallet would miss it the least. I love Taobao,
I've bought so much on Taobao over the years,I've had some spectacular wins and fails on it.
I love, just the concept of you can get anything.OF: Yeah
Anything. OF
(28:12):
what I'm seeing in front of me right now.LR: Well, you can't actually, that's why
I had to make it myself out of PlayfoamOF: Playfoam cervix, I'm going to do a
little search for "Playfoam cervix”.LR: You're not gonna find it.
OF (28:24):
No. LR
Actually, I think what I would miss the least iswhen people, kind of like, ‘Chinasplain’ to me.
Oh god. LR
‘Chinasplaining.’ And then if I have a differenceof opinion - that's, you know, gleaned from 15
years of experience - I've been brainwashed.OF: Hmm, yes. Is there anything that still
(28:48):
surprises you about life in China?LR: I was surprised the other day to
learn - from a bunch of nurses thatI was talking to - that you can get
condoms on 饿了么 [Èleme] arrive at yourdoor in 20 minutes. And then if it breaks,
you can get the morning-after pill 20 minutesafter that. And I was like “Maybe you should
just stop buying condoms on 饿了么 [Èleme]”.OF: Just dial up the 饿了么 [Èleme].
LR (29:11):
It makes a lot of sense. OF
to eat, or drink, or just hang out?LR: Honestly, it’s… I love my sofa.
OF (29:21):
Yeah LR
all day with people, and talking to people, and Ijust love Netflix. I really… it's a really boring.
No, having been through the conversation we've just had, all the things that you deal with, I can
imagine the sofa being the place you want to go.LR: Yeah. I mean, I do… I love going out with
my close friends - my friends who are my familyhere - who I can talk about the good and the bad
(29:47):
with. And so it's not a place, it’s a people.OF: What is your favourite WeChat sticker?
LR (29:53):
My favourite WeChat sticker is actually one that says ‘Google it, you lazy ****’.
I don't use it very often, because it's rarelythe context where I can. There is a safer
version of it, which just says “Google it”.OF: Yes, you need to do a “Bing it” too.
Yeah, ‘Bing it, you lazy ****’. OF
(30:16):
does it? What is your go to song to sing at KTV?LR: Look, KTV is an art. You've got to
choose wisely, for the right time in the evening,and the right moment of the room and everything.
But I think probably my favourite just, like,kick-things-off songs would be something like
(30:37):
‘Sweet Child o' Mine’ or like Cher’s ‘TurnBack Time’, or something just that you
could belt out and get things going.OF: Yes. These are belting rocks.
Just belt it, just belt it. And, like, graphic 80s actions.
OF (30:51):
Oh, if only there was a video recorder in this room right now. Anyone listening,
if you can imagine that Kiss photo with thetongue sticking out, there were elements of that.
LR (30:52):
Yeah, that’s about it. OF
media or sources of information do you rely on?LR: Oscar, only you.
OF (30:57):
Oh, baby. You’re lying! LR
I really just pick from whatever I get my hands
on. I don't have a set favourite source.OF: Louise, it’s been a real pleasure.
I only have one regret, and that is wespent so much time talking about your work,
we know very little about you.LR: There is nothing about me.
(31:19):
That’s nonsense. You've opened my eyes, this is something which I am not an expert
on at all. But it's fascinating.LR: You're welcome. It's definitely
a huge topic because it spans an entire life.OF: Yeah. Well, before you leave, the final thing
I ask everyone in that chair is, out of everyoneyou know in China who would you recommend that I
(31:39):
interview for the next series of Mosaic of China?LR: I am going to recommend Barbara Poppell.
She is in child development, and has an amazingperspective on how parents can help kids becoming
their best little peoples that they are.OF: Wow, that's such an apt person
to hand off the baton toLR: Yeah, I just pass it over.
(32:01):
I've done the babies and thebellies and the boob juice,
now you take them on for life. I'm done.OF: I can’t wait to meet Barbara,
and thank you again.LR: You're very welcome.
[Outro]OF: Well as I mentioned just before the end right
there, we only scratched the surface of gettingto know Louise in this episode. But just to give
you a taste of who she is, she’s an Aussie who’smarried to a Canadian, who has worked in places
(32:26):
like East Timor and Nepal before moving to China.So in case you were wondering where her accent
from, it’s a mixture of all the above. And asfor some of her other talents, I have also posted
images online of the boobies that she crochetswhile on her sofa, some artwork that she has made,
and even an example of the crazy cakes she bakes.So she doesn’t just spend her time messing around
(32:51):
with Playfoam making cervixes, she does otherthings too. Or should that be ‘cervices’.
Speaking of cervices, not only will you havenoticed that Louise’s object is the perfect
counterpoint to Cocosanti’s object from lastweek’s episode - shout out to Kevin - in fact,
January happens to be Cervical Health Awarenessmonth, so if that’s applicable to you,
(33:13):
please consider this a nudge for you togo out and get a cervical cancer screen.
And one final update since we recorded theepisode is that the NICU where Louise sends
intensive care babies has just openeda new section where you can pay extra
to visit your baby every morning in a smallerroom, and get updates from the doctors without
(33:34):
endangering other vulnerable babies. So, aspredicted, things are continuing to improve.
Since you’re listening to theREGULAR version of the podcast,
now is the time for me to tease you withsome snippets from the PREMIUM version.
Please head to mosaicofchina.com andfollow the link there to subscribe.
[Clip 1]LR: But then you look
like crazy religious freaks, as everyonewalks down the street, bowed in prayer.
(33:57):
[Clip 2]LR: The woman who's having
the baby herself has, kind of, taken me aside andsaid “You need to get these people out of here”.
Yeah, right. [Clip 3]
LR (34:06):
The first drugs for pain-free birth was chloroform.
OF (34:13):
Woah. [Clip 4]
LR (34:14):
You see women, as soon as they get pregnant, they're encouraged not to have sex.
[Clip 5]LR: And the
doctors will file across and speak to you. Youmaybe have a baby wheeled past there as well,
that you could catch a glimpse of as it goes by.OF: Yeah.
[Clip 6]LR: We have
sometimes some very busy rooms.OF: Right.
We have people with GoPros, we have… OF
(34:36):
Yeah, we have, like, everything. [End of Audio Clips]
There’s also a bunch of other images that I’veposted on social media, so please check them out
as always. And if anyone out there is listeningout for connections with the answers from other
episode, the bizarre one from today’s conversationis that the KTV song Louise mentioned,
Sweet Child of Mine, is exactly the same as theone mentioned by the Pain Management expert,
(35:00):
Lissanthea Taylor, from Episode 28 of Season 01. Ican’t believe these two Aussie women, both of whom
are supposed in the business of improving health,would inflict that kind of pain on other people.
Mosaic of China is me, Oscar Fuchs,with artwork by Denny Newell.
My catch-up chat with Astrid from the ShanghaiSymphony Orchestra follows after this,
(35:21):
and I’ll be back with the next fullepisode the same time next week.
[Catch-Up Interview]OF:
Astrid, hello.Astrid Poghosyan: Hi, Oscar.
OF (35:39):
It's so nice to see you again. AP
to see you too. It's been a while.OF: It has been a while. But here we are.
And it's been an interestingyear since our recording, right?
AP (35:51):
Indeed, it was very unexpected. OF
talk about when Coronavirus hit.Were you in China at the time.
I was. I was in Shanghai, and it was actually the last days of our operating.
And then as I already had planned to go to LA,I was like “OK, never mind, I'm just, you know,
(36:12):
I'm just gonna follow the plan. So I went there,and then that was the time when… it only took me,
like, seven days there to realise that itseems like things are getting pretty tricky.
So basically, when I locked my door in Shanghai,I was like “I'm gonna be back in two weeks”. And I
locked the door for an entire nine monthsOF: Nine months.
Yes. Because at the last minute, I decided that… because back then,
(36:36):
you know, all the airlines started to shut down.
So I bought a ticket to Armenia.OF: You're a violinist, of course.
Did you have your violin when you left China?AP: No, that's the first time I left the country
without my violin. This was a moral to be learnedin the future, you never leave your instrument,
(36:57):
even for two weeks. And that was the mostshocking thing ever in my life as well, because
I've never been separated from my violin foreven two days. And this time, it was nine months.
And I felt like, you know, I abandonedmy child somewhere, god knows where,
and nobody's taking care of it. Even thoughsome people will say it's just a piece of wood.
(37:18):
But it's not, it's a life. So it wasreally stressful from that side as well.
So I had to find a replacement.OF: Oh so at least you could
play some violin, right.AP: I could, but you know,
it's just a little bit… you feel like cheating.Because you found a replacement somewhere else,
in a different country.OF: Totally.
And then you have your own one waiting for you at the place of origin. So
(37:42):
the moment I came back, the first thing I did wascheck up on my violin. But I didn't pick it up.
I needed time to just, you know, feel it,that it's there I'm back, it’s around me.
And then after a while, I just took it and Istarted playing on it a little bit, you know.
OF (37:56):
Wow, that’s nice. Let's talk about, then, when you did come back. So what was that
situation when you finally returned to China?AP: Luckily the embassy in Armenia of China
was so nice. And they opened the whole buildingfor my application to, you know, turn on the
computer after eight months. That moment, thewhole energy felt like the entire country is
(38:18):
working on my return back to China. So I had theseapplications, and I had like a 48+ hour trip here,
transferring through four differentcountries. So I eventually arrived and,
you know… But that's the human being, you know,once you arrive, whatever you experienced before,
gone! It’s just like, all the difficulties, allthe tiredness or whatever, just the idea that
(38:41):
you're back home. Ah, just this feeling.OF: Yeah. I'm so glad that you are back.
Unfortunately, the person who yourecommended, she is still stuck in Taiwan.
AP (38:52):
Unfortunately. OF
in the next season, the one coming upnow, but I did find a nice replacement.
So I hope that you will enjoy that.AP: Thank you, Oscar, looking forward
to catch up more. Thanks for having me, as usual.
[Trailer]OF: Boobies. Boobies,
boobies. OK, already I'm blushing.LR: It's a little much.
[Intro]OF: Welcome to Mosaic of China,
a podcast about people who are making theirmark in China. I’m your host, Oscar Fuchs.
Today’s episode features another newguest without a connection to Season 01,
it’s Louise Roy, who is a women’s healthpractitioner in Shanghai. That might make
(00:27):
some people immediately reach for the offswitch, but believe me when I say this, and
I don’t care who you are - Chinese, non-Chinese,male, female, parent, non-parent - you will learn
something in this episode that will makeyou think differently. Oh, and stay to the
end for a catch up with Astrid Poghosyan, theArmenian violinist from Episode 04 of Season 01.
(00:48):
If you want to follow theimages that accompany the show,
please follow the @mosaicofchinaaccount on Instagram or Facebook,
or add me on WeChat using the ID (00:54):
mosaicofchina, and I’ll add you to the group there myself.
Are you ready? Are you looking at theimages? OK, then we’ll begin the show.
[Part 1]OF:
Thank you so much for coming, Louise.LR: You're very welcome,
I’m very happy to be here.OF: And let me get your title
right, because it's quite a long one,right? “Director of Patient Support,
(01:17):
Prenatal Educator, Lactation Counsellor…LR: I'm also the Director of Operations. So…
OF (01:23):
Oh, that’s easier. LR
OK. LR
Director of Operations, and it's Ferguson Health
LR (01:29):
Ferguson Health, exactly. OF
about what that means. But before we do, tell mewhat is the object that you have brought that in
some way represents your life in China?LR: I have brought my cervix.
OF (01:42):
Wow. LR
it's not the one actually inside of me.OF:
Oh gosh, OK.LR: It is a rainbow model
cervix made out of my children's Playfoam. Andthis is how I know that they will be in therapy
pretty quickly, because they look at me and say,“Mum, what do you making?” And I said “Well,
I'm making a rainbow cervix in various degrees ofdilation and effacement, darling”, and they say
(02:07):
“Oh, okay” and they just keep playing.OF: So explain what that is.
LR (02:12):
So this is a teaching tool. I have to show what happens to the cervix in the
process of labour.OF: Right.
And it goes from long and closed, to very, very, very thin and 10-centimetres dilated,
big enough for baby's head to get through.OF: Yes. That is such a strong visual aid
for what you're discussing, right?LR: It very much is, yeah. So I teach
(02:33):
prenatal classes - labour and delivery classes- to expecting parents, and they're coming to
learn about birth, and what birth is, becausewe're so far removed from it. We don't even
see animals giving birth anymore, let alone ourmothers and our siblings having babies, and our
neighbours having babies, we don't see it anymore.OF: OK, so what, in short, does your job entail?
Bellies, Babies and Boobies, is the shortest I can make it. Because it's bellies, it’s babies.
(03:00):
It’s boobies, because I'm a lactation consultant.
But on top of that, there's also a layer ofeverything else that we do for women's health.
So it can be contraception, it can be conceptioncounselling, it can be pregnancy loss and helping
someone through the worst days of their life.OF: Hmm. Well, we've crashed through a bunch
(03:22):
of taboos there in the first sentence,haven't we? Boobies. Boobies, boobies. OK,
already. I'm blushing.LR: It’s a little much.
OF (03:29):
Well, where shall we even start? So, childbirth seems to be one of those things
which is so imbued with tradition.LR: Sure.
Because in China, from what I know, there are many traditions about
childbirth, which people do adhere to still.LR: Yeah, and tradition is a hard thing to fight
against. And I personally don't fight againsttradition, but I fight for my clients to have
(03:55):
the most up-to-date, evidence-based informationand understanding. If they're doing something,
it's because they want to.OF: OK, so what are the
traditions then, here in China?LR: The confinement period traditions,
the timeframe after having a baby where it'sconsidered an appropriate amount of time to rest
(04:15):
and recover from the birth.OF: Right.
LR (04:17):
So in China, the first month is the most important. And
they will restrict bathing in general, goingout, certain foods - there’s whole menus
designed around what shouldn't beeaten - the list goes on, actually,
(04:38):
if you really look into it, it's quite complex.OF: Hmm. I've heard of these traditions, and I
do not know where it comes from. Do you know?LR: Yeah, you know, and a lot of the times it
seems crazy when you look at it on the surface,and someone says “What, she doesn't bathe for a
month?” I always say “Context is everything”.So if we look at somebody having a baby
(05:00):
500 years ago - even 100 years ago - typicallythey didn't have access to clean, safe water.
Water would have had so much bacteria in it forbathing, and that was fine in their everyday life.
But when a woman is postpartum - she's just hada baby, her body's a little run down, you know,
she’s tired, she may have a tear -having a bath sitting in dirty water,
(05:26):
you know, that's gonna be a bad thing.OF: That’s gonna be an infection, which is death.
Exactly. It's gonna be an infection. And that means death. So if you don't understand
what bacteria is, you're just goingto correlate, women who bathed after
birth got sick and died; women who didn'tsurvived. So don't bathe after birth. Once
you see that context, it makes a lot of sense.OF: It does. In fact, it makes me think, why don't
(05:50):
we in the West have the same correlation?LR: I guess we're just dumber.
OF (05:53):
Yeah, OK. Well, then let's go back to another one then, you were saying that
there are certain foods that you don't eat?LR: Mmm-hmm. Yeah, so there are certain foods
that will be more prescribed, but it'sa lot about the ‘format’ of the food,
if I could say that as much. As you can tell I'mnot a foodie… “I'd like the ‘Format Menu’ please.”
(06:15):
I mean, soup.OF: Ah.
LR (06:17):
So, soup is a huge one in the confinement period. Chicken and fish soup, particularly, are
really recommended. Why chicken and fish? Well,it makes sense, again. Chicken and fish are small,
and you know, you finish consuming it before itcould go off, in a time before refrigeration.
(06:39):
If you were to eat beef or pork, it's a biganimal, that the meat may not be so fresh.
OF (06:45):
Of course. LR
you're drinking a lot of water when you havesoup. And that's good because you're losing…
Hydration. LR
a lot of water after you have a baby. And thewater for drinking might not have been so clean
in the old times. But if it's made into a soup,it's boiled. And boiled water is much cleaner.
(07:08):
It's all falling into place. LR
OK. And now that we are in the modern age, we don't necessarily
need to worry about water being clean or not…LR: Yeah, our water is clean, our homes are
heated, we have safe food and drinking water.OF: But these traditions persist.
LR (07:25):
The traditions persist. So I just like people to know, if they're making choices, they’re
informed choices. They can choose to followthis diet. They can choose to eat a sandwich.
They can do what they want, solong as they have the information
to know why they're doing one way or another.OF: So will there be a case where there is a
(07:48):
younger mother, she's more modern, and she istrying to sneakily eat a sandwich, but her more
traditional mother will whack it out of her hand?LR: All the time.
OF (07:59):
Oh right. LR
mum goes outside, of she tells her mom "Can yougo do this” and then she sneaks into the shower to
have a shower. So it is a battle between families.The generational gaps can be really overwhelming.
Yes. And I'm guessing it's just the same as everywhere else, because the mother
(08:19):
has gone through it when she gavebirth, so she knows all about it. So
you can't really negotiate with her, can you?LR: Well, you'd think so. But actually,
the mother herself didn't take care of her ownbaby, her mother did. So traditionally the baby's
grandmother will take care of the baby. Sothe mother herself is focusing on resting
(08:41):
and recovering. So when her child has a baby, nowit's her job to take care of her grandchild. For
the first time ever she's taking care of a baby.OF: Because she didn't take care of her own baby.
LR (08:54):
She didn't take care of her own baby, her mother did. So we have also a lot of,
you know, it's hard to tell your mum“No”, in any country, in any culture.
But it's also a lot of education from ourpart, where we're talking to whole families
“This is how you bathe the baby, this is howyou burp the baby, this is how you breastfeed”.
(09:19):
Then we have… potentially they also have a 阿姨[āyí], a 月嫂 [yuèsǎo] actually is a baby nanny
for the confinement period. It's a particular job.And they go one month to one month to one month,
to different families…OF: A 月嫂 [yuèsǎo]?
月嫂 [Yuèsǎo], yeah. OF
the room when you're giving the advice?LR: Yes. So they're called as soon as the baby's
born, because they help take care of the baby inthe hospital. It's actually not necessary in the
(09:44):
private hospitals for them to be there, becausewe have nurses day and night to help with that.
But in public hospital, yeah your family takescare of you in the hospital. In an international
healthcare setting, we do have that flexibilityto choose what works from different cultures,
and we have families from all over the world.It gives us that that luxury, to the point where
(10:10):
I'm not sure how I could ever leave.OF: Yes, that's a good point, because you
could then go back to Australia, and then you'dhave a similar kind of entrenched mindset of how
they do things there.LR: Mmm-hmm.
OF (10:21):
Interesting. Yeah. And so, talking about this interface between
the international people that you see andthe local system, at what other points do you
interact with the local system?LR: So that's a really good question,
it’s a question that people ask us whenthey're choosing a healthcare system.
(10:42):
There are occasionally situations wherethe licensing of a private hospital isn't
comprehensive enough to cover very,very extreme medical conditions.
We haven't actually had to haveanyone deliver outside of our setting.
(11:06):
We've had, occasionally, babies have to transferto the high high level public hospitals.
Medically it's very sound, the NICU - neonatalintensive care - in China is very, very good,
well, in Shanghai, is where my experience is. Butthe culture of care is very different. And again,
(11:28):
that's context, right? So it's common in othercountries that if your baby is in the NICU,
you would still have access to the baby,you would still visit the baby, you would be
very much involved.OF: Of course, right?
LR (11:44):
Right, it makes sense. And this is what we come into thinking is ‘normal’.
We think that is the right way to run a NICU.And in the context of a NICU where you have
lower numbers, it's easily feasible. However, inShanghai, we're talking about hundreds of babies.
OF (12:07):
Oh I see. LR
24/25 weeks of gestation. Sothey're very, very vulnerable.
If you have people coming fromall over surrounding districts,
selling everything, spending everything they have,to get treatment for their babies, living in the
(12:30):
hospitals, living in streets around the hospital.OF: Oh, because they don't go back to
their hometowns. Yes, right,LR: No, because they're near
to the baby to talk with the baby’s doctors.They don't have money for Shanghai hotels.
Right. LR
If everyone came into the NICU,
(12:51):
it would be a public health disaster.OF: Right. Which is so interesting,
because pre-COVID, I may not have understoodthat. But now it's such an obvious petri dish
for spreading viruses and bacteria.LR: Uh-huh. To the most vulnerable
babies.OF: Yes.
LR (13:07):
In an ideal world, we would have five times more NICUs in Shanghai, five times more staff,
a system set up that allowed for more contact.OF: Right.
But that’s not happening now. OF
I mean, you can imagine that they willinvest, and it will improve day by day here.
Yeah. I think that even when we look at the changes in the NICU in the last 10 years,
(13:30):
they have been huge. They now have breastmilk donation banks, you do see the babies,
you do get to talk to the doctor at least.OF: So you did just mention breastfeeding.
Uh-huh. OF
one of your other areas of expertise.LR: Yeah, the boobies. Boob juice.
OF (13:46):
OK, I'm still giggling, I promise… LR
you can’t help yourself. Boob juice.OF: ‘Boob juice’! Let’s talk boob juice.
What are the issues around lactation? Becausethis is another thing where we seem to have got
so far away from what is natural, haven't we?LR: Gosh, yeah. We have this concept that
breastfeeding is so complicated, but nobody everthinks that the baby pig - and his mother - has
(14:13):
a complicated breastfeeding journey. Butfor humans, we have societal expectations
on women and babies that are inaccurate. And90% of the time, when somebody comes to me,
I have to explain to them how the situation wasnormal, not something that needed intervening on.
(14:36):
It's about going back to “What is normal? Whatis evolutionarily sound? How did we get here?”
How did we get here? LR
Like, where… What happened that we are so disassociated with the suckling pig?
LR (14:52):
It's such a big topic. It truly is such a big topic, but so many things all kinda converged at
the same time. Technology made formula…OF: Yes, the obsession with milk
formula here in China, that's a weird one.LR: Uh-huh, uh-huh. Yeah, and for a long time,
China hadn't signed an agreementthat would prevent the marketing
(15:18):
and advertising of baby formula.OF: Oh that's the reason.
Yeah. So most countries around the world have signed this particular
code - it's called ‘The Code’ in breastfeedingcircles - limiting direct marketing to parents,
and limiting what can be saidabout baby formula. Prior to that,
marketers could say “This is better for yourbaby”. Doctors could say “This is better for
(15:43):
your baby. Forget breast milk, that’s old news”.It's not legal here anymore. And it is really,
really, very much frowned upon,OF: Right. But it used to be something
which was more de rigueur a few years ago.LR: Exactly. A whole generation who skipped
the normal experience. In the rest of theworld, breastfeeding is no easier. Because
(16:04):
we've had years of mothers told “Don't coddle yourchildren”. And it changed the way people parented.
And breastfeeding was a part of that.OF: Right. So you're now on a mission to
re-educate us about breastfeeding, right?LR: I’m on a mission that people have
all the support and information they need,to make the best choices for them and their
(16:28):
babies. That's my goal. I don't really care ifyou breastfeed or not - which sounds strange
as a lactation consultant to say that - I carethat you had the information, and it was correct.
You weren't derailed, misguidedly or deliberately.OF: Interesting. And then, how do you translate
(16:49):
that sort of advocacy - that sort of advice-givingand consulting - to the actual birth process? Are
you there during the process, continuingto give advice, like, as it's happening?
So that's actually what a doula is? OF
So when you went through my titles earlier, you missed one, and that's I'm
a certified labour doula.OF: You’re a labour doula.
(17:09):
A doula. A companion through the process of birth. The doula will not direct your care,
they will say “Here's the situation; hereare your options; the pros and cons of each
of those options are…” and then the couplethemselves make the decision. It should be
(17:32):
like that in medical care, but it's often… you gosomewhere, and the doctor says “Take this pill”.
OF (17:36):
Yeah. LR
three different pills we could use”. They're goingon the track of “I know this one to be the best
for you. So I'm going to use this one for you”.OF: So you jump in there at that point,
and then give the options?LR: Well, our doctors tend
to be more in the role of…OF: Already on that way
LR (17:56):
Already on that way. OF
But if I were… and I used to have a childbirth support company. And I would go into hospital
settings all over Shanghai. And they could beeverything from local to the fanciest hospitals.
And it would be that the client had hired me toattend their delivery, not that I was hired by the
(18:19):
hospital to help the client. So I very much wasthere as somebody who was there for my client. But
not just throwing everything at this client, atthe risk of alienating the staff of the hospital.
It's a diplomacy between them. Otherwise,you'd never get to go back for the next client.
OF (18:39):
Give me an example then. LR
if a doctor were to be about to do somethingthat's irreversible. It might be a good choice.
But it's something that the client - the patient- should be involved in the decision making. So in
the past, I would see that this is about to happen- because I have the vantage point of seeing,
(19:05):
knowing the anatomy, knowing birth, knowing whathappens, knowing how it's done, knowing which
tool is going to do what thing - see it about tohappen to say “Excuse me, just a minute doctor”,
and then turn to the client andsay, “The doctor’s about to break
the water. Do you have any questions for them?”OF: “Oh, wow. Why is it specifically for this
(19:25):
procedure? Why not for alloperations, in that case?
LR (19:27):
It is a really good question, and informed consent is something that is a golden rule and
a gold standard in medical care, but it's notalways practised to the point where it could be.
OF (19:39):
Right. And I guess because this is a moment, which is so unique, I'm guessing that's
why this unique role of a doula has emerged.LR: Yeah, and I think that you can't have that
many staff around for other things, and peoplewouldn't be motivated for it. But for birth, it's
such a huge moment in your life.OF: Yeah. In my mind, I'm picturing,
(20:02):
then, there is the doctor, there is the midwife,there is a doula, like, it's a whole party.
LR (20:07):
It is. OF
Yeah. OF
is it always a joyous occasion, or you know,when are the situations where it's less joyous?
So, you know, birth has its highs and it's lows. So you have the birth that's beautifully
normal, everything's fine, baby’s healthy,mother’s healthy. And then you have times
where it's not so. You also have expectations.Traditionally, in China, a boy was desired.
OF (20:33):
Oh, of course. LR
the “It's a girl!” and, kind of, people go “Ah”.OF: Oh right. How funny, I didn't even think
about that. But of course it still happens.LR: It does, it’s much less in Shanghai.
Yes. Interesting. But I'm a bit confused. Like, you literally do the “It's a girl!”
(20:53):
thing. But nowadays, like, at scans you… Wait aminute, you're looking at me like I'm an idiot.
LR (20:57):
In China, you're not supposed to find the sex of the baby before the birth. The reveal
parties that people have in other countries,that’s not supposed to be happening in China.
OF (21:08):
Of course. LR
a long history in China of selecting which babyyou'll take to full term, based on the sex.
Yes. That’s interesting, it of course makes sense that you wouldn't tell
the parents about the gender of their child. ButI'm looking into your eyes, because your clients
(21:30):
would be a mix of Chinese and non-Chinese, right?But you still have to abide by the same rules.
LR (21:36):
The hospitals are bound to follow these rules. We have signs all over the hospital,
you don't ask the sex of the baby.OF: Oh, that's there, is it?
Mmm-hmm. OF
situations. So you know, at the beginning, whenyou did introduce the list of things that you do,
(21:57):
dealing with an outcome that is not expected, thatwouldn't just be about gender, of course. That
would be about the feasibility of the baby itself.LR: Yeah, exactly, so there… Miscarriage
is the first thing that most people thinkabout. Miscarriage is one in four. This is
primarily during the first trimester, thisis why people traditionally don't announce
(22:20):
they're pregnant until after the first trimester.Which is kind of sad, actually, to me, because
this is a time when you do need help and support,and it's incredibly taboo still to this day.
You know, we say most of those miscarriagesare happening in the first trimester,
(22:43):
then we have… sometimes this happens later
in the pregnancy. And of course, that’s… it'sheartbreaking at any time, but it's particularly
sad when you’ve felt a baby grow insideof you, and felt the movements, and had
plans and hopes, and this baby doesn't make it.OF: And this is part of the role of the doula, is
(23:08):
it? To manage the situation when this does happen.LR: Not every doula does this, but I have done
grief support training for parents with perinatalgrief situations. And it is something that
for someone, it's the worst day of theirlife. But if you can make it less ‘worse’,
(23:29):
then you've done something that's profound andlasting. In China, it’s if the baby doesn't make
it at any point, the family aren’t encouragedto have photos or clothes or hold the baby,
it's just whisked away as medical waste.OF: Medical waste.
Yeah. So even the concept of “This family wants to cremate
(23:50):
this baby, and they want the ashes back". It'slittle things, it doesn't sound like much,
but it changes everything. I'm thankful that I canbe a person who can make this situation better.
OF (24:05):
Wow. And how does that affect you? LR
quite a while, being very impacted emotionally.And I don't think you can do it without being
impacted emotionally. I will talk to a therapist,and I think anybody should in that situation.
(24:28):
You know, I find myself ‘go, go, go, go go’, andall of a sudden, something happens and I will
burst into tears, and it all comes out. Like,you can't push it away. You can push it down,
but you can't push it away. And it's good toget it out. Because you're very much in a very,
very, very raw situation. It's hard.OF: And in the same way, I can see why
it's such a privilege to share that withsomeone who is going through something so
(24:52):
similar. Like, you must have a bond withthe mother and the father at that time.
LR (24:56):
Forever. And you may not be a person they ever want to see again.
OF (25:00):
No. LR
that people really do take you into their family.These babies and these families live in my heart
forever, they really do. And it's very special.OF: Well, I am looking at the object you brought.
It is a colourful spiral of circleshere. And it's making me think, yes, we
(25:23):
did end that conversation on a very real butsad note. But the colourful circles in front
of me are reminding me that it's also happy.LR: It's thankfully, very few situations that
are so sad and so tragic. It's mostly, the highsare high and they're fantastic. And to be able
(25:44):
to have the privilege and the honour of joiningfamilies in this, on an almost daily basis, is
hard work, it’s exhausting, and it's fantastic.OF: Louise, this was not hard work or exhausting.
But it was fantastic. Thank you so much.LR: Thank you very much, it was really fun.
(26:04):
We now go on to Part 2. LR
[Part 2]OF: I think we're gonna
run a little bit long in the first half, becausewhat you said was so special. So let's try and
quick-fire our way through these there questions.LR: Quick fire. I’m Australian, I can't say
anything quickly. But let's try.OF: Question 1. What is
your favourite China-related fact?LR: Do you know what, my favourite China-related
(26:26):
fact comes from my now eight year old son who toldme that male pandas can do a handstand and then
pee. So that they can mark trees higher. Can youimagine a panda doing a handstand at all, and then
peeing, just so they can mark a tree higher?OF: Oh, wow.
LR (26:45):
That's not in the guidebooks, is it? OF
word or phrase in Chinese?LR: I think that actually 舒服 [shūfú]
is one of my favourite words.OF: Oh yeah.
舒服 [Shūfú] is just.. it sounds 舒服 [shūfú]. 舒服 [Shūfú] sounds 舒服 [shūfú]. And 不舒服 [búshūfú],
when I feel 不舒服 [búshūfú] it perfectly explains…like, I don't have to diagnose exactly what I'm
(27:05):
feeling right now, I just feel 不舒服 [búshūfú].OF: Can you explain what it means?
It feels uncomfortable. And 舒服 [shūfú] feels, you know, it just feels soft and nice
and comfortable and relaxing.OF: Yes. That's so… It does
sound cosy, 舒服 [shūfú].LR: It does, doesn’t it?
OF (27:19):
Yeah. What's your favourite destination within China?
LR (27:23):
I don't get to travel much - I think you probably hear that from a lot of people in
healthcare, I don't travel a lot becausebabies, babies, babies, they’re just born
all the time - but I really enjoyed visiting,years back, 峨眉山 [Éméishān] and 乐山 [Lèshān].
I liked 峨眉山 [Éméishān] particularly because itjust… I come from the Blue Mountains in Australia…
OF (27:42):
Nice. LR
laid-back mountain-y kind of thing.OF: Yes. LR: It was nice.
If you left China, what would you miss the most, and what would you miss the least?
LR (27:50):
Taobao. OF
It’s ‘most’ but I think my wallet would miss it the least. I love Taobao,
I've bought so much on Taobao over the years,I've had some spectacular wins and fails on it.
I love, just the concept of you can get anything.OF: Yeah
Anything. OF
(28:12):
what I'm seeing in front of me right now.LR: Well, you can't actually, that's why
I had to make it myself out of PlayfoamOF: Playfoam cervix, I'm going to do a
little search for "Playfoam cervix”.LR: You're not gonna find it.
OF (28:24):
No. LR
Actually, I think what I would miss the least iswhen people, kind of like, ‘Chinasplain’ to me.
Oh god. LR
‘Chinasplaining.’ And then if I have a differenceof opinion - that's, you know, gleaned from 15
years of experience - I've been brainwashed.OF: Hmm, yes. Is there anything that still
(28:48):
surprises you about life in China?LR: I was surprised the other day to
learn - from a bunch of nurses thatI was talking to - that you can get
condoms on 饿了么 [Èleme] arrive at yourdoor in 20 minutes. And then if it breaks,
you can get the morning-after pill 20 minutesafter that. And I was like “Maybe you should
just stop buying condoms on 饿了么 [Èleme]”.OF: Just dial up the 饿了么 [Èleme].
LR (29:11):
It makes a lot of sense. OF
to eat, or drink, or just hang out?LR: Honestly, it’s… I love my sofa.
OF (29:21):
Yeah LR
all day with people, and talking to people, and Ijust love Netflix. I really… it's a really boring.
No, having been through the conversation we've just had, all the things that you deal with, I can
imagine the sofa being the place you want to go.LR: Yeah. I mean, I do… I love going out with
my close friends - my friends who are my familyhere - who I can talk about the good and the bad
(29:47):
with. And so it's not a place, it’s a people.OF: What is your favourite WeChat sticker?
LR (29:53):
My favourite WeChat sticker is actually one that says ‘Google it, you lazy ****’.
I don't use it very often, because it's rarelythe context where I can. There is a safer
version of it, which just says “Google it”.OF: Yes, you need to do a “Bing it” too.
Yeah, ‘Bing it, you lazy ****’. OF
(30:16):
does it? What is your go to song to sing at KTV?LR: Look, KTV is an art. You've got to
choose wisely, for the right time in the evening,and the right moment of the room and everything.
But I think probably my favourite just, like,kick-things-off songs would be something like
(30:37):
‘Sweet Child o' Mine’ or like Cher’s ‘TurnBack Time’, or something just that you
could belt out and get things going.OF: Yes. These are belting rocks.
Just belt it, just belt it. And, like, graphic 80s actions.
OF (30:51):
Oh, if only there was a video recorder in this room right now. Anyone listening,
if you can imagine that Kiss photo with thetongue sticking out, there were elements of that.
LR (30:52):
Yeah, that’s about it. OF
media or sources of information do you rely on?LR: Oscar, only you.
OF (30:57):
Oh, baby. You’re lying! LR
I really just pick from whatever I get my hands
on. I don't have a set favourite source.OF: Louise, it’s been a real pleasure.
I only have one regret, and that is wespent so much time talking about your work,
we know very little about you.LR: There is nothing about me.
(31:19):
That’s nonsense. You've opened my eyes, this is something which I am not an expert
on at all. But it's fascinating.LR: You're welcome. It's definitely
a huge topic because it spans an entire life.OF: Yeah. Well, before you leave, the final thing
I ask everyone in that chair is, out of everyoneyou know in China who would you recommend that I
(31:39):
interview for the next series of Mosaic of China?LR: I am going to recommend Barbara Poppell.
She is in child development, and has an amazingperspective on how parents can help kids becoming
their best little peoples that they are.OF: Wow, that's such an apt person
to hand off the baton toLR: Yeah, I just pass it over.
(32:01):
I've done the babies and thebellies and the boob juice,
now you take them on for life. I'm done.OF: I can’t wait to meet Barbara,
and thank you again.LR: You're very welcome.
[Outro]OF: Well as I mentioned just before the end right
there, we only scratched the surface of gettingto know Louise in this episode. But just to give
you a taste of who she is, she’s an Aussie who’smarried to a Canadian, who has worked in places
(32:26):
like East Timor and Nepal before moving to China.So in case you were wondering where her accent
from, it’s a mixture of all the above. And asfor some of her other talents, I have also posted
images online of the boobies that she crochetswhile on her sofa, some artwork that she has made,
and even an example of the crazy cakes she bakes.So she doesn’t just spend her time messing around
(32:51):
with Playfoam making cervixes, she does otherthings too. Or should that be ‘cervices’.
Speaking of cervices, not only will you havenoticed that Louise’s object is the perfect
counterpoint to Cocosanti’s object from lastweek’s episode - shout out to Kevin - in fact,
January happens to be Cervical Health Awarenessmonth, so if that’s applicable to you,
(33:13):
please consider this a nudge for you togo out and get a cervical cancer screen.
And one final update since we recorded theepisode is that the NICU where Louise sends
intensive care babies has just openeda new section where you can pay extra
to visit your baby every morning in a smallerroom, and get updates from the doctors without
(33:34):
endangering other vulnerable babies. So, aspredicted, things are continuing to improve.
Since you’re listening to theREGULAR version of the podcast,
now is the time for me to tease you withsome snippets from the PREMIUM version.
Please head to mosaicofchina.com andfollow the link there to subscribe.
[Clip 1]LR: But then you look
like crazy religious freaks, as everyonewalks down the street, bowed in prayer.
(33:57):
[Clip 2]LR: The woman who's having
the baby herself has, kind of, taken me aside andsaid “You need to get these people out of here”.
Yeah, right. [Clip 3]
LR (34:06):
The first drugs for pain-free birth was chloroform.
OF (34:13):
Woah. [Clip 4]
LR (34:14):
You see women, as soon as they get pregnant, they're encouraged not to have sex.
[Clip 5]LR: And the
doctors will file across and speak to you. Youmaybe have a baby wheeled past there as well,
that you could catch a glimpse of as it goes by.OF: Yeah.
[Clip 6]LR: We have
sometimes some very busy rooms.OF: Right.
We have people with GoPros, we have… OF
(34:36):
Yeah, we have, like, everything. [End of Audio Clips]
There’s also a bunch of other images that I’veposted on social media, so please check them out
as always. And if anyone out there is listeningout for connections with the answers from other
episode, the bizarre one from today’s conversationis that the KTV song Louise mentioned,
Sweet Child of Mine, is exactly the same as theone mentioned by the Pain Management expert,
(35:00):
Lissanthea Taylor, from Episode 28 of Season 01. Ican’t believe these two Aussie women, both of whom
are supposed in the business of improving health,would inflict that kind of pain on other people.
Mosaic of China is me, Oscar Fuchs,with artwork by Denny Newell.
My catch-up chat with Astrid from the ShanghaiSymphony Orchestra follows after this,
(35:21):
and I’ll be back with the next fullepisode the same time next week.
[Catch-Up Interview]OF:
Astrid, hello.Astrid Poghosyan: Hi, Oscar.
OF (35:39):
It's so nice to see you again. AP
to see you too. It's been a while.OF: It has been a while. But here we are.
And it's been an interestingyear since our recording, right?
AP (35:51):
Indeed, it was very unexpected. OF
talk about when Coronavirus hit.Were you in China at the time.
I was. I was in Shanghai, and it was actually the last days of our operating.
And then as I already had planned to go to LA,I was like “OK, never mind, I'm just, you know,
(36:12):
I'm just gonna follow the plan. So I went there,and then that was the time when… it only took me,
like, seven days there to realise that itseems like things are getting pretty tricky.
So basically, when I locked my door in Shanghai,I was like “I'm gonna be back in two weeks”. And I
locked the door for an entire nine monthsOF: Nine months.
Yes. Because at the last minute, I decided that… because back then,
(36:36):
you know, all the airlines started to shut down.
So I bought a ticket to Armenia.OF: You're a violinist, of course.
Did you have your violin when you left China?AP: No, that's the first time I left the country
without my violin. This was a moral to be learnedin the future, you never leave your instrument,
(36:57):
even for two weeks. And that was the mostshocking thing ever in my life as well, because
I've never been separated from my violin foreven two days. And this time, it was nine months.
And I felt like, you know, I abandonedmy child somewhere, god knows where,
and nobody's taking care of it. Even thoughsome people will say it's just a piece of wood.
(37:18):
But it's not, it's a life. So it wasreally stressful from that side as well.
So I had to find a replacement.OF: Oh so at least you could
play some violin, right.AP: I could, but you know,
it's just a little bit… you feel like cheating.Because you found a replacement somewhere else,
in a different country.OF: Totally.
And then you have your own one waiting for you at the place of origin. So
(37:42):
the moment I came back, the first thing I did wascheck up on my violin. But I didn't pick it up.
I needed time to just, you know, feel it,that it's there I'm back, it’s around me.
And then after a while, I just took it and Istarted playing on it a little bit, you know.
OF (37:56):
Wow, that’s nice. Let's talk about, then, when you did come back. So what was that
situation when you finally returned to China?AP: Luckily the embassy in Armenia of China
was so nice. And they opened the whole buildingfor my application to, you know, turn on the
computer after eight months. That moment, thewhole energy felt like the entire country is
(38:18):
working on my return back to China. So I had theseapplications, and I had like a 48+ hour trip here,
transferring through four differentcountries. So I eventually arrived and,
you know… But that's the human being, you know,once you arrive, whatever you experienced before,
gone! It’s just like, all the difficulties, allthe tiredness or whatever, just the idea that
(38:41):
you're back home. Ah, just this feeling.OF: Yeah. I'm so glad that you are back.
Unfortunately, the person who yourecommended, she is still stuck in Taiwan.
AP (38:52):
Unfortunately. OF
in the next season, the one coming upnow, but I did find a nice replacement.
So I hope that you will enjoy that.AP: Thank you, Oscar, looking forward
to catch up more. Thanks for having me, as usual.
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