NEPAL PART I

When I arrived in Kathmandu, Nepal, the first thing I noticed wasn’t the mountains. It was the way people look at you.

They look a little longer but not intrusive, not uncomfortable, they just seem very present.

There’s a quiet curiosity here and people approach you gently, offer help, ask where you’re going, make sure you’re okay, without wanting anything back. It feels welcoming in a very soft, almost unnoticed way. Even the mountains weren’t the first thing I noticed, they are incredible.

At first, I thought they were clouds. Soft shapes in the sky, but then I realized they were snow-covered mountain peaks, towering above the city. One of my first visits took me to the university teaching hospital.

I tried to walk in without any images in my head of what a birth space look like , with the intention to just observe, to notice and not to judge.

The Maternity ward of the hospital is split into two buildings.

In one building, high-risk women* are cared for. This is where doctors work, where epidurals and cesarean sections are possible, where complications can be handled.

Right next to it is the hospital birthing center, run by midwives and nurses. This is where low-risk women* come to give birth.

Women* spend the early part of labor in one room, and when labor shifts into the active phase, they move into the labour room.

When I walked into that room, I had to pause for a moment.

It was bright, filled with natural light. The windows were milky, letting light in but protecting privacy. On one side of the room were three mattresses on the floor, space for three women* to give birth even at the same time.

The idea behind it is clear: women* are encouraged to move, to choose their position, to not be confined to a bed. There is space for upright birth, for squatting, for kneeling and at the same time, it asks something, to let go of the idea of birth as a private, isolated moment.

If anything doesn’t progress as expected, women* are transferred directly to the high-risk unit next door.

After birth, women* are cared for in one large postpartum room. There are around fifteen beds, mothers lying with their babies, surrounded by family members who come to support them.

There is no hospital food provided. Care doesn’t end, but it looks different. Family plays a central role here, in a way that felt very present and very normal.

After this visit, I left the city.

A long journey was ahead of me with buses, walking, waiting ....about four hours in total. I traveled south of the main Himalayan mountain range to a small rural district.

Several villages are spread across the hills, all connected by one single dirt road.

Each village has their own health post, it's the most basic form of public healthcare here. They provide essential services and are often the only point of care for women* in the area.

Birth spaces here look very different.

The labor room is small, there’s lesser light and usually just one birthing bed, with little room to move or change positions.

Here, it’s still normal for women* to receive an episiotomy (a surgical cut to the perineum to widen the vaginal opening during birth).

From what I've got to witness so far, Midwifery care in Nepal depends a lot on where you are, in cities, births are attended by trained midwives and nurses. In rural areas, care is often provided by professionals with SBA training (Skilled Birth Attendant training), designed to ensure basic, lifesaving care where full infrastructure isn’t available.

From this point in the mountains I continued another hour, by motorbike and on foot, to visit a young mother who had just given birth to her twin babies two and a half months ago.

She welcomed me into her home and shared her birth story with me. Her story and the stories around it need their own space.

I’ll share it in the next post.