LA Nonprofit Seeks to Educate Armenians About Medical Options
When Astrik Vardanyan gave birth at a Los Angeles-area hospital, she was separated from her new born child and taken to a recovery room where she stayed completely alone, for around one to two hours after a painful C-section. It’s standard hospital protocol, but for Vardanyan, the experience of not being able to bond with her newborn was the closest she has ever felt to insanity.
Though a traumatic high dose epidural during her first labor experience left her unable to move her legs for two days, no amount of physical pain compared to the emotional distress she experienced in that room, away from her child.
“We never recovered from the recovery room,” she says.
To suggest that Vardanyan, a medical anthropologist and mother of three, feels cheated by the American hospital system when it comes to labor, with its interventions in the form of drugs, restriction of mobility, hi-tech machinery, and ultimately, surgery, is an understatement. But as the story goes, adversity has a tendency to lead to opportunity, and her bout with hospital protocol ultimately did just that.
These days, at a humble day care center in Glendale, among Cheburashka dolls, crayons and posters of English and Armenian alphabets, she and her husband Dr. Arthur Poghosyan, a psychiatrist specializing in children and adolescents, hold research-based seminars encouraging natural childbirth, breastfeeding and co-sleeping while discussing the down sides of infant male circumcision and immediate umbilical cord clamping. Too much medical intervention, they say, often leads to a domino effect, causing problems in labor and childcare to multiply.
Founded in 2004 and named after their youngest son, the “haikProject” also seeks to shift some of the diasporan focus from the homeland to the large Armenian-American community in L.A in an attempt to talk openly about issues often left unaddressed and ignored when it comes to childbirth and care, imparting knowledge as a preventative measure.
They hope the knowledge they provide can act as a preventative measure so that no other parents go through what they did.
“Unfortunately, I didn’t have a chance to have natural childbirth myself,” Vardanyan says. “I said to myself, I wish I had known. That has become the organization’s motto, that ‘no parent should ever have to say, I wish I had known.’”
The focus on the Angeleno-Armenian community, still swelling with emigres, most recently from the Republic of Armenia, is much needed, says Shakeh Haroutiounian, a haikProject advisory committee member and owner of Axia Learning, an educational services company.
“I feel we have so many children that we can help here,” she says. “We have this responsibility to address our community’s needs.”
The project began after Vardanyan was pressured by hospital staff to circumcise her sons, leading her to research the age-old practice in the Armenian-American community for her master’s thesis.
What she uncovered, including how forced circumcision in males was used during the Armenian Genocide as a means of conversion to Islam and how in turn, many Western Armenian families have now adopted the procedure on the basis of hygiene, eventually led to the haikProject, umbrellaed under the Armenian Child Wellness foundation. The nonprofit advocated against male circumcision, contending that the removal of the foreskin disrupts its protective, immunological and sexual functions and, as a procedure performed without anesthesia, carries with it harmful side effects and risks.
The organization eventually transitioned from its single-issue advocacy into something more.
Recognizing that the World Health Organization (WHO) and the Centers for Disease Control and Prevention outline that U.S. maternal and infant mortality rates rank as one of the highest in the industrialized world, despite the country leading in highest per capita spending on healthcare, the focus of haikProject broadened, advocating “the natural, timeless way of birthing, children and child rearing,” Vardanyan says.
Vardanyan and her husband set out to reach the Armenian-American community and whoever else was willing to listen about the negative effects of using formulas as a substitute for breast milk and hospital protocol that they say leaves women powerless over the birthing process — a process their bodies are programmed to handle naturally in most cases.
Over the past year, their seminars and lectures have been attended by graduate students, grandparents and those hoping to start a family.
After the birth of their son, composer Allen DerMarderosian and his wife began attending Vardanyan’s seminars to learn more about alternatives to the mainstream medical model.
After a year of attendance, he says he’s picked up valuable information and found the dialogue useful.
“It’s interesting to get other people’s experiences and information about dealing with circumcision and breast feeding,” he says, adding praise for Vardanyan and Poghosyan. “They’re both very passionate and they come from a genuine place of caring about this very deeply.”
It shows. In a recent telephone conversation, Vardanyan sounded distraught, having just found out about the death of a newborn from massive head trauma due to alleged obstetrical negligence. Parents Seda Kaplanyan and Tigran Gadyan filed a wrongful death lawsuit last October against Dr. Kevin Galstyan, alleging his “misuse of a pressurized vacuum device used to deliver the infant,” according to press release from their attorney, Dr. Bruce G. Fagel.
Vacuum extraction, where a metal or plastic suction cup is attached to the baby’s head and used to assist in the vaginal delivery when labor is prolonged, can cause scalp swelling as well as hemorrhage. Vardanyan says the supine position, in which women are lying down during birth, increases the need for extraction as well as the use of forceps.
These standard procedures leave women with less autonomy in making choices about how they would like to give birth. Giving birth in an upright position, according to WHO, appears to be associated with benefits, including reduction in the duration of the second stage of labor — precisely when extraction is used.
“This is a typical scenario when you don’t let the mother be in a position that is convenient for her,” she says. “It is being universally ignored in the American hospital system.”
While attendance has remained steady, conjuring up interest from the Armenian community — where discussion on issues like circumcision, sexuality and childbirth is taboo and akin to airing out dirty family laundry — has remained a challenge.
At one of haikProject’s seminar’s last month, a discussion group assembled after Vardanyan’s talk, “Childbirth can be Ecstatic,” where she recounted the sometimes sordid history of childbirth and the rising trend of midwifery in the U.S.
The group was small — only half stayed behind to participate — and getting the all-Armenian crowd to open up about the topic of childbirth proved difficult.
Dr. Lisa Manuelian, a psychologist specializing in women’s health issues who collaborates with the haikProject and hosts the after-seminar discussions says keeping quiet about sensitive issues is common in Armenian culture.
“We are taught to keep things within the family and taught non-verbally not to talk about these personal things, especially out loud and especially to strangers,” she says. “We’re hoping we can change this through the project. There is a lack of education when it comes to these topics.”
Manuelian, whose client load is 70 percent Armenian, says many in the community also place a huge amount of emphasis and trust in medical doctors without questioning the information given.
“We don’t ask for evidence, we just trust and I think that part needs to change, within our community,” she says. “I think that if we do we will feel empowered.”
DerMarderosian, a third generation Armenian American, agrees. “My impression is that in the Armenian community, people tend to be very rigid about certain things and ways of thinking,” he says.
Newer generations are helping shift attitudes, however, with many that are seeking help for medical issues more openly these days.
“I feel that that’s changing with the newer generation of expectant mothers and fathers,” says Manuelian. “We’re becoming more open.”
As Vardanyan and her husband, who have both traveled back to their native Armenia, presenting and lecturing on circumcision at Yerevan State Medical University and Armenian Urological Association, continue their seminar work, the aim remains the same: providing a service to their community and advocating for the right to have a choice when it comes to child birth and care.
“It shouldn’t be a competition between two professions,” Vardanyan says while stressing we should be grateful for obstetricians and the advancement of technology in medicine. “It should be a complimentary model.”
They might face public push back on at least one issue in the U.S., as several medical organizations tout benefits of neonatal circumcision.
The American Urological Association, although acknowledging risks such as bleeding, infection and penile injury, says that when circumcision is “performed on healthy newborn infants as an elective procedure, the incidence of serious complications is extremely low,” with minor complications reported to be three percent. The AUA also cites a connection between decreased incidence of penile cancer among U.S. males and neonatal circumcision as well as the urinary tract infections being at least 10 times higher in uncircumcised boys.
The Centers for Disease Control, who has not yet determined if male circumcision should be recommended for any population, according to their website, cites several studies that have documented male circumcision as reducing the risk of acquiring HIV.
The practice also varies greatly in Armenian communities depending on background.
While Vardanyan has found the incidence of neonatal circumcision in Western Armenian families, in Armenia, the practice is done in less than one percent of the male population, according to an original article published on Circumcision Independent Reference and Commentary Service, an online comprehensive reference library on circumcision.
Armenian cultural taboos surrounding circumcision also hinders open discussion,which makes researching the topic and getting parents to attend haikProject seminars, that much more difficult. This might extend to the medical community as well, as several doctors with Armenian backgrounds in the Los Angeles area declined to comment on the subject of circumcision for this article.
Despite the challenges, DerMarderosian says haikProject’s determination will pay off. “Even if only one mother listens, it’s worth it because that’s one more child that gains the benefit from it.”