"Sorry. I haven't slept. We had five babies born overnight," says midwife Robin Lim greeting a couple who last night gave birth to their second child.

The baby was born under the protection of Lim's vision for a three-pronged approach to childbirth - culture, nature and science - practiced by the Indonesian midwives at the Nyuh Kuning birthing clinic in Bali, run by Yayasan Bumi Sehat, or Healthy Mother Earth Foundation.

The clinic was established by Lim and the foundation's board six years ago to provide assistance to impoverished women during childbirth and to reduce maternal and infant mortality rates, which in Indonesia still stand at around 20,000 deaths annually, according to Indonesia's September 2008 Millennium Development Goals report to the United Nations. Those statistics frequently translate in human terms to postpartum hemorrhaging, often attributable to poor prenatal nutrition.

Poor prenatal nutrition, poverty and the loss of traditional midwives place women and babies at severe risk, Lim says. As a midwife, mother and author of books promoting healthy birth and breast-feeding, US-born Lim felt compelled to do what she could to help prevent postpartum deaths in women and promote breast-feeding for their children. She sold up her home in the United States and began helping women in Bali. "What does a woman do when she goes into labor on a raining night with no transport to get her to hospital and no one to help?" asks Lim of the situations she witnessed in those early days.

Bumi Sehat, and its sister clinic in Aceh, today helps all sorts of women, from those living in the slums of Denpasar to Indonesian movie stars and expatriates seeking a beautiful birth for their children. All receive the same care, comfort and gentle birth - or hospitalization when needed - from this legendary warrior for women and children's right to a safe and gentle birth.

Lim is tireless in her dedication to families. A pat on the shoulder, a warm smile and she is on the move again, despite her lack of sleep. She comforts everyone and makes them all feel special, including new fathers. When Lim momentarily comes to rest she embroiders - delicate French knots appear under her hands as she continues to chat and welcome people.

In 2006, Lim's work in prenatal health care and gentle birthing was recognized by the Italy-based Alexander Langer Peace Award; she was also invited to speak to the Italian Parliament on the needs of pregnant and lactating women. Yet she is more at home here at the fully accredited birthing and family health clinic where impoverished local women receive the support before, during and after birth that they greatly need and deserve. A mother of seven - with a few extras absorbed into her caring arms over the years - and a grandmother, Lim is a champion for women and children and their right to have a noninvasive birth and assistance with breast-feeding.

"Children here *in Indonesia* are 100 times more likely to die in their first year of life if they are bottle-fed," says Lim. She adds that every mother who gives birth at the clinic goes home confident in her ability to breast-feed, supported by regular postbirth home visits by staff midwives to address breast-feeding concerns. Midwives at Bumi Sehat will "physically remove anyone who tries to enter to promote bottle-feeding", says Lim of the skilled midwives who last year helped in almost 600 births; every baby was successfully breast-fed. Almost of equal importance in good infant health welfare is maintaining the umbilical cord and placenta intact for some time after the birth.

"Delaying cutting the umbilical cord in now recognized by the World Health Organization; benefits to the baby of that delay are increased health and intelligence, because of the blood flow from the placenta to vital organs," says Lim

Another benefit is T-cell absorption, which helps protect against cancers. "The idea of clamping quickly is to harvest T-cells, presumably for cancer treatment in later life. This is expensive and experimental. I believe it's better to leave the cord intact longer and let the babies get T-cells at birth. I believe this is also a world peace issue. Giving people their birthright - an intact ability to love," says Lim, pointing out that protecting the baby with a gentle transition into the world, maintaining the umbilical cord and placenta and never separating the mother and her newborn reduce feelings of trauma and abandonment in newborns, an emotion that can later scar people for decades.

Lim's harmonious philosophy on births is backed up by Dr Hariyasa, head of the Bali Gentle Birth Study Group. Hariyasa has introduced water births to Harapan Bunda hospital, inspired by the Bumi Sehat model, says Lim.

Western birthing protocols, from which Western women are turning away, have made inroads in developing nations, first with bottle-feeding and rapid cord clamping; now many Indonesian women are choosing to have an epidural anesthetic during labor.

"Currently breaking over Indonesia like a tsunami is the rise in epidural anesthesia for vaginal deliveries. They are needed for caesareans, but not for normal births," says Lim. She stresses, however, that medical science has a vital role to play in maternal and infant welfare. "A three-legged stool stands strong, even on bumpy surfaces. The midwives, nurses, doctors and families involved with Bumi Sehat believe in a three-legged approach to safer motherhood and infant survival - culture, nature and science."

Ambulance needed

Bumi Sehat is in dire need of an ambulance to transport mothers in labor, newborns and their mothers home after birth, and emergency cases to hospital.

"No woman and baby leaves here *Bumi Sehat* on the back of a motor cycle. Every woman is taken home in a car safely," says Lim.

Currently Bumi Sehat staff members donate their time and vehicles to take new mothers and their babies home, which can mean a long wait as volunteers are tied up with work and other commitments.

"The Ubud Rotary Club is fundraising for an ambulance for us, which we desperately need. The Ubud Rotary Club is wonderful," says Lim, adding other valuable supporters of Bumi Sehat are The John Fawcett Foundation, Rotary Clubs International, the British Community Committee from Jakarta and Direct Relief International.

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