Av. Petit Thouars 4534 house 6, Miraflores, Lima, Peru
To conceive, gestate, give birth and raise our children, we can walk hand in hand with nature.Dr. Angela Brocker
Pakarii Casa de Nacimiento was the first birth center in Peru. It was opened in Lima in 1995 with the purpose of promoting and expanding the philosophy of natural birth and water-birth. In the native Andean language of Quechua, Pakarii means “dawn, coming out to the light, starting something new, being born.” Pakarii was founded by Angela Brocker, a German physician (surgeon) trained in Peru and Mexico. Dr. Brocker envisioned a birth center where the wisdom of Andean traditional midwifery would be combined with humanized birth techniques and modern obstetrical knowledge. The Pakarii model of care was developed in conjunction with Andean traditional midwives and the renowned Fernando Cabieses (Mexican-Peruvian neurosurgeon and researcher) of the Instituto de Medicina Tradicional (now the Center of Intercultural Health of Peru, CENSI).
The initiative for Pakarii also came from women who were seeking birth alternatives. Obstetrical interventionism and obstetrical violence were on the rise in Peru. C-section rates in Lima were 40% in the public sector and 70-90 in the private sector.
Pakarii’s has been at the forefront of re-introducing “natural” birth and home birth into the Peruvian mainstream culture. They have also played an important role by advancing the training, professionalization, and availability of doulas. Pakarii has appeared numerous times on national television and other media. Pakarii has also greatly contributed to the education of obstetricians around the country. The Pakarii staff are involved in research to continue to develop their integrative model of care.
Pakarii now provides a wide variety of specialized women’s services by midwives, physicians, therapists and doulas. Pakarii’s holistic, woman-centered model of care includes essential education for fertility, pregnancy, preparation for childbirth, postnatal period, and support women’s health throughout the life cycle. Pakarii’s staff emphasize physical and emotional accompaniment as a goal of the birth experience.
Pakarii has forged a new culture around birth in Lima and Peru. Pakarii’s more respectful and less medicalized model of care has returned women to their essence and capabilities. Pakarii has demonstrated that most low risk women can have successful pregnancy outcomes with more “natural” management. This is supported by a c-section rate of only 9% for women who initiate pregnancy care at Pakarii. The Doula movement initiated by Pakarii is now strong and doulas assist women giving birth at private clinics as well as Pakarii Casa. In 2019, Pakarii organized an important conference attended by government officials as well as experts in the area of humanized birth. There are favorable indications that the political barriers to birth center models of care could be lessened. The founder of Pakarii, Dr. Angela Brocker, has now begun a Peruvian Association for Humanized Birth.
Pakarii still faces challenges from Lima’s more conservative social groups around birth. There is always ‘an eye’ on Pakarii in the Lima scene. But because of its history and success, Pakarii has been able to maintain an “extra-official” permit as a birth center while regulation remains unclear for independent birth centers in Peru. Pakarii has also been able to maintain direct access to birth certificates through the Ministry of Health.
- Free information nights
- Women’s wellbeing holistic workshops
- Gestation school
- Parenting school
- Doula school
- Breastfeeding workshops
- Medical, gynecological, obstetric, pediatric and midwife consultations
- Delivery options, including home, Pararii, and hospital
- Water birth
- Reiky therapy
- Bach Flower therapy
- Acupressure therapy
- Massage therapy
- Lactation counseling
- Home consultations and therapies
- Temazcal (maya) or Inipi (lacota) birth ceremony
- Placenta ceremony
Additional program features:
- Transfers: Public hospitals: Essalud and Instituto Nacional Materno Perinatal (ex-Maternidad de Lima); private clinics: Hogar de la Madre, Clínica Good Hope, Clínica Delgado, among others.
- Freedom of movement and birth positions for the laboring woman, freedom in decision-making process, respect for the couple’s expression (non-judging) during labor.
- The umbilical cord is cut only after the birth of the placenta. Mother/baby and father/baby skin-to-skin contact is encouraged, together with immediate breastfeeding after birth.
- Baby’s height and weight are only measured after 2 or more hours after birth.
- Home visits are conducted after birth when necessary, both for mother and baby care. Check-ups last a minimum of one hour and home visits are offered when needed, including for baby’s consultations.
- Traditional Andean customs include the availability of a reso for use during labor. A reso is a length of cloth is tied around a high wooden beam. The laboring and birthing mother can pull down on the cloth during contractions.
- The placenta is given to the mother/ couple. Placenta ceremonies are offered. Some families choose to bury the placentas in the Andean traditional way and bring a close to the experience of the birth in this way.
Books, including Parir: la danza de la vida
More than 40 articles published in national and international magazines