Birth as a Rite of Passage

Apr11

Part of my philosophy of birth is that it is a significant rite of passage for women, men, and families, not a medical event, emergency, or health crisis. I recently finished working through The Pink Kit and the little book that came with it had some thoughts to share on this subject in the “final word” segment of the book:

We would like to warn you against expecting a ‘perfect birth,’ or for that matter anything in particular, except that you will get through it, with your baby–just about everyone does, no matter what they know and do!

The fact is, there is no such a thing as a ‘perfect life.’ Think about what life passages you may have undergone so far–cutting teeth, starting school, menstruation, the first sexual experience, loved ones dying.

Birthing is also a rite of passage–into parenthood–and like any other passage, it comes upon us and we just have to deal with it. It’s an awe-inspiring experience, and it would be perfectly natural to want to prepare in some way. And you can do that. But to some extent the experience is still out of your control.

Giving birth is definitely the most significant and impactful rite of passage of my life–it is the the gateway to motherhood, which has been the single most life-changing role I’ve had. I believe that this significant, transitional, rite of passage is worthy of appropriate level of awe, respect, and preparation. It is a sacred passage. Accordingly, I also believe the birthing woman should be treated with reverence and respect.

For Labor Support Remember TLC or BLT

Apr10

When supporting a woman in labor, remember to use “TLC”:

Touch–this can be massage, hand-holding, foot rubs, stroking her hair, and encouraging frequent position changes. It also includes the use of water (hydrotherapy).

Listen–this is half of the emotional support in labor. Listening builds trust and meets emotional needs. Use active(reflective) listening and lots of encouragement.

Communication–there are two types in labor. One is information sharing–about her progress, her choices, ideas of things to try, interventions, complications. The second is mediation with hospital staff–this can involve reminders about mother’s wishes, and assertiveness about care.

Or, you can use “BLT”:

Breath–remind her to breathe if she is holding her breath. Model a “cleansing breath” if she is stressed. In through the nose and out through the mouth (like a sigh) can be helpful.

Language–this can be mind-body communication, internal conversation, or verbally telling, showing, or modeling (body language).

Touch–as discussed above. Large muscle massage or firm pressure usually feels better to the laboring woman than light patting, stroking, or “tickling” at the skin or clothing level of her body.

Material on TLC is drawn from the International Journal of Childbirth Education, June 1998. Material on BLT from The Pink Kit–New Focus: Breath, Language, and Touch.

Feeling Powerful

Apr9

As I’ve mentioned before, I love collecting quotes about birth. This is a great one about power and birth from Christiane Northrup:

“Imagine what might happen if the majority of women emerged from their labor beds with a renewed sense of the strength and power of their bodies and their capacity for ecstasy through giving birth. When enough women realize that birth is a time of great opportunity to get in touch with their true power, and then they are willing to assume responsibility for this, we will reclaim the power of birth and help move technology where it belongs–-in the service of birthing women, not as their master.”

—Christiane Northrup MD

I found this on the Birthing Utopia blog.

On an unrelated note, I absolutely LOVE the glass pendants available from Family Tree Glass. I bought several of the birthy belly pendants at the LLLI conference in Chicago in 2007. Since then, the artist has started making wonderful family pendants and also slinging mama pendants that are just phenomenally beautiful. I love them so much. My birthday is coming up. Perhaps my husband will read this and take a hint…;-)

What to say to a woman in labor?

Mar30

I always encourage support people to speak from their hearts when being with a woman in birth–your words mean a lot when they are authentic to you! However, I also realize people would like a “head start” on some good things to say. While all women are different and have different preferences, my observation is that praise and love are good sentiments to express–“you’re doing so well, ” “you’re so beautiful,” “you’re so strong,” “I love you,” you’re amazing”–those kinds of things.

I recently came across this section in the Birthing From Within Keepsake Journal that gives some other ideas of phrases to get you started:

Soften around the pain (or pressure/contraction/fear)

You are stronger than the pain

Keep going

You ARE doing it

I love you

Breathe into it

See your cervix opening

I prefer “you are so strong” to the “you are stronger than the pain” suggestion. “You ARE doing it” is a very helpful response to the comments women sometimes make during labor such as “I can’t do this.”

Pain, Power, & Accomplishment

Mar21

I love this section from Giving Birth with Confidence (Lamaze). It explores the role of pain in labor and its relationship to personal power and accomplishment:

The pain of labor, like most pain, is protective. Responding to pain with movement, including walking, rocking, and position changes, not only helps the baby rotate and descend through the pelvis, but also protects a woman’s body during the process. As the cervix stretches and dilates, oxytocin levels increase, and contractions strengthen and become more effective. As pain increases, endorphins are released that help women cope with the demands of the stronger contraction and the descent of the baby. Actively responding to the pain..then not only promotes comfort but promotes the progress of labor…Because the pain of labor is not associated with trauma, but is a part of a normal, physiologic process, it is sometimes compared to the pain associated with other challenging physical activities. Those who push themselves to climb the last hill, cross the finish line, or conquer a challenging dance routine often report feelings of euphoria and increased self-esteem. Researchers have found that women who experience natural birth often describe similar feelings of exaltation and increased self-esteem. These feelings of accomplishment, confidence, and strength have the potential to transform women’s lives. In many cultures, the runner who completes a long race is admired, but it is not acknowledged that laboring women may experience the same life-altering feelings. [Birth classes] help each woman find ways to meet the challenges of birth confidently and purposefully, and to discover her strength in birth.

The above explains very well why it is that I do what I do–I want each woman to have the chance to experience that transforming power, that sense of personal accomplishment, the increased self-esteem, and the euphoria of knowing “I did it!” I climbed my mountain, I ran my marathon…I gave birth to MY BABY!

Comfort Measures & Labor Support Strategies

Mar14

From the book Special Women by Polly Perez. I thought this was a helpful, quick review of things to try when assisting a woman in labor:

“When assessing labor pain consider the following:

Remember ‘When in doubt check it out.’

Ask the mother the following questions.

What’s going through your mind

Is there something you are afraid of?

What do you think will help?

Tell me how you feel.

Encourage the mother to empty her bladder hourly.

Make sure the mother remains well hydrated.

Encourage the mother to relax her voluntary muscles in her buttocks, thighs, abdomen, and pelvic floor.”

Also consider trying these positions during birth:

standing

swaying

lunge

squat

kneeling

leaning

side-lying

slow-dancing

hands and knees

rocking

sitting

dangle

supported squat

sitting on a birth ball

Birth & Apples

Mar10

What does birth have to do with apples? Well, I read two things this week that made me think of both apples and birth. First, in an Ode magazine editorial that was about “apples and entrepreneurs.” The editor introduced me to the word “pleonasms” –used to refer to words that contain unnecessary repetition. He was discussing apples, “after all, what’s an apple that grows without chemicals? It’s just an apple. If any kind of apple needs a modifier, it’s the kind that isn’t grown organically. Those we should call ‘chemical apples'” (instead of labeling the other an “organic apple”). Of course, I immediately thought of birth. I was considering how we have to use the terms “natural birth,” “normal birth,” “organic birth,” “physiological birth,” “unmedicated birth” and more. Taking a cue from this Ode editorial, what is a birth that isn’t interfered with? Just a birth. In theory, the other phrases we use are pleonasms like “organic apple.” (Same with “breastmilk,” actually. Our own species-specific milk should not need a modifier…)

Still related to apples and birth, but moving into another area, I have a particular interest in “good birth experiences” and how mothers tend to get very valid and real emotions dismissed with comments such as “at least you have a healthy baby.” Or, they face insinuations that they are “selfish” for caring about a good birth experience (the assumption being she somehow cares more about “the experience” than “the healthy baby”). I have already explored this subject in an article for the International Journal of Childbirth Education in Sept. 2008 and also in this post, but I loved this explanation in The Big Book of Birth when addressing disappointment over having a cesarean birth: “…in cases where a mother feels disappointment because the birth didn’t go as hoped, it is like saying to her, Well, at least you got a healthy baby and dismissing any other emotions or experience. It is not helpful because the expectation was not to not have a healthy baby–the expectation was to have a vaginal birth. It is comparing apples to oranges since there were two separate individual hopes: one the joy of a baby, the other her experience of bringing that baby into the world. The apple being the healthy baby we all want and usually bear, the orange being what we hope for in our trials and tribulations on the way there.” (Or, the orange being our “good birth experience.”)

More About the Three P’s of Birth

Mar7

Some time ago I wrote a post about the commonly used “three P’s” of birth. The P’s most often referred to are the Powers (contractions), the Passage (pelvis and soft tissues), and the Passenger (the baby). In my post The Three P’s I came up with some different P’s that could be used instead–both P’s that help and P’s that hinder birth. In reading The Big Book of Birth recently, I came across another section about the three P’s. She uses: Patience, Practitioner, and Partner as the three things we need in labor:

“Everyone involved in labor needs a lot of patience….Partners need to stay focused on the laboring woman and often need just as much assurance that things are going well…Practitioners need patience because every woman’s body does this ever so slightly differently…”

She goes on to explore the role of the Practitioner and how while the primary role is clinical care for mother and baby, women “also need respect and reassuring language for their body and their experience. This has a profound impact on how we experience labor. If we feel undermined, ignored, violated, discouraged, condescended to, or made to feel stupid or as if we have not been acting in the interest of our baby…this tends to skew our entire perception of the day our child is born.”

Similar to posts I have made before about the role of fathers at birth, she emphasizes that the role of the Partner is important primarily because “our partners…[who] know us so well, are often the most valuable person in the room when it comes to ‘being there’ for us.”

Fears About Birth and Losing Control

Mar4

A topic that frequently arises in birth classes is about the fear of “losing control” in labor. Losing control, “losing it,” or “freaking out” are concerns expressed by women preparing to give birth. It is important to acknowledge that this is a common fear. I also like to ask parents to think about what “freaking out” or “losing it” would mean to them? I ask them to consider what benefits there may be to losing control. I also say, “What if you do freak out? Maybe, so what?! Maybe it is okay. Maybe it is good. Maybe it is helpful.” (This doesn’t come across in print quite the way it does in real life!) Surrendering to the flow and power of birthing can be of tremendous benefit. Losing it can mean letting go and letting the power BE. Letting the energy be. Letting birth carry you with it, instead of wrestling for control of it. (When discussing this topic, it is important to remain mindful that for mothers-to-be who are survivors of abuse, language about “surrender” and “letting go” can be very threatening and unhelpful.)

Thinking about “losing control” makes me think about the things that you can have over control of when it comes to your birth experience (I’ve also been reading The Big Book of Birth and it addresses this):

1. You can control who who choose as your doctor or midwife (and can choose to switch at any point in pregnancy if the match is not a good one).

2. You can control where you give birth.

3. You can control who you ask to attend your birth as support–your partner, your best friend, your mother, your sister, a doula. (Anyone who attends should be there for YOU, not because they want to “see a birth” or because you feel obligated to have them.)

4. You can control how you prepare yourself for birth and the education you seek to help you explore your options.

5. You can control the type of books you read and the information you seek about birth.

6. You can control how you care for yourself during pregnancy.

7. If you are having your baby in the hospital, you can control when you go to the hospital.

Hypnobabies rephrases the usual concept of “transition” in labor as “transformation.” This is the time in labor in which many women fear “losing control.” Women may also pass through another transformation point as they move from early labor into active labor–this is sort of a “moment of reckoning” in which it becomes clear that it is really time to DO this! Erica Lyon, who wrote The Big Book of Birth referenced above, addressed this subject really well:

“…as a mother shifts from early labor to active labor, she begins to have an awareness that the labor is getting bigger, strong, more powerful. This often translates into a feeling or idea that you are going to ‘lose it’ or ‘lose control.’ This is a temporary, transient feeling that tells you labor is progressing. It does not mean you will go running naked and screaming down the hallway of your birth facility. What is really happening is a momentary emotional state that reflects your ‘social self’ beginning to fold inward. Labor is not a rational process, it is a body function that is experienced as a gradually intensifying event. You do not think your way through it. You do it. “

Essentially, this is a point in labor when you stop fighting with the “birth power” and begin to BE it. The process of birthing becomes your entire focus. I remind and encourage people to welcome the increasing intensity of labor–and suggest taking a “make it bigger!” approach to greeting and welcoming contractions, rather than trying to avoid or minimize them.

Pam England from Birthing From Within also has a great article about “Losing It” in labor.

Other posts about fear and birth:

Birth Fear
Fear & Birth
Fathers, Fear, and Birth
Fear-Tension-Pain or Excitement-Power-Progress?
Cesarean Birth in a Culture of Fear Handout
Worry is the Work of Pregnancy
Fear Release for Birth
What If…She’s Stronger than She Knows…

My Second Birth

Feb25

The birth of my second son was very rapid and hence the story of his birth is much shorter than my first birth story!

The Birth Story of Zander Thomas

By his mama, Molly M. Remer

Zander Thomas was born swiftly and smoothly at home on Monday, May 29, 2006 at 2:45 a.m. Birth weight: 9lbs 2oz! Length: 21 ¼ inches. Head circumference: 14 ¾ inches. The labor and birth lasted a very intense & surprising total of two hours…

After a few hours of regularly spaced practice contractions during the afternoon of May 28^th, I woke at 12:45 a.m. on May 29^th finally having some “real” feeling contractions—I had tons of practice contractions throughout my pregnancy with Zander (including four different episodes earlier in May of several hours each with contractions every 5 minutes or so, but not with that real feeling edge to them). When I greeted these contractions in the very early morning, I felt a distantly familiar sharper edge to them and a sort of “sick” feeling as they built and peaked, instead of the gripping tension of practice contractions. I decided I needed to use the bathroom and spent 15 minutes in there considering whether something was really happening or not (loose BM’s made me think I could possibly just be feeling “cramps”!). I was disappointed that I had no “show” or any promising discharge at all 😉 I told the baby that it was okay to come out and we were ready for him. I finally left the bathroom and paced around the kitchen watching the clock on the microwave and wondering if it was too early to wake up Mark. At 1:30 a.m., I woke him up to tell him, “Something is definitely going on!” I got out my birth ball and we worked through about 3 contractions together, chattering excitedly in between about when to call our support people. I told Mark about not seeing any “show” yet and so it might not be the real thing after all—I rubbed my belly and said, “come out blood!,” got up to go to the bathroom and was pleased to see some nice bloody show! I felt pretty hyper and cheerful and was trying to figure out when I could take a shower and so forth. The contractions picked up even more to what seemed like 1 or less minutes apart—we stopped watching the clock after the first three on the birth ball, which had gone from 5 minutes, to 4 minutes, and then 3 minutes. It was like watching a labor in fast forward! I decided there was no time for a shower, but brushed my hair and put it in a ponytail and after two more contractions, asked Mark to run and get my birth shirt and my birth bracelet (from my Blessingway ceremony in April). It was about 2:00 a.m. at this point and we decided to call Mom and my midwife.

I kept wanting to lean on something, but having trouble finding the right height. I was compelled to lean on something though (the recliner was too rocky, the birth ball was too low…). Mark suggested himself 🙂 I hung on him during several back-to-back contractions and realized that I was starting to feel some pushy pressure. I felt like squeezing my legs together, but instead reminding myself to let my legs be open and to be a clear, open channel for birth. I also said, “It’s okay baby, you can come out!” Mom arrived at about this time (approximately 2:15) and shortly after, I dropped to my hands and knees with my head and arms leaning over the birth ball. I quickly decided I felt like I was “standing on my head” and so pushed away the ball and went to straight hands and knees with my head leaning on Mark and his arms around me. I kept saying, “This is MAJOR!” I was pushing a little at peaks of contractions and vocalizing loudly as well as continuing to talk myself down out of feeling out of control with an ongoing chant of, “It’s okay, I’m okay, it’s okay.” I also made a joke about maybe only being 2 centimeters dilated 😉

I felt something drip and asked if it was fluid. Mom said “no” and I pushed again and my water broke with a soft warm gush (Mom said, “now it is!”) I asked if it was clear and it was. It was about 2:30 and I felt pushy in earnest. I soon started to feel some burning and knew the baby was coming soon. Lann woke at this point and joined us in the living room, held by Mom. I heard the midwife’s car pull up at about 2:40 and Zander’s head was fully crowning as she came in (no time for gloves!). I was conscious of letting myself gradually push him out, waiting for each urge instead of pushing through it (I also began to feel a tearing sensation in front). The midwife let me know as I eased out his eyebrows, then eyes, then nose, and entire head and then he blooped out at 2:45 a.m.! I sat down and she passed him around to me. I saw right away that he was a boy, just as seven different dreams had told me prenatally! My sweet new baby was all warm and slippery and covered with blood (me too! Even my feet! The blood was from two labial tears, one sort of inner “split” and the other right next to my previous unrepaired tear. Perineum, normal and intact—I tear the “wrong” way instead. Lucky me :(). Zander cried one small cry as we was being passed to me and then was quiet and snuggly. As he was born, Lann called out, “I like him! I like him!” Zander rooted around and nursed on both sides shortly after birth and the placenta followed spontaneously about 40 minutes after his birth.

This labor and birth literally drove me to my knees with its intensity. I felt a bit like it was a train and I had to hop on and keep up! I really feel I surrendered to the power of the birthing energy and let it flow and carry me along with it. I did not struggle or resist and if I felt the urge to resist, I consciously “doula’ed” myself to let go and be open.

Birth is an incredible experience that makes me feel so good about myself! I have never felt so awesome and powerful as I do as a birth giver—it is such a meaningful experience. I am pleased with my ability to surrender to the energy and power of birth and to finally, “get out of my head” (I am usually much more intellectual than I am instinctual, but that part blessedly shuts down and lets my instincts work during birth!). I feel I truly and authentically trust birth and that that inner knowing was manifested physically in my birth experience.