Worry is the Work of Pregnancy

Dec3

This is a concept I like to introduce in childbirth classes. I first came across the phrase “worry is the work of pregnancy” in my most favorite of birthing books, Birthing from Within by Pam England. I’ve noticed that women often feel like they shouldn’t have worries during pregnancy and that talking about their fears is somehow “dangerous” (like it will make the fear come true). Bringing fear out into the open and “looking at it” instead of keeping it tucked away and bothering you is actually one of the best ways to work with it. Another common concern is that your worries are “silly” or unfounded. It is okay to have worries, even “silly” ones! The strategy Pam suggest for exploring your worries is as follows:

Explore each worry with questions:

° What would you do if this worry /fear actually came true?

° What do you imagine your partner and/or birth attendant would do/say?

°   What would it mean about you as a mother if this happened?

° How have you faced crises in the past?

 °  What, if anything, can you do to prepare for, or even prevent, what you are worrying about? What is keeping you from doing it?

 °  If there is nothing you can do to prevent it, how would you like to handle the situation?

What Do I Mean By Normal Birth?

Nov28

I realized I have used the term “normal birth” several times without explaining what I mean. First, I wish to be clear that there is no value judgment in the phrase normal birth–it simply refers to the physiologically normal process of birth. It is birth as it is biologically programmed to happen and allowed to unfold without interference in a physiologically normal way. This is “normal birth”–birth that is unhindered, undisturbed, and not interfered with. Approximately 90-95% of births would be normal births if left undisturbed. The other 5-10% benefit from the presence of (or access to) a skilled birth attendant.

Birth is physiological and biological in nature, but is influenced and shaped by personal, social, cultural, and historical factors.

Normal birth is sadly a rarity in our present birth culture in the U.S. What we have come as a society to view as “normal” parts of birth are often actually things that impair or interfere with the normal process and the natural unfolding of this exquisite biological event.

What is Holistic Childbirth Education?

Nov28

A definition I like is one from midwife and author, Penfield Chester:

“The holistic model holds that birth is a normal, woman-centered process in which mind and body are one and that, in the vast majority of cases, nature is sufficient to create a healthy pregnancy and birth.”

My certifying organization, ALACE, uses the word holistic to mean a childbirth educator who incorporates psychological aspects and mind-body integration into their classes.

The Three P’s

Nov28

Continuing my alphabetical “theme” I thought I’d write about the three P’s of birth. The “classic” three P’s are the passageway (pelvis), the powers (contractions), and the passenger (baby). Some people include a fourth P–the psyche (mind). These three P’s interrelate to create the labor and birth experience. This is a very mechanical, reductionist, and very simplistic way to look at the intricacies of birth and the interplay of a variety of physical, emotional, psychological, and even social factors that influence birth. So, I started thinking about other P’s involved with birth and came up with quite a list!

Powerful, praise, people, pain, partner, pleasure, pride, planning, patience, persistence, productive, purposeful, proactive, plasticity, plentiful, pragmatic, pleasant, precious, presence, perseverance, preparation, and privacy!

Of this new list of P’s I think patience, privacy, and preparation are most important. I include “pain” on this list of positive P’s because pain is an important part of birth–it is pain with a purpose. I have lots more to say about pain, but I’ve saving it for another post! 🙂

I also thought up a list of P’s that are often unhelpful or detract from or hinder labor and birth:

Protracted, presumption, peremptory, pelvimetry, pitocin, pressure, program, performance, PUSH, PUSH!, “proper/polite” (feeling like you have to be), prolonged, proscribed, prescribed, probing, “progress,” people, problems, panic, politics.

What is Active Birth?

Nov27

One of the single session classes I offer is specifically about Active Birth. I received a question asking what I mean by active birth. Active birth is an approach to birth that emphasizes movement and the use of gravity to help during labor and birth. It is a way of “describing normal labor and birth and the way a woman behaves when she is following her own instincts and the physiological logic of her body. It is a way of saying that she herself controls her body while giving birth, rather than being the passive recipient of a birth that is managed by her attendant.” I incorporate some of the ideas into any class I teach, because I feel like it is an essential component of preparation for birth.

The term active birth was coined by Janet Balaskas, the author of the classic birth book Active Birth and the founder of the Active Birth Centre in London. She specifies that active birth is “nothing new,” but is instead a term for describing normal woman-directed labor and birth.

Active birth is in direct contrast to “active management” of labor.

The Three R’s of Childbirth

Nov26

A concept I find useful to share in birth classes is that of Rhythm, Relaxation, and Ritual–the Three R’s of Childbirth. This is a concept developed by Penny Simkin and is illustrated in her labor support video by the same name. Ritual refers to a repetitive coping mechanism that spontaneously arises during labor–it usually is rhythmic and may be something like humming, singing, repeating a favorite phrase, tapping, vocalizing, rocking, swaying. You can think about and plan for possible labor rituals in advance, but the ritual that is most useful to you is often one that just arises on its own during your own individual labor and birth.

These are three R’s that enhance a woman’s experience of birth and help her cope with her sensations. When thinking about them today, I also came up with three R’s that detract from a woman’s birth experience: Routine, Restriction, and Risk (perception of).

I also considered other supporting R’s: Rest, Relationships, Rapport, and Respect.

Birthing Affirmations

Nov22

One tool I like to offer during birth classes is the use of birthing affirmations. I have a list of favorites that I hand out and I also encourage couples to create their own affirmations that hold personal meaning for them. An affirmation is a positive phrase that you repeat to yourself. Some women like to cut these phrases out and post them around the house to read during pregnancy (such as on the mirror in the bathroom or on the wall in the bedroom). The affirmations can then “sink in” and when labor comes, they are part of your mental vocabulary of birth. Also, some women in labor find the use of rhythm to be a useful tool (humming, singing, swaying, rocking, etc.) and repeating a soothing phrase can be part of this rhythm.

Another use of affirmation is to have your labor support partner read your favorites aloud to you as you labor.

Some favorites from my list are:

  • I trust my body to know what it is to do.
  • I feel confident, I feel safe, I feel secure.
  • My mind is relaxed; my body is relaxed.
  • My body is made to do this.
  • This present moment is all I have to be with.
  • My body knows how to birth our baby.

The corresponding affirmations for a partner to use:

  • Trust your body to know what it is to do.
  • You are confident, You are safe, You are secure.
  • Your mind is relaxed; Your body is relaxed.
  • Your body is made to do this.
  • This present moment is all you have to be with.
  • Your body knows how to birth our baby.

Rolla Area Groups for Mothers

Nov21

Forming supportive networks with other women is something that is important to most women. These contacts are especially important for new mothers. Early motherhood can be a very isolated time. A time in which massive changes are occurring in your family, your personal life, your identity, your relationship, and so forth. Rolla has several support groups available for local mothers:

La Leche League of Rolla, a mother-to-mother group for breastfeeding mothers or women who plan to breastfeed, is available with monthly meetings (informal get togethers with babies and toddlers welcome!) , an email discussion list, and free phone or email help for breastfeeding support.

Mindful Mothers is a group for mothers with children of all ages who wish to make informed parenting choices, including natural birth, attachment parenting, gentle discipline, holistic health care, nutritious whole foods, and environmentally conscious living. (This is a welcoming, supportive environment, you do not have to do everything “holistic” or “natural” in order to be welcomed into the group!)

Mothers of Preschoolers (MOPS)–the local chapter has twice monthly meetings at First Christian Church. The first Thursday of the month there is a speaker and the third Thursday there is a “creative activity.” Childcare is provided during the meetings.

If you know of a local mothers’ group that is available, but not listed here, please email me and let me know!

Mammal Birth

Nov14

At the LLL of MO conference this month, I attended several wonderful sessions by Diane Wiessinger who makes the connection between giving birth on a woman’s own terms contributing to an easy breastfeeding relationship. She also emphasized the fact that we are mammals and just like other mammal mothers certain things contribute to or detract from our ability to give birth in a safe and healthy manner.

Diane shares the following description of why your baby’s birth matters:

“A trip to a strange place with strange smells. Bright lights, busy people. Numbness. A carefully cleaned and wrapped baby who doesn’t stay with Mama. Any other mammal would reject her baby after a beginning like that. Which means that most American mothers have to welcome their newborns with their heads and not their hearts. Not the best start for confident mothering. Not the best start for breastfeeding. Not the best start for love.”

She also says, “Don’t be fooled by the Birth Channel. A normal birth is not a medical event or a source of horrible pain. It happens on its own, with the woman moving in whatever way feels right to her, feeling the labor and feeling–being–in charge. Find someone who will support this.”

Read more of Diane’s insights on her website.