Tag Archive | childbirth

Pain, Power, & Accomplishment

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

Another Healthy Mother/Healthy Baby Quote

Mar12

Since my previous post just touched on this issue, I wanted to share another quote. This one is from the Winter 2008 issue of Midwifery Today in an article titled From the Homefront to the Frontlines:

“Although the popularly desired outcome is ‘Healthy mother, healthy baby,’ I think there is room in that equation for ‘Happy, non-traumatized, empowered and elated mother and baby.'”

I completely agree!

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…

Nature & Birth

Feb20

Today I read a good post called The Nature of Nature. The woman’s birth was precipitous (= 3 hours or less) and she said, “if I were to compare it to something in nature, it would be a riptide.” She concluded her post with this powerful observation: “I am starting to see that a woman’s strength in birth is also in the letting go and allowing herself to tumble fearlessly with the current, never losing sight of the belief that, when the energy of the tide is through, she will find herself upright again on the shore.”

Coincidentally, I just finished reading a book by Sheila Kitzinger called Homebirth. One of the quotes I marked to share was about the exact same thing:

“The power of birth is like the strength of the water cascading in a mighty rush down a hillside. It is the power of seas and tides, the power of mountains moving. There is no way of ignoring it. You cannot fight it. No amount of technique can enable you to be in control of it as you might be in control of a car or a computer. Your birth partner should aim not to manage, conduct, or coach you through this experience, but rather to give you strength and confidence as you allow your body to open and your baby to press through it to life.”

As I noted in comment on the blog post referenced above, I gave birth precipitously to my second son. I viewed the brevity as a gift and felt a tremendous and irreplaceable sense of triumph, empowerment, joy and euphoria. However, I also felt RUN OVER BY A TRUCK! Actually, the analogy I often use is that it was like a train speeding past me and I had run to catch up and jump on for the ride. A nature-based image that kept coming to me was of being a rock and having waves crash into me over and over again–and then part and flow around me.

My total labor was 2 hours. The serious, intense, active part of labor was about 45 minutes in length. As I surrendered to the tides of birthing, I kept saying, “This is MAJOR!” And it was. 🙂

Another related quote from Homebirth:
“Your breathing dances, you get into the swing of contractions, swimming over each as it rises in crescendo, or breasting it like a great ocean wave. You float, you ride, you ski down the mountain slopes, or leap into the void…The imagery that is likely to be helpful to you will include active verbs of opening, releasing, spreading, unfolding, and fanning out. As contractions sweep through you, concepts that suggest power, energy, strength, and perhaps, storm or even whirlwind suddenly make sense, along with wave and water fantasies–verbs such as stream, pool, flood, gush, flow, and cascade. And all over the world, in many different cultures, woman use visual images of fruit ripening and of the baby’s head like a hard bud in the center of a flower unfurling petals. As you read about birth, and whenever you take time to relax and enjoy anticipatory fantasies, create you own images and dreams that will give positive meaning to all the sensations of labor. Doing this will help you to savor fully an adventure that can be among the most thrilling, intense and satisfying experiences of your life.” (emphasis mine)

Fear-Tension-Pain or Excitement-Power-Progress?

Feb14

I love re-framing traditional concepts of birthing to more positive and empowering perspectives. Recently, I was reading an older issue of the International Journal of Childbirth Education and came across a concept that I immediately loved and will incorporate into my birth classes from now on. Most childbirth educators are familiar with the Fear-Tension-Pain cycle–wherein fear raises tension in the body which leads to pain and so on. Reducing one element in the cycle leads to reductions in the others–i.e. reducing tension through relaxation techniques leads to less pain and then less fear.

While this is still a very useful concept and I will continue to use it, the new perspective I just read about was the Excitement-Power-Progress cycle. The idea being that labor can be greeted with excitement and welcome instead of fear and anxiety. As the power of birth grows, so does the progress towards meeting your baby! So, you can greet the increased power with excitement and confidence and know that your body is making beautiful progress.

The author of the article I was reading (Stacey Scarborough), phrased it like this:

“Fear = EXCITEMENT about being labor and having a baby!

Tension = POWER, strength, or energy!

Pain = PROGRESS”

Using the right ingredients…

Feb6

I seem to be able to relate just about everything I ever read to birth. Some time ago, I read a book called Things I Learned from Knitting and in it the author recounts a story about her attempt to make her friend’s delicious stroganoff:

“The recipe was for a fantastic mushroom stroganoff that I thought was one of the yummiest things I’d ever eaten. I hurried to the grocery store to buy all of the ingredients, but there was one problem: I couldn’t afford them. I decided to make do. I bought substitutes…It called for cream; I used milk. It called for portabella and shiitake mushrooms; I used regular button mushrooms. It called for butter; I used margarine. The wine? I substituted water. I painstakingly put together my version of the stroganoff and was absolutely devastated when it was a pale (and sort of gross) imitation of the glorious dinner I had eaten at my friend’s. I explained the outcome to my mum, telling her that I must not have the skill at cooking that my friend had. I proposed that I just needed practice making the dish…’Darling, practice all you want, but you can’t make a silk purse out of a sow’s ear.'”

How does this relate to birth? When women share their stories with me in person, online, or in articles, I am struck by how often they’ve tried to make do without the “right ingredients” and then blame themselves (or nature) when their birth didn’t turn out the way they had wished. They may have gone to a hospital with a 50% cesarean rate, chosen a physician unsupportive of natural birth, spent much of their labors on their backs in beds, labored while attached to any number of restrictive pieces of technology, taken powerful medications, and so on and then grieve the loss of the beautiful birth experience they had planned.

So, what are the right ingredients? Every woman is different and each birth is different and has its own lessons to impart. However, we do know that some things are the “right ingredients” for many women if they would like to have a normal (physiologically unfolding) birth:

Labor begins on its own (no induction, no pitocin)
Freedom of movement throughout labor (no restriction to bed)
Continuous labor support (from a doula, your husband/partner, or a supportive friend)
No routine interventions (any interventions should be based on the unique needs of you and your baby, not hospital protocol or “this is what we always do”)
Spontaneous pushing in upright or gravity-neutral positions (try squatting, kneeling, hands and knees, or side-lying)
No separation of mother and baby after birth with unlimited opportunities for breastfeeding (do not have the baby taken to the nursery and breastfeed early and often!)

Another wonderful ingredient is confidence in yourself and your body’s natural ability to birth your baby.

Please do not be afraid to seek out a care provider and a birth setting that recognizes the importance of the right ingredients and who will do everything possible to help you use those ingredients to “cook” up a healthy, rewarding, normal birth for you and your baby!

For more information about Six Care Practices that Promote Normal Birth, visit the Lamaze site.

Breaking through…

Dec8

From the book Joyful Birth, I wanted to share this quote:

“The memory of [my son’s] birth has become a talisman that I hold in my heart as I journey deeper and deeper into motherhood. For these moment’s come again in every mother’s life–the times when we are asked to walk straight into our pain and fear, and in doing so, open up to a love that is greater than anything we ever could have imagined: all life’s beauty and wonder, as well as all the ways that things can break and go wrong…Again and again, motherhood demands that we break through our limitations, that we split our hearts open to make room for something that may be more than we thought we could bear. In that sense, the labor with which we give birth is simply a rehearsal for something we mothers must do over and over: turn ourselves inside out, and then let go.”