Cultural Definitions of Motherhood: The Butterfly Must Find Its Own Way Out of the Cocoon

There are several cultures where childbirth is understood to be a rite of passage. Beliefs surrounding this transformation are important because they inform the way in which women give birth.

The first culture that jumps to mind would be the Kung of the Kalahari Desert, where young men and women practice rituals that bring them into adulthood.  The most significant right of passage for the Kung men is to hunt and kill their first large animal. For women, the right of passage is giving birth. The Kung is a very subtle tribe who don’t honor bragging.  For example if a young man comes back from a hunt and boasts about making the big kill they will be ignored.  Instead they will quietly start passing out meat, indicating that they accomplished this feat.  For women to gain the same kind of honor, they go off on their own to give birth in the bush without saying anything to anyone. Once the child is born, they very quietly come back and start nursing their baby under a tree.  At this point everyone notices and comes by to congratulate her.  She is then honored for her stoicism and her warrior like abilities in her right of passage.

Another great example is Japan.  Most births still take place in the hospital, however there are maternity homes with live-in midwives where women go for pre-natal care and birth.  The Japanese and the midwives who work in these maternity homes have a specific saying about labor pain; they call it “metamorphic”.  They say that going through labor is a metamorphosis because it changes the woman into a mother the way that crawling out of the cocoon changes the caterpillar into a butterfly.  They adhere to an old story that states if you help the caterpillar out of its cocoon it will die.  It has to emerge by itself in order to survive and to be strong.

Japanese midwives approach birth with great patience.  They believe that the struggle and pain of labor helps the mother to grow and transform herself. The mother must look deep down inside herself and find out who she is.  The baby also needs the struggle of being born; the work is what transforms both the mother and the baby into separate beings with the power and the strength to go on and to be the mother-baby pair that they need to be.

The babies muscles will get exercised during birth which will prepare the baby to be ready to breastfeed.  This will also enable the baby to be aware of the smells and hormones needed to latch on.  If it’s born by cesarean section for example or if there are drugs at birth the baby’s consciousness will be reduced as well as the flow of necessary hormones.

The mother’s metamorphosis releases massive doses of oxytocin while she’s in early labor. Late in labor a flush of adrenaline gets her on a high and gives her the power and strength to push the baby out. Right after this stage comes another flush – the biggest flush of oxytocin she’ll ever get in her entire life.  This will transform her and the moment of suffering, pain and pushing.  If you watch women’s faces at this moment there’s a suffusion of joy and ecstasy in their expression.  Then the milk lets down, the prolactin comes and the hormones all work together to make the caterpillar turn into the most beautiful butterfly.

This excerpt is part of a video interview with Robbie Davis-Floyd and is being re-published with permission from Mindful Mama.

 

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Overcoming Fear Associated With Childbirth

There are a lot of scary myths surrounding childbirth, which can cause women to become afraid. Fear triggers the “fight or flight” response and can shutdown the birthing process. Laura Shanley discusses the importance of overcoming fear and provides insightful tips for mothers who are preparing for birth.

Fear, Stress and the Birthing Process

Did you know that your face turns white when you’re afraid because the body thinks the blood and oxygen are needed in your arms and legs to fight a perceived danger? This is part of the “flight or flight” response. If we feel that we are in danger, blood is drained from the face and other internal organs; digestion shuts down. This is why you can have stomach problems if you’re in a constant state of stress and fear.

There’s a book called “Why Zebra’s Don’t Get Ulcers” – that really explains how well our bodies would function if we didn’t keep triggering fight-flight.  Because of fear and stress, we keep sending blood and oxygen away from our digestive organs, our sex organs, etc. If we were not on high alert all of the time, then our bodies could function at a much higher level. This is true every day of our lives, but is especially important during pregnancy and birth.

Our natural, physiologic response to stress and fear can actually make birth traumatic, causing a host of problems. This begins building long before a woman conceives. Our society focuses way too much on the different things that could go wrong in birth. We should spend more time focusing on how well our bodies really will function when we are in a relaxed state.

Overcoming Fear

For me, overcoming fear was a spiritual process.  I know there are women that have given birth to healthy babies without having spiritual beliefs, but I found strength and courage through the realization that there is a larger consciousness. I also believe that the human body was created intentionally; That we aren’t just a mass of chemicals that accidentally came together – that there is great intelligence to creation and we can somehow feel that within ourselves.

My advice to other moms?

1.    Ask for direction and inner help. Look within yourself for guidance and direction – trusting that it’s there.

2.    Simply believing that courage is available actually makes a big difference in your birth outcome.  Affirmations can be very powerful in this way.

3.    Pay close attention to how you’re feeling throughout the day.  For example if you start feeling anxious during the pregnancy ask yourself “what was I just thinking about?”

4.    Surround yourself with positive thinking people.  If you go see a friend or family member who is continually telling you about the danger and possible complications of birth, I would say that you have the right to not be around that person.  Often times, these people are trying to convince themselves and others around them of their decision, and their remarks have nothing to do with you or your birth experience.

5.    Research. Read positive birth stories. This will help to remind you that other women have stood in your shoes, and they’ve succeeded.

6.    Pay attention to your dreams. I had a dream about how I should give birth to my son standing up, which I had never thought of because I was on my hands and knees for my first birth.  He ended up being born breech (vaginally). This opened my eyes to the idea that dreams are just another resource.  Do not discount your dreams, intuition, impulses, emotions, etc.

LAURA KAPLAN SHANLEY is an author, freelance writer, speaker and childbirth consultant widely recognized as one of the leading voices in the natural-birth movement. Her expertise is frequently sought out by television and movie production companies, as well as media outlets around the globe. She has been featured in media outlets such as ABC News, “20/20,” “The Doctors,” BBC, Discovery Channel, Disney, The New York Times, Reuters, and The Washington Post, among many others. In addition, she works with women on a one-on-one basis, providing them with childbirth education and emotional support before and during pregnancy. She is a frequent speaker at childbirth conferences, providing her unique perspective and inspiring insight. Laura maintains a website dedicated to natural childbirth, www.unassistedchildbirth.com, and has published articles for an array of news outlets. During her free time, Laura enjoys hiking, writing poetry and spending time with her four adult children and one grandchild.  

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Vaginal Birth After Cesarean: Saying ‘No’ To Interventions

This week we are thrilled to feature Desirre Andrews (midwife assistant & ICAN President) of Preparing for Birth as she discusses how to say no to interventions after a previous experience with cesarean birth.

Let me begin by saying I am a VBAC and Cesarean mother of 4 boys. Officially I am designated as a 2VBA2C mother. I too, have walked this path out just like countless other women. Many VBAC hopeful mothers are in a club they did not ask to be a part of regardless of why or how the cesarean occurred.  The first or last birth leaves not only a uterine scar but different possibilities for any subsequent future pregnancy and birth. It can be a very sobering, shocking, even overwhelming realization that there may never be a vaginal birth in the future or again.  The option at birthing versus repeat surgical delivery can be determined by accessibility and cultural expectations, needs and desires.

Why would there be an issue of VBAC access by hospitals and providers? VBAC is not a procedure that requires specific training or skill, unlike surgery. In a nutshell, it is the usual extension of pregnancy and labor to push out a baby vaginally. In essence, it IS the biological norm and expectation. The uterus does have incredible resiliency in healing, like other muscles in the human body. It is also widely recognized by and large to be a safe, reasonable option for women and babies by the National Institute of Health  (NIH) and the American College of Obstetricians and Gynecologists (ACOG) as evidenced in 2010 statements all backed up by years of evidence.

Some issues in access availability are language in the previous practice guideline statements stating immediately available anesthesia is needed (this idea knocks out vast number of rural facilities from offering access), physician liability concerns (cost of liability insurance, thought of being sued), lack of true informed consent between mother and physician comparing repeat surgical risk and VBAC risk, physician fear and desire for making labor and birth a zero risk venture (life is not risk free, either is labor and birth and can never be), and overall physician/hospital culture (what pressures, protocols and practices are widespread in an area).

Yes even with all of these, some changes are being made toward more access, albeit very slowly in most area. Women are compelling providers and hospitals to offer access through determination, evidence, self-advocacy, exercising options, rights and open communication. It is possible. Another point to look at is women are more and more choosing alternate places to birth whether at free standing birth center or in the privacy of their own home (with a midwife or unattended) when access is declined in the hospital environment.  Women are increasingly saying no to those who refuse to give options and choice.

The culture in which a childbearing woman lives (family, friends, co-workers, faith community) affects decision making for the positive or negative. When some or all of those in these cultural areas are supportive of VBAC, she is more likely to choose going for it. When it is the opposite and she is told to just do the “easy” thing (for whom, surely not the one undergoing surgery), ask “Why would you WANT to labor? How lucky you are to be able to get out of it.” or “What does it matter anyway? All you want is an EXPERIENCE, A healthy baby is all that matter anyway….”  All of these negate the woman herself. It is more than okay to want the vaginal birth. It is good to look at what is the healthiest birth avenue. That goes a long way to seeing how the best experience is also the healthiest experience for both mom and baby.

I asked a recent VBAC mother, Katie Z. how her culture affected her decision to go for a VBAC. She stated “Friends and family were extremely supportive, especially after seeing what I went through with (my) cesarean and subsequent PTSD. The community (at large) most was surprised it was no longer once a cesarean, always a cesarean.”

She was able to more readily and easily pursue the desire and need to have a healthier experience because she was fully supported by those in her life. Conversely, some women are willing to buck the trend within their culture and have a VBAC. With lack of support, fear mongering and too often misguided advisement, it is much more a challenge to gestate peacefully and prepare for birth. It is possible, but much more difficult when those a woman cares most about are not be in her corner. I will share that with my fourth son; very few in my world shared my point of view. Thankfully my husband and certified nurse-midwife did. That was really all I needed. Frankly, it can be a dangerous thing to tell a determined woman “no”. She is very likely going to find a way.

Bottom line, there are options though to exercise them it may require much effort, research, relocation, financial planning, meeting with administrators, changing providers and more.

For more information on VBAC www.ican-online.org and www.prepforbirth.com

Desirre Andrews, CCCE, LCCE, CLD, CLE, Midwife Assistant & ICAN President. Preparing For Birth, LLC – http://www.prepforbirth.com.

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Loving Hands: Birth Through a Doula’s Eyes Part 2

This week we are delighted to bring back Cole Deelah to shares the second part of her insightful story of birth from her point of view as a Doula.  Cole has over 10 years of birthing experience and has created her own independent childbirth curriculum.

The atmosphere in the birth center was fabulous: dim lighting, candles by the tub, inspirational music softly playing when I wanted it, and temperature controlled to my liking…I truly don’t know how anyone achieves a natural birth in a brightly lit hospital. The half-darkness helped me to stay calm. In fact, for most of my labor, I kept my eyes closed and just wanted to be left alone with the comfort of the select few members of my birth team.

The midwives took turns monitoring my progress.  Every 15 min or so they were listening to the baby’s heartbeat with the Doppler. I was so glad I was not restricted in my movement in any way by an electric fetal monitor or by an IV.  They were also checking my blood pressure and my temperature often. Everything was normal, which was very reassuring.  I also remember how vastly important it was for me to have someone’s hands to hold during each contraction.

My husband was the best support I could have ever asked for.  He was calm and reassuring.  He held my hands and gave me water to drink.  When he needed a break, my doula was there, holding my hands, massaging my hands, telling me I was doing great.  I am forever grateful for the hands I held during each contraction.

I think the atmosphere in the room started to change around 3:00am (24 hours after my water broke), when I still was not pushing.  I remember Jackie telling me that another hour or two and they’d need to take me to the hospital.  I was so scared.  I did not want to end up with a C-section.  I’m not sure if the thought of going to the hospital motivated me or slowed things down, but soon after that I began pushing.  I felt an urge to push, but it was not an uncontrollable urge…I think I was rushing it because I was scared.

We encouraged you to tune into your body and push only when you couldn’t not push. You became very introspective at this point, totally tuning the world out and listening to your body. You moved your hips back and forth, side to side, and began lots of loud vocalization. We could all hear the slight push that began to appear at the peaks of some birthing waves. You were not quite ready, though, and chose to return to the warm water of the birthing tub.

At this point, I know I was in transition.  I was afraid I would not be able to push the baby out. Later, my doula told me a conversation I had with my husband during this time.  Me: “I’m scared.”  Him: “The baby is coming.”  Me: “The baby will come any day now.”  Him: “You are doing great.  The baby is going to come.”  Me: “The baby will come any hour now.”  Him: “You’re right.  The baby is coming.”  Me: “The baby is going to come any moment now.”

I also remember telling myself (silently) that I was NEVER going to have another baby again.  Then I said a prayer out loud,  and I thought about all the people who cared about me and the baby. It gave me strength and at that moment, I chose to surrender to miracle of birth.

Shortly afterward, we started to really hear pushing noises from you for longer durations. You moved to the edge of the bed and squatted… really feel more pressure and starting to ‘wish push’ with each peak. We reminded you  to conserve your energy until you had no choice but to push. Like magic, within the next two contractions, your pushing changed, your body had taken the reigns and you were submitting to the power of bring your baby forth.

Now I was definitely feeling the urge to push, and push I did.  For pretty much the whole time, I remained in a full-squat position with my arms supported on the edge of the bed and my hands squeezing my husband’s hands.  I was beginning to feel progress, and I continued to be encouraged by the midwives and my doula saying “Great job Lynnette.”  “This is normal.”  “You’re doing great.”

Then, the midwife got a mirror and placed it under me to see if she could see even just a little part of the baby during one of my pushes. I was elated when I heard that the baby was crowning. The whole atmosphere of the room changed, and I knew in my heart that I would indeed be willing to have more children and I would definitely choose this same route.  I was going to have this baby at the birth center after all!

This indeed was the most painful part of labor, but without a doubt the most joyous.  I had been so afraid of this part, but it was the best and easiest part (mentally and emotionally) of labor.  Real progress was being made and my baby was coming into the world.

I was impatient at this point and was trying to wait for a strong contraction before pushing, but I just pushed and pushed, wanting my baby to be born. Looking back, I should have taken more time with this part and waited for the peak of contractions to push…I think this is why I ended up with a tiny first degree tear requiring 2 stitches).

Before I knew it, my daughter’s head and then shoulders emerged from me. And with one final and amazingly awesome feeling, her body came forth.  She was born at 8:05 am (29 hours after my water broke). I was told, reach down and take your baby, which I did!

Your eyes popped over, you cooed ‘oooh!’, broke into a smile, and took your baby by the arms, lifting her out of your body and into your loving embrace.

I brought her to my chest and smiled and looked in her beautiful eyes and knew that I was blessed beyond measure.  She was perfect.  Her skin was amazingly pink and she looked into my eyes and let out some beautiful baby sounds.  She weighed 7 pounds 2 ounces and was 20 inches long.

I cried with joy and exclaimed, “Oh my gosh, she’s my baby!  Oh my goodness.  Hi sweetie.  Hi sweetie.  Oh my goodness.  I love you so much.  I love you so much.  Hi sweetie.  Hi sweetie. She’s so cute!  My baby girl; I love you.”

The midwives and my doula all helped me with breastfeeding within 20 or 30 minutes of the birth.  My baby latched on right away with no issues whatsoever. She never left my arms. This was the most amazing bonding time, completely uninterrupted by the routine things (bath, shots, baby warmers, etc.) that would have been done at a hospital.  Instead of all these procedures, I got to hold my baby skin to skin and bond with her.

The placenta was birthed and then my family came in to see the baby. My husband played his guitar and sang a beautiful version of “Somewhere Over the Rainbow”. Our baby stayed awake and alert for a good 2 hours after the birth, staring into our eyes.  Afterward, we were left alone with her in the peace and quiet of the birthing room.  We were told to nap, but I was so happy, so high on life, that I could not sleep a wink.  I did rest. I did smile.

Our journey into parenthood had begun.

Beautiful family! What a blessed event! The laughter in that room, the joy and triumph, love and peace! It was an honor to attend you during the birth of your beautiful baby girl!

Cole Deelah is the mother of 5 beautiful, home schooled children and the wife of one feisty entrepreneur. She resides and works in the Houston area as a birth doula, childbirth educator, and midwife apprentice. She has over 10 years experience in the birth field and has written an independent childbirth curriculum and head’s up a local cooperative of doulas. Cole has authored articles in such publications as Midwifery Today, the International Doula magazine, and others. She has plans to become a practicing midwife and travel the world with her husband and children, supplying basic life skills and maternal and neonatal healthcare to underdeveloped and developing countries.

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Happy Pills: Preventing the Baby Blues Naturally?

This week, Mother’s Advocate discusses the warning-signs and indications of postpartum depression with Jodi Selander — activist, mother and Director of Placenta Benefits.

MA: What is the difference between the “baby blues” and “postpartum depression” and how common are they?

JS: Postpartum depression is a very real and physiological occurrence that can begin anytime between birth and twelve months postpartum.  It is generally experienced as a series of symptoms, which are identified along a spectrum of severity — ranging from baby blues (which is the mildest and generally corrects itself in the first three to four weeks postpartum), all the way to postpartum psychosis. Postpartum psychosis is incredibly serious and often leads to hospitalization.

The majority (80%) of women experience some sort of post-natal mood instability, mostly in the “baby blues” range.  Baby blues shares many common symptoms with full-blown postpartum depression, but is not technically considered a “disorder” by the medical establishment unless the symptoms extend longer than 3-weeks. Symptoms may include: weepiness, mood instability, mood swings, feelings of anxiety, not wanting anyone else to hold the baby, unwillingness to be alone with the baby, or fear husband or partner going back to work or even leaving the house.

15-20% of women who experience the baby blues will go on to experience full-on postpartum depression.  When depressive symptoms last for longer than 6-8 weeks, a doctor may prescribe an anti-depressant.

MA: What causes mothers to feel depressed or sad postpartum?

JS: Aside from the physiological factors (hormone re-balancing and physical recovery), I believe postpartum is largely cultural. There is a lot of emphasis on building confidence during pregnancy and empowering the birth experience, but there is a real lack of practical support once the baby is born.  Those first few weeks are filled with visits from friends and family and interaction with a care provider. But once the flurry dies down, the changes that come with a new baby can become overwhelming.  It’s hard to have confidence as a mother, especially if you’ve never done it before — and the job is so important.  Every decision you make feels like a life and death situation, and women tend to internalize everything.

It’s not just “oh the baby is crying again” —  it’s “why is my baby crying again, what am I doing wrong? Why can’t I not stop this? Does this mean I’m not a good mother?” Women place a lot of pressure on themselves, and I think there’s a lot of pressure that society places on mothers as well. We elevate motherhood as a noble and worthy institution, which is fabulous, but we don’t give any sort of structure to support that pedestal.  In my own personal experience, this leads to an incredible lack of confidence — and that’s very unfortunate.

MA: When should mothers seek medical support?

JS: This is really where the husband and/or partner comes into play.  He or she should be aware of the symptoms of postpartum depression and notice when a mother is showing signs. Often a mother will not seek help for herself,  and her partner should not be afraid to seek help for her — before it becomes a serious issue.  If you notice that your wife or partner is still not herself after 6-weeks, suggest that she make an appointment so that she can be seen for treatment.

MA: What is the preventative measure, especially for women who have the baby blues?

JS: Most women who have just given birth are going to have depleted iron stores. The placenta is packed with iron and has a lot of vitamins and minerals that your body needs postpartum.  I advocate that mothers utilize placenta encapsulation — whereby it’s completely dried and then ground — to restore the body’s natural balance.

Placenta is used in traditional Chinese medicine to treat fatigue and to enhance lactation, and it has been scientifically shown to increase milk production. The hypothalamus is part of the brain that regulates the endocrine system and studies show that it takes about two weeks for the hypothalamus to receive the signal that the baby’s been born. The placenta capsules help the body to maintain homeostasis during this period, until her body would normally regulate itself.

I’ve had hundreds and hundreds of clients, and everybody calls the placenta capsules their “happy pills”. It’s nature’s perfect gift.

Jodi Selander, Director of Placenta Benefits, started researching placentophagy in 2005 during her second pregnancy. She found substantial information documenting the benefits it offered. Having dealt with depression for many years, Jodi had many risk factors for developing postpartum depression. With a B.S. in Psychology, she understood the devastating effects depression could have on women and their families. As a natural health enthusiast, she wanted an alternative to pharmaceuticals that might help avoid those issues. Jodi continues to work toward her mission of making placenta encapsulation an option for every new mother with the launch of the Placenta Encapsulation Specialist Training & Certification Course in May 2008. As a member of the placentophagy research team at the University of Nevada, Las Vegas, Jodi has helped develop and perform several research studies on placentophagy. She traveled to New Orleans in November, 2010 to present the findings at the annual meeting of the American Anthropological Association. This research is incredibly important to her mission of validating the use of placenta for postpartum recovery. Her goal is to have a qualified person in every city offering encapsulation services, so that women everywhere can enjoy a happy, healthy postpartum experience – the way Nature intended.

This interview was originally filmed for Mindful Mama Magazine and has been transcribed with permission from Mindful Mama Magazine.

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Nothing to Fear: Finding Faith Amidst Fable

As any pregnant women with a burgeoning belly can attest, there are a preponderance of frightening birth stories out there, and little apparent reluctance in sharing them. Birth is perhaps the one unequivocal commonality we all share; everyone on earth today was born.  It is a completely normal physiological process with generations of proof of efficacy and yet many, if not most couples in our culture today approach their births with some degree of fear.  And yet, the mere word- BIRTH- seems to have the power to conjure fear in western women. Men, too.

So where does it come from? In previous generations, women had a healthy reverence for the intensity of birth.  Compared to women today, they were much more familiar with the sights, sounds and smells of labor, but had a very limited understanding of why some women survived child labor and others did not. First time mothers also struggled to grasp  how something that looked so intense, would feel.

With technological advances, antibacterial soap and more prevalent hand washing, the possibility of death has become as remote as our direct experiences with childbirth. Very few people actually experience a birth other than their own, but we are inundated with conflicting and scary representations of birth.  Thus, we fear what we think we know. Our collective understanding has shifted from a very real concern for life and safety to a second-hand anxiety.

A woman has merely to suspect pregnancy, and suddenly find herself  overwhelmed with information — from ‘reality’ birth on numerous television programs and its more humorous Hollywood caricature, to an endless stream of products and contraptions marketed to parturient women claiming to ease, soothe, simplify, (read: correct) her birthing process. Taken separately, each of these influences has the potential to undermine a woman’s confidence in her inherent capabilities; the cumulative effect can corrode it entirely. It is in the absence of this confidence that fear absolutely thrives!

But, how do we heal this pervasive cultural influence?

The simplest answer is that the antidote to fear is faith. It matters not wherein the faith is placed; be it a Most High entity, or basic physiological science,  it simply boils down to how deeply a woman believes in her ability to give birth to her child. Whether she borrows her faith from a greater spiritual practice and views her experience as merely an extension of this greater understanding, or whether she simply studies the facts of the body’s process in labor and the statistical likelihood of safe delivery and is duly assuaged by belief in her own body’s capabilities, a woman coming to the experience with a trust fortified in fundamental understanding is much more likely to have a successful birth.  She’ll enjoy her birth more.

Happy birthing is completely subjective, but it’s probably safe to say that not spending the entire experience in terror is more pleasurable — and more conducive to surrender, which is critical.  Armed with a fundamental belief that birth can be achieved or that whatever takes place will lend to a higher purpose, a woman can more fully give herself  to the process. This is the shift of faith. The entire spectrum of variables — prenatal care model, childbirth education methodology, labor support, etc — cannot overcome the significance of the role that sheer faith plays in the labor experience.

So perhaps the most important preparation for birthing is bolstering faith; cultivating a sense of independent, sustainable trust. Of course, we must also embrace fear as part of the gift, in that it teaches us how to better connect to and prepare for the process and we can also participate in a paradigm supportive of birth (choosing the best support team possible) –  but these things cannot supplant a woman’s core beliefs. Only she has the power to choose faith.

In time, each woman empowered by her a pleasurable birth experience contributes to a shift in the collective consciousness — gradually reframing fear. Every woman within herself, and all women within their communities. Men, too.

Piper Sunshine Lovemore is a Certified Doula, Organic Birth participant and consultant, Lamaze Certified Childbirth Educator, Placenta Encapsulation provider and all-around natural childbirth advocate. Her core belief is that an informed experience is empowering, no matter the particular outcome. To that end, her goal is to educate and support families through their birth experience primarily through reconnecting them with their own embodied wisdom. Piper believes deeply in the importance of community and the richness of a diverse support network. She strives to nurture her community by organizing and attending activities with her family in her free time. She and her partner, Chaz, live in Hawaii with their three children: Che’ Pax, Plum and Rocket, and they look forward to expanding their family further. Take a moment to be inspired by Orgasmic Birth. Watch the trailer… www.orgasmicbirth.com.

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Pssst: The Baby is Not Coming Out of Your Butt

How do you make birth education enriching and funny? Karen Brody, playwright of BIRTH and founder of BOLD – a global movement to make maternity care mother-friendly — talks about “butt humor!” Through the genius combination of truth and laughter, Karen’s message of facing fears and connecting to your intuition is loud and clear.

If you’re a mom with young kids, any mention of bodily parts and their sounds (butt farts and mouth burps for example) has the potential to produce roars of laughter that could be heard on a boat off the Swahili coast of Lamu. In 2005, when I wrote my play “Birth”, a portrait of how low-risk mothers are giving birth in America today, the cesarean rate was 25% and rising. Not hugely uplifting material to present to an audience. I needed a laugh desperately. And that’s when I met a mother who gave me playwright mana-from-heaven: butt humor. If it could work on my kids surely it could work on audiences. And it has.

Meet Vanessa: “Women always say, ‘you’ll forget the pain’. Trust me, even with an epidural, you don’t forget about the pain of a baby coming out of you. How could I forget a sensation that felt like the baby was coming out of my butt? Nobody tells women this. Believe me, you never forget a baby coming out of your butt.”

The irony is, that for all the belly laughs Vanessa gets from the audience, there is a deep truth in her message: mothers are scared out of their butts to give birth.  Of course a baby is not going to come out of a woman’s butt, but how the baby will navigate through the birth passage is a source of endless worry for many pregnant moms.

As a result, moms are running to epidurals and other interventions.  Roughly 50-70% of mothers today have an epidural for pain relief. (Midwifery Today, Issue 95, Autumn 2010). Among the 100+ mothers that I interviewed before writing my play “Birth”, most told me they chose an epidural simply because everyone else was having one.

Nearly 100% of my interview subjects had not researched the risks/benefits of epidurals.  As Judy Slome Cohain, a midwife, points out: “Women get epidurals for one of the main reasons so many women smoked pot in the 1970s – their friends are doing it”. (Midwifery Today, Issue 95, Autumn 2010).

Wait – you mean that a woman who has a PhD in physics and flies all over the world impressing audiences with her knowledge had no idea that epidurals can cause a fever in mother and baby? Probably.

A growing number of doctors tell us pregnant moms are asking for more intervention and that’s why the cesarean rate is now over 30 percent. This may be partly true. But the deeper questions we must explore are these: What is it about our culture that feeds a pregnant mom’s blind rush to grab an intervention? What is the baggage that prevents women in the United States from having powerful births?

One word: Fear

Again, Vanessa: “GIVE ME THE EPIDURAL!!!! I thought I was going to die. Yes. Honestly, I don’t know how women go natural. You don’t get a medal for doing it natural so why do it?”

It’s true.  Women don’t get a medal for giving birth naturally. There is no powerful birth award. So why do it?

One word: Faith.

The clear antidote to counter fear is faith.  The more faith we have in our bodies – the more we connect to our inner knowing that birth is normal process – the quicker our fear subsides. Try it. Every time you feel fear connect to your body (dance, laugh, take a nap) and what happens? Less fear.

Instead of feeding fear, I vote for pregnant mothers feeding connection and embracing truth. Here are three suggestions to help pregnant mothers connect to the truth that pregnancy is a normal process:

1.     Movement. Spend at least 10-15 minutes every day doing some form of movement even if it’s just to close your bedroom door when you get home and dance around the room with your eyes closed. Look for CDs/DVDs that specifically help you connect to your body, like Toni Bergen’s Journey Dance.

2.     Yoga Nidra (otherwise known as: sleep!). Every pregnant woman needs sleep! Yoga nidra is a powerful, guided meditative practice that gives you quality sleep and allows your body to welcome emotions and beliefs for “tea and conversation”. It has helped many people overcome trauma, stress, and connect to their inner knowing. Commit to 10-20 minutes every day. You can purchase CD’s online. Robin Carnes’ CDs are great for the beginner.

3.     Journal. Free-write for 10-15 minutes every day.  Just put your pen down on the paper, no topic, and let your hand write away! You will be surprised where you go. (thank you, Natalie Goldberg!).

Want a transformational challenge? Do one of these three suggestions for 40 consecutive days. Then ask yourself what kind of birth you want.

Karen Brody is the playwright of BIRTH and founder of BOLD, a global movement to make maternity care mother-friendly. She also runs The My Body Rocks Project where she teaches workshops, gives talks on “How to Creatively Empower Birthing Women”, and trains doulas, childbirth educators and activist in her My Body Rocks method for having a mother-centered birth. She is also a passionate napper and has written about the importance of sleep for mothers in the Huffington Post and Mothering Magazine. She is currently registering mothers for her two online courses: My Body Rocks Pregnancy class and a 40-Day Nap Challenge for Moms and in April will offer a teleseminar outlining her new new mother-centered birth trainings. For more information visit:  www.boldaction.org and www.mybodyrocksproject.com.

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Elective Cesarean vs. Spontaneous Labor

Does early elective birth impact fetal development?  Kristen Oganowski — doula, blogger, aspiring childbirth educator, PhD candidate and mother of two — weighs the risks associated with early induction.

As women near the end of their pregnancies, many encounter an onslaught of questions and comments from friends, family members, and even their care providers about when their babies will be born:

“So, when are you going to induce?!”

“Do you have your c-section scheduled yet?”

“Since 37 weeks is ‘full term,’ why don’t you just schedule and induction already?”

“Babies really only gain weight during the last few weeks of pregnancy, so we can schedule your induction or cesarean section as soon as you’re technically full term!”

But as casually as people discuss scheduled birth in everyday conversation, current research shows that the topic might deserve a bit more seriousness after all.  In fact, the topic of early elective birth has been buzzing throughout the world of maternity care advocacy lately.

Early elective births are scheduled cesarean sections or inductions of labor that occur prior to 39 weeks and without medical indication.  And while many care providers and moms choose to schedule birth before the 39th week of pregnancy, one message has become increasingly clear in recent years:

Because of the risks associated with early elective induction, women and their care providers should avoid scheduling elective inductions or cesarean sections before 39 weeks.

Research shows that when babies’ births are scheduled before 39 weeks, they are at an increased risk for respiratory problems, NICU admission, and even neonatal and infant death.  These risks are serious, and they have even prompted various hospitals in the United States either or to require onerous paperwork in the event of an early scheduled birth or to prohibit early elective births altogether in order to minimize these risks.

Acknowledging both the seriousness of these risks and the fact that the induction and cesarean rates have been growing with alarming frequency over the past two decades, The Leapfrog Group (a hospital quality watchdog group) recently released the results of a survey documenting the rates of early elective births at hospitals across the United States.  Setting a target rate of 12%, the Leapfrog Group found that the hospitals’ rates varied from nearly 0% to well over 50%.  Notably, the wide variations in these rates even occurred in hospitals within the same city or region.

On the one hand, these results (which hospitals offered voluntarily) demonstrate just how crucial it is for women to know not only their own care provider’s induction and cesarean rates but also the rates and patterns of early elective birth at the location where they will give birth.  On the other hand, they also demonstrate just how important it is for women to know why they should think twice about scheduling their babies’ births before 39 weeks.  Avoiding early elective birth isn’t about trying to make busy families’ lives more inconvenient—it is about protecting their new babies from the harms of scheduling their births too early!

This doesn’t mean that inductions and cesarean sections should never happen before 39 weeks.  When scheduling birth is medically indicated—when a mother and/or her baby’s health would be compromised by continuing pregnancy—then the benefits of an early birth certainly outweigh the risks.  To this effect, Childbirth Connection has published a resource on labor induction that outlines the instances in which the evidence does  support induction of labor as a way to improve outcomes for mothers and/or babies.  This resource also defines the circumstances in which research is either inconclusive regarding the effects of labor induction or clear about the ineffectiveness or even harm of induction.

But without a medical indication for an early scheduled birth, there is the chance that a baby will miss out on the important fetal development that occurs up to and perhaps even beyond the 39th week of pregnancy.  This information is especially significant considering that many women are told erroneously by others (including some care providers) that babies “only gain weight” during the last weeks of pregnancy.

As a final note, it is also important to remember that unless an induction or planned cesarean is medically indicated, there are benefits to waiting for labor to begin on its own—even after the 39 week mark.  Induction and cesarean section at any time carry risks and thus should not be taken lightly by mothers or by care providers.  For unless otherwise indicated, waiting for labor to begin spontaneously is healthy for mothers, and it’s healthy for babies too!

Kristen Oganowski, CD(DONA) changed career paths from academic philosophy to maternity care advocacy after being utterly awed and inspired by the births of her two children: one born via cesarean, one born via VBAC.  Now she is a doula, blogger, aspiring childbirth educator, PhD candidate and mother of two in Columbus, Ohio.  You can find her speaking up for healthy pregnancy and birth on Twitter (@BirthingKristen), on Facebook, and on her blog, Birthing Beautiful Ideas

 

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Your Baby’s Consciousness at Birth

The healthy birth practices we support lead to mothers and babies having the safest, healthiest, most satisfying births possible. This advocacy is now more important than ever, as evidence supporting the theory that babies are conscious at birth continues to grow. We are pleased to have Dr. Carrie Contey, a prenatal and perinatal specialist, join us to discuss optimizing your birth environment for the benefit of both you and your baby.

Thanks to the pioneers of prenatal and perinatal psychology, we are gaining awareness of how birth profoundly imprints itself on our lifelong health and behavior. In one landmark study, children under hypnosis were able to recall the very minuet details of their birth experiences. These stories were matched to the reports given by their mothers, who were also under hypnosis. Babies are undoubtedly conscious — physically, mentally and emotionally — at birth. This fascinating discovery confirms that facilitating a better birthing experience for all mothers and newborns is absolutely essential.

Sensory Consciousness

Physically, an emerging newborn is well aware of his or her environment during birth, as most senses have developed weeks prior. During birth, a child is capable of hearing, touching, tasting and smelling everything around him or her. So, how can we care for baby’s senses at birth?

Seeing: Because a baby’s eyes are so sensitive and used to seeing light filtered through mother’s belly, the lights should be dimmed. We must allow baby’s eyes to adjust to the outside world slowly and without shock.

Hearing: Likewise, a baby is used to hearing sounds that are muffled by flesh and fluid, so speech should be soft and noises should be kept to a minimum.

Tasting: If possible, nothing should be placed in the newborn’s mouth before he or she has a chance to breastfeed. Babies are prepared for and expecting to taste their mother’s breast milk soon after birth. Imposing bottles or syringes on them during the perinatal period is invasive and detrimental to bonding.

Smelling: Babies are precisely sensitive to smells. The birth environment, especially in a hospital setting, can be overwhelming to the olfactory system. We must be mindful of the potency of all natural and non-natural agents used around baby during birth.

Touching: Through touch, we communicate love, fear, tenderness, violence, confidence and ineptitude. Within seconds after birth, mother’s hands should be the hands that welcome her children, and reassure them that they made it, and they are safe and loved. Anyone else who has contact with the baby should use respectful, loving touch when handling the newborn.

Mental & Emotional Consciousness

More and more parents are talking to, playing music for, and bonding with their unborn babies. If babies can learn in utero, one could easily infer that they are also learning during birth. Babies are not only affected by the words said to them during birth, but the emotions surrounding the event, as well. Creating a powerful and positive birth setting is key to bringing baby into this world peacefully. So, how can we foster baby’s mental and emotional health at birth?

Through re-birthing and other therapeutic techniques that allow people to re-experience their births, we know that birth is often scary, stressful and painful for the newborn. Addressing the baby and telling him or her what is happening — to both baby and mother — during the birth is key, and especially crucial during any invasive procedures. Verbally reassuring babies that they are safe and supported during their journey can alleviate some of the fear they might experience.

Leaving the womb is a profound transition, and can be disorienting and shocking to the system. Once the baby is born, everyone in attendance must be thoughtful of how they place their attention on the baby. The birthing environment should be filled with love, joy and reverence for the newborn child.

Bonding With Baby

Upon delivery — and before the child is taken away from the mother for bathing, weighing and other interventions — baby should be placed naked on the mother’s abdomen. In that position, the child can smell her smell, feel her warmth and hear her voice. Once again, they are together, yet seeing each other for the first time. Shortly after birth, the child enters a quiet alert state. During this time, the newborn is very still and often molded to the mother’s abdomen — but able to see, hear and respond to his or her new environment. Both newborn and mom are instinctually prepared for and expecting this time to bond — face-to-face, skin-to-skin and mouth-to-breast — immediately after birth and for the next several months. This initial bonding period is crucial for a mutually healthy and fulfilling birth experience.

No longer can society afford to ignore the consciousness of babies at birth, and the detrimental effects caused by many current methods of birthing. It’s important that anyone present at a birth — mothers, birth support persons and care providers — honor and respect the birthing process, and yield to the innate wisdom of the newborn.

Carrie Contey, M.Ed., M.A., PhD, received her doctorate from Santa Barbara Graduate Institute in clinical psychology, with a specialty in prenatal and perinatal psychology. She has been passionate about birth, babies and parenthood since she was a child herself, and has dedicated her adult life to pursuing the academic study and hands-on art of early parenthood and optimal human development. Carrie is a nationally-recognized early parenting coach, consultant, speaker and educator. She is also the co-founder of the Slow Family Living Movement, and has served on the board of directors of the Association for Prenatal and Perinatal Psychology and Health (APPPAH). She lives, works and plays in Austin, Texas. To learn more about Carrie Contey, please visit her Web site.

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The Benefits of Free Range Labor

This week, we are absolutely thrilled to feature Science & Sensibility’s new Community Manager, Kimmelin Hull, on the Mother’s Advocate blog. Kimmelin was inspired by Lamaze’s recent press release about “free range” labor, and decided to visit Healthy Birth Practice #2: Walk, move around and change positions throughout labor on a personal level. Here, she shares the wise words of a woman who has recently undergone two different birth experiences — but committed to staying mobile during both.

One year ago, my best friend and physician assistant colleague, Liz, gave birth to her second child. Less than two years prior, she and her husband welcomed their first child into the world. Liz’s birth experiences occurred in two different states with two different providers. Her first pregnancy and birth were anything but normal — as she explains in her reference to a “highly medically-managed” pregnancy, which continued into birth. Her second birth was quite different and yet, she created the opportunity for herself to employ “free range labor” during both labor and birth experiences.

During both of Liz’s pregnancies, I was honored to help she and her husband prepare for the births of their children — through knowledge sharing, informal childbirth education discussions during a visit to them leading up to their first birth experience, and telephone labor support during Liz’s second labor. (I will never forget secreting away into the quiet guestroom of our house during the late-night hours while the rest of my family slept, verbally supporting Liz via telephone, as she worked through the transitional contractions that hit during their drive to the hospital.)

Liz graciously accepted my request to an interview in which she and I discussed and compared her two birth experiences, with a focus on the topic of movement during labor. Here are her insights:

Kimmelin: Can you describe the differences between your two labor and birth experiences?

Liz: In many ways, the two labor experiences were the same and in many ways different. With both pregnancies, I carried the babies until 39 weeks gestation. With both, I labored down from 4 centimeters to 8 centimeters in one hour. With both, I remained active and moving — until 8 centimeters with the first, and until birth with the second. With both, I had my husband present for support. And with both, the physician did not arrive in time for the birth of my child.

With the first, I had a highly medically-managed pregnancy, and I believe that alone contributed to my fear of having a natural childbirth. I had an IV, monitor, and my water was broken by nursing staff at 4 centimeters. I was not, however, in active labor pain. As mentioned above, I labored quickly, but found it difficult to maneuver in a hospital room with an IV attached. I opted for an epidural at 8 centimeters.

My second delivery was easier, as I was home when labor started and was able to move through my own familiar surroundings, my own clothes, my own bed, etc. When I did arrive at the hospital, I was fully dilated. I found recovery to be enormously easier with the second delivery.

Kimmelin: What factors do you think influenced the difference in your two babies’ births?

Liz: For the first birth, the biggest factor that made labor difficult for me was being hooked to an IV. I am GBS (Group B strep) positive, and was admitted to the hospital at 4 centimeters and dilated without painful contractions, but had to have IV antibiotic prophylaxis and have my water broken (basically augmenting labor!). When I finally went into labor, I found it difficult to move with the IV and monitor attached. For the second birth, I went into labor on my own — no induction or augmentation. The biggest factor that made labor easier for me was the ability to move within my home and surroundings before going to the hospital. I will add for both deliveries, I was fortunate to have tremendous support from the nursing staff to help facilitate my need to move during labor.

Last but not least, my husband and I were better prepared emotionally in meditation, reading, and undying support from a dear friend who is a childbirth educator to have a natural delivery the second time around. Even though I had this same support during my first pregnancy, the experience of already having a vaginal delivery helped to ease my fear the second time.

Kimmelin: Considering the speed and intensity of your second baby’s birth, what labor-coping techniques helped you through your labor? Why do you feel these things helped?

Liz: Moving! Hindsight reminds me that my contractions were erratic with intensity and timing, so I had no idea when the next would start or end. Unfortunately, I didn’t have the chance to “think” about which strategy I would use for the next contraction. However, my body naturally wanted to move through each contraction. I found myself getting on all fours; I had my husband push very hard on my sacrum as I bent forward on the counter; [I benefited from] receiving a giant bear hug from anyone willing while I stood; all of these techniques just came naturally to me to find comfort, as my body just knew what to do.

Kimmelin: Looking back on the births of your children, do you feel your physical behavior during labor and birth influenced your emotional experience? If so, in what way(s)?

Liz: Yes, I was able to move more during my second labor and birth, and I feel as though this reduced my stress and anxiety level, as opposed to the first labor and delivery where I wasn’t able to move as much. Looking back, I now realize having to lay still while being hooked to IV and monitor had caused more anxiety for me and my husband.

Kimmelin: What thoughts and/or advice (if any) would you offer health care providers and/or the partners of laboring women in terms of providing assistance for walking, moving and changing positions in labor?

Liz: To anyone in the presence of a laboring woman, they need to know that any position she can get comfortable in is acceptable. (I still remember the look of shock on my sister’s face when I was on all fours on the hospital bed). This goes for health care providers, as well. If the laboring woman cannot lay supine during a contraction for the monitor to be strapped on, please trust in her body — the baby is OK for those few minutes — and wait for the contraction to pass. Specifically to health care providers, respect the wishes of the mother’s/partner’s birth plan, and do everything in your power to facilitate a safe and comfortable environment for the laboring woman. Petition for a birthing bar, balance balls and bath tubs in your maternity ward, and practice medicine that goes “back to the basics” of allowing free movement during labor. After all, having a baby is the most powerful and natural act the human body can endure. Pain serves a purpose and doesn’t always need to be treated.

Elizabeth Posoli-Futch is a physician assistant practicing urgent care medicine at a community hospital in the Northern suburbs of Philadelphia. My deepest thanks go out to Liz and her family for sharing these insights surrounding the births of her beautiful daughters. Happy first birthday, baby M!

This blog was originally posted on Science & Sensibility, and has been repurposed and published with permission from Kimmelin Hull.

Kimmelin Hull, PA, LCCE, has been a Lamaze Certified Childbirth Educator since 2005, is trained as a physician assistant, and is the author of A Dozen Invisible Pieces and Other Confessions of Motherhood. Kimmelin has also written freelance articles for regional and international parenting magazines, and maintained her own blog site, Writing My Way Through Motherhood and Beyond since 2008. A member of Montana Childbirth Collective, Kimmelin has participated in numerous community education, normal birth and gentle parenting advocacy events. Ms. Hull joined Lamaze International’s research blog, Science & Sensibility, in early 2010 as a contributing writer, and now operates the site as the Community Manager, editor and chief contributor. A mother of three, Kimmelin and her husband raise their family in the beautiful Rocky Mountain town of Bozeman, Montana.

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