politics of birth

I just found an interesting article that looks at how we view birth and how we view who should be the decision maker in birth.  I found this paragraph in particular interesting, because I just was having a conversion with a friend who was not "allowed" to push on her hands and knees.  Which, I of course, thought was ridiculous.

"The politics and power relationships of the labor and birth process may be seen to revolve around the word "allow." To allow is to make possible through a specific action or lack of action, or to consent to or give permission.1 The concept of allowance gives the power to the healthcare provider, whether physician, midwife, or nurse and makes the laboring woman dependent upon this allowance. Allowance removes some aspects of choice and consent from the woman and makes her dependent upon the actions and beliefs of the healthcare provider. To define the services one offers to pregnant women using the phrases "I allow" or "I don't allow" transfers all control to the provider. To "allow" ambulation during labor is to give a tacit approval and to not "allow" a trial of labor after a previous cesarean birth (TOLAC) is to imply that TOLAC is dangerous and imprudent. To "allow" an action implies an authoritarian relationship, similar to a parent and gives political power to the healthcare provider. The concept of allowance signifies that the healthcare provider is the expert, that the provider knows what is best without discussion and that the provider will always make the best decision for the woman. This language extends to nursing also; nurses are "allowed" to perform some procedures in hospitals and not in others. More respectful language would imply mutual consent between the parties in the discussion, or political cooperation and compromise.

Compare the statement "midwives are allowed to attend TOLAC and vaginal birth after cesarean" with the statement "midwives are qualified to attend TOLAC and vaginal birth after cesarean." Similarly, compare the statement "laboring women are allowed to ambulate during labor" with the statement "laboring women are encouraged to ambulate during labor." The emphasis moves from permission to active voice."

I would love to be a fly on the wall of physicians offices and see how they offer alternative choices to women. Do they "allow" women to move, or do they encourage it?  What if a doctor doesn't agree to a different type of care, like delayed cord cutting, how do they respond to that?

As I thought about these questions, the words permit, allow, offer, and provide all began popping up in my head.  All of these words entail a power structure that is pretty inherent in our medical system.  We, the patients, are allowed or permitted or have certain choices.  This seems wrong to me.  The doctor/care provider is not our parent.  They are not here to teach us right or wrong.  I think they should be here to provide us with choices.  To offer us their expertise and opinions, but at the end of the day, we are the ones that make the choice based on what we feel is best, no matter what the doctor feel is best.

Unfortunately, our system is very steeped in this hierarchal manner.  I would love to hear others ideas on how to help change that.  I think the increase in homebirths is definitely a sign that more women are wanting a different relationship with their care providers.  As well as the increase interest in alternative medicine.  Women are looking for ways to gain that control back in their lives.

Childbirth choices-what good decision did you make?

"S: You said you were not a self caretaker – can you think back and think of one moment when you were?
me: (thoughtful) – well…I guess the only time I can think of is when I asked my midwife to break my water. I needed it to be over and I knew that breaking my water would at least make it go faster.
S: Yes. That took a lot of courage.
me: I process this statement – courage? is that true for me? I think back…
me: yeah, it did take a lot of courage. the labor pain was so intense I was fearful – so it did take a lot of courage to ask for my water to be broken knowing that it would increase that pain. Craig had told me to ask her to break my water earlier but I knew I couldn’t do it at that point because I was so afraid.
me: peace floods my being. I did have a moment of being a warrior – even if fleeting.

That moment took less than 5 minutes but it changed me. The feelings of regret, sadness, only feeling lucky…gone. I KNOW that in each of my birth experiences I had a warrior moment. I accept that I am human who makes mistakes, takes my body for granted and can have unspoken expectations of others that can lead to disappointment…I am human. I am a courageous human who believed in her body, who did most of the right things and needed all of my experiences to make me a loving, caring and understanding doula."

http://naturalmomlovesprada.com/?p=620


I loved this experience of this mom.  In labor, there are many times when we feel fearful or that we did something wrong.  There are times when we feel we caved, or behaved badly.  Questions often filter through women's minds, "Was I too noisy", "Why did I say I would do that", "if only I had done this".  Often times we look back and think of everything we wish we did or could have done.   


I would love for every women to think of one moment in her birth where she felt she did something right.  It may have been a certain position you decided to choose.  It may have been a moment when you understood what it was you needed to do.  It may have been saying no to an intervention.  It may have been saying yes when you had originally intended not to have anything.  What ever it is, I think it's important that we find these moments these are "our" moments.  These are the moments that help us understand who we are and who we can become.

Uses for a warm compress during birth

Warm compresses are something that many midwives use, and I feel like they have have a place in the care of women in labor and birth.  From my own experience having used warm compresses during the second stage of labor, it definately helps to decrease the pain felt while pushing.  Below, I've included some other ways to use this cheap and easy way of working through labor pains.

Heat is a good way to help with general aches and pains during pregnancy, labor and birth.  Many times, joints and muscles get tired and sore.  A heat pack is a good way to help relieve this pain.  You can place them on the back for back labor, as well as the abdomen and groin area.  This could help relieve some of the tension felt in these areas during labor, helping to relax and reduce pain.

There is some anecdotal evidence that heat packs may help speed up early labor.  It at least may help make it more comfortable.

Placing a heating pad or a warm blanket with the mom could also help relieve chills.  This would be useful after a c-section when the temperature of a mom is significantly decreased.  A warm blanket may also be useful for general relaxing purposes when the mom is tired or needing more rest.

Because heat also helps to increase connective tissue extensibility, this may be useful to help the baby move down the birth canal and through the pelvis.

Another great way to use warm compresses may is during the second stage of labor to help reduce the pain during crowning and in the following days.  It also may help to prevent anal tearing and urinary incontinence.

Heat packs also help with pain for the incision after a c-section.  This will also help promote healing to the area.  If you are using a heat pack for this reason, use ice for the first 24 hours, then switch over to heat.

In order to keep a heat pack in place, it can be placed in stretchy underwear or held in place by another person.  Just take care that it is not too hot so that it won't burn or get too uncomfortable.  Also make sure that there is a few layers of cloth between the heat pack and the mom's skin.
It may also be useful to use for the afterpains felt after birth.

Reasons that Heat May Help

It provides a competing sensation that helps to reduce the amount of pain felt.  This is described as the gateway theory of pain.

It provides a source of distraction so that the mom has something else to focus one besides the labor pains.

It helps relax and loosen tight muscles that helps reduce pain due to tight muscles or not allowing the uterus to relax and do it's job.  Check out my post on the fear-tension cycle for more info on this.

It promotes healing of any tissue that has been damaged and may reduce the amount of time it takes to heal.


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430322/
http://www.medscape.com/viewarticle/494120_12

http://www.ncbi.nlm.nih.gov/pubmed/20536800
http://www.ncbi.nlm.nih.gov/pubmed/18031878

cultural sensitivity in birth

"Cultural Sensitivity

The third piece of the puzzle is cultural sensitivity, which:
• is an affective construct that relates to values, beliefs, and attitudes.
• implies that an individual has an open attitude in relationship to themselves and others, allowing them to explore their own beliefs and values as well as being receptive to the beliefs and values of others.
• emphasizes approaching others with humility while taking the role of learner rather than assuming one has sufficient knowledge."


I had to explore this idea after reading it in my cultural competency course.  This idea made me step back and think about how I help people learn.  Do I really do this, with this kind of attitude in mind?...and if I don't I really should.


As a doula, I come in contact with all sorts of viewpoints regarding birth.  Some are super natural and others prefer any and all intervention.  Most are somewhere in between.  Then, there is me.  I come to them with my own set of assumptions and world view regarding birth.  The key is learning how to teach, while also figuring out what it is that I need to learn about the person  I am teaching.


Most of the time, as care providers, we need to do a lot more listening than talking.  I like the idea in this quote of allowing others to explore their own beliefs.  We do this by presenting information, then listening to what the other person has to say about that information.  I know that this is something that I need to work on.  

Choices made during a difficult birth

I just need to applaud the women who face difficult decisions in birth.  I feel blessed in that my births are pretty smooth.  I've never had my water break, I've never been gbs positive, I've always progressed, there's never been any question about the health of my baby.  So, yea, I have natural births, but in pretty smooth sailing waters.

As I watch what rougher waters look like though...those women who are trying to navigate between the natural and the medical with no crystal ball to tell them how their body would respond to either, I am amazed at their capacity to make decisions for themselves and for their unborn child.

Often times these decisions are not in their plans, and were never expected in the first place.  They are often made under fears and trepidations with a great sense of the unknown.  I say that mountain is just as  hard to climb, if not harder than a normal straightforward normal birth.  So I want you all to know...those who have faced those troubled waters that you are amazing and deserve just as much recognition as any woman who has ever born a child.

Happy Traumatic birth story?!:)

I'm not sure how to describe this birth story I found, but I loved it and it was written in such an easy to read manor...it makes the experience seem funny, hard, and worth, yet it could be a very traumatic experience also.   The way this author tells it, though, it doesn't see like it is...anyways  enough of me..here's the story...

Here’s the down low on my experience.

1. Water breaks. On the couch. Which reminds me…

ONE COUCH FOR SALE…CHEAP.

2. I think that heading to the Farmer’s Market for a few last minute items=a good idea.

3. Water REALLY breaks at Farmer’s Market. Which reminds me…

ONE PAIR OF NAVY BLUE TRACK PANTS FOR SALE…REALLY CHEAP.

4. Then nothing much for four or five hours and then some huge* contractions for the next four or five hours.

A note on contractions: Holy $#(@! What the &*@#?? Seriously? &*(#^$(@#Q@#@(%!!@&$)(#%. Ok. I’m ok.

5. Enter midwife.

M: Your cervix is at a “1″.

K: Ha ha. You mean like it’s Number One?

M: No. Like 1 cm. As in, you still have 9 more to go.

K: (See note on contractions.)

6. Three hours later, I’m ready to go. That’s right. One to Ten in three hours.  I’m like, in the 99th percentile for cervix opening.

7. Push. Push. Push. (See note on contractions.)

8. Done, awesome. Lovely, perfect, most handsome boy Finn Vincent slides out at 6:55 AM, April 14th.

Stats: 7 lbs. 7 oz. 19.5 inches long. It’s the most awesomest thing I have ever done. And I’ve been to a lot of neat places, and done many awesome things. Still, it’s the Most Awesome. He is, evidently NOT in the 90-something percentile for size, but he is in the 100th percentile of being mine.

Ok, so here’s where it gets a little dicey.

9. An hour later a Freak Occurrence: I develop a hematoma (I was in the 99th percentile of hematoma size, which is two grapefruits!) because I tore an artery in the inter-pelvic space between the birth canal and my hip. Weird, right? After receiving excellent care from my home birthing team who is puzzled by my blood loss (hematoma burst) yet Perfect Blood Pressure (seriously, I had lost more than a liter of blood at still had 120/70 blood pressure…let’s hear it for health!) I was transported to the hospital. Had two surgeries, one blood transfusion, and I’m feeling SO much better now!

A lil’ note on me: I decided when I woke up in recovery, that I would NOT view my situation as anything less than as it needed to be. While in a hazy fog I decided that I would be thankful in that moment for being flat on my back — a sensation I had come to miss while prego. Also, my husband and baby were waiting for me in my room, where the hospital let them move in and stay with me. My also super-friend-lactation expert met me 5 minutes after recovery, where she had the babe latched on in less than a few minutes. He’s in the 99th percentile of eating. Come to think of it, so am I.

Another side note: I think breastfeeding is awesome. I’m playing will all the positions and all the methods used by Hunter-Gathering populations (where they nurse for 3-5 minutes every 15-20 minutes) as well as the developed nations’ methods of feeding for longer, less often. It’s fun.

They said it would be 5-7 days before I could go home.

I was healing well in 2 days, had refused all morphine and pain meds, so they let me go home on day three. (Let’s hear it for health!)

I couldn’t walk when I came home. Wow. That was a big one for me.

They said it would be 12 weeks before I would be out walking.

I took my first walk (14 minutes) on Day 3 of being home.

I can now walk 40 minutes (slower than normal) and do so every day.

Finn has been cuddled or carried every moment of his life so far. We are practicing with different techniques and apparatuses. (Why is the plural of apparatus apparatuses and not apparati? Language seriously bugs me sometimes.) I am enjoying wearing him and no, we don’t have a stroller, which freaks people out. Which is fair, cuz there are a lot of things people do that freak me out, so we’re even.

Here he is:

Moral of the story: I, despite making excellent beans and cornbread and knowing how to ride a horse, would have been the robust pioneer woman who didn’t make it through child birth. But, thanks to my fast acting team and some great surgeons, I’m typing a blog a week and a half later.

Another moral of the story: Striving for excellent physical health can not only help you have an excellent delivery, but can also significantly impact your recovery should you have an outcome you weren’t (or were) expecting.

Looking forward to getting back to it…with modifications. Wow, it’s a lot of work! Kudos to every mom and dad out there. You are in the 99th percentile of parenting. (What the HECK is all the percentile business about, anyway. If I ever use the word “percentile” seriously, you can pour a glass of water over my head. Geesh.)

*Huge contractions have been modified to “tiny” contractions after finishing the course.

http://www.katysays.com/2011/04/27/a-baby-story-and-giveaway-results/

I've also been looking at this story according to Maslow's theory.  I find it interesting that here was a lady that had a pretty traumatic experience, and yet I felt like she was able to have all her needs met and ended up feeling good about the whole thing.

Hypnobirthing-my thoughts and observations

There was an article on hypnobirthing in my newspaper this morning and I thought I'd post thoughts about that technique here.

I have never used hypnobirthing myself...I think I found my own way into a form of it just because I learned through practice.  Having done five kids naturally, you kind of get a lot of practice.  Many women find themselves it what I've heard called labor zone.  This is a very relaxed place.  Many times they appear to be sleeping while they are working through contractions.  This has all been done without the formal hypnobirthing training, but I do believe it involves some of the same techniques.  These techniques involve learning breathing and relaxation ideas to help rid yourself of stress and fear and allow your body to work the way it's supposed to.  This techniques work very well to help ease labor pain.  I have also seen many women do very well with hypnobirthing and I feel like it has helped many women work with their labor in a way that decreases the pain.

There is just two issues I have with it.  First off, it makes the claim that if you use this method, your birth will be painless.  I have heard many people say how much this is true.  I have also seen women appear to be in no pain as they work through their contractions(or pressure waves, as they are called in hypnobirthing).  The problems I have seen with this are with women who are doing very well working through their contractions, but are still feeling pain.  I have seen a look of hopelessness as they have turned to me and said "this isn't supposed to hurt.  What am I doing wrong?".  Many times, they have given up because they came into this labor with the expectation that they would feel no pain, and yet they do.  They were not prepared for that possibility, and were not prepared to deal with that mentally.  Also, it doesn't leave room for women to incorporate their own ways of dealing with birth.  Such as their own rituals or visualizations that may spontaneously occur that help them cope.  From what I've seen, hypnobirthing has a set scripts and visualizations.  It doesn't seem to allow room for women who need to be vocal and move and make a ruckus during labor.  There are many women that are more external focused and trying to do so much inward work is difficult.  Whereas, letting out a good roar helps them cope more.

Bottom line, I think hypnobirthing is a wonderful way of working through labor.  It has many benefits and I really think anyone could use these techniques to help them.  But, I don't think it will makes everyone's birth painless or easy.  I see it as another tool to tuck in your belt to use, but should by no means be the only tool.  For those who are interested in more info, here's a few websites I've found helpful:

http://enjoybirth.com/blog/-a hypnobabies doula(technique is similar to hypnobirthing) talks about her experiences and use of hypnobirthing
http://www.hypnobirthing.com/-website for the original hypnobirthing tehcnique-the Mongan method
http://www.monkeysee.com/play/13420-the-hypnobirthing-method-videos on hypnobirthing
http://www.hypnobabies.com/-a website on hypnobabies-talks about some of the differences between hypnobirthing and hypnobabies
http://childbirthsolutions.com/articles/hypnobirthing-what-is-it-and-how-does-it-work/-a good overall view of hypnosis during childbirth

means to an end

"Labor and delivery is seen as a means to an end and an unavoidable event to get a baby. Not a life changing, empowering, sacred experience".


I don't remember where I saw this quote, so I apologize, but it was one that really struck me.  This is quite often how many women view pregnancy, labor, and birth.  That these experiences in and of themselves don't mean anything, because it is the outcome that matters.  While it is important to acknowledge that a healthy baby is the number one priority, that does not mean that we should not acknowledge the experience itself.  


There are so many experiences that we have in life that happen while we are trying to achieve our final goal.  We go to school in order to gain knowledge.  Does that mean that the experience of school is not important?  We gain knowledge in order to have a job or career we want.  Does that mean that that knowledge does not matter except for that reason?  What happens when we don't get the job we wanted, or we don't finish the schooling we originally intended, does that mean it was all worth nothing?  


I think most people would agree that the experience of school is important in and of itself.  The same could be said of birth.  We can learn, grow, and become better people through all the experiences that happen to us, including birth.  I would submit that labor and birth should not be viewed as just a means to an end, but a complete experience in and of itself.

Supreme act of faith

‎"Having a child is the supreme act of human faith"J.D. Kleinke author of Catching Babies

I posted this quote on my facebook page and I've kind of had it rattling around in my head ever sense. It has made me start to think about what faith is and what exactly do we have faith in as it pertains to childbirth. Here's a bunch of definations of this term: http://www.google.com/search?hl=en&client=firefox-a&hs=C9F&rls=org.mozilla:en-US:official&defl=en&q=define:faith&sa=X&ei=y5eETfeKG5S2sAPsnNn-AQ&ved=0CB8QkAE


From my own religion we have a scripture that says faith is something we hope for which is not seen but is true. I may be biased, but this is the one I like the best:) It's an interesting concept...to have hope for something that we can't see, touch, or understand. It sounds pretty crazy from some view points. But that is exactly what we do when we have children. We hope for something wonderful, transforming, sacred. Not just the whole birth experience, but the whole becoming a mother experience. We have a hope that we'll have a healthy child. We hope that we'll be able to feel a sense of control and wonder at the whole process. Birth centers around hope.

Then comes the tricky part...what is true. We hope that the medical profession knows what they are doing. We hope that our bodies will function correctly. We have hope that we will be respected. We hope that there is a larger picture to this whole life and that we can understand that. And many hope that some force/power/God out there is mindful of us and our desires to be good mothers, and who is watching over us as we birth.

What's true what's not...that's for each of us to decide. But I found faith to be a very powerful force behind birth and how women birth. It's often not acknowledge, but it's there. Whether you place your hope in medicine, your own self, or another person, it's there for us to discover and develop.

I'm not sure I'll come to any conclusions or great epiphanies with this post, but I feel the need to just acknowledge that that faith exists in most women. And that it exists within us as mothers. It's up to us to give it form and meaning. It's up to us to discover how that idea may transform us.

VBAC

So I'm getting ready to talk to a lady about VBAC options and I came across this video. I thought it was an interesting look at one families perceptions of their two births, as well as pain felt and healing achieved.

Maslows Heirarchy of Needs-Safety needs

"This means feeling free from threat of physical and emotional harm. Safety needs include the need for structure or order. It also involves feeling protected from injury or pain."

This is a hard one because I think everyone needs different things in order to feel safe. I think it's important to really discuss this with the person whose birth you are attending. It's sort of daunting, and I'm not quite sure where to start:)

First off, I think most people want a safe birth...ie healthy baby and healthy mom. This is the aspect of care that hospitals cater to. But there really is a lot lacking in how the medical world views safety. Beyond just a mom and baby that is alive there is a huge list of what women need to feel safe. It can range from needing all the technology available because that is your view of safety, to not wanting anyone else around because that is how you feel safe. Some may fear pain so much that labor itself feels very unsafe without instant pain control, while others feel like if any sort of medication was given, then that would be unsafe.

I think that if you are going to work with a woman in birth, you need to understand what her concept of safe is, and how she needs that provided. This is hard because what I consider safe can vary drastically from what you consider safe. I had an interesting example of this in some facebook conversations discussing unassited birth. Take a look if your interested: http://www.facebook.com/permalink.php?story_fbid=190371727669339&id=119679234738589

So, here's my list of what I need to feel safe(and this has changed over the years):

1)I need to trust my caregiver and the place where I give birth. This has been a hard one for me because I haven't really felt totally in line with some of my caregivers or places I've given birth. It has made a difference.

2)I need a caregiver that I feel will respect my choices. Someone that actually understands that I have choices.

3)I need a caregiver that is comfortable with just chilling for awhile.

4)But, I do need a caregiver. I want someone who can do the worrying for me. While I know I can resuscitate a baby(I'm NRP certified), and I know what to do in emergencies, I don't want to be the one that has to worry about that during labor.

5) I am much more comfortable with people around me. I like to laugh and tell jokes during labor, but they have to be people that I know and trust.

6)I need my husband there. He reminds me that I'm strong and can do this.

7) I need to be able to eat, drink, sit, stand, push when I want where ever I want.

8) I want people with me, but not people I don't know or trust. Having unknown people around throws a kink in my laboring.

9) I need people around who believe in me and my ability to birth.

10) I need space to think when I need to.

11)I need to know that I have quick access to technology if needed, but it's hidden if I don't.

12) I need to feel respected by those around me.

I would love to hear what other people feel they need to feel safe:)

Electronic fetal monitoring

"Joseph Campbell, the comparative mythologist noted that cultures which are the most subject to the variable forces of nature, such as seafaring peoples, have the most rituals, in order to exert some sense of control over the uncontrollable. The obstetrical community must fit that model, insisting on specific rituals of care, even in the absence of absolute evidence of their efficacy, in order to gain a sense of control and mastery of the birthing process. The fetal heart rate tracing is poured over like tea leaves or cast bones, and the doctor becomes the shaman.

This belief system has been preached to future physicians and obstetricians, who passed it along to their students until the whole culture of childbirth medicine became steeped in a religious-like belief in the power of the fetal monitor, labor curves, ultrasound measurements and the like. This belief is similarly conveyed to patients who are assured that if their pregnancy was managed according to the protocols developed by trusted researchers, their babies would be delivered without fail and without harm.

Reality, however, has proven otherwise. Despite close and continuous monitoring in labor by the best trained and most capable staff and doctors, babies still die suddenly, or are born with unexpected asphyxia, or unanticipated illness. Families feel bewildered and betrayed and seek explanation and often recourse. If the latest technology was employed, then certainly human error must have been the cause."

This quote comes from the science and sensibility blog. And it was oh so timely. I just taught in a college class about the birth process. During this presentation, I spoke about electronic fetal monitoring(efm) and how that is not necessarily the best option during birth. My opinions on this has come from research and also my own experiences.

First off, the efm was implemented without any prove that it was effective in preventing fetal death or complications. Since that time, it has actually been shown to have no benefits of intermittent monitoring(where the heart rate is listened to every 15-30 min). The only thing that I can think of that is beneficial is that it allows the nurse to be out of the room more often, and that is more beneficial to the nurse and hospital, not the patient.

Second, it is much easier for a woman to labor, both physically and mentally, without being tied down to a monitor. For some women, the heart rate is picked up fine while they are moving around, but for most movement caused distortion in the heart rate. This makes that reading invalid or picks up the wrong rate rate which throws everyone into a frenzy.

Yet, the efm has become sort of a religious ritual. Many doctors gasp at the thought of not using one. It certainly does allow them to think that they are in control of a force that is very uncontrollable.

Really the question should not be why wouldn't we use the efm, but why would we? I don't think anyone could truly give me a good answer.

The strength that is ours

"MY MOM IS THE STRONGEST HUMAN BEING THAT I KNOW!"

This was written on a blog from a friend of mine. Her mom is currently being treated for cancer. It made me think of all the strong moms I've been privileged to know in my life. I find it interesting that throughout history women have been portrayed as the weaker sex. I suppose strength wise they are but that is such a small part of strength. Mothers in particular have an incredible amount of strength when it comes to defending and protecting their families. I don't even know how many times my own mother has reared up to protect her own:)

I remember a lady I took care of as she was having her baby. Afterwards she looked at her baby and her husband and in reverent tones declared..."look what we have done". And another beautiful family had begun. I think of my grandma as she was dying. She was so calm and peaceful and giving encouragement to all those around her. My dad said she knew how to die. Their is a story in my religion of a woman whose oxen became sick as she was crossing the plains. They refused to move anymore. But she would not give up hope. She knelt...said a prayer...and pulled those oxen to their feet to continue on.

I've seen women who are terrified of c-sections choose to have a necessary one. I've seen women choose to work through labor without drugs because they feel that is what is best for their child. Among my own friends I've seen great trials overcome. Tears split and heartaches felt. Yet they endure. Not just endure...they flourish. They serve. They bring hope. They kiss away tears. And bring joy to one of the most cherished of all...a little child. I honor the women in my life...I honor my friends. I honor those who experience heartache disease or pain. For these are my examples that I build my own life upon. We are all stronger than we think.

Letting go

http://www.theunnecesarean.com/blog/2010/10/20/baggage-check.html

I read this post, and it really summed up what labor is like for many women. What happens many times during labor, is that we have this perfect image of what it is supposed to be and how things will play out. But like many things in life, labor doesn't always go as planned. Even if it's just the fact that you didn't get the epidural right when you wanted it. Interestingly enough, most research shows that it's not the amount of pain a woman experiences that determines how you feel about a birth, but how much control you feel. But sometimes labor is uncontrollable.

Here's the almost almost nonsensical thing about labor and birth. Yes, you need to have as much control as you can, but you also have to learn to give up control. It's interesting, but by giving up control(to your body, to the fact that your baby really does need resuscitation help, to allowing the contractions to role through you), you are really allowing yourself more control. Does that make sense?:) Sort of.

I read in a book about different women's birthing experiences and how they perceived them. With two different women, they both were pressured to have iv's in labor. One fought it and got what she wanted but she perceived her experience as being negative. The other knew that she would have to fight and choose at that time that it wasn't worth it and let them give her an iv. She perceived her experience as being positive. So who gave up control in these situations and was it worth it or not. That's really not for me to decide, but I thought it was interesting.

Another example from my own labors: When I fight contractions, they hurt more. But there is an innate desire to be in control of them. To conquer them, to take charge of your body. So when I try and control those contractions, I have more pain. When I take a step back and allow my body to just do what it needs to do...in a sense giving up my desire to control it, it is less painful and more fulfilling. When I accept the pain as just being, that pain decreases. So by allowing myself to give up control...I become more in control? Sounds funny, but true.

This happens in so many walks of life. There are so many instances when I can say that I am more peaceful, more fulfilled and happier when I allow myself to let go. For instance, the other night I was upset with myself for something I said to my daughter. I wanted to make it better, amend my wrongs and apologize. But, it was 11pm...she was sound asleep. So I sat and stewed for a while. I couldn't let it go...I needed control and to see it through. I slept horribly that night. If I had been able to let go of what I couldn't control, I would have had a much better night, and things would have still turned out the same(I was able to talk to her the next day).

Now I would never try and judge another's situation and whether or not they should let something go...that's a very personal issue, but I do think there is a value in letting go of things. And as odd as it sounds, peace really is gained sometimes when we are able to let go of control.

a miracle

“Birth is the sudden opening of a window, through which you look out upon a stupendous prospect. For what has happened? A miracle. You have exchanged nothing for the possibility of everything.” ~ William MacNeile Dixon

I was sitting with my little first grader the other day, helping him with his math. He is just learning addition, but up until this day, it had been with pictures to help him understand what he was doing. On this particular day, they started taking out the pictures and just leaving the numbers. After we did one problem like that, he looked up at with this thoughtful look on his face, and started thinking out loud..."so wait, if I add 3+4...." a light came on in his face, "that equals 7. Right mom. That equals 7!" I could just see the wheels turning in his head and a light shine on his face. If any of you have seen the Miracle Worker it was a similar feeling to when Helen Keller figures out that water was water. It was amazing to watch. It's almost as if I was watching my little boy transform himself into something greater, better, and with a greater light.

Well, as strange as it sounds this same thing happens when I see a baby born and a family made. There is a light, a glow, a nod from the beyond that this is right and good. It truely is a miracle...like so many others we encounter in our lives as mothers. The miracle of a family born, a child transformed, a mother made, a couple solidified....it is when we "have exchanged nothing for the possibility of everything".

Fear and Pain-my own experiences

The one time I really feel like I understood this concept was my last labor. I was getting into good active labor and I really started tensing up. I think I was a bit more worried this time about what to do with my kids and just making sure they were going to be OK in general. My fear in this case, was that our baby sitter wouldn't be able to make it or that my kids would wake up in the middle of the night and be worried. I remember thinking how this labor seemed more difficult and I couldn't figure out why. I felt a lot more tense and the contractions hurt more than I expected at that point.

At this point, I remember thinking I needed to breath. My focus then shifted away from my worries and concerns, to just relaxing and letting my body work. I was amazed at the difference it made. I was much more able to cope and the sensation of pain was diminishing.

It makes sense to me that pain would diminish as our fears and tensions diminish. When we are afraid, we tense up. Just thinking through this, I bet that when we tense up, our body's contractions have to work harder to push through that tension. In a way, it creates more work and more pain for our body to work against the tension brought on by fear.

New post on journey to birth

If any of you have been following my blog for awhile, you have seen my other blog www.jouneytobirth.blogspot.com. This is a blog devoted to artists who do birth art. I have just added a new artist so check it out. For anyone that is interested, I am always looking for artists. Just drop me a note. I prefer to have images that would not be offensive to anyone:), so I don't post pictures of women without clothes.

Fear tension cycle

I've just put together a few quotes I've found about the effects of fear/tension/pain. Some of these quotes were written for those experiencing back pain or chronic pain, but I feel they can apply to labor pain as well. I'm going to add my own experiences in another post.

"One of the first things that happens to all of us when we’re under stress is that we tense up—preparing to take action as part of the ancient fight-or-flight pathway in our body. When we can’t run or express our distress, and that distress is chronic, we tense even further. Interestingly, the words for emotional tension and muscle tension are the same. We feel tense emotionally and our muscles also tense up. And this is painful. Remember the last time you had a muscle cramp? You can’t move or think of anything else until that muscle relaxes. All manner of ordinary circumstances, such as fear of loneliness, financial failure, or having to deal with a difficult co-worker, child, or spouse can all result in muscle tension that we’re not even aware of. It’s not surprising that exactly the same class of drugs, the benzodiazepines (such as Valium and Ativan), can relax both muscles and anxiety. But these drugs don’t solve the problem; they merely mask it, and worse yet, they are highly addictive.

Chronic back pain results from stressful thoughts or emotions that aren’t released fully but instead are held in the form of chronic muscle tension. If you then believe that your back is damaged, you may begin to brace yourself, or begin assuming positions to guard against potential damage. This behavior and the beliefs that fuel it then trap you in a vicious cycle of pain and fear. The longer this goes on, the more it leads to psychological conditioning that deceives you into fearing physical activity. It has been found that fear of pain, especially in back pain sufferers, plays a very important role in the perception of pain. Frustration, anger, and depression further deepen the cycle."

http://www.drnorthrup.com/womenshealth/healthcenter/topic_details.php?topic_id=58

"Injury and chronic pain contribute to muscle tension because muscles automatically contract around a painful site to support and protect the area.

Furthermore, if you adopt a guarded position to help protect yourself from pain, this will lead to further muscle contractions. A guarded position might mean walking with a limp or holding your neck in an awkward position. In this way, the muscle tension arises from a painful condition and then further contributes to pain. Furthermore, muscle tension can put pressure on nerves, leading to tingling and numbness."

http://prc.canadianpaincoalition.ca/en/coping_with_muscle_tension.html

"A MODEL OF PAIN-RELATED CYCLES

Much felt pain includes secondary pain resulting from pain-fear-tension cycles. Indirect actions that shift elements of the pain-fear-tension cycle or the related positive cycle are often able to decrease felt pain signals. By the time pained clients get to a bodyworker, it may be that most of the pain is secondary or that what started the cycle no longer exists
Primary pain or signal pain causes reflex holding, a splinting of injured or threatened parts by tight muscles, an early shift toward secondary pain cycles.

This double cycle summarizes the many ways we can lower or raise pain signals. Decreasing tension or fear can improve pain, just as tension and fear go down when pain stops. The linked positive cycle shows why gentle, pleasurable, rhythmic movement within your window of comfort not only leads to more effective body use, but can also decrease pain signals.

Physiologic background and assumptions:
In health, pain is a signal that something needs attention. Chronic pain also signals something needing attention, even when a response to stop the signal can't be found.

Secondary pain involves local muscle spasms, which limit circulation as tight muscles mash blood capillaries, cause waste products to accumulate, and produce pain signals. Holding against pain tightens muscles to create more tension, pain, and fear.

In the body, lower motor neurons (nerve cells) in the spinal cord extend out to the muscles and control contraction. Unless they are stroked and relaxed by signals from upper motor neurons in the brain, lower motor neurons fire all the time, causing muscle contraction, rigidity, and loss of control. In stroke, for example, loss of upper motor neurons results in rigidity and loss of relaxation ability in affected body parts. Tetanus produces rigidity because the nerve endings from upper centers are poisoned by tetanus toxin.

Increased sensory signals (like those from touch or gentle movement) give information about the body to the upper motor neurons of the functional mind. This sensory information lets these control centers automatically balance needed tension and release unneeded tension. Blocks to taking in sensory signals from the body are added pain, fear, tension, trying hard, tight goals, pressure, and thinking instead of feeling.

Positive assumptions are pain as signal, pain as message, pain as tool, pain as accepted (even if disliked). A negative assumption is pain as enemy. Even excessive, unwanted, unneeded pain, if assumed to be an enemy, is fought against and the rejection of hurting body parts creates disconnection and limits healing. Because body feedback is so important, signals not listened to will get stronger, not a response we want with pain signals."

http://www.joeleegriffin.com/Trager/Pain_Signals.htm

Empowerment-what it means and why it's important

I've been thinking a lot about this topic as I have witnessed several different births. This is usually a term that women in the birthing circle use to describe how they feel after a natural birth, but it goes beyond this. To be empowered involves being able to access information and then make decisions based on that for yourself. But the real clincher to this concept, is that a women comes away from an experience, having confidence in herself, whether or not she chooses to give birth naturally.

Often this is expressed as having confidence in her bodies abilities to birth, but again, I think it goes beyond this. Going through the process of birth is much more than just believing that your body works. It is reaching out, struggling, overcoming, leaning on others, working through something hard, and coming out on the other side a stronger person than you were.

Imagine how important that is for a new mom to work through something like this as she begins her life as a mother. How many times do we as mothers, face seemingly impossible tasks? How many times do we face the pain and struggle of defeat? How many times are our pillows soaked with tears? And yet, we learn something in this birthing process that prepares us for this. We learn to find, explore, and stretch ourselves beyond what we thought possible. And at the end, we learn the sweet joy that a new life can bring. What better way to prepare us for motherhood?

The many faces of birth

I find it so interesting to see how many different ways women view birth. For some, it's just a means to an end. The process is completely irrelevant. For others, giving birth is a part of having a child and means as much to them as anything. There was one couple I took care of that loved all the iv's, the monitors, the technology. For them, this is what birth should be like, and to do it any other was was appaling to them. For another young mother, birth was a beautiful process and should not be intruded on by technology unless needed.

All these prospectives have brought such a richness to my work. But I always have to remind myself that it's ok if someone thinks something different than me. Sometimes it has been a struggle, but it's been a struggle that I've appreciated as it has helped me to learn to view life from different perspectives. That's something I have always valued.