This Doula's Recipe For A Good Birth

Today I am going to write my recipe for a good birth.  From all I have seen and experienced, these are what matter the most.

1.  Where you give birth matters.  A hospital can work, but in my opinion, it is not the safest place to give birth.  If you are healthy and your baby is healthy a birth center separate from a hospital has far better outcomes for you and your child.  Want to hear a scary statistic.  Neither do I, but here it is: The United States ranks 60 out of 180 countries, below China, even Slovakia, for goodness sake in maternal mortality!  Not to disparage China or Slovakia, but seriously we are a first world country with top medical care; this should not be so!  Of course there are many reasons why, and you could get into a very heated debate on this topic which I will not touch for the time being.  My point is that the maternal mortality rate for midwifery model care is much lower.  If you are healthy and your baby is healthy, one of the best preventative steps you can take is to give birth at a birth center with skilled professional midwives.

2. Get regular chiropractic adjustments.  I do not use a chiropractor regularly and have not when pregnant.  But from my own birth experiences (my third baby remaining very high and needing help during labor to descend versus those who've had chiropractic adjustments attesting to the fact that their babies remain quite low and engaged) I have come to the conclusion that adjustments are immensely helpful.  The body is in alignment which means the baby can descend without undue trouble which, in my opinion, really helps things along during labor.  A caveat!  Not all chiropractors are created equal.  Just like not all doctors, nurses, midwives, etc...  You get my meaning.  There are some chiropractors out there who do more harm then good.  Get a referral and make sure who you are seeing is qualified and good at what they do.

3. Eat & Distract.  The best thing you can do when labor starts is to eat a good meal and distract yourself.  Give yourself and your labor the gift of the un-watched pot.  Have a labor project planned i.e. bake something, clean something, garden, go for a walk, go out to dinner, to the movies.  When you can no longer concentrate on anything but what your body is doing, then it is time to whip out your coping mechanisms and call your support team.

4. Just say no to vaginal exams.  Aside from the initial exam upon admittance to the hospital or birth center which serves to give a baseline, there really is no need for frequent or even scheduled/regular interval exams after that.  Although you may think you want to know, it is really not helpful at all and may in fact be harmful as it increases the risk of introducing germs, not to mention the psychological effect of hearing you are not very far along!  You can tell an awful lot about where you are in labor just by watching attentively and listening.  Allow yourself to just trust the process and unless something is not going well, leave well enough alone.

5. Don't break those waters!  Artificial Rupture of the Membranes (AROM) may in fact speed up your labor but it comes with a high risk guarantee.  Although labor may speed up, so will your contractions, in length and intensity.  For many that point may rocket them into a labor pattern that overwhelms them and makes them feel out of control and scared thus necessitating the need for drug intervention when perhaps it may have been avoided.  If you are going for a birth without medication, breaking your bag of waters won't help you as much as you think it will.  Plus, your baby is no longer protected by that soft cushy bag and may experience some stress as a result.

6. Don't rush pushing.  Many well-meaning doctors and nurses decide that when the time comes for pushing that they should act as the woman's cheerleaders.  It is my belief that especially without sufficient knowledge on what to expect from pushing, a woman with excited eager cheerleaders around her is more likely to feel inadequate and pressured rather than supported and encouraged.  The reason being, pushing is not an issue of strength.  Once the baby has descended, the body responds by pushing involuntarily.  The baby is then slowly, I repeat, slowly, maneuvered down the birth canal and out.  Slow is better.  The body knows this instinctively.  Contractions tends to space apart from one on top of the other or every minute or two to sometimes 4 or 5 minutes apart.  This is normal and healthy.  The baby is supposed to crown and go back in.  Pushing hard for 10 seconds is a waste of energy.  Why not just go with your body's urges and push along with your body then let yourself rest?!

One more thing on the topic of pushing...don't be coerced into pushing lying down unless you yourself feel best doing so.  It is far from ideal and will make you and your baby have to work that much harder.  And once again, it can also cause stress for the baby.  In case you didn't know, stress, or variations, decelerations in the baby's heart beat, make everybody very nervous, and with good reason!  Do what you can to avoid stress, don't have your waters broken prematurely, labor and push as much as possible in an upright position, and you will avoid the more common causes for stress.

7.  Finally, and perhaps this should be first, Just Say Yes!  Accepting your labor however it comes and however it goes, will in my mind guarantee a perfect birth for you.  When you believe in your own strength and when you let yourself do what you need to do, your labor will be perfect no matter what happens.  So, when labor starts, don't fight it, don't be scared; be courageous, be strong and say YES!!

How to Give Birth... Ancient Egyptian-Style

A few nights ago, it was story time with my daughters.  I brought out the library bag to search for a new book and came across a lovely compilation I'd grabbed earlier in the week titled, The Barefoot Book of Dance Stories.  I pulled it out and immediately both my daughters started saying, "Oh, Mama, do the one with the baby!  Do the one with the baby!"  (Now this may not seem strange to anyone with daughters since most are interested in babies, but my daughters, blessed with a doula for a mother, take their interest in babies to a whole new level.  They've heard me talk about birth often, and watched The Business of Being Born with me and the documentary, Birth Story with Ina May Gaskin, and they will often ask me to show them the births.  Like I said...a whole other level.)  I began reading the story.  It was called, The Goddess Danced.

What a beautiful story!  I loved reading it to my daughters.  I make sure when I'm talking about birth with them that I keep my tone positive and affirming.  I don't allow too much to be shown or heard that I feel is beyond their age-appropriate level.  What I am doing, is generating a history of birth stories that will allow my daughters to look forward to birth and to expect it to be hard work.  By using story, I am giving them an image of birth that will excite them not scare them.  The Goddess Danced, is a perfect example of this.  I've included a brief synopsis below:

Ra, the god of the sun, being a god, could do things that mortals could not.  He frequently fell in love with women on earth.  One time, he spied Ruditdidit, the wife of one of his priests.  She was very beautiful.  He visited her and wooed her.  Soon she became pregnant with triplets.  In order to help her have an easy pregnancy he made sure she had plenty of figs, grapes and pomegranates and he sent her earthenware jars of goat milk.  For nine months she was happy and well rested but when labor began her pains were great.  She wept and wailed and called out to Ra for help.  He heard her and sent four of his goddesses and one of his gods to help her.  They disguised themselves as street musicians (in that time street musicians were considered to be excellent midwives) and entered the house to help Ruditdidit.  The one god, Khnum, stayed outside with Ruditdidit's husband and drank barley beer.  The goddesses found Ruditdidit lying on her side in great pain.  One of the goddesses, Isis, started to dance while the others made music with their instruments.  Isis reached down and pulled Ruditdidit to her feet.  Together they swayed and danced, swinging their hips and twirling.  "Isis made Ruditdidit's stomach ripple like waves, her hips like mountains shuddering in a quake.  Ruditdidit did as Isis commanded, her belly moving back and forth, up and down until she was quite dizzy but the pain had receded.  Then, when Ruditdidit was ready for the birth, Isis stopped dancing.  She led Ruditdidit back to her bed where the woman squatted by the bedside and began to push.  Isis put her hands out, and the triplets fell into them--one, two, three."  Ruditdidit's husband, the priest Rausir, left a basket of corn as payment and went in to see his wife.  Isis flipped the basket and transformed the corn into gold coins, "but the priest, Rausir did not find that out until much, much later, for three new babies and a tired wife turned out to be a lot of work."

Is that not the most beautiful birth story?!  I absolutely love it.  Not only does it mention diet and rest as being important during pregnancy but it also mentions music and dancing as key elements in helping ease labor pain and help labor progress.  So cool!!!  Who wouldn't love to be pregnant if they were fed figs, grapes, pomegranates and goat milk all the while resting from their work and being pampered?  Who wouldn't love to labor with their own troupe of musicians making music and dancing with you all the while encouraging your efforts?  I know I would.  Maybe they need to encourage more musicians to become doulas...  But, I'm getting sidetracked.  Back to Ruditdidit.

I didn't mention it in the story, but by the time the goddesses arrived to help Ruditdidit, she had already been laboring for more than 24 hours.  She was tired and in a lot of pain.  Now most labors will be completed within 24 hours, but every so often there are those labors that will go on for much longer or will get stuck.  (Of course, in Ruditdidit's case, she was carrying triplets and they were half-immortal, which is not a complication any of us have to worry about!)  Still, labors do get stuck sometimes and sometimes we do need to think outside the box in order to help get unstuck and move labor along.

Labors get stuck for a variety of reasons.  Sometimes the mother becomes worried or anxious.  Sometimes something happens to throw the mother out of her concentration, an interruption or some minor annoyance.  Even if it seems minor, anything that throws a mother out of concentration can really impede labor's flow.  (Why do you think wild animals birth at night where they feel completely private and safe?!)  Sometimes the mother's uterus is just plain tired and needs rest and nutrients in order for it to continue making progress.  When any of these happen, a mother may feel at a loss as to what to do next.  This is where stories can step in and help.  What did your grandmother do in her labor?  If not her, what did your friend's grandmother do? You get the point. We can learn from others' experiences.  We can learn from the birth stories we've heard.  In this case, we can learn from Ruditdidit's prolonged labor.  We just need to start dancing!

I'm not joking.  Each and every traditional culture has its own version of a birth story and I guarantee that not one of them tells of the woman lying down passively enduring labor.  Quite the contrary.  Most traditional cultures tell stories of women working until labor was imminent and only then dropping what they were doing to squat and push the baby out.  Sounds primitive, but hey, it has worked for thousands of years...

This story was probably written to serve exactly the purpose I mentioned above, to help women with prolonged and difficult labor.  This story although meant for children, most likely taught an entire culture: this is how you give birth.  Unfortunately, today we have lost most of the stories and what we've kept is a more medicalized version of what to expect.  I think we're actually doing more harm by this.  The stories are inspiring and instructional without being too scary or over-informative.  I think it is high time we revived the birth story as a means for helping prepare women to give birth.

Four Proven Pain-Management Techniques

Today I am going to write about four proven pain-management techniques to be used during labor.  We've all heard about the normal ones; movement, water, massage, positioning, but in this post I want to touch on the lesser-known but just as, if not more, effective techniques that I learned from Ina May Gaskin.  Now some of you may take issue with the word, proven.  The only "proven" pain-management is drugs, right?  Not right.

But first...

Don't skip this because it is IMPORTANT.  So often we read something, a diet plan or an advertisement for something like a cure for male-pattern baldness, and we get all excited because of the flashy promises and guaranteed results.  We try it...and it doesn't work.  What happened, we wonder?  Then we read the fine print: results not typical, or something to that effect.  Well great.  Unfortunately, in our world  of product promotion, sales, competition, big business, we, as consumers, are becoming more savvy and anything that looks like a caveat or a fine print makes us run for the hills.  We don't even need to read it to know where this is going.  It means that no matter what you assert, your product is not going to work on me.
I would like for you to suspend your instincts while I maintain that there are proven pain-management techniques for labor and there is a fine print.
Will you read on??  I hope so.

The Fine Print:
There are no short-cuts.  There, I said it.  No matter which way you look at it, these pain-management techniques will not in any way resemble a pill or a shot or a quick fix of any kind.  In order for you to be able to manage your pain effectively, you are going to have to work for it.
Not your typical advertising claim, now is it?!
But, if you think you can handle that kind of fine print, then keep reading.  It only gets better from here :)

Pain-Management Techniques:

#1  Keep Calm and Carry On:
Surround yourself with people who are calm about the birth process.  This may not seem like a lot of work or even important enough to rank first in the list, but trust me, the importance of this simple step cannot be overstated.  At your birth, you need to have people who are going to look lovingly at you and say, "yes, this is normal," and "you are doing a perfect job," or "those are wonderful sounds you're making right now."  Basically, you want people who will encourage your efforts, bolster your confidence and lesson your fear and anxiety.  This may require un-inviting people to your birth (most definitely not an easy thing to do) or switching providers (even less easy), or taking that extra step to seek out a doula or someone who you know will provide that positive, calm support.

#2  Laugh:
Expect to laugh.  Try to laugh.  Erase whatever image of birth you may have that tells you that birth should be a solemn, serious event.  It can be.  But that wouldn't be much fun, now would it?  Seriously, though, if you can laugh or even smile, however tiny, you will be amazed at how your body will respond.

#3  Kiss:
Forgive me if this is TMI, but it should be said, and I love Ina May Gaskin for saying it.  What happens when you kiss a guy?  Blood rushes from his head to his you-know-what, and what happens?  It gets bigger.  We don't talk about it much, but the same thing happens to women.  When we kiss, we get bigger too.  Why?  Hormones.  It's a beautiful thing.  And, by the way, I'm not talking about close-mouth, puritan-style kisses either (I hope you know what I'm talking about).  Make everyone leave the room and enjoy some snuggle time, just you and your partner.  It not only helps ease your pain but boy can it get things moving!

#4  Attitude Adjustment:
Try to observe your attitude.  If you notice that the pain is getting unbearable, take a peek at your thoughts and what their tone is like.  Are you succumbing to the temptation to wonder, "how much longer?"  Are you approaching each contraction with the thought, "dear God, I can't take much more of this!"  Any negative attitude regarding birth and the process will increase your pain.  Although we may think this is out of our purview; it is not.  Let me reiterate, IT IS NOT!!!  This, more than any other area is entirely, firmly, completely within your grasp.  Fake it, till you make it if you have to.  Even if you don't believe yourself; know that you can change your attitude merely by acting like it. Your body will respond.
The next time a contraction comes, change your thoughts, or even better, start talking out-loud and say something like, "Yes!" or "I got this!" or anything that spontaneously comes to you that will help you reverse those negative thoughts and transform them into positive body-affirming truths.

Final Consideration Points:
These techniques, unlike the more commonly-known techniques of movement, water, massage, etc...require practice, habit-building, in order for you to be able to draw upon them when labor begins.  Don't we, when stressed, tend to revert back to a more basic, and base, version of ourselves?  Our pretensions are stripped away and we are left with our own naked vulnerability.  Quite a scary thought.
Unless you have forged habits to draw on.  Habits like staying calm when you most feel like blowing your top; laughing instead of crying when the unexpected happens; kissing, especially when you least feel like it; and training your thoughts to focus on the positive.  The more we practice these techniques in our everyday lives the better we will be able to "switch them on" when labor begins.

Results Are Typical:
Again, to run counter to your typical marketing outcomes, I will maintain that when you use the above techniques you can expect your pain to be manageable, and sometimes even exciting or exhilarating.
Birth is normal.  Our bodies are designed for birthing.  We can birth.  It is possible to feel pain and ride it.  You will have to work harder than you have worked ever before and possibly after.  That's why how we birth matters.  That's what makes it so good.