Sphincter Law- Part 1

doula at work
In birth work, obstetricians use the Law of Three Ps:

• Passenger (baby)
• The Passage (the pelvic structure and vagina)
• And the Powers (strength of uterine contractions)

From these Ina Gaskin believes stems the misunderstood capacity of a woman’s body from both the pregnant woman and the doctors who work with them. From the misunderstood capacities are the causative factors leading to all the interventions and procedures that now create problems in birthing, such as: Cesarean sections, Forceps use, vacuum extractors, etc.

The blame is placed upon women, for what obstetricians see as “dysfunctional birth”. Women have birthed for eons without a hitch; doctors perceive having a baby as “a problem of physics rather than a millions-of-years-old physiological process (168)”.

The Basics of Sphincter Law

• They function best when the atmosphere is private, and familiar.
• They do not open “at will” and do not respond to commands such as “Push!”
• When in the process of opening (relaxing) they will suddenly close down if a person is upset, frightened, humiliated, or self-conscious. This is the reason why in most traditional cultures women assist women in birth.
• If the mouth and jaw are relaxed, there is a direct correlation to the ability of the sphincters opening in the cervical and vaginal area (or the anus, for that matter).

What are the Sphincters?

These are a grouping of muscles that surround the rectum, bladder, the cervix and vagina. Each has a function for the body. These muscles remain contracted to keep the openings of certain organs held shut until something needs to pass through.

How do they work?

They work in conjunction with the brain. The brain has two sections that directly influence the functions of the Sphincters. These sections are the neocortex and the brain stem (or “primal” brain).

The brain stem is the portion that is directly connected to hormonal functions, and more instinctual. The hormones it releases (related to birth) are oxytocin (the main ingredient in the drug Pitocin, used to induce labor), endorphins, and prolactin.

Whereas the neocortex stimulation works to inhibit the brain stem from hormone release. It is “stimulated” during labor by asking too many questions of a woman in labor, bright light, and failure to protect her privacy during birth.

The sphincters work with the brain stem (and its many hormonal excretions) by a relaxation response. They respond to emotions. A good example of this relaxation response is what happens when toilet functions are interrupted. Everything gets held in, and it takes a while to relax again, right?

~more on the “Sphincters” next week!

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See the #fireworks I created by blogging on #WordPressDotCom. My 2015 annual report.

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Source: See the #fireworks I created by blogging on #WordPressDotCom. My 2015 annual report.

2016 will be even better!  Thanks and gratitude for all those who are following this blog, and reading my posts!

Merry Christmas and a Happy New Year!!

 

 

 

How to “Trust the Process” in Childbirth

Trust the Process

Trusting is a big word. We oftentimes say we trust others, but do not even trust our own selves. The nurturance of our babies and bonding that would be necessary in utero, assists in developing a trust between baby and mother. But before working on the baby-mother bond learn to trust your own instincts.

Science has determined that the mother-baby bond is essential after a child is born. But what about the significance of bonding while the baby is growing inside the uterus? This is the essential missing information not communicated to women in our modern times.

Due to the obsession of the over-technological world we live in, we forget to listen within. We tend to not realize important knowledge lies inside our psyches. We avoid listening to our bodies. The cues are there, we just do not stop to listen.

The pregnant body is communicating what it needs all the time, and, believe it or not, the unborn baby is, too. All we have to do as mothers is learn to listen, give ourselves permission to trust the connection, and take the time to respond (Peters & Wilson, 22).

For survival, the baby must begin to adapt to its environment while in the womb in order to survive. There are special molecules that act as messengers, to allow the mother to communicate to her baby in utero. Components such as hormones and neuro-peptides cross the placental wall, sending information to the fetus.

Emotional intelligence is taught to the fetus via this mechanism. So he or she learns the whole range of emotions via the mother. Her responses teach the fetus. She sets the tone, so-to-speak for coping within the world.

Creating the bond with the fetus is a spiritual act that transcends the normal functions of mothering. How one adjusts to life, begins during the prenatal period.

Researchers and clinicians have found that prenatal and birth experiences of the mother, effect the birthing patterns she has with her own babies. These would include cultural patterns imbedded in the lives of the family. We can prevent “life-constricting patterns (McCarty, 9)” that are developed while in utero by addressing these issues and healing our own birth traumas.

This scientific approach closely parallels the work of John Upledger in his ground-breaking work with Cranio-Sacral and Somato-Emotional Release therapies. His theory is that the body stores memories at the cellular level.

Have you ever massaged someone, or been massaged, and a small soft-tissue lump is discovered that almost feels like it “crackles”? That is a “energy cyst”. When released it creates an emotional response, and the muscular tension abates. It is thought this “cyst” holds the memory of the injury. In Unpledger’s book, he states that traumatic injury can be fully healed by the release of these “cysts”.

I have come to look upon this phenomenon as ‘tissue memory’. By this I mean that the cells and tissues of the body may actually possess their own memory capabilities. These tissue memories are not necessarily reliant upon the brain for their existence [[Upledger, 64].

I would consider this muscular and tissue intelligence. If Upledger’s theory is true [and is likely, due to hundreds of patients having experienced his work] then it is an important aspect to consider for the mother and the mother-baby bond.

There are four essential KEYS to developing the mother-baby bond, and learning to be aware of and trust your own instincts.

Being: an awareness of thoughts and feelings
Observing: a state of mindfulness
Nourishing: involves all the things women do to tend to their emotional and physical needs.
Deciding: to make an active participation in creating your own reality. A conscious agreement
to make decisions based on deep inner-listening.

Steps to making the conscious agreement are:

1. Separating ourselves from all external influences (even for a few moments in the day)

2. Get quiet and pause. A few deep breaths in order to connect to your “source”

3. Listen. What is your gut saying to you? How does your body feel? How is your body reacting? How does your baby react to what you are feeling, physically or emotionally?

4. Then decide and commit. This is when you honor your feeling and that of your baby. Make a decision that will be in harmony with the messages your intuition says.

Through this practice, then you will develop a trusting respect for your own intuitive thought process, allowing it to guide you. You have several months of your pregnancy to find your awareness of self and of your baby.

When the day comes for labor to begin you take this newly-developed self-awareness, the bond you created between you and baby, and the education you have gained about safe birthing practices to trust fully the process of labor! “Listen” to your own self, and what your baby is telling you.

Relax into labor, BE with it. OBSERVE what is transpiring within your own body, and NOURISHING your emotional / physical needs while you are in labor. Then DECIDE. Decide to trust your instincts, trust your body (which is wonderfully made!), and to trust your bond you’ve made with your baby…

COMMIT to Trusting the Process.

REFERENCES:

McCarty, Wendy Anne. Ph.D. , R.N. The Call to Reawaken and Deepen Our Communication with Babies: What Babies Are Teaching Us. International Doula. Summer 2004, Vol 12.

Tracey Wilson Peters, CCCE, C.L.D., and Laurel Wilson, IBCLC, CCCE. The Mission Piece: Consciousness and the MotherBaby Bond. Pathways to Family Wellness. Issue 31, Fall 2011

Upledger, John E., D.O., O.M.M. Your Inner Physician and You. 2nd Ed. North Atlantic Books. 1997

Midwife Model of Care VS Hospital Model – Part 1

doula at work

The Midwifery Model of Care

This ancient form of birthing care approaches the idea of birth as more holistic way of care-giving, recognizing the female power of creation. It also acknowledges the holistic view with a seamless unity of mind, body, and spirit; that mother and baby are inseparable units, birth is a normal healthy process.

Visits are much longer. The Midwife is attentive to the pregnant woman, answering her questions. Care-giving, education, counseling are all a part of the Midwife Model of care.

Nutrition is emphasized as the means for a healthy pregnancy, good birth, and strong thriving babies. Companionship during labor is considered important to minimize the use of technology to intervene in the process of birth.

The Midwifery Model has not time-constraint on the process of birth. Labor has its on rhythm, “…it can start and then stop, speed up or slow down and still be normal (Gaskin, 184)”. Midwives give continuous assistance throughout the duration of labor and delivery, and postpartum support after the baby is born. Women can move freely and eat freely throughout the process of labor.

Medical Hospital Model of Care

A product of the industrial revolution, and male derived, its basis is technology and medicine. It is assumed that the body is machine-like, full of short-comings or defects (some has stated child-birth as “pathological”). Pregnancy and labor are viewed as an illness, and that to prevent harm to the mother and baby, must be treated with drugs and/or medical equipment. Also, birth MUST take place within 24 hours.

Mind and body are separate entities. Women are consigned to the bed in a supine position, hooked up to electronic fetal monitors, intravenous tubes, and blood-pressure machines. Eating and drinking, after a certain point in the labor process, are not allowed. Analgesia is administered to ease labor pains since the Medical Model of Care deems pain as unacceptable.

Office visits during pregnancy are short, and questions are discouraged. The mother must take the back seat in her concerns during pregnancy, and passive role during labor. Women are treated homogeneously, with individuality considered unimportant.

Water Birth – Part 2

THE USE OF WATER FOR LABOR

Water Birth Tub-from"Birth Pool in a Box"

Water Birth Tub-from”Birth Pool in a Box”

Some suggestions for labor:

• The temperature should be body temperature
or slightly lower.
• Be equipped with an efficient pump, heater, and
a thermostat.
• A thermometer and large plastic strainer to
clear the water.
• At least 2 feet deep, to cover the abdomen when
she is doing squats or is kneeling. In order to
encourage the “freestyle movement” it should
be a pool that is at least 5 ½ feet wide.
• Optimum time: during active labor (5-8
centimeters in dilation).
• When having back labor, get into the water. The water relaxes and acts as a counter-pressure.
• If you have previously had an active labor and then stalls once in the water, get out of the pool
and move: squat, kneel. Walk, sway hips.
• Or if the labor is stalled, get into the pool, sometimes it’s just the relaxation you need to get
things started again.

It is safe to use the pool once your membranes have ruptured. Birthing centers with experience using the pool have not had any increase in infections reported.

Don’t expect all pain sensation to cease. It will decrease the pain, but does not make it completely go away. Often it’s how you move in the water, not just the pool of water.

An advantage of using the water pool for labor in the hospital is that you can really feel a sense of privacy, allowing space to sink into your own intuitive self for labor. Anxiety and blood pressure both are lowered when in the water. The stressors of hospital atmosphere is diminished, lowering the catecholamine (stress hormones) and “the secretion of endorphins” which are the relaxants that you body naturally produces, and the hormones that produce pain relief.

WATER FOR BIRTHING

Water birth is perfectly safe.

Sears & Sears state “The school of water-birthing that practices slow emergence (baby is left under the water, SIC) can be dangerous (156).” They use the example of water mammals that birth in the water, and how these mammals assist the newly born immediately to the surface.

An additional need when doing a water birth, is some salt. Adding salt allows for the pool water to have the same salinity as the amniotic fluid of the womb. The amount necessary is a generous tablespoon of salt. Before filling the pool be sure it is cleaned with mild disinfectant, and rinsed, “unless disposable liners are provided to contain the water (Balaskas, 208)”.

If your membranes break while in the water, there is no need to change the water. The amniotic fluids and “bloody show” are both sterile.

During birth in the water, the relaxation of the sphincter muscles may cause some fecal matter to be excreted. This is when that suggested plastic strainer comes in handy. There is no “evidence to show that it contaminates the water sufficiently to contribute any risk of infection (Balaskas, 212)”
You can kneel on all fours, squat, or be in a semi-sitting position to birth. Your partner can be in the pool with you or sitting just outside the pool.

Once the baby is born, the attendant (doctor or midwife) check to be sure the cord is not around the baby’s neck, and unravel the cord if it is. The baby may float to the surface on its own, or you may gently guide the baby to the surface.

Breathing will not occur until the baby emerges to the air, the coolness of the air causing the reaction to breathe. Occasionally the baby may need suctioning to clear the air passages. The cord has not been cut yet, so there are dual sources of oxygen. “In the rare circumstance that the baby doesn’t breathe, it is wise to take baby gently out of the pool into a cooler atmosphere. This will trigger the breathing reflex (Balaskas, 214)”. If necessary oxygen can be administered.

The baby can be held in the water, at breast level. It is best to sit or kneel in a vertical position. The rooting reflex will be strong, so turn the baby to face you, yours and baby’s bellies facing, to make breastfeeding easier.

You can stay safely in the water until the placenta is expelled, which generally takes place 10 -20 minutes later. Pay attention to the cord, if the pulse decreases it means the placenta is about to be expelled. The baby can be handed to the partner, and you can stand up slowly and leave the pool. If the expulsion occurs sooner and you feel the placenta released from the body, you can still stand up slowly once you have realized it, the cord can be cut before leaving the pool.

The persons you have present to assist the birth can cover you and baby as you leave the pool. It would be important at this time to have the temperature raised in the room. If you had not expelled the placenta before leaving the pool, you can stand or squat at this juncture to deliver the placenta. Then sit upright and enjoy your baby with comfortable warm coverings.

At this point, the midwife or doctor will check both you and the baby. After their examination, you can go to your bed and “…relax with your baby tucked warmly beside you (Balaskas, 215),…”.

 

REFERENCES

Balaskas,Janet. Active Birth: the new approach to giving birth naturally, Rev. (1992) The Harvard Common Press
Sears, William and Martha Sears. The Birth Book: everything you need to know to have a safe and satisfying birth. (1994) Little, Brown and Company.

Positions for Labor-Part 2

POSITIONS FOR LABOR – PART 2

Variations of the Squat

The Supported Squat

birthing• Your partner sits or squats behind you, toboggan-like style with back against the wall or bed, or using a chair for support
• Or your partner can be in front, doing a squat, and hold your hands for balance.
Standing Supported Squat
• As you relax down into the squat, take the weight off your feet and melt into the arms and against the body of your partner.
• In this position your body will tell your mind to relax
• You then surrender your mind and body to your labor
Dangle Support Squat
• Your partner supports from behind, or two people supporting you (one on each side) helping in supporting you in the squat position.

Kneeling

image004This position is a natural extension of the squat position when the labor is too intense.

• Kneel on the floor with a pillow
• Lean against a chair
• Or get on all fours
o especially good for back labor
o to try and turn a posterior positioned baby
o or if your labor is accelerating and seems unmanageable.

Kneel-Squat Position

• Kneel with one knee while squatting with the other leg.
• Alternate between legs, or you can do a rocking and swaying motion.
Knee-Chest Position
• Your knees are on the floor, while your head and arms are on a pillow
o Slows overly intense contractions
o Counteracts an urge to push when your cervix is not fully ripened.

Sitting

CHAIR STRADDLE• Sit straddled over a low stool, toilet seat, chair or birthing bed angled like a seat
• The best of these is the sit-squat over a low stool, for the same reasons as the plain old squat position

 

Side-Lying

SIDE-LYING• Does NOT use GRAVITY in the same manner as the SQUAT.
• Best on the left side, to prevent the uterus from compressing major blood vessels that run along the right side of the backbone
• It provides a way to labor without pressure of the uterus on the back, and allows for some sleep in a long labor.
• Use pillows for your head, and pillows under the knee of the right leg, and support pillows behind your back.
o It allows you to quickly roll into the kneel or up into a squat
o Once the contraction is done you can roll back into your nest of pillows.

 

*Images from The Birth Book, Sears & Sears (1994) and internet birthing images/stock photos*

REFERENCES:

Balaskas, Janet. Active Birth: the new approach to giving birth naturally, rev. (1992) Harvard Common Press.

Dick-Read, Grantly. Childbirth Without Fear: principles and practice of natural childbirth, 2nd ed. (2013) Pinter & Marition.

Sears, William and Martha Sears. The Birth Book: everything you need to know to have a safe and satisfying birth. (1994) Little, Brown and Company.

Water Birth – Part 1

WATER BIRTH

Water Birth Tub-from"Birth Pool in a Box"

Water Birth Tub-from”Birth Pool in a Box”

In the 1960s Russia began using the Water Birth technique, and Michel Odent (a French Obstetrician) studied its use to benefit the process of birthing in the seventies and eighties. Odent shared what was discovered in the book Birth Reborn. Until the 1990s, the United States still did not use the method even though it had gained world-wide respectability.

WHY IT WORKS

Water relieves pain during labor because of “the law of buoyancy” also known as Archimedes principle. It says that when an object is placed in water, it will displace a volume of water in equivalence to its own weight.

A pregnant women feels an almost weightlessness when she is in the water which supports muscles and bones. This allows for the uterus to spare its energy. As the muscles of the abdomen, thighs and back relax…so will the birth passage.

More depth the mother has in the pool, the greater effect of weightlessness. This is especially good for back labor. As the muscles of the back relax, the internal tissues will also. It then will allow baby to maneuver, especially if positioned in the posterior direction.

Stress and anxiety causes the release of the stress hormones, which may not be the best idea for both baby and mother during labor. Stress hormones in the effort to protect will move the blood from non-vital areas of the body, which includes the uterus (considered by the natural hormonal reactions as a non-vital organ). Without the full flow of blood the uterus, the baby becomes oxygen deprived.

Water also “tricks the pain sensing system (Sears & Sears,153).” When the body of the pregnant woman is immersed it acts like a continuing body massage, and the temperature and touch-sensitive nerve receptors of the skin are stimulated. This process floods the nervous system with “pleasant sensations, virtually gridlocking the gate to painful stimuli (Ibid.)”.

WHAT THE RESEARCH SHOWS

In The Birth Book, Sears & Sears state that from 1985 to 1995 about 18,800 women used a Jacuzzi like pool at a birthing center in Upland, California. Dr. Rosenthal, the director and obstetrician stated that the women had almost always experienced shorter / easier labors, and had 1/3 the cesarean section than hospitals.

Other benefits experienced:

• Another birthing center used water birth for VBAC and had 87.5 success rate.
• Mothers labeled “high risk” because of high blood pressure which had reduced dramatically within a few moments after submersing in the pool.

Non-Professional Labor Support

NON-PROFESSIONAL LABOR SUPPORT

father in delivery room

 

 

 

 


By the baby’s Father or Partner of the woman:

• Can speak for her, to interpret her needs and desires to the staff.
• Assurances, relaxation, encourage her to drink and eat snacks.
• Assistance in walking during labor, assist in getting in and out of the shower or birth tub, etc.
• If knowledgeable, help with breathing and focus in the 2nd stage of labor

Note: to work effectively, the father needs to be well informed. He needs to know what to expect. If he gets panicky he should leave the room to regain composure and then re-enter. First-time fathers especially need to be informed and may still have need of assurance. This can be assisted by his attendance at the Childbirth Education classes.

By a female relative (Grandmother, mother, aunt or sister):

• [At the hospital] Can speak for her, interpret her needs and desires to the staff.
• If they have experienced a natural birth, their assurances are “gold”. They will know what and when to do things to support the process.  If not, they need to become informed about natural childbirth.
• Assurances, relaxation, encourage her to drink and eat snacks.
• They can assist in labor as well, by walking with and supporting the laboring mother; assist her getting into and out of the shower or birth tub, etc.
• Can help with breathing and focus in the 2nd stage of labor.

RECOMMENDED POSTS To READ:

Let Your Monkey Do It
Overdue Pregnancy


FUTURE POSTS YOU WILL NEED TO READ:

Hospital VS. Midwifery Model of Care
Pain in Childbirth
Normal Vaginal Birth
Optimal Fetal Positions
Positions for Labor
Water Birth
Premature Rupture of Membranes
Fetal Distress
C-Section
VBAC