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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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.

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.

Trust the Process

Trust the Process

Birth is Natural, Trust This…

WHAT IS NATURAL CHILDBIRTH?
FACTS YOU SHOULD KNOW

Natural childbirth is:

FEARLESS childbirth
TRAINED childbirth
RELAXED childbirth
EASIER childbirth
SATISFIED childbirth

especially if a mother is helped to GIVE birth to her baby
consciously without too much discomfort, instead of ‘being
delivered’ while unconscious.

~Grantly Dick-Read  Childbirth Without Fear


The purpose of childbirth education is:

  • To INFORM women about all aspects of pregnancy and labor, in order to take the fear out of childbirth.
  • TRAIN women in nature’s process of birth, breastfeeding, and good nutrition.
  • Teach RELAXATION techniques, to reduce discomfort during childbirth.
  • Help women with techniques to make childbirth EASIER.
  • The result should be more SATISFACTION.

Women have helped and supported other women in childbirth since the dawn of time. In our modern times, this practice has diminished. Today we have been subjected to the medical/scientific process that is not focused on the natural way. It is geared more towards heroic measures, mostly based on erroneous ideas or for the time-structure of the doctor, rather than the timing of nature in a natural childbirth.