Western Culture & Colonization of Birth

Western Culture

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The West encourages reading and the attendance of Childbirth Education classes, along with other strategies for birthing.  In traditional cultures women “…prepare more symbolically.  They avoid all actions and thoughts that have anything to do with ‘getting stuck’ or ‘closing up’ and work on ‘letting go’. In traditional societies, women often go to midwives to confirm the pregnancy and then again only if there are special problems… (Nichols & Humenick,145)” prior to childbirth.

Another aspect is that most women within many traditional cultures used to be more directly involved in the childbearing and child birthing aspects from a young age. Her mother or aunts and grandmother would have taught her about the processes of childbearing and childbirth during childhood and/or adolescent years.  The concepts used to have “…been integrated into her maturity into adulthood (Ibid.)”. It would have come from her experiential life and stories told to her instead of a class or books.

Unfortunately, much of this kind of experience and tradition has been lost or is no longer practiced today by women. Some of the other women will talk about this or that grandma who was a midwife, and who may have been allowed at IHS for a birth. When I have asked women, they mostly talk about a more negative experience of their childbirth, if they speak up.

Traditionally, the birth of a baby was in the home, not a hospital.  Some cultures used “a special hut [that] is constructed for that purpose ;…(Ibid)”. But today, birthing mostly takes place in a hospital setting.

Close to the reservation are border towns, where bias and prejudice color the atmosphere of birth. Due to past experiences with IHS, many women may opt to not have their babies at these hospitals. Without midwives to deliver locally, this is what women on the Rosebud (Sicangu Oyate) Reservation face today.

In border towns, the hospitals have their own regulations as to who may attend the birth. They may also decide on whether a woman can have assisted births (Nurse-midwives/doulas/or family supporters).

De-Colonization of Birth
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In the 90s, several women, including myself, were having weekly meetings regarding birth in Indian country. Each week we would have speakers come to share their stories and ideas.

I found it interesting that the biggest objections came via a native woman who was working at IHS. She bluntly stated that no midwife would work through the IHS hospital in Rosebud, if she had a say.

IHS or PHS is a government funded health organization in the United States intended specifically for native health care.  Unfortunately it has its own regulations based upon the government in which native people have been the object of clinical abuse and government sanctioned studies [such as the Eugenics Program; See: ]. The intent of these studies was to lower native populations.

Such historical actions color the way in which indigenous women see childbirth in the dominant society. It creates an atmosphere of distrust in native women, that they too would be subject to similar treatment.

And lest we forget, there have been studies that demonstrated genetic memories. So whether the Eugenics Program was known to them or not, the emotional trauma would still be triggered.

Native women feel marginalized by non-native providers of health care, due to attitudes of the providers. If native health care providers are not available, cultural competence of the health care provider that is on hand is an essential for the indigenous person giving birth. In a study conducted with first-nations women, specially the Mi’kmaq, Lothian stated that “Women need to be assured they can have trust in the birth process (Lavell-Harvard & Lavelle, 50)”.

There are native women who have become Doulas, and who are nurse-midwives. In Vancouver, BC there is a group of women from the Squamish people working to assist women [Ekw’i7tl Doula Collective]. In Minnesota there is a group of native people from the Anishinabe that is training women in Doula work, Childbirth Education, and Breastfeeding [Mewinzha Ondaadiziike Wiigaming /Bemidji, MN]. In New Mexico the first native birthing center [The Changing Woman Initiative] is being developed for  indigenous women.

 

 

 

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Birth Trauma Part 3

According to Cheryl Tatano Beck, traumatic birth is defined as “an event occurring during the labor and delivery process that involves actual or threatened serious injury or death to the mother  or her infant. The birthing woman experiences intense fear, helplessness, loss of control, and horror” she had later revised that statement to include the woman feeling stripped of her dignity.

What is the cause of women perceiving their birth experience as traumatic? It is the systemic elimination of protective care during the birthing process.

In Beck’s study of 40 women she says that there were four themes that emerged. Theme #1 was to care for the women and treating them as human beings. Theme #2: Lack of Communication.  Theme #3 was safety. Theme #4: The ends will justify the means.

With theme One: #1 women feeling they were objectified, and treated arrogantly and with a lack of empathy. The women were #2 left alone, and abandoned. The #3 birthing mother’s needs were not met by the hospital staff. An example given was of a woman from Puerto Rico who was on all fours, when a nurse brought in 20 students to observe…without her consent.

In theme Two: #1 no one communicated with the woman in labor. They were described as having conversations with one another within earshot but not directly talking with or to the laboring mother. As if she were non-existent.

In the third theme:  the #1 laboring mothers felt that the staff (nurses and doctors) did not adequately deliver safe care. #2 The mothers were not being allowed input into the care being given for their own selves and actually fearing for their own and / or the infant’s life!

In theme Four:  entailed #1 the sense that what was endured and experienced by the mothers was the sense of being “pushed to the background” as everyone around them were celebrating the baby’s healthy birth. These women #2 felt invisible, only the infant mattered.

The experiences mothers have had led to severe post-partum trauma and depression.  Beck, Driscoll, and Watson’s book Traumatic Birth goes into detail about feedback loops [pp. 10-12] that describe the interaction of the mother and child after a traumatic birth, with a listing of the causes and consequences of the cause. Sometimes even breastfeeding is difficult, creating “…intruding flashbacks, disturbing detachments with their infants, feeling violated, enduring physical pain, and insufficient milk supply…” Often the anniversary of a traumatic birth amplifies the feedback loop.

 …

My own reaction to the shared experiences the women in this book had illustrated the barbarism of western medical professionals, a barbarism that is completely contrary to those principles I listed from the ACOG website in part #2.

The women who tell their story of childbirth weave an astounding sense of personal alienation.  It is no wonder that there is PTSD, depression, self-destructive behaviors, socially isolationistic behaviors and pelvic floor injuries as a result of the improper calloused form of care received. Many of the women feel as though they were raped, yet most had no “history of physical, emotional, and/or sexual abuse” so birth precipitated  a sense of having “the loss of the soul”.

I only touched on a small portion of the book in these three posts. In the next few blogs, I would like to address how we can alter the outcome for women in these circumstances and possibly change childbirth for women.

A Good Question

What needs to happen, in order to fix a broken system? Your probably wondering what I mean by a broken system. I am talking about the care of women, and especially birthing.

In a nation that has been considered “advanced” we are so far behind the eight-ball that it becomes shameful. Our c-Section rates were seriously through-the-roof, and although some improvement has been made still higher than most “civilized” countries! The average being around 31%.

Along  with that outrageous number of c-Sections are the ever-climbing mortality rates of women in birth, predominately women of color. This is shameful in a country that is supposed to be “advanced”!

On top of both high c-Section rates, and high mortality rates for birthing, is the across-the-racial-board birth trauma. It should NEVER happen! But, we have nurses and doctors who force women into procedures, who intimidate and threaten.

The media makes it seem that birth is both dangerous and extremely painful. When that consciousness is embedded in the psyche of women, and you have a medical field that relies on mechanical means to monitor births… the stage is set. We have normalized bad birthing practices, and outdated concepts about birth.

That is without discussing the current political scenarios.

The next few blogs will address the history behind, and the current information about birthing in the United States. The outdated concepts surrounding birth practices need debunking. The normalization of bad birthing practices needs to have a light shown upon it, in order to make it STOP.

It is time to become educated,

get angry,

and create a change!

My sister site will also be publishing this information, although later, at joyousbirth

Orange

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Citris Aurantium: Fresh Fruit

Both the unripe and ripe fruits are used in Chinese Medicine. The unripe bitter fruit is more potent. The unripe bitter fruit (zhi shi) is used for constipation or to move stagnant chi energy. It can be used to make an expectorant for coughs. This bitter fruit is NOT recommended for use in pregnancy.

The ripe fruit has multiple properties for the pregnant woman. It is high in vitamin C and when eaten with the pulp, it contains Rutin.

A Small Orange contains the following nutrients:

Amount Per  1 small (2-3/8″ dia) (96 g) 100 grams 1 fruit (2-5/8″ dia)
Calories 45
% Daily Value*
Total Fat 0.1 g 0%
Saturated fat 0 g 0%
Polyunsaturated fat 0 g
Monounsaturated fat 0 g
Cholesterol 0 mg 0%
Sodium 0 mg 0%
Potassium 174 mg 4%
Total Carbohydrate 11 g 3%
Dietary fiber 2.3 g 9%
Sugar 9 g
Protein 0.9 g 1%

 

Vitamin A 4% Vitamin C 85%
Calcium 3% Iron 0%
Vitamin D 0% Vitamin B-6 5%
Vitamin B-12 0% Magnesium 2%

 

*Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.

 

Sweet Orange Essence Oil

The essence oil of the sweet orange blossom can be used in a diffuser for lack of energy and / or depression. Sweet Orange is an excellent choice for women who are having difficulty in labor and who are lacking energy. Do not use the essence oil in the bath during pregnancy, and use with extreme caution with infants present. Be sure to dilute with a carrier oil, such as Sunflower or Almond.

Neroli Essence Oil
Citris bigaradia

Neroli is derived from the bitter orange blossom.  It should not be used during pregnancy, but can be used during labor and right after delivery. Neroli helps with stress, fright, exhaustion, and shock. It is also great for anxiety. An excellent choice when there are complications in labor causing the mother to be exhausted, and anxious. If there has been a traumatic birth it will assist with the shock after the birth. Use only with the advice of a trained professional who knows about aromatherapeutic treatments. Do not use in a bath and limit its use around infants.

Sphincter Law – Part 2

doula at work

Sphincters May Close Suddenly if the Owner is Frightened

The sudden contraction of the Sphincters is a fear-based reaction, as a part of the fight-or-flight response of adrenals. The Adrenaline/catecholamine level will rise in the bloodstream when frightened or angered.

If a female animal in the wild is in process of birth, the birth process will reverse if the animal is startled by a surprise encounter with a predator. Humans can do the same thing.

In her book, Ina May’s Guide to Childbirth, Ina describes a situation where during labor a woman developed a fever; soon it became apparent that there was a bladder infection. She was seven centimeters dilated, but stalled in labor. So Ina chose to transport her to a hospital.

The laboring woman was examined by a doctor that was rough…who stated she was only 4 centimeters. Her dilation retracted from 7 to 4 centimeters as an automatic response to the roughly-handled internal exam…a natural self-protection, evidence of the function of the sphincter function.

What Helps the Sphincters?

• Trust, comfort, familiarity and safety
• Laughter
• Slow and deep [abdominal] breathing
• Immersion in warm water which calms and relaxes
• Relaxation of the mouth and jaw
o Relax the throat and jaw by singing
o Release an audible low moaning sound (similar to the sounds of lovemaking)
o “horse-lips” similar to the tone that horses make when they make that sound with their lips flapping, or “raspberry” sound.
• Relaxed labor supporters

~This information was taken from Ina May’s Guide to Childbirth. Ina May is an internationally known Midwife, who has delivered babies and written books on Midwifery and natural childbirth. She works at THE FARM, in Tennessee.

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!

The Vocabulary of Pain

 

father in delivery room

The following information was written in order to understand pain in childbirth. This is a preliminary to understanding what your body senses when in labor.

Pain Threshold

The definition is “the point in which an individual first perceives the presence of pain”. This could be when ice or heat no longer is affective for blocking and / or reducing pain.
Each person has their own threshold. It is thought that threshold remains the same throughout ones life. But, Childbirth educators have found that the threshold is quite flexible. It is found that when comfort measures are used that effectively reduce pain or make it easier to bear, and the woman is distracted from her comfort measures, then the comfort measures no longer are useful. It will take a stronger stimulus to then break through the pain. Nothing had changed in the strength of the pain itself, “rather, her distraction reduced her pain threshold so that less pain was necessary in order for her to notice it (162)”.

Intensity
Intensity is defined as “the quantitative measure of how strong or severe the pain is (Ibid.)”. The usual measurement is a scale of 0 to 10. O being no pain, and 10 meaning that the pain is out of control.

Character
Character is a qualitative measure, using verbal or pictorial descriptors and analogies. Pain character may be described as burning, aching, tearing, or sharp like a knife. Character is the most important aspect to consider when managing pain.

Duration
Concerning when pain is first noted, and how long it lasts, and whether it is a steady pain or sporatic. It is particularly significant in that smaller diameter nerve fibers may, after repetitive signals become more responsive to pain signals. Many management strategies that are not pharmaceutical focus on the larger nerve fibers, which respond well.

Location
It is where the pain is perceived in the body. Depending on the location, the distress level may rise and start to interfere with eating, breathing, sleep, concentration, or the ability to otherwise function normally. If she is unable to concentrate due to location or any other aspect of the pain, she will be less able to use the pain management strategies she has learned.

Sensation Threshold
It is the point where the stimulus was first perceived. When reached, it is when the client first is aware of itching, cold, pressure, pain, or any other sensation. Of these, pain is the most important in that it could signify potential or actual tearing. Other sensations that may later become concerning may eventually grow strong enough to be perceived as pain.

Pain Tolerance
Defined as the greatest severity of painful stimulation an individual is able or is willing to tolerate. “Encouraged Tolerance” is the highest level of pain a person will tolerate when encouraged to try to tolerate more”. It serves a purpose, but not for women in labor as it may lower the tolerance to pain. It actually would translate to suffering rather than just pain.

Categories of Pain

Cutaneous
Occurs at the dermal level, and is sharp, localized, and generally tonic. An example would be the prick of the needle when given an injection.

Visceral
Occurring at the organ level, could be sharp or dull. There is less localization and could either be tonic or episodic. Examples: uterine contractions, severe constipation, and intestinal gas.

Somatic
It occurs at the soft tissue level. It is dull, aching, not localized and usually tonic.

Nerve Compression
The pain results from pressure on one or more nerves. It may be localized, or be referred pain to one or more regions of the body.

Women with Disabilities -The Healthcare Team- Part 1

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When do you start your Search?

The search should begin as early in the pregnancy as possible. When you do a gynecological examination is the opportune time to decide if you are able to become pregnant. Hopefully, that will occur with a doctor with whom you feel comfortable.

But if the pregnancy was unexpected, or you have not found that great doctor with whom you feel comfortable, the earliest point of time is best. It is important for the baby’s sake. It has been discovered that women who receive care late in the pregnancy or have had no prenatal care at all tend to run a higher risk of infant mortality.

Finding a doctor may be a challenge. Some will immediately advise an abortion. Other doctors will become enthused by the challenges.

You need that doctor to know you well enough to understand the way the changes of pregnancy will affect you. Health issues unrelated to the disability you have will most likely need to be addressed early.

How to Find a Doctor

You could find the doctor via those with whom you trust. You may also get recommendations from the doctor who has been working with your disability.

Evaluating the Doctor’s Practice

The recommendations of friends with whom you trust can assist you in assessing the skills of the doctor. Or listening to the impressions of the patients the doctor has had in the past.

Sometimes there may be differing experiences; it’s in this instance that the opinion of an older and well-trusted doctor in the community may come in handy. There is no singular way to assess what doctor may work for you, other than knowing what you are looking for in the care administered by a doctor.

Check the office policies, by checking with the receptionist. You can ask about fees, for normal birth and caesarian section. Ask about payment and billing, insurance the doctor will accept. You will need to know what hospital the doctor is affiliated. Also check the doctor’s flexibility with requests, such as persons allowed to attend the birth, and whether the doctor will work with you on having a natural birth. Most importantly, check accessibility, if you are using a wheelchair…are the rooms and bathrooms set-up for your ease of use. The answers to these questions may narrow the choices of whom to visit.

You could ask for only a consult, rather than a visit with a full physical examination until you have decided upon which doctor you will use. Bring with you the father-to-be or an advocate. You then will have someone to share impressions and ideas with, or who would think of questions you may have not been able to think about in your nervousness.

The Vision

CHAIR STRADDLE

It has been my long-term goal, to start the work of Childbirth Education on the Rosebud Reservation, then expand the birthwork to local native women assisting families and extended family in childbirth.  This vision includes a mobile bus that would be able to reach even the most rural of communities to assist in health care for pregnant and post-partum women, and a free-standing childbirth center.  BIG dreams!

Today, I was thinking “What are the obstacles for young women who may be interested in becoming a Doula?” Well, first it would be the funding necessary to have the training as a Doula. So I set-up a scholarship funding campaign on Go Fund Me.

The campaign is designed to raise money for a minimum of 10 women. I believe that is a good start!  If you are interested in supporting my vision, here is my campaign: https://www.gofundme.com/rstdoulas

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