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Ideally, giving birth is a natural and joyous experience, a blessed event in which the forces of creation and transformation can be shared by all present. This is to goal most of us try to achieve during our birthing experiences. Giving birth as a couple in your own home gives you the opportunity to fall in love all over again, both with your baby and with each other. The birth experience is a rite of passage and a transforming process that touches every aspect of your perception on life.
Unfortunately, most women in our culture do not achieve this experience. Instead, they end up experiencing a largely self-fulfilling prophecy of birth as a painful, terrifying ordeal and/or as a medical, high-tech, drugged, intrusive process over which they have no control. Birth is greatly influenced by our ideas and our attitudes. The images we have of giving birth, our expectations, conditioning, and our body image, determine not only how we react, but it influences the length of our labors, its progression, and how we feel about it afterwards.
Our culture still carries much of the idea that childbirth is a fearful and painful experience. It is both exciting and enlightening when these concepts suddenly fall away in the light of new revelations. The revelation that some women are beginning to experience is that childbirth doesn't have to be fearful or painful. It can be a very positive, joyful experience when you are prepared physically, emotionally, and mentally. As we deliver our children with these positive experiences, our children after us will be able to face their birth experiences with a familiar outlook and the knowledge that it can be a rewarding and positive experience for them as well.
ABOUT PAIN
Although we tend to assume that what hurts, really hurts, psychologists have discovered that there are many things that can influence our experience of pain.
FACTORS IN LABOR WHICH AFFECT THE EXPERIENCE OF PAIN
INCREASE PAIN
Hunger
Tiredness
Worry, Uncertainty
Focus on Pain
Tension
Fear of Unknown
Loneliness
Feeling Helpless
Waiting for Pain
DECREASE PAIN
Satisfaction
Being Rested
Focus on Others & Environment
Confidence
Relaxation
Knowledge
Company of Partner & Friends
Focus on the Present
Being Self-determined & Active
Medical interventions can lead to needless pain, difficulty or complications during labor or birth. These include but are not limited to:
- Confinement in bed.
- Routine IV.
- Continuous external fetal monitoring (EFM).
- Frequent cervical checks.
- Induction or augmentation of labor by various means including stripping the membranes or breaking the waters, or use of Pitocin.
- Epidural anesthesia. Medical Risks of Epidural Anesthesia During Childbirth - By Healing-Arts.org.
- Setting time limits for pregnancy, dilation or pushing.
- Use or insertion of instruments to monitor (internal fetal monitor) or remove baby (forceps, vacuum extraction).
- Use of lithotomy position for pushing and "delivery".
- Routine episiotomy.
- Cesarean (due to non-emergency or iatrogenic emergency).
Complex historic and cultural reasons and standard medical management practices view of pregnancy and birth as "emergencies waiting to happen" or "fear-based practice" rather than inherently safe processes.NON-DRUG SOLUTION OR PREVENTION: Find a health care provider/midwife and birthing site that will permit your complete freedom of movement and positioning during labor and birth. Provider should:
- Desire to control birth and keep mom passive/quiet.
- Impatience or desire to make the birth conform to a health care provider's schedule or hospital routine.
- Fear of litigation.
- Honest belief that baby might actually be "in distress" (from overusing EFM and/or misinterpreting results).
- Mother demands a scheduled induction or cesarean for various reasons.
- Mother demands "pain relief" or health care provider/staff expects that she will demand it.
- Health care provider's training and learned mindset compel him or her to take these measures.
- Take a supportive rather than interventionist approach to normal birth.
- Minimal cervical checks.
- Use of doptone or fetoscope instead of continuous EFM during labor.
- No induction or gentle, natural induction methods (sex if waters intact, walking, nipple stimulation, etc.).
- Instead of IV, mother takes fluids and light foods throughout labor, as needed.
- No time limits on pregnancy, length or labor, dilation or pushing as long as mom and baby are ok.
- Permitting mother to assume instinctive positions such as squatting or all fours can help baby be born much more easily and eliminate "need" for episiotomy or even cesarean.
Mama2Mama.org: Putting Labor Sensations Into Perspective
HUNGER is best dealt with by eating light foods during early labor and drinking juices to keep up your blood sugar level. (The hospital procedure of refusing food and drink to women in labor in case general anesthesia is required then necessitates the use of routine IV drips).
Here is a recipe for Labor-Aide that might help keep up energy and electrolytes.1 quart water
Red raspberry leaf tea (or pregnancy formula tea consisting of 2 parts red raspberry leaf, 1 part nettle, 1 part alfalfa, and 1 part peppermint leaf) can be made up before labor begins and used as a warm or cold tea, or frozen into ice cubes or herbal popsicles. This tea is great for adding other necessary herbs that may be needed during labor and afterward. It is very nutritious and help prevent bleeding problems, helps with promoting adequate contractions, and the red raspberry leaf is a great female tonic.
1/2 teaspoon salt
1/3 cup honey
1/4 teaspoon baking soda
1/3 cup lemon juice
2 crushed calcium tablets
Light soups and juices (can also be made into juice popsicles) are also recommended.
TIREDNESS can be prevented by resting your last month of pregnancy, sleeping through early labor if it is night, and relaxing fully between contractions.
FOCUS ON PAIN intensifies it. If you keep your attention focused on your surroundings, your partner, and the purpose of the labor, this will keep your attention directed externally so the pain doesn't register in your consciousness. Staying focused on everything but the pain is an invaluable tool in helping you deal successfully with contractions.
WORRY & UNCERTAINTY are handled by preparation. Taking childbirth preparation classes, knowing what to expect, and being able to interpret what is happening with your body. A good coach can help immensely in maintaining confidence.
TENSION is probably the major cause of pain in labor. A baby is born through contraction of the uterine muscle. The uterus is the strongest muscle in the human body. If the rest of your body is relaxed, your uterus can do its work effectively, without the pain or exhaustion of muscular tension in your abdomen, legs, or shoulders. Relaxation, aided by touch, encouragement, and attention of those who love and care about you, is the key to a comfortable and joyous labor.
WAITING FOR PAIN is self-fulfilling, because it causes tension, which actually creates pain. It can cause all your past experiences of pain to become jumbled together and be carried into the present, along with all the fears of the future. Experiencing each contraction and each rest period as each one comes solves this problem, for the experience in a given moment is never so intense that it cannot be accepted. Staying in the here and now is one of your best tools.
In addition to these factors, our experience of pain is influenced by our attitude towards it. If we can simply recognize pain for what it is, a sensation our body is registering to inform us of our situation, and meet it calmly and dispassionately, our body can accept the message we send back such as "I know what is happening and I don't need any further signals right now, thank you."
Poor physical conditioning, malpositioning of mother, especially lying down too much, too soon; mother not adequately hydrated or nourished before or during labor can all contribute to a birth that is prolonged and exhausting. Become fit and exercise during your pregnancy before labor starts to help with building physical stamina.
FitFor2: Keeping Fit During Pregnancy
Have an Active Birth don't go to bed unless you are truly tired and your instincts are guiding you to rest. Getting into bed tends to slow labor down (unless they put you on Pitocin). Stay hydrated and take light nourishment during your first state labor. Make sure you take frequent bathroom breaks to keep you bladder and bowel as empty as possible.
TOOLS FOR GOOD LABOR SUPPORT
Your partner will probably be your primary support and he plays an important role in helping you stay relaxed and enjoy your labor. But other friends and family members can also fulfill that function for the single mother or can relieve your partner during labor. Some couples may consider obtaining a Doula to assist them with labor support. This may be very helpful in a hospital or birthing center since the regular staff will not be able to provide much in the way of continuous support. At home, for a homebirth, you will have your midwife and her assistants (if any) to help with labor support. Here are some other tools you can use to help with keeping your labor as a positive experience and tension-pain-free as possible.
PREPARED CHILDBIRTH PREPARATION
Women do better in labor and birthing when they learn to say yes to every sensation they are feeling and open up to birth, which is extremely intense and may even be uncomfortable or painful at times, rather than trying for a painless birth. Keeping your expectations within a realm of calm, relaxed reality will help to keep you grounded during your birthing experience. Even if you have a good theoretical grasp of breathing and relaxation, attending classes will provide you with an opportunity for regular practice, update you on current techniques that can be used for relaxation and visualization during labor, and it will help your partner to be more immediately involved in your pregnancy. If you decide to take a group class, you will be able to meet other expectant couples. In private or group classes you will obtain a better understanding of birth through visual aids, films, slides, tapes and so forth.
MoonDragon's Pregnancy Information: Childbirth Preparation Classes
MoonDragon's Pregnancy Information: Childbirth Preparation Methods
MoonDragon's Pregnancy Information: HypnoBirthing
HypnoBirthing.com: About the Mongan Method
LeclaireMethod.com: About the Leclair Hypnobirthing Method
MoonDragon's Pregnancy Information: Birthing From Within
BirthingFromWithin.com: About the Birthing From Within Method
BradleyBirth.com: About the Bradley Method
There are many things you can do to make your goal of a natural birth easier to cope with!
EMOTIONAL PREPARATION
Fear of pain, fear of failure, or unwanted emotions from past births, miscarriages, abortions, or sexual abuse can negatively influence your feelings and decisions so your present birth is also less than ideal. Pregnancy is a good time for cleaning out your emotional "closet" and discarding any trapped emotions from past experiences. The exercises found in books listed below will provide valuable tools for approaching this birth with as much clarity as possible. Some excellent books for exploring your feelings about birth include:
- Creating a Joyful Birth Experience by Lucia Capacchione and Sandra Bardsley
- Birthing From Within by Pam England and Rob Horowitz
- Pregnant Feelings by Rahima Baldwin
- An Easier Childbirth by Gayle Peterson
- Transformation Through Birth by Claudia Panuthos
If you have had a previous birth (especially one that was difficult or less than you desired):
- Rebounding from Childbirth: Toward Emotional Recovery
by Lynn Madsen
This is excellent for women grieving and healing past births.
- Ended Beginnings
by Claudia Panuthos, Cathy Romeo
If you have a history of miscarriage, infertility or other loss, this book can be very healing, appropriate for resolving issues from previous childbirth experiences, and issues of pregnancy loss.
- Open Season: A Survival Guide For Natural Childbirth & VBAC in the 90s
by Nancy Wainer Cohen, Clar Doyle
For women considering vaginal birth after cesarean (VBAC) or those trying to avoid a cesarean.
- Silent Knife: Cesarean Prevention & Vaginal Birth After Cesarean, VBAC
by Nancy Wainer Cohen, Lois J. Estner
For women considering vaginal birth after cesarean (VBAC) or those trying to avoid a cesarean.
If you are interested in learning more about choices and "informed" decision making for your pregnancy and birthing care:
- The Thinking Woman's Guide To A Better Birth
by Henci Goer, Rhonda Wheeler
Necessary reading to make informed choices.
- Heart & Hands: A Midwife's Guide To Pregnancy & Birth
by Elizabeth Davis, Suzanne Arms, Linda Harrison
Subtitled A Midwife's Guide to Pregnancy and Birth, is not just for midwives. It's an excellent and thorough resource for parents-to-be who are thinking about delivering their child with a midwife, or who are concerned about the medical establishment's over-control of birth.
- Birth As An American Rite of Passage
by Robbie E. Davis-Floyd
Why do so many American women allow themselves to become enmeshed in the standardized routines of technocratic childbirth routines that can be insensitive, unnecessary, and even unhealthy? And why, in spite of the natural childbirth movement, has hospital birth become even more intensely technologized? Robbie Davis-Floyd argues that these obstetrical procedures are rituals that reflect a cultural belief in the superiority of science over nature. Her interviews with 100 mothers and many health care professionals reveal in detail both the trauma and the satisfaction women derive from childbirth. She also calls for greater cultural and medical tolerance of the alternative beliefs of women who choose to birth at home.
- Immaculate Deception II: Myth, Magic & Birth
by Suzanne Arms
Immaculate Deception (I and II) opens eyes to the realities of childbirth. It is not by nature a dangerous process -- an illness that modern medicine has only recently learned to deal with adequately. It is, however, a physically and emotionally demanding process for which our culture does not adequately prepare women, much like menstruation, breastfeeding, and menopause. Hospitals are not "safe" places to give birth. Women who are uneducated about and unprepared for childbirth are placing their lives and their children's lives in the hands of chance, luck, and fallible professionals. No place is a "safe" place to give birth for these women.
- Obstetric Myths Versus Research Realities: A Guide to the Medical Literature
by Henci Goer, Don Creevy
Anyone working to improve the childbearing experience and help women avoid unnecessary intervention has encountered numerous "obstetric myths" or "old doctors' tales." And while the evidence in the medical literature may be solidly, often unequivocally, against whatever "the doctor said," without access to that evidence, the pregnant woman is quite reasonably going to follow her doctor. This book is an attempt to make the medical literature on a variety of key obstetric issues accessible to people who lack the time, expertise, access, or proximity to a medical library to research concerns on their own. This compact, accurate, yet understandable reference is designed for people without medical training and organized for easy access.
- Spiritual Midwifery
by Ina May Gaskin
From the amazing birthing tales to care of the newborn, Spiritual Midwifery is still one of the best books an expectant mother could own. Includes resources for doulas, childbirth educators, birth centers, and other organizations and alliances dedicated to improving maternity care at home and in hospitals.
RELAXATION
Perhaps one of the most important keys to coping with labor is relaxation. Relaxation allows you to work with and stay on top of your contractions, riding each wave as it comes to you. Rather than breathing faster or trying 128 different positions to get comfortable (which may be impossible during intense active labor), Relax More!
- Be in and stay in the present moment. Do not concern yourself about what has already occurred in you labor or what will occur in the next moment, minute, or hour.
- Center your attention on your breath and keep telling your body to relax and release all tension. Tension and fear increase the pain you feel. Keeping any set of muscles contracted for the duration of labor is going to be very uncomfortable. Your uterus relaxes between contractions, and the rest of your body should be relaxed all the time. Pain is also caused by resisting what your body is attempting to accomplish and the sensations you are feeling. This results in more pain and tension. And enjoy your release. Although labor is extremely intense at times, you will NOT be pregnant for very much longer, and you're not going to be experiencing labor and birth for very long, or very many times, either, so savor the experience. It involves a whole set of new sensations and emotions. The goal we are aiming for is a completely relaxed body in which the contracting uterus is allowed to do its work of opening the cervix while you conserve your energy.
- Relaxation is not a passive process. It is a self-directed interaction between your body and mind. One of the main tools used to achieve this is intention. You are going to sit or lie in a comfortable place, completely relaxed, while strong uterine sensations recur from time to time, and tell your body and your various groups of muscles (especially those in your shoulders and lower belly to release, relax, and stay relaxed.
- Have available anything you use which helps you relax. Lotions for massage, pictures of children, pets, or favorite places to focus on, a favorite pillow, anything that is familiar, which will make you feel comfortable.
- There are tapes and videos out there, which can teach you relaxation techniques and labor coping skills. Pregnancy yoga and the new HypnoBirthing are becoming pretty popular!
- Practice and repetition are helpful, for they teach the body new response patterns, which has become automatic (like learning how to type). By practicing breathing and relaxation exercises regularly, your body can learn to greet strong sensations with relaxation and slow breathing, rather than filled with tensions, recoiling and holding the breath, as we usually do. This relearning will come to your aid in all stressful situations, from experiencing emotional upheavals to visiting your health care provider or dentist.
BREATHING DURING LABOR
If you have taken any birthing classes, you will have learned a breathing pattern, to help you cope with your contractions. If a method like Lamaze, they will be slower for early labor, a little faster for active labor, and very fast during transition with shallow, panting breathing for strong contractions. Some women may find this method works fine for them, but it doesn't work for everyone (including myself and my homebirthing clients). If you find it is actually harder for you to concentrate on a breathing pattern, and you are losing your concentration, then do what feels right (which you should do anyway!). Don't hold your breath, that is one of the worst (and most common) things that women do.
Your breath is intimately connected with all your physical and emotional states. It not only reflects them, it can also produce them. Professional actors often use the breath in this way to produce the emotions they need while on stage.
Use your breath as a tool. Keep yourself centered in it. Place your attention on your breathing, and feel as if you are floating in the middle of the breath. Keep the breathing as slow as possible. Many people who have been trained in the Lamaze Method don't really believe it is possible to maintain slow breathing throughout labor, but the Bradley Method teaches only slow breathing and it really does work. I used it through my five births with my children long before I ever took a childbirth class. With only slow breathing, you end up much more relaxed, are more in touch with your body, don't run the risk of hyperventilating, and enjoy labor more because you aren't bouncing around the ceiling doing rapid breathing.
BREATHING BETWEEN CONTRACTIONS
Let your breathing be relaxed throughout your labor.
In between contractions, the breath can actually dispel tensions you may have gathered during your last contraction and help you to relax. Use each out-breath to relax a little more deeply.
Let the in-breath fill your entire body, surrounding and relaxing each muscle or wherever you feel tension.
Use the out-breath to send it away.
BREATHING DURING CONTRACTIONS
Intentionally using a slow breathing pattern during your contractions provides a focal point for your concentration, keeping you centered and calm through each contraction as it builds and subsides (just like riding an ocean wave).
The breathing helps you to stay relaxed and when you are relaxed, your breath flows slowly and rhythmically. This is another added plus for slow breathing.
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Breathe with deep, slow breaths, raising your belly up off your uterus. This is called diaphragmatic or "sleep" breathing.
As you are deep breathing during contractions, your belly should actually raise off your uterus during each inhaled breath. This assures that your breaths are deep and keeps the muscles in your lower belly relaxed, free from tension and pain during contractions.
The cleansing breath is really a deep sigh at the beginning and end of each contraction, signalling to those around you that you are having a contraction, and signalling to yourself that it is time to concentrate again. The Cleansing breaths serve as punctuation marks for your experience. You greet each contraction with relaxation and a deep breath and then say goodbye to it at the end (since you will never see that one again!), releasing tension that may have crept in.
Relax completely for a few seconds after the final cleansing breath and feel throughout your entire body, releasing any tension which may have accumulated. Then turn to your partner and give each other feedback on what worked, what felt, what you need, and so forth.
ATTITUDE & BIRTHING ENERGY
When you are in labor and giving birth, you the laboring mother, are the channel for the Life Force, the energy of creation and transformation. As such, you will need to be completely open to the birth process. There is no right or wrong way to "behave" in labor. You can breathe or bellow, you can laugh, howl and growl like a wolf or sing, you can quietly meditate or you can get up and belly dance. When you are birthing, you do what feels right to you and what ever you need to do to maintain equilibrium at the same time that you surrender to the power of birth. It is similar to riding the surf in the ocean.
If you become like a huge sponge, soaking up all the energy from your partner, midwife and friends, things are likely to become slow and constipated. If you can put out energy, more can flow through you. A good example of working with the energy in a positive direction would be to hug and kiss with your partner, really giving to him and letting him share in the powerful energies coursing through you. By telling him how much you love him and how much you love your friends is the same as saying it to the baby and this can really help to open you up. Be positive in all that you say. If you are finding it difficult to stay on top of the situation (sometimes the old negative "junk" that still clutters our minds are trying to get your attention), make positive statements about what you are trying to do. Some examples might be: "I am opening up," or "I am relaxing more and more." If you are having difficulties or need something, ask your attendants for it. If you are having doubt or fear, verbalize it. Don't hold anything back, air it out and let it flow away from you. You may get the information or reassurance you need, or just stating it may help to get rid of it. Unconscious or repressed fears directly influence your body and your labor. Read the books listed above to help develop tools to working with the energy of birth in great detail.
INTERACTING WITH YOUR PARTNER
You and your partner form a single energy unit during your birth. If there is any negativity or lack of acceptance between you, try to get it worked out before the birth. Otherwise, you will end up having to do this during the labor, which is not what you really want on your minds at this time. You have enough to accomplish without the extra burden of negative energies between you and your partner. During your pregnancy and especially during your birth, you should nurture each other, be sensitive to each other's needs and be grateful for the other's attention and affection.
AFFIRMATION
Whether you call your partner your birth coach (this is not an athletic competition where a coach yells at his players) or birth support, his primary job will be to help and encourage you to deal with the process of your labor as best as you can. There is no right way or wrong way for you to have your labor and there is no ideal method in which you will be measured against. Each labor and each woman is different and should be handled as an individual with specific needs and desires. Your partner and other birth support members are much more helpful by giving praise to the laboring mother for doing a terrific job than it to criticize her. Your partner should tell you after a good strong contraction that you are doing fine. If you get tense during a contraction, your partner should verbally encourage you with touch to relax more while she has the next one. Your partner should be accepting, but he should not forget that he has a responsibility to actively help you with your relaxation and your labor.
COMMUNICATION
After a contraction the partner-birth support should see if the laboring mother likes what he did to help her through the contraction. During early labor there will usually be at least 5 minutes between contractions. This is plenty of time for discussion and for working together to greet each succeeding contraction with more relaxation than the last.
During active labor or transition, however, the laboring mother will need to conserve her strength and energy and may not feel like talking. So understand, that if she brushes the partner-birth support's hand away, its a way of saying that no longer feels good and is not a rejection of the of the support's efforts. Realized too that as labor progresses, what feels good or what is needed changes, and be as receptive to the birthing mother's needs as possible. Sometimes in transition, nothing feels good, and she may start giving you contradictory messages or not knowing what she wants. Recognize that this is one of the symptoms of transition. It does not reflect on the value of the partner-birth support's presence with her. Remind her that the strong contractions are opening her cervix so the baby can be born.
BEING HERE-AND-NOW
By keeping the laboring mother in the present moment, Whether the uterus is contracting or the body is at rest, the mother will be able to maintain her concentration. Anyone can bear 60 seconds of intense sensation. The labor support-partner will need to keep her focused on the present moment than on "how long it's been" or "how much longer it's going to be," the support will be helping her to accept and deal with what she's actually feeling. If she is losing her concentration, orient her to the objects in the room, point to something outside the window, have her look at the people who are there, ask her to describe what she is actually feeling. And then use direct, eye-to-eye contact during the following contractions.
NON-VERBAL COMMUNICATION
As the laboring mother's partner, he really should know her body and he can see where she is tensing. During pregnancy, practice relaxation sessions should be done frequently including touch-relaxation. This way it becomes automatic during labor. Strengthening non-verbal communications through touch-relaxation can help her body directly by encouraging tense areas to release tensions toward the partner's hand.
MASSAGE
Massage also helps. Some women do not like to be touched while in labor, and others want a continuous massage. It will be trial and error, what you find may help you and may not. Also, what may help you in one stage of labor, may not the next, as it gets more intense.
A light circular massage of the pregnant moms belly and upper legs often feels good during contractions and helps keep the legs from pulling in. Rub gently but definitely, using the entire hand, always keeping it in contact with the body to eliminate her uncertainty about where it's going to come down next. She can also lightly massage herself during contractions (called effleurage).
MoonDragon's Pregnancy Information: Effleurage
She may experience a lot of lower-back pain as the baby descends lower in the birth canal and presses against the sacrum. It can be even more intense if the back of the baby's head is pressing against her backbone. This is called back labor. You can help by using firm, strong continuous counter-pressure during a contraction on both sides of the spine in the area of the sacrum.Pushing up on the ischial tuberosities (the "sit-down" bones found on your lower buttocks) can also help. Use strong, continuous counter-pressure during the contraction.
Grasping the lower belly or the inner thigh sometimes feels good and helps her to release.
Nipple massage (stimulation) helps release oxytocin, which stimulates labor contractions. This is especially useful if labor contractions are insufficient during labor.
It is also used after the baby is born to help deliver the placenta. This is the reason why midwives in a homebirth will have the mother put the baby directly to the breast. During the next 6 weeks postpartum, while the baby is nursing, the mother will feel her uterus contracting. This allows the uterus to return to it's normal size quickly, controls any lochia/bleeding problems by keeping the uterine muscles contracted and in a tight "ball".
HAND REFLEXOLOGY IN LABOR
Women traditionally have been seen grasping bedposts, hands of attendants, and other objects during the intensities of labor. There are acupressure points on the hands that directly relate to the uterus. When these points are stimulated it facilitates smooth, rapid, and relatively painless functioning of the uterus. Some midwives recommend holding two strong combs in such a way as to press on these acupressure points of each hand, squeezing them tightly during contractions and relaxing between contractions. Women and midwives have stated that using this method have found their labors progressing rapidly and the women feel the combs helped them to relax. It is a suggestion to try, especially if a woman is having a sluggish labor and would like to speed it up.
REFLEXOLOGY FOR BABIES
WORKING WITH INTENSE CONTRACTIONS
As a labor partner, continue to encourage the laboring mom to breathe with slow breathing and stay with it. During the strongest contractions, help her keep on top of them by establishing eye to eye contact and breathing with her during the contractions, emphasizing the out-breath. If she loses her breathing rhythm or feels she can't go on, you may need to be very firm and directive, getting her complete attention and insisting that she breathe with you during the contraction. Continue to encourage her and let her know she is doing fine and the labor shouldn't be much longer. She will be much more comfortable if you actively work with her during these strongest contractions and keep her attention focused on the task at hand. Don't let her get lost in a contraction or labor. Establish in advance that you blow out together and then breathe in together with direct contact. If she happens to lose her rhythm during a contraction, have her breathe out with you and then breathe in and reestablish the rhythm with her. Have her verbalize during her breathing if she feels the need. Keep it a low-pitched tone, such as a deep groan, growl, or other noise. Do not let her scream or yell in a high-pitched tone, this tightens the very muscles that she is trying to relax. Keep it more like a low animal sound.
After the contraction, help her smooth her body out releasing tensions and breathe directly with her during the next contraction. Unless she is one of the women using a Lamaze method of rapid breathing that works for her, she should keep her breathing slow and deep.
Help her to relax, both verbally and through your touch and manner. Placing a hand on her lower belly early in labor, and making sure her breathing is moving all of these muscles will help prevent tension. If she is having back labor and is comfortable in bending over on pillows while on her knees, have your midwife or her assistants apply counter pressure and/or use Reiki energy working on this part of her anatomy while you continue to work with her directly face to face with focusing and breathing.
This will likely be the most important time for you, as her partner, to express your love for her in such a direct, unselfish and effective manner as during labor. Your care, direct attention, and love will provider her with the immense support that she needs.
POSITION CHANGES DURING LABOR
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Especially early on in labor, keep moving. Laying in bed can slow labor down, and can make you even more uncomfortable. Try different positions throughout your labor, one that might work in early labor, may not, in active labor and vice versa. Being vertical is the best position for labor in terms of the strength and frequency of contractions and how fast your cervix will dilate.
Studies have indicated that the effectiveness of contractions in dilation of the cervix is doubled in the upright standing position and women found this position much less uncomfortable and painful than lying on their backs.
Women in all cultures other than in the Western cultures use standing, kneeling, and squatting postures for labor and birthing. In rural Mexico, women hang a rope from the ceiling and hang onto it in a kneeling position, with buttocks resting on the heels.
So, the recommended positions for labor are walking during a contraction, leaning up against the wall or your labor support, "dancing" with your labor support (wrap your arms around their neck like slow dancing and when you get a contraction, hang on them), sitting in a rocking chair or a birthing ball and rocking, and getting on your hands and knees (rocking or not). While on the bed, put the head of the bed up and lean on it, leaning on the bed from the floor.
Another version of this is where your back is to your partner, and he loops his forearms under your arms and you hang when you get a contraction. This can be done with your partner and another birthing assistant where one gets on either side of you and supports you while you are having a contraction. A version of this method, you can try squatting during a contraction while being held on each side by your partner and another assistant. Squatting is your best aid for increasing contractions, speeding up progress or helping the baby down the birth canal. It can be a difficult position for those of us who don't squat while we work (unlike women in many other cultures), so you will usually need support from your partner, your friends or midwife, or her assistants. You can also hold onto a bed or the back of a chair, and then sit back between contractions. Birthing in a squatting position while being supported usually do not need perineal support since pressure is equally distributed all around the vaginal opening.
Sit or lie down when you are feeling tired or when you need to relax, but the more you are able to be vertical, the better your labor should progress. When you lie down, lie on your left side (the best for your circulation), or propped up in the contour position with lots of pillows.
Do not lie flat on your back (supine position). Except for being hanged by the feet, the supine position is the worst conceivable position for labor and birthing. It can cause compression of the maternal blood vessels supplying the uterus and result in maternal hypertension and fetal distress. It can also lead to a loss of gravity, less efficient uterine contractions, greater discomfort and longer labor. It decreases the ability of the pelvis to open and makes the birth canal narrower.
HomeBirth.org/UK: Optimal Foetal Positioning
Back Labor No More
OTHER ONLINE RESOURCES
Posterior Babies - What Mothers Can Do - from the UK's Association for Improvements in the Maternity Services (AIMS)
www.aims.org.uk/posterior.htm
Mother-Care: Posterior Babies/A> - Article on posterior babies, with photos of a pregnant mother's tummy when carrying a posterior baby, and tips on how to spot a posterior presentation.
Mother-Care: Posterior Presentation - A Pain in the Back! - Article by midwife Valerie el Halta on posterior babies and how to turn them anterior for faster, easier labors.
UK Midwife Archives: Birth Presentation - Page on presentation, from the Association of Radical Midwives.
GentleBirth.or: Midwife Archives - Positioning - The Midwife Archives on the gentlebirth.org website have an amazing collection of wisdom and experience on just about every subject related to pregnancy and birth. The pages on positioning start at with this page.
CefCares.org: Fetal Positions - Article on positioning and how to improve it, with good diagrams of baby in womb and pictures of exercises for the mom.
Suzanne Yates: Exercise for Relieving Backache - Suzanne runs Shiatsu courses for parents and professionals in Bristol, UK.
Shiatsu and Optimum Foetal Positioning - Originally published in 'Practising Midwife'.
The Farm: Positioning & Dystocia
Charity's Site: Read How She Got Through Her Long Homebirths
WATER DURING LABOR
Using water during labor for comfort measures and to help with discomfort and relaxation is wonderful. Warm water has shown to decrease the pain, and also take some of the weight/pressure off that the mother in labor feels. If you can't get in a tub of water, then you can get in the shower, and let the stream of water hit your lower back. This is especially useful if you are having back labor.
Some women rent a birthing pool for their birth and set it up in a room in their house. Others may try to use a large, deep "Kiddie pool" that you can buy during the summer. Be careful of potential water damage from either method and make sure you have a good water pump that will fill and empty the containers. Some birthing pools or tubs come complete with a water heater. Others do not and you will have to add more warm water as the water cools.
waterBirthInfo.com: All About Waterbirth and Waterbabies
waterBirth.org: Imformation About Birthing In Water
YourWaterBirth.com: Water Birth Pools, Assessories, Products
VISUALIZATIONS & GUIDED IMAGERY
Visualization can be a valuable tool in preparing for birth. Visualization of normal labor and birth can help your body and emotions to prepare in a way that bypasses the conscious brain. Visualizations are done in a state of relaxation and they can increase your confidence in your body's knowledge and ability to give birth (just as it knows how to grow your baby). They can be valuable tools for counteracting specific concerns from previous birth experiences, such as a cesarean birth for example. There are many CDs and cassette tapes available with guided visualizations and several of the books recommended here contain visualizations you may find helpful.
MoonDragon's Pregnancy Information: Relaxation Practice
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MoonDragon's Pregnancy Information: Preparation For Easy Labor
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MoonDragon's Pregnancy Information: Guided Imagery Labor
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MoonDragon's Pregnancy Information: Labor Pain Truth
MoonDragon's Pregnancy Information: Labor Prep
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MoonDragon's Pregnancy Information: Childbirth
MoonDragon's Pregnancy Information: Labor & Delivery Stages
MoonDragon's Pregnancy Information: Positive Birth Environment
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Some information & photos were obtained from Special Delivery by Rahima Baldwin.