Pushing

The decidedly female act of pushing a baby out of her body and into the world may be the most amazing instance of female power that exists.

Pushing, also know as second stage is the part of the birth where the baby is pushed out of the mothers body. Well, you probably already knew that but, it is an interesting topic on many levels. Many women enjoy this part of the birth because now, instead of relaxing through a possibly painful contraction they get to work with their uterus as they together try to expel the baby. It can be painful or painless. It is often hard work for the mother. Women often hold their breath and bear down. It can be a noisy time too. The sounds emerging can be very primal, some even call it a roar as a mother does what seems to be impossible to bring her baby into the world.

Motherhood

How does pushing relate to being a mother? There are many lessons inherent in pushing. It is hard work with a tremendous reward. Learning to do this will give a mom a belief in her ability to mother and overcome physical challenges. I had never been athletic in any way before having children. After the birth of my first child, in which I pushed for 4 hours, I felt more physically capable than I had ever before. I ran my first 5k a few months later and it was difficult but I knew I could do it because, it was way shorter and easier than childbirth. It gave me a tremendous confidence in myself that I never had before, that I didn't even know was there.

What are we so afraid of?

When you look at the recent history of birth in America it is striking that this is the part of labor that often women have taken away from them.

(For a brief history and books with more check out: http://www.naturalchildbirth.org/natural/resources/history/history01.htm )

During the days of twilight sleep women were often totally unconscious for this part of their birth. A large surgical opening was made between the vagina and the rectum (called an episiotomy) and the baby was pulled out with forceps by a male physician. When I first started learning about birth I assumed this model of care was far, far outdated. But, if you start talking to women, even our mothers, women in their 60's and even 50's, this is how they gave birth. I remember talking to a coworker while pregnant. The last thing she remembered about the birth of her first son was telling the doctor that she didn't want them to give her anything to make her baby sleepy. She woke up hours later and a baby she did not even remember giving birth to was brought to her. The days when women were delivered this way are not that far past.

Today, women are almost always conscious during the birth of their babies, but we are missing out on pushing for a different reason: the rising c-section. http://www.childbirthconnection.org/article.asp?ck=10285 There are varied reasons for the cesarean section, many of them valid. But I think we can agree that a rate around 31% is ridiculous. There are numerous risks to the c-section that I won't get into here. What I want to talk about is why this is happening and what it does to women on an emotional level.

Power

A trained natural birth mother, comfortable in her abilities and her body is often quiet or peacefully moaning during labor. She may lose control briefly and scream or get louder, but labor in general is an incredibly peaceful event. A well supported women will be surrounded by loved ones and care providers who respect her in this miracle. This may change when she starts to push. Pushing requires great physical exertion and with it are often physical noises. Have you ever watched an athlete of any sort? They use their breath and their body to make noises to increase their physical power. Laboring women often do this too -purely based on instinct. A natural birth mom roars her baby into the world. This moment is magnificent and it is powerful. And- it scares the hell out of a lot of people, including women themselves.

I want to make clear that when a woman pushes her baby out, of her own free will and under her own power she is demonstrating the great power of femininity in a glorious way. She is noisy and she is amazing. She is literally pushing a 6 to 10 pound baby out of a very small part of her body. I don't care what male sport you can think of, there is nothing that even compares to this. There is inherent power in the pushing and birth of a baby.

This is why, I believe, this part of birth is so often silenced and taken away from women. An unconscious woman does not birth her own baby. It is surgically removed from her vagina by a male 'expert' in delivery. She doesn't help at all. Her power is gone. Fast forward to today, a woman who has her baby cut from her lower abdomen is not an active participant in the birth of her baby. She is having the help of a trained surgical team. If this procedure is unnecessary or coerced then she has lost her power. We instead have a silent woman with a surgically removed baby. Who has the power in this relationship? The obstetrician, not the woman. This is why a woman who feels like her c-section was unnecessary is often so dissatisfied with the experience. A mother medicated with an epidural or something similar is also often quiet during her pushing stage. She must be instructed on how to push her baby out if she can not feel to do it herself. She must be told when and how long to push by "experts" who are closely watching a fetal monitor. This whole process is backwards. An unmedicated mother does not wait to be told when to push. She knows! She tells other people when it is time. If she is in a supportive environment, people are paying attention to her, not a beeping machine attached to her. She moves how her body tells her, not how the obstetric surgeon instructs her. If she is in tune with her body she positions herself in a way that is ideal for her and the baby, but possibly inconvenient for the person catching.
I had an OB nurse tell me that many of the mothers delivering at her hospital were so medicated that they would stop pushing when instructed, even with the babies head sitting right on the perineum. They would wait until the doctor entered the room, even for 10 or more minutes. They could feel nothing! This is ridiculous! The woman should be pushing when she wants and when she feels is convenient.

To Close-

I have to admit that pushing scares me too. It was the part of my second birth that I feared the most. It is the time that I lost control and my body took over. It is also a beautiful and powerful time for a woman. It is often noisy and intimidating for all who witness it. We fear female power in this country. If women become powerful we expect them to do so in the way that a man does, by making money or obtaining high office. We never embrace the ways that women are powerful on their terms. It is grudgingly OK if women go about getting power in the male approved avenues. But we seem to think that it is too disruptive and loud if a woman shows her power in a female way that can never be duplicated by man. This is the reason we silence women in the moment and the height of their glorious and howling power. This is also the reason we must stop this practice and embrace what we as women can only do.

Orgasmic Birth

Just wanted to put this out there, I got this from another source, it is about a birth move being covered on 20/20 this week:
Here is the website for the movie if you are intrested in buying it. It is very good and has lots of good births in it in a few diffrent settings.
http://orgasmicbirth.com/

20/20 Features Orgasmic Birth
watch it this Friday!
Be sure to watch (or TiVo) 20/20 this Friday, December 12! Why? Because FINALLY an A-list media outlet in the United States is covering the "best-kept secret" - orgasmic birth. The link between childbirth and pleasure is crucial for women today to know as they make informed birth choices. Debra Pascali-Bonaro' s powerful film, Orgasmic Birth, will be featured in the segment. (Yay, Debra! Many BOLD locations this year brought their community her ground-breaking film.). BOLD's 2007 organizer in Memphis, Tennessee, Kimberly Baker will be one of the stories in the segment! Kimberly not only produced the play, Birth, she also played the character Jillian..who has an orgasmic birth experience when giving birth to her forth child at the end of the play. BOLD is mentioned in the 20/20 online piece...and who knows...maybe we'll be mentioned in the television segment!

The Natural Alignment Plateau

As I discuss the benefits of labor and birth on the making of a mother I can not overlook something that is often missed or misdiagnosed. Within the Bradley Method it is called the Natural Alignment Plateau (credit to Marjie Hathaway). It is the time sometime during labor when there is a 'stall' in cervical dilation. Sometimes this occurs just before transition, but can happen at any time when it looks like nothing is happening! It is often misdiagnosed as the all too commonly heard "failure to progress" or "CPD" (big baby, small mama). What it actually is nobody really knows, but any woman who has cervical dilation checked frequently during labor may be familiar with it, if not by name.
According to textbooks, a woman should dilate in a specific way, usually so many centimeters per hour after she has reached active labor. If you are getting frequent cervical exams (another subject altogether) you may hear something like this:
3:00am = 5cm; 4:00am = 6cm; 5:00am = 6cm; 6:00am, still 6 cm; 7:00am =6cm (You must be broken!)
Around this time, if not earlier you may hear murmurs that you need a "little something to get things going" because "your body just needs a little help, you look tired honey, no reason to drag this out all day". This can be emotionally and mentally discouraging since this entire time you are laboring right along with no apparent progress, despite your hard work and even pain.
However, a woman left alone is often very different from a textbook left alone and is quite capable of rapidly dilating around 7:15 and having a baby in her arms by 7:30am.
This apparent break in progress that is easily measurable by a cervical check is what we refer to as the natural alignment plateau. It is a time in labor where it looks like things aren't happening (though it certainly feels like they are). It is easy to think that maybe this woman's body just doesn't work right when in fact, it simply works in it's own way and speed.
What is going on at this time? Let us assume that work is certainly underway- what is it? If you are not dilating your body could certainly be preparing for your baby in many other ways. Maybe the baby is rotating to a more convenient position so that it can edge its way out of that birth canal. Maybe your breasts are preparing to produce colostrum. Maybe the mother herself needs a few more hours to be pregnant and prepare emotionally for the birth of her child. Maybe she needs time to let go of the pregnant time (which some women really do love and miss) and prepare for the new journey into motherhood. Maybe mom needs a few more hours with just her husband before they become a family. There are many reasons why a woman would appear to "not progress" when she is in fact progressing in many ways- they just are not easy to measure or see.
Mothering-
If you are already a mother you can probably see how this stage in labor prepares you for your birth as a mother. We all love being mothers but it is without a doubt a job with difficulties. A mother who stays home with her children may find herself to be socially isolated, pausing her education or career, delaying vacations or other things for herself, and so on. We give things up to be a mother. Sometimes the things we give up make it look, from an outsiders view, like we are failing to progress.
I would contend that mothers do in fact progress as people and human beings, something Betty Friedan thought was a basic human need. However, when your day begins swirling a cloth diaper in the toilet, and ends... well, swirling a cloth diaper in the toilet, it is easy to feel like not much is happening. Besides of course, lots of cooking, cleaning, shopping, bathing, and basically jobs that even if you do them all day and go to bed exhausted, they are not actually over!
What do we learn from this journey as a mother? I think we all get to make our choice about that. It is easy some days to feel miserable and buy into the idea that if you are not producing something easily measurable (money in real life as opposed to dilation in labor) you just are not really doing much. But- we as women must recognize the value of our work, that though never finished, rarely appreciated, and often, simply unnoticed, it is indeed valuable.
It is important for us also to continue to progress as we mother, even if we are the stay at home variety. Education does not have to stop because we don't have time for a formal education. Nor does service, learning, personal skills or many other things. We are probably, just by the nature of our jobs as mothers, developing some pretty key life virtues. Namely, patience, unconditional love, charity, humility, and sacrifice.
Yes, the mother in our world is often seen as somebody who doesn't progress if she does not go along with the commonly accepted measurements, but she can certainly progress in ways unseen and unmeasurable. I feel incapable of preaching on this subject because I often feel like I am not progressing as a person as I mother my children every day. Despite my own failings in this area, I know that women need to find joy and value in this time of life. It is a gift given to focus on the things we need to improve that are necessary not for monetary benefit, but for spiritual and emotional benefit. Just as in labor, we must trust that our bodies are working, that we are capable, and that just because what we are doing is invisible, it is still work and it is still important. We must also forget about what 'experts' seem to think matters, and listen to our instincts about what we need to be doing at this time in our lives.
I certainly do not mean this as a sappy glorification of motherhood. I do not want to patronize anybody. But these lessons must be learned by all of us. It is amazing to me that our bodies try to teach us this lesson before we even have that baby in our arms.
Fight the Power!

Hard Labor and Transition- Letting Go

To Begin-
I got to be a small part of a home birth yesterday. There is a reason why I am so passionate about this subject. I know of nothing else that can move you in such a profound, transforming way. For so many you mention birth and the words that spring to mind are pain, suffering, epidural, surgery, necessary evil,etc. But what birth often is and what it is capable of being are two very different things. The power of it is amazing. To be a part of it makes me laugh and cry and just be so glad to be alive. Birth is beautiful, divine and splendid. I know of nothing else that brings us so close to the veil that separates life and death and at the same time is positively euphoric. Birth makes me grateful to be a woman so that I can experience something that rocks me to the depths of my soul. I wish I could put into words the wonder of untouched, natural birth. I stand in awe of women who let go of themselves and their fears and their pains so that they can be a part of this process.
Hard Labor-
I am working through in this blog my thoughts on the emotional purpose of labor. It is something that I have thought about so much and I hope as I put it into words it makes sense. I started with Early Labor and today we are moving on to hard labor and it's purpose.
Early, easier labor is softer and slower with longer breaks to give mama a chance to tie up loose ends and prepare for the baby physically.
As we get into hard labor we are no longer worried about the laundry or dinner. The woman in hard labor often closes her eyes during contractions. She may keep them closed even in between. She sometimes can not talk between her contractions and may not even want to be touched. She is often quiet and still. The waves come closer and stronger together till you start to care little about what you are wearing (if anything) and what you look like.
I heard a natural birth mama say once that you meet a part of yourself you didn't know was there in labor. This describes the process so perfectly. A woman in hard labor is meeting herself. She is finding her strengths and her weaknesses. As she closes her eyes, she turns into herself. This is the time that she must face any demons that she may have and let them go.

A natural birth mother is often surrounded by loved ones. Sometimes a husband who has trained with her for this event. Maybe she has hired a doula to help her emotionally and physically. She may have a midwife who stands as quiet support and guardian of the event. She may be surrounded by family members and children. No many how many or how few people are there she must, on a very primal level, deal with it on her own. Nobody else can take the difficulty away from her. It is a burden that she must carry herself.
This may sound like no fun! Why bother with this whole process which can certainly be painful and long? When we remove a woman's pain, we also stop her from making an amazing self discovery which is hard to find- and it is specifically designed for woman. The discovery is this: she is capable of ANYTHING. When we numb her we take away the epiphany of birth and the lesson that she must learn to mother- it may be hard and even seem unbearable- but you can do it- and it will be worth it.
Transition-
Hard labor often leads to transition. The time just before pushing when rapid dilation occurs and contractions are right on top of each other. Not all women experience this- maybe one third have a difficult transition from labor to pushing. Those who experience it will never forget it.
When I took a childbirth class before the birth of my first child, transition was the thing that I was most afraid of. Why do women fear this? It sounds crazy for one thing and you hear stories of women doing what could be called nothing less than freaking out. Ask a group of women how many of them want to lose total control of themselves emotionally, physically and mentally and see if anybody raises their hand. This is a prospect that simply scares women to death. We don't want to "lose it". One of the beauties of birth is that sometimes it makes us do just that.
I can honestly say that with the birth of my first child I experienced no noticeable transition. I never yelled at anybody in rage. I did not freak out or "lose my cool". I was kind of proud of myself. I did it and I kept it together. I wouldn't even describe it as painful. It was hard but doable.
But not so with my second. As it came time to push I was in agony. I can honestly say that I have never been in so much pain ever in my life. Honestly, I don't remember exactly what I said or did (labor la la land as it is sometimes called) but it certainly felt like death was a possibility. I freaked out. I yelled. Everybody around me was quietly encouraging while I shouted back that I could in fact I could NOT DO THIS. This baby was never coming out.
Midwife- "Touch the babies head- it's right there, you baby will be here soon"
My head- "That is not my babies head! You are LYING TO ME!"
Midwife- "You are doing a great job"
My head- "Why isn't anybody helping me!!!!"
Midwife- "Here she comes"
My head- "I CAN"T DO THIS! WHAT WAS I THINKING!!!"

Like many others before me I experienced the exquisite self-doubt, pain and basic craziness that sometimes occurs just before a baby is born. And then - as quickly as it had started, it was over. An amazing baby in my arms... (I will talk about this later- the climax).

The Point-
What is the purpose of this overwhelming part of labor? I know that some believe that labor is painless if done right or that it is not supposed to hurt and only does if you fear. I don't know if this is true or not. I do know this: sometimes it is painful - and when it is, it has a purpose. Sometimes that pain is telling you to get up and MOVE. Swing your hips, walk, shower, whatever- it (the pain) is telling you to move so you can move that baby down. (Check out this link with pictures of positions and the purpose of movment in labor http://www.transitiontoparenthood.com/ttp/parented/pain/positions.htm )
There is another purpose though that is hard to quantify or describe. Losing control and letting go of our decency, our inhibitions, our good manners, everything we have learned about swearing, and our modesty, is an important path to motherhood for some women. Maybe we don't all need to learn this, surely some women already recognize that they have no control over their lives. But- many of us need this lesson. We will not always be able to control everything. Sometimes our lives spin out of control. Sometimes we need to let go and just let life happen. This is probably why when we lose it in labor- the real work gets done and things really move fast and happen. For labor to work you (the mother) sometimes just has to get out of the way and let it wash over you, even when it pounds you into the ground. You let it. This is when you learn something about yourself.
I wish I could actually describe what this means. I don't know if there is a phrase in the English language that describes this for women. It separates the men from the boys? Doesn't quite fit. Somehow this creates a great sisterhood of women around the world, across cultures and borders. We fought a battle, and in order to win, we had to stop fighting alltogether and just let it take us down. (Again, only male gendered war phrases seem to apply). Never the less, the scary, crazy part of labor has many beautiful lessons for the birth of a mother. When I say that I wish more women could experience this, I mean it. Do I want them to suffer? Of course not! I just wish we could all go on this journey and experience it as I know we are supposed to. Birth should be drunk deeply, felt in our bones, and it should make us howl with joy and pain. It should take us to another level physically, emotionally and spiritually.
Ladies- embrace it. This is a gift given us- Let us not miss out on it so that we can be more comfortable or so that we save face with those around us and stay in control. Open up and let it move you. You deserve the beauty that it can bring into your life and your being.

Early Labor and Induction

I want to start this blog by talking about the various stages of pregnancy and labor and discussing how they teach us as women how to be better mothers.

Most labors begin a little easy. Dr Bradley described labor as a hike up a mountain with early labor being the foothills or the putsy-putsy stage. Early labor is usually slow, contractions spaced out and relatively short. You may be able to talk through them. Many women are excited at this point. Your body is telling you it is time! Soon you will be holding the sweet thing you have been incubating and preparing for for nine months. Labor at this point is not necessarily hard so mom is not working too hard. Early labor may start or stop and it can be confusing. Is this really it? It can be difficult to tell, and sometimes we pay attention too soon and wear ourselves out.


What does early labor teach us about motherhood and why is it a necessary part of having a baby?
Because early labor can stop and start, come and go and just basically confuse us, it teaches an important lesson of motherhood- patience and adaptation. Any mother knows that patience is something that we need more of! Patience with our kids and ourselves and our husbands. It is hard to be calm and loving for a minimum of twelve hours a day (if they sleep all night!). It is hard to be kind and loving when we don't feel well and there are lots of little people yanking on our actually clean clothes and screaming for something while we struggle to prepare dinner. Patience is also something that you don't necessarily have to have a lot of when you are childless. You can do things on your own time and schedule. You can plan something and it actually happens at the appointed time! Amazing isn't it! I should have appreciated that when I had the opportunity.


Early labor, though not too difficult physically helps us understand that our life is no longer our own. We now exist to spend much of our day serving others who may not realize what we are doing. It is exciting as is motherhood, but it is not necessarily something we can control or make shorter. It starts when it is ready and stops when it wants. It is our first lesson in adapting to a situation that we do not have total control over.

INDUCTION

One of the saddest things about the induction epidemic in this country (remember my post from yesterday, there are actually hospitals with 95% induction rates) goes much deeper than just the risks of induction (which are many). From a spiritual or emotional perspective, picking your due date and time robs a woman of one of the first lessons of motherhood- we can't control everything! And- we probably are not supposed to. When we pick a day to have a baby we are picking what works best for us and our schedule. It may not at all be what works best for that baby. The baby in fact may not be quite ready to breathe. It may just not be low enough for a vaginal birth. It may need some more time inside for a hundred little things that science can not even yet measure. We are not thinking about the baby - we are thinking about ourselves.

(This is not a totally scientific observation- but when I asked these nurses why people were induced the biggest reason was not medical need- though you could certainly come up with one to put on a chart if you had too- No, the biggest reason was convenience for either the doctor or the mother or both.)
So when we induce labor at an arbitrary date and time we miss one of the great surprises of life- when will that baby come?!

We miss the lesson of patience. We continue to believe that we can and possibly should be able to control what happens to us and those around us. We encourage the idea that we or 'experts' know best, not the body or our instinct. We miss a chance to learn flexibility and letting go. What is more, we miss the emotional preparation that early labor gives the mother. Early labor tells you- something is happening, your baby is coming, we don't know when or how, but start preparing.
I hope that women everywhere can embrace this chance to let go of our desire to control and plan and just let labor happen and learn from it what it is trying to teach. Labor's lessons are many and they are profound. They will prepare us for the magnificent journey ahead that is motherhood.
(For additional info on the risks of induction see: http://hencigoer.com/articles/elective_induction/ )

Why Mama Birth-

A few months ago while training to teach natural childbirth, I interviewed nurses at local hospitals in Texas about their maternity wards and some of their birth practices. What I found was disturbing but not uncommon. Both had induction rates of close to 100%. Both had cesarean section rates near 50%. Both had epidural rates close to 100%. Both were surprised when a woman actually came in in labor! To any sane person this must be shocking. You could logically assume that the high induction rate might have something to do with the high c-section rate. And yet- people do not seem disturbed by this trend.
http://pregnancychildbirth.suite101.com/article.cfm/reason_for_cesarean_rate_increase
Fewer and fewer American women are actually experiencing birth in an untouched way. Fewer are even going into labor when the baby or their body (or both) begin the process. If the nurses I interviewed are correct, about 95% of these women are never even feeling a natural normal labor contraction not induced by intravenous pitocin.
These statistics are disturbing to me in many ways. I am an advocate for natural birth. Why go natural? Many studies point to the dangers of c-section, medication, induction, etc for the mother and baby. Talking to women, the dangers are probably more often experienced than they are actually recorded. But this is not the reason I am most upset by this disturbing trend.
What is most disturbing is that women are missing out on the experience of birth! What- I know, I am starting to sound crazy... Why would anybody want to experience something that everybody knows is painful? You know the classic argument, would you have a cavity drilled on without medication just so you could experience it? What use is that kind of experience?
I believe deeply, in my core that childbirth and everything that goes along with it serves a purpose.
WE ARE SUPPOSED TO EXPERIENCE CHILDBIRTH FULLY! This issue is about more than things that can be proven. It runs deeper than statistics, scars, fear, or anything that can be measured. What has happened to childbirth in this country is hurting women and their babies in ways that we have yet to understand or even contemplate. I want to explore the unquantifiable reasons to birth our babies without wires and machines and disruption and drugs.
For the next few days I want to talk about about how birth and the experience of it helps prepare us for motherhood. That is why I have titled this mama birth- because the birth experience does not just bring forth a baby- it births a mother.