Letting go for labour

The fear-tension-pain cycle – letting go for labour, ways to prepare your mind to release.

So you’re pregnant – congratulations! Now you’ve started to share the good news, we at the Daisy Foundation are willing to bet that you’ve started getting the horror stories – the failed inductions, the 3rd degree tears, the days long labour…right? In the words of Chandler Bing could that BE less helpful?

Think about your reaction when you got the last round of grim labour stories. You winced, you grimaced, you clenched your pelvic floor and tensed your knees together? Oh yes, that’s the good old fear factor – fight or flight – setting in. Fear makes your nervous system produce adrenaline, which increases your heart rate, makes your breathing shallower, blood diverts from your non-essential organs and your muscles tense. Perfectly understandable…but now think about where your baby’s going to come from. Uh huh. Your body being tense from your belly button to your knees isn’t going to help your baby on their way, is it? Your fear leads to tension, and tension leads to pain.

When adrenaline is produced in a labouring woman, it inhibits the production of two other hormones; oxytocin and endorphins. It’s these two hormones that are responsible for stimulating the contractions of the uterus, and for blocking the feelings of pain a woman feels. Without these present in sufficient quantities a woman’s labour will be longer, more stressful, and more painful than if we allow our bodies to limit the production of adrenaline.

So what if you were told that you can help prevent the pain of labour? Let’s start by looking at the fear aspect of the cycle. Fear of the unknown is a well-established phenomenon and it holds true in labour too. Just as each woman and each pregnancy is different, so too is each birth experience. For a first-time mum with no point of reference, the thought of pushing a baby out of a hole that small can be pretty terrifying. Reduce the unknown, however, and you can reduce the fear. And that’s where antenatal education comes in. A knowledgeable, informed woman is one who no longer fears the unknown. Now – no woman can plan their birth experience entirely, otherwise we’d all be having two-hour labours with no tearing or pooing (am I right?) but by becoming knowledgeable about the birth process, about the options available to you and about how you can influence the birth to be the best possible outcome on the day by playing the hand that’s dealt, then you can make it all a lot less scary. What’s more, by being so well prepared, this knowledge becomes innate and you won’t have to rouse yourself too much from your birth bubble to give consideration to anything that might need a decision from you. Coming out of that internally focussed zone allows adrenaline to creep up – not good for your oxytocin levels.

We’ve looked at how you can reduce your fear by preparing your cortex (your ‘thinking brain’, responsible for knowledge and decision making) ahead of the big day, but you can also prepare your limbic system (or ‘emotional brain’) to release fear. Now your limbic system is responsible for many things, one of which is your fight or flight reflex…yep, that again. And where knowledge and information can affect your cortex, we need a different language to speak to the emotional brain. Something that will help you exercise the part of the brain which switches on – and off – that adrenaline switch. This is where relaxations and visualisations come in. Using guided visualisations such as seeing each contraction as a wave building up in intensity, peaking and gently rippling away while in a state of pain-free relaxation can encourage your body to return to that state when anchoring itself to those visualisations in labour. Your breathing becomes easier and floods the body with oxygen, your muscles are relaxed and free of tension which makes each contraction more effective, you’re disassociated from feelings of pain which keeps oxytocin and endorphin levels high. Pretty impressive, right?

There’s another way to keep adrenaline, fear and tension out of the birthing room with you, and that’s the room itself. Imagine a stark white, brightly lit room that smells slightly of Dettol that hums with the electric lights. Now picture a dimly lit, warm room filled with your favourite scent and music. It’s unlikely you’re going to be feeling very comfortable in room number one. And if you’re not comfortable, if you don’t feel safe and secure, then your adrenaline will rise and your labour might stall. So really think about preparing your birth space to be a place where you can feel comfortable in. Many hospitals and birth centres are really accommodating at letting you take in goodies from home.

The most important thing to remind yourself in labour though? I trust my body to birth my baby. What we believe, our bodies can conceive!

Daisy x

(Contributed by one of our Cheshire Daisy teachers, Meg Hill)

Your emotional response might not be because of my post

Your emotional response might not be because of my post.

“We are committed to excellent education, unconditional support, informed choice…”

Excellent Education:
The commitment to excellent education means delivering the most up to date, science based FEDANT approved information that we have available.

Unconditional Support:
Means no judgement on any Daisy Teachers behalf about what you chose or why – ever.

Informed Choice:
Your choices, informed by your thoughts, feelings, emotions and knowledge. In the abridged words of January Harshe: I don’t care what birth you had, as long as you had choices.

Genuine Choice?
What makes us unique and wonderful is the fact that we are not all the same. How boring that would be?! Yet when it comes to pregnancy, birth and parenting it seems to be really hard to celebrate these differences.

Part of the reason for this difficulty is the sheer weight of emotion that goes with becoming a mother. We become tired, hormonal, perhaps anxious human beings looking after life at it’s most fragile and it is hard, very very hard to read about how CIO is “terrible” when we are on the very edge of sanity from exhaustion.

Are we really free to make genuine choices that are really our own? Is the mum who is unable to breastfeed because she has to return to work really making a choice? Is the the mum who uses sleep training really making a choice when she has no family around her to take the baby and allow her to rest? Is the mum who opts to use formula because she’s been told it will help her baby sleep really making a choice?

Your Emotional Response.
If you read an article or blog which does not fit with your life experience it may be that you can take it lightly, with a pinch of salt or just shrug it off as one of those things. You are quite happy with the choices you made, they are working for you, and that is great! Really great – I applaud the mums, dads and families amoung us who can allow themselves that degree of self love.
But for some of the reasons mentioned above you may feel a huge emotional response to articles which you read that don’t align with your personal experience or current emotional state. This is completely natural and normal – most likely everyone experiences emotions like this at some time or another. Reading words on the internet is also fraught with difficulty. Your own voice weighs in and you perhaps read accusation where warmth was intended.

Sometimes what we might actually be feeling is guilt or sorrow about our own past decisions and how it may or may not have affected our own children. We feel angry that we couldn’t have done it differently or that life and circumstance made it otherwise. We feel judged – but I wonder how much of that feeling of judgement comes from the words on the screen or our own critical inner voice, the sorrow, the feelings of personal failure, the internal struggle, the trauma experienced.

I have seen women lambast breastfeeding articles for ‘shaming’ women who can’t breastfeed because they themselves couldn’t. But reading on the actual reasons these women couldn’t breastfeed were astonishing – cancer survivors, auto-immune disease sufferers to say but a few. For these women this was never a choice, the choice was cruelly taken away. This is an extreme example to highlight the diffculty in unpicking the reasons that women and people feel upset, judged or angry about articles especially to do with pregnancy and parenting.

We have few spaces in modern society which allow a person space to fully experience their emotions without someone jumping in to share worse stories, offer a conciliatory ‘there there’ or roll out mantra’s such as ‘at least you have a healthy baby’.

Holding a space which is committed to excellent education but knowing that the sharing of such information may ellicit strong emotional responses in individuals is a tough balancing act and one that every Daisy teacher strives to achieve in person, online and with every mum and dad.

So if you recognise something in this blog or if you go on to read something which causes you pain and upset – that’s OK. You are allowed these feelings. But before you comment, before you berate yourself or the author or the person sharing – take a breath, count to three and figure out what it is you are upset about and be kind to yourself.

“I did then what I knew how to do. Now that I know better, I do better.” Maya Angelou

Daisy x

(Contributed by our Sheffield teacher Fi Hennessy)

Does instinct overrule evidence when it comes to birth?

How can you best prepare to navigate your birth experience? There are those that will follow their instincts and trust in what they think or know their bodies are capable of – which is great! There are others who will consume every last shred of evidence they can get their hands on and make decisions accordingly – also brilliant. So how can you marry the two options – trust in your instinct or follow the evidence?

In an ideal world, mums to be would be fully informed of the choices she could make during pregnancy and labour. The information would be presented in a non-biased and non-threatening way. (1) She could take the time to assess the different options and be listened to and respected for her choices even if they went against current medical advice. Of course this does happen for many women accessing maternity care however for some the experience may feel different. So what is going on?

What is ‘instinct’? Do we all have it? And why is evidence important if we have instinct?

“an innate, typically fixed pattern of behaviour in animals in response to certain stimuli.” (2)

“the way people or animals naturally react or behave, without having to think or learn about it “(3)

Women are built to birth because we have done since the dawn of time. Our limbic brains run on hormones which when undisturbed will run the dance of labour and birth in almost magestic normality. Women who birth undisturbed demonstrate instinctive behaviours without being told to – they breathe through their noses and mouths, they sway and move, they moan and crouch, they seek privacy and dark, they adopt comfortable positions to ease their labour and birth their baby’s – they instinctively hold and stare at their newborns and smile the smile of love. So yes, in some respects we all have an instinct to birth.

Modern Instinct?

We tell mums to ‘trust your instincts,’ ‘of course you’ll know what to do’, ‘trust your body’ but at the same time bombard her daily with messages of how she can’t trust her instincts or her body or her baby. Time and again mums say that they didn’t really believe they were pregnant and it was so reassuring to see the scan picture. And from that scan we get growth charts and EDD’s and progressions and expectations and neat box ticking exercises which gently erode mums confidence that her body and baby are built to work together. Society tells mums what to eat, what not to eat, how much alcohol to drink or not drink, vitamins to take, activities to avoid and those to take part in. Is it any wonder that mums own instinct becomes harder for her to hear?

Evidence

But sometimes it’s not as simple as just listening to your instinct, your instinct may tell you that a c’section is the right decision for you, that induction is ready for you – how do we balance the evidence we recieve about pregnancy and labour with our own instincts about what is right for us?

“the available body of facts or information indicating whether a belief or proposition is true or valid.” (4)

Untangling the evidence can be a mine field. But it’s always worth asking questions of the evidence presented whoever is presenting it. What does the absolute risk versus the relative risk (5) how does this fit with your personal comfort with that risk? What do your instincts say at every point of gathering new information?

“Risk is a very personal concept and different women will consider different risks to be significant to them. Everything we do in life involves risk. So when considering whether to do X or Y there is no ‘risk free’ option. All women can do is choose the option with the risks they are most willing to take. However, in order to make a decision women need adequate information about the risks involved in each option. If a health care provider fails to provide adequate information they could be faced with legal action.” (6)

Balancing Instinct and Evidence

So where does that leave you? The mum approaching her labour to meet her new baby, perhaps over whelmed by the amount of evidence, advice and stories being fired across your path. The first thing to do is take a step back and have a big breath of air! (7) You’ve got this, you really do (8)

Secondly, make a plan – you don’t have to leave your instincts and evidence to chance, understanding your options means you have options. (9) Book a class (10) understand what it means to give birth and have a think about your options, where to give birth, how to manage your birth preferences, get your birth partner prepared. Balance your personal level of comfort with risk give your circumstance – don’t just go with the flow, after all you never know who’s flow you might end up going with.

Take the time NOW, this side of labour to consider the evidence and then when you and your baby are ready listen to and trust your instincts which will be the perfect balance of mind, body and soul for your labour, to meet your baby.

Lots of Love,
Daisy x

External Links.

  1. http://www.birthrights.org.uk/library/factsheets/Consenting-to-Treatment.pdf
  2. https://www.google.co.uk/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=instinct
  3. http://dictionary.cambridge.org/dictionary/english/instinct
  4. https://www.google.co.uk/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=evidence
  5. http://patient.info/health/absolute-risk-and-relative-risk
  6. https://midwifethinking.com/2016/07/13/induction-of-labour-balancing-risks/
  7. https://thedaisyfoundation.com/breathe
  8. https://www.facebook.com/groups/MamaYouveGotThis/
  9. http://www.telegraph.co.uk/women/health/forget-mother-nature-pregnant-women-can-control-how-they-give-bi/
  10. https://thedaisyfoundation.com/find-a-class/

Written for Daisy By Fi Hennessy, our Sheffield teacher.