Author: Cathy Daub, PT CD, CCE (BWI)

What would your life be like if you knew only day but not night.
Or what if you only knew hot, and not cold? Or what if you
knew only sadness, and not happiness. What if there were only male and not female? Being
born into the world means being born into duality. Duality simply means that our
understanding of one word is determined to a large extent by its opposite. An interesting
duality is pain vs pleasure. We wouldn’t know pleasure without pain. Pain and pleasure are flip
sides of the same coin. To know one, is to know the other. This is a life principle.

Being fearful of labor pain results in many women numbing themselves to the
experience of birth. They are so fearful that they don’t even want to use the word
“contraction” preferring “surges” or “waves.” But the uterus is one amazing muscle whose
power can bring us closer to who we really are. The uterus is a magnificent muscle that knows
how to expand from the size of a fist, to encompass a full grown baby. It has two layers of
muscle fibers, the vertical outer layer and the horizontal inner layer. During contractions, the
upper layer of fibers of the uterus contract becoming a little shorter and thicker with each
contraction so that by the end of the first stage of labor, they are bunched up at the top of the
uterus and ready to push the baby out. The lower, thinner fibers of the inside layer draw up
and back, thinning and dilating the cervix. During labor, the power felt by a woman is greater
than she can imagine and can take her by surprise. She realizes she is much more than she
thinks she is. Nature has orchestrated this coordinated effort to birth a baby so well that we
can trust this innate wisdom with which all women are born.

As BirthWorks doula student Tara Thompson from VA wrote, “It’s common for us as birth
workers to not emphasize the fact that childbirth is often painful and difficult work. Reframing
the words we choose to describe it and being sensitive to not embellishing the hard aspects of

birth is common, and for good reason because focusing on a perceived negative is not always
helpful.
With that being said, I think women appreciate honesty and acknowledging that it will
be hard work and will be uncomfortable and painful at times. However, this is a GOOD thing
(and what makes our jobs as doulas important)! We need strong and intense contractions to
bring a baby down. We cannot have pleasure without pain.”

There is a saying that “Pain is the interval between two pleasures.” In conception, the pleasure
of intercourse/orgasm is followed by pregnancy and the hard work of labor, but then the new
mother looks into her baby’s eyes and is transformed for she has now become a mother.

Thompson goes on to acknowledge this principle of life by saying, “There is often a break
between contractions. Between conception and birth, there will be labor. Many aspects of life
have this pattern of pain between pleasure. To be able to enjoy the pleasures of life, there
needs to be the hard work (pain).”

Yes, having a baby is hard work but the baby is also a miracle. In fact, a woman who chooses to
feel her labor, experiences a power within she didn’t know was there and leads her to say at the
end, “If I can do this, I can do anything!” This is empowerment – supreme pleasure and
satisfaction. Understanding the role that duality plays in our lives, is what helps us to move
forward in life, becoming stronger and more confident human beings.

And during this holiday season, we can give thanks to the universe for the gift of love that has
been given to all human beings, but especially to women in birth who feel the work of labor,
regardless of birthing vaginally or by cesarean. Birth is love and love is the gift.

Our Birth Doula training is very comprehensive and includes not only Optimal Pelvic Positioning and “The Four Principles,” but also ways in which to enhance character development.  One of the ways we do this is by having our students complete the BirthWorks Doula Journal Workbook in which one of the exercises is to write responses to insightful quotations.  Here is an inspiring one we would like to share with you that is pertinent not only to doula work but to life itself.

 Quotation:

“The more we become ourselves, the more we change”. – Carl Rogers

This quotation speaks of accepting fully who we are.  In a society that tells us how to act, think, look and feel this can be incredibly difficult.  Many seemingly subtle experiences create a culture of how and who we should think, feel and be – a parent reassuring a child that, “That didn’t hurt” when they fell off their bike (it might not have hurt the parent but the child sure is hurt).  An Aunt insisting, “Come on and give me a hug, you’re not shy” – though the child is feeling shy in that moment. Teenagers are told who they should “like”; until recently this person must have been a member of the opposite sex.  If someone likes long floral skirts they may be seen as old fashioned, or hippy – everyone seems to have forgotten that floral skirts have gone in and out of fashion many times over the years.  As adults society has all sorts of messages – you should own your own home; you may only have one sexual partner – a dog and two kids is a complete family unit; you should be saving for retirement etc etc.

 

In this barrage of repression many people find it hard to find themselves.  It takes a lot of work to dig through perceived ideas and false personalities to find their true self.  It may even take decades of work through therapy, meditation, restorative practice and life crises.  It’s worth the journey though  for once we have found this true self we have found real freedom and real liberation.  Unshackled we are able to live in movement, flowing with the tide of life, able to shift and change with our current situation or environment.  We are free to live completely in the “Now” because we understand that we are merely consciousness flowing through a series of present moments.

 

Such acceptance is of huge benefit to us in our practice of being a doula as it allows one to be flexible and resilient.  It let’s us accept that other people are complete individuals and we are able to differentiate ourselves from them (differentiation being the ability to hold on to ourselves, our values and our opinions while accepting that there is room for more than one valid opinion and remaining connected whilst dealing with the anxiety that comes from these differences in opinion). We realize that though we may be doing things we may not be comfortable with for our own selves, it may be the best way to meet the birthing mother’s needs at that time.  It allows us to lend ourselves to our clients though they may not always heed our advice and may make decisions that we personally would not make.  It allows us to be gentle and compassionate in all our dealings with our birthing couple and with the entire birthing team.

Our Birth Doula training is very comprehensive and includes not only Optimal Pelvic
Positioning and “The Four Principles,” but also ways in which to enhance character
development. One of the ways we do this is by having our students complete the
BirthWorks Doula Journal Workbook in which one of the exercises is to write responses
to insightful quotations. Here is an inspiring one we would like to share with you that is
pertinent not only to doula work but to life itself.

Quotation:
“The more we become ourselves, the more we change”. – Carl Rogers

This quotation speaks of accepting fully who we are. In a society that tells us how to
act, think, look and feel this can be incredibly difficult. Many seemingly subtle
experiences create a culture of how and who we should think, feel and be – a parent
reassuring a child that, “That didn’t hurt” when they fell off their bike (it might not have
hurt the parent but the child sure is hurt). An Aunt insisting, “Come on and give me a
hug, you’re not shy” – though the child is feeling shy in that moment. Teenagers are told
who they should “like”; until recently this person must have been a member of the
opposite sex. If someone likes long floral skirts they may be seen as old fashioned, or
hippy – everyone seems to have forgotten that floral skirts have gone in and out of
fashion many times over the years. As adults society has all sorts of messages – you
should own your own home; you may only have one sexual partner – a dog and two kids
is a complete family unit; you should be saving for retirement etc etc.

In this barrage of repression many people find it hard to find themselves. It takes a lot
of work to dig through perceived ideas and false personalities to find their true self. It
may even take decades of work through therapy, meditation, restorative practice and life
crises. It’s worth the journey though for once we have found this true self we have
found real freedom and real liberation. Unshackled we are able to live in movement,
flowing with the tide of life, able to shift and change with our current situation or environment. We are free to live completely in the “Now” because we understand that
we are merely consciousness flowing through a series of present moments.

Such acceptance is of huge benefit to us in our practice of being a doula as it allows
one to be flexible and resilient. It let’s us accept that other people are complete
individuals and we are able to differentiate ourselves from them (differentiation being the
ability to hold on to ourselves, our values and our opinions while accepting that there is
room for more than one valid opinion and remaining connected whilst dealing with the
anxiety that comes from these differences in opinion). We realize that though we may
be doing things we may not be comfortable with for our own selves, it may be the best
way to meet the birthing mother’s needs at that time. It allows us to lend ourselves to
our clients though they may not always heed our advice and may make decisions that
we personally would not make. It allows us to be gentle and compassionate in all our
dealings with our birthing couple and with the entire birthing team.

 

She labored in the water, feeling her body becoming lighter as her abdomen tightened in another contraction.  Her partner looked at her saying, “Are you okay?” with a thumbs up to encourage her.  She smiled back at him looking relaxed in the water.  But inside she felt huge.  Her mind was whirling as she felt the power connecting her to all the women who have given birth before her. She was not alone. This power was sustaining her through strong, hard, contractions.  She thought to herself, “If they could do it, so can I.”

Birth is sacred.  What can be more sacred than the formless taking form through the human body.  This is something we may often forget, getting preoccupied with all the other concerns in birth.  For those attending births, the process may become routine and lose the wonder and awe of what has just happened.

Experience of the Body – Birth is an integrated experience of the mind, body, and spirit.  We know it is an experience of the body because we can see the body, feel the body, and hear the body.  We see the abdomen growing a woman as her fetus approaches full gestation.  A pregnant woman can feel her baby kicking inside.  These are tangible  experiences.

Experience of the mind – Birth is an experience of the mind, and even though we can’t see the mind, we believe it exists because of all the thoughts and emotions that surface during pregnancy, labor, and birth.

Experience of the spirit – When it comes to the spirit, there is more ambiguity because the spirit means different things to different people.  But the energy driving the passage of a soul taking birth must come from somewhere, and this remains one of the mysteries of life.

I believe love and spirit are synonymous with each other and that they cannot be separated.  Love is in spirit and spirit is in love.  From the time of conception to the end of our lives, the body serves as an instrument of the spirit.  The more the body can be viewed as a vehicle through which the spirit works, the more smooth the process of birth is likely to be.  At birth, a part of the body has now become separate from it and a baby is born with his own personality, inclinations, and tendencies.  This process can be likened to a flower.  The flower can be viewed as a vehicle for the fragrance so that it can be expressed.  This fragrance brings us joy.  In the same way, the body can be seen as a vehicle for the spirit bringing joy.  The sweet fragrance could not be enjoyed if it weren’t for the flower.  The spirit could not be enjoyed if it weren’t for the existence of the body.  Just as fragrance is in the flower, so the spirit is in the body.  Both the flower and the body are material and can be seen.  Both the fragrance and the spirit are nonmaterial and cannot be seen.

When a woman in labor views her body as a “vehicle” through which the spirit can flow, she is more likely to surrender to the forces of labor, welcoming contractions as they become stronger and more intense.  She feels more confident and has less fear.  She is more in touch with her instinctive nature and follows its guidance.  Focusing on the awe and wonder in the power of such birth-forces can bring a woman inner strength that will serve her well as she progresses into the unknown of labor.

 

“Birthing in the spirit is the birthing of our ancestors.  Before birth in the western world became mechanized and dehumanized, women and men honored the sacred ability of women to create and bring forth life.  Birthing in the spirit is reconnecting with those natural, primal beginnings.  More than just relaxing and letting go, birthing in the spirit is moving through the portal of birth to the transcendent place that birthing takes women;  the place of connectedness to every being and to the earth.  It is feeling life itself pulsing through your veins with the simultaneous power of a volcano and the peaceful silence of snowfall.  It is losing yourself entirely and only then knowing the core of who you really are.  Birthing in the spirit is what women do when we are honored, cared for compassionately, and deeply trusting of our bodies’ ancient wisdom moving us to that sacred space.  Birthing in the spirit is the ritual of motherhood;  it is through the intensity of the experience of birth that women find the power and the compassion to give all of themselves, and then to give more, to their babies.  It is in that place that we become mothers.”                                                           Jacque Shannon-McNulty

As a Libra, balance has always been an important concept for me.  As I have worked in birth for so many years, the concept of balance becomes even more important. There is a very fine line of balance in the body, physiologically, as when our temperature is even one degree higher than normal, we feel ill.   The body is always adjusting and being in balance keeps us healthy. When the body is too hot, it will sweat to regulate temperature.  When the body is cold, the pores on our skin close to keep in heat.  We can feel unbalanced in life when stresses become too great. Our bodies crave balance, and balance keeps us healthy.

The other important consideration with balance is realizing how connected every part of our body is.  When one part is out of balance, the whole body feels it.  Remember the hand relaxation exercise I wrote about in another blog?  Besides being a great exercise for women in labor, it also teaches us something else.  If you squeeze both hands very tightly and hold them that way for 30 seconds, you will have time to follow where the tension is moving in your body.  The tightening will slowly spread throughout the body, becoming more subtle the further it is from your hand, but gradually, you will be aware of it.  This means that tightening the hand will have an effect on the muscles of the pelvic floor.  Therefore, the more relaxed her hands are, the more relaxed is her pelvic floor musculature.

It is very important to have all aspects of the pelvis with its muscles and ligaments, balanced in birth.  For example, if the baby’s head is not positioned directly in the middle of the cervix, it will take longer for the cervix to dilate.   If a ligament is tight on one side, the baby may not be able to descend. If a woman is very fearful of contractions, her body may be in a fight/flight mode of survival trying to protect her with a guarding energy that creates an imbalance in her body.

You may be familiar with the exercises taught to birthing women to release their pelvic floor i.e the Sidelying Release and Forward Leaning Inversion (also called “Belly over the table”) originated by Dr. Carole Phillips.  It is important that the Sidelying Release is carried out lying on both sides so the entire pelvis experiences a release.

But just knowing and doing these pelvic floor exercises is not enough.  We must think in terms of the entire system because every part of our body is connected.  For example, how is a woman in labor breathing?  Are her breaths short and fast or long, deep, and more relaxing?  The more relaxed she is, the better her progress in labor especially if she is upright and moving around.  Then her entire body is moving in synchrony with the rhythm of her labor and she is sensing a balance that feels peaceful.  Even though strong contractions are coming and going, she is in her instinctive, primal brain that knows everything is okay and she is in the “zone” moving with her labor and guided by her body wisdom that already knows how to give birth.

And sometimes, doing all of these things still results in a baby not descending for one reason or another such as a tight short cord, but a woman who feels balanced in her life and in her labor,  still knows she did the best she could, is thankful for interventions that help birth her baby, and feels grateful for the experience.

Balance is very connected to peace and contentment. So many people say, “I want peace,” as they feel their lives are in pieces.   Helping women in birth to find peace automatically results in a feeling of balance and in that moment their breath is slower, their body is in synchrony, and  all is well.

At our professional forum our speakers commented on the following:

Question #1: What is the most important thing that women need to learn:

Amber Price: They have the power to change anything. One voice can make change. Consumer
demand is important.
Lewis Mehl Madrona: Consumer demand brought the epidural epidemic. If consumer demand
was for fewer epidurals, it would happen. Women need to see birth as a joyful experience and
not a fearful one.
Nancy Wainer: Remind women that their bodies are designed to give birth.
Michel Odent: The most important question to ask today is, “What is the future of humans?”
Obstetrics is trying to neutralize the cesarean section. Most people are looking at the past –
nobody looking at the role of hormones. We must consider another question, “Are we
neutralizing the laws of natural selection by obstetrics?”

Question #2: What will it take to do this? Is the pendulum swinging in a way to create
better outcomes?

Amber Price: Ways to change the world perspective is through the images that are shown in the
media, at baby showers, and other birthing events. We need to change the words we use around
being a woman and women at birth.
Lewis Mehl Madrona: We need more funding for midwives. Studies do count and need to show
the value of midwives. Maybe midwives can get masters and PhDs, do research, and publish.
Nancy Wainer: Have big billboards saying, “I had a natural birth!” Give talks in elementary
schools about natural birth. High schools are too late – we need to reach younger children. In the
media, have TV commercials of “I had a beautiful unmedicated birth!”
Michel Odent: Before asking the question, it is more effective to analyze the current situation.
We are neutralizing the laws of natural selection. Some women give birth easily and some don’t.
Some mothers and babies die. This is the law of natural selection. But today, some give birth
naturally and some by cesarean section. We have neutralized the law of natural selection. We
need to change our way of thinking. The key word is “protection” against factors that cause
stimulation of neocortical activity in labor.
Lewis Mehl Madrona: I believe that today, epigenetics is more important for the natural selection
of genes. Autoimmune disease is now known to be a change in function of the gene. The
environment is a switch that can turn genes on and off.

Michel Odent: The secret is the evolution of evolutionary thinking. Pure genetics is hereditary
but suddenly some traits are acquired in life through epigenetics. We have to enlarge our concept
of evolution. The mother is transporting genes and the microbiome to her baby long term – we
need to think pure genetics.

Question #3: If there was one road block for peace in birth, what would you replace it
with?

Nancy Wainer: Replace the belief that a cesarean section is an okay way to have a baby.
Michel Odent: It depends on your perspective…there are two places to give birth: home and
elsewhere. Both need to be safely available to women.
Amber Price: The biggest impact is for normal birth to be staffed by midwives.
Lewis Mehl Madrona: Have equal payment for equal work.

Question #4: What advice would you give to birth workers? What can they do today?

Lewis Mehl Madrona: Tell positive birth stories wherever you are be it in line at the grocery
store or at Walgreens. Guide them to think positive about birth.
Amber Price: Use a common language with consumers such as RMC or Respectful Maternity
Care.
Michel Odent: Talk with pregnant women. Birth must release hormones; one is oxytocin, the shy
hormone. Talking with them about birth helps them understand what is happening in their
bodies.
Nancy Wainer: Share your joy.

Question #5: Peace in Birth is achieved through….?

Nancy Wainer: Chocolate
Lewis Mehl Madrona: Peace anywhere is achieved through the process of radical acceptance.
When making a judgment, breathe deeply – realize the whole life that person must have
had…send love. I’d be happy to have a doula come talk to my medical residents. Have the
courage to reach out and have conversations.
Ambe Price: First, find the right persons to talk to. Be willing to have casual conversations, one
on one. This is the modality for moving forward. Invite providers into your community. They
will come because they want to learn more. We can’t change a culture from the outside.
Secondly, birth for one woman may be great and for another traumatic. Women are asking for
the image of empowered birth without doing the work of labor. Technology is here to stay.

They need to see positive images of women giving birth. Monday morning quarter backing is
extremely dangerous as in “If I’d been there, she wouldn’t have had a cesarean.”
Gabe Tullier: If you don’t understand what a person is doing to you, get on the same page. That
releases serotonin and brings peace.
Nancy Wainer: Peace comes from doing the best you can do in each moment. We can’t control
everything.