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Balance in Birth and Life

by Cathy Daub, PT, CCE and CD(BWI)

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.

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Oxytocin: The Love Hormone

My name is Ashton Gelzinis, and I am one of the founders of Birth Naturally Brevard, LLC, a childbirth education and doula service business. My partners, Julie O’Neill and Elizabeth McLean, and I have served women in Brevard for several years and love every minute. We are also the owners of a small retail shop called The Oxytocin Emporium where we sell merchandise to support our doula clients and sister birthworkers! We absolutely love the name of our shop because of our fascination with the hormone oxytocin. We hope that our work only raises the levels of oxytocin in the room!

During our time supporting pregnant women and their partners, we have found ourselves fascinated by the process and how women’s bodies evolve and prepare in the weeks leading up to their birth. The hormones of undisturbed labor and the role they play not only during birth, but throughout the mother’s postpartum recovery are nothing but amazing. There are lots of hormones at play during this process, but the one we all hear most often is oxytocin.

Oxytocin. “The Love Hormone.” “The Cuddle Hormone.” This single hormone plays a major role in women’s bodies throughout their lives, but most importantly in pregnancy, birth and postpartum. Oxytocin is produced in the hypothalamus and released by the pituitary gland. Outside of pregnancy and birth, oxytocin contributes to fertility, digestion, wound healing, morality, personal connection, and many other situations throughout our lives.

“Oxytocin is the hormone of love. We share it when we have a good conversation, we share it when we make love, and when we hug, and BIRTH is the biggest brightest time of oxytocin sharing.” -Robin Lim

Let’s look at how this incredible hormone contributes to birth – the way it is supposed to. It plays a pivotal role in the birth process, not only to encourage surges, but it provides the mother with space to fall in love and bond with her newborn.

While laboring, the mother’s body releases oxytocin in response to the pressure of the baby on the pelvic floor. This release of oxytocin brings on those amazing powerful surges that help to efface and dilate the cervix, push the baby down into the birth canal, and birth the placenta. Oxytocin is released throughout the pregnancy, but really reves up just before and during birth for these reasons. In certain situations, mothers can encourage a release of oxytocin with nipple stimulation, a quiet, intimate break with her partner, or clitoral stimulation. If a labor is considered “slow to progress,” trying some of these techniques may help encourage that release and speed up the process rather than using synthetic oxytocin that doesn’t work in the same ways in the body.

Once the baby is born, more oxytocin is released, the placenta is delivered and afterbirth contractions continue to help close up the placental site and slow bleeding.

When her baby is born, the mother takes one look at this new life and gets another burst of this amazing hormone to help encourage her to bond and fall in love her new bundle. Oxytocin forces us to slow down and focus on what is most important – nurturing and feeding our baby. Every latch causes another release that helps to slow any postpartum bleeding and encourages her uterus to return to its original size before baby. The oxytocin released during nursing also encourages a healthy milk supply.

Another interesting oxytocin tidbit is that not only birthing mothers release oxytocin. Partners who are involved and present for the birth of their child release higher levels of oxytocin through the end of the pregnancy. Their levels actually continue to stay higher than average for about 6 months after the birth. This hormone in partners who didn’t give birth perform a very similar job – encourages bonding and loving. It truly is the “Love Hormone.”

In any birthing room, let’s do our part to let this hormone work it’s magic. Let’s give women the space they need to birth their babies. Let’s step away from the technological additions to birth and let mothers’ bodies work. When a woman is undisturbed, her body’s hormones work together with her baby to find just the right path for them. As doulas, we hold space, we remind mothers that the oxytocin is working and her body is nothing but incredible. That truly is the honor of my life. Let the oxytocin flow!

 

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Adina’s Testimonial

Attending the BirthWorks childbirth education workshop in Mt Dora, Florida this May was way more than I bargained for! The place was absolutely stunning. A Victorian style historical hotel with sprawling grounds against a backdrop of the magnificent lake and quaint town. But even more than that was the content of this 3 day workshop given by Cathy Daub. The workshop was so comprehensive and included topics such as grieving, mother daughter relationships, optimal pelvic positioning as well as many others that are not usually included in typical childbirth preparation classes. They were all taught through hands on experimental learning and not through didactic teaching. It was the BirthWorks experience I came out with!

One of the really vital things was teaching and facilitating using open ended questions and letting the other party find their inner guide to direct them. That evening I had a chance to really practice this skill. Being a doula, I had a client in labor and sent a backup.  Right before pushing, my backup called me asking if I could speak to the client as she was panicking about pushing. Instead of going into my long speech about why she shouldn’t be scared to push and how she’s done this in the past, I asked her what her fear was. She said she’s afraid she can’t do it. I asked her what she felt she needed to be able to move forward and she said she thought she needed help from the doctor. I said what kind of help. She said she remembered from her last birth that the doctor did supra pubic pressure because the baby’s shoulders got stuck. I gently reminded her that the only reason the doctor did that was to help the shoulders but the head was out already. So she said, “oh ok, but I’m still scared.”  So I asked her, “What do u want?”  She said she wanted her baby to come out without pushing. I said great. Imagine it. She said she can’t because she  has no energy. So at that point I told her to visualize G-ds energy as she inhales coming into her uterus and as she exhales pushing out her baby. She said,”Ok you visualize it for me!”   I said sure and she hung up empowered and pushed her 9 and half pound baby out with one push!!!

It was such a great lesson for me and I can’t thank Cathy and BirthWorks enough!

Earlier that day this same client was laboring pretty slow so I instructed my backup to do the rocking technique we had just learned that morning and she progressed very quickly to 10 cm!

Recently I had a prenatal meeting for a client who had 2 previous c sections and I used the grieving process we learned, asking her if she wanted to share anything that was hurting her  and she ended up telling me about a few childhood moves her family made when she was in school and how she was afraid to get too close to anyone and then have to move again and she came up with the idea that she was scared to carry something through to the end, the finish line. Explaining to her how we birth the way we live, both her previous births she stalled at 3 cm and wasn’t able to progress further. That awareness was amazing for her and it’s all due to the skills I learned in the grieving session.

Thanks a lot!

Adina Hoffman

 

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Profession forum at the BirthWorks Peace in Birth Conference 2019

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.

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The Baby Way

What better way to show cardinal movement, rotation of a baby through the
pelvis, than by demonstrating with The Baby Way, manufactured by BirthWorks
International. This is an “Ah Ha” moment for any pregnant woman, helping her to
understand the importance of movement in labor.
Our imagination is much more powerful than we may realize. Showing a baby doll
fitting snugly through a pelvic model, even if cloth, still gives the impression of a
tight fit. When women feel their own pelvises in BirthWorks classes, they can
experience and imagine more space that is there for their baby to move into.
Then when they see the diameters of the pelvis in The Baby Way, they understand
how the baby rotates to move through the pelvis in optimal pelvic positions. This is a powerful connection sure to have a
great impact on any woman giving birth.
The Baby Way is a must have tool for anyone birth professional including childbirth educators, doulas, nurses, doctors,
and pregnant woman. (See demonstration on BirthWorks website interview Nicholas Olow with Cathy Daub)

www.birthworks.org/product/the-baby-way-2/

The diagrams below show the pelvis in an upright
position which is optimal for birthing. Note that the
pelvic inlet is wider from side to side. Since the
widest part of the baby is the shoulders, the baby
must enter the inlet and then tuck his chin to turn 90
degrees so the shoulders can pass through. In
contrast, the outlet is wider from front to back.
Therefore, the baby must turn 90 degrees once again
to move his/her shoulders through the outlet.
Turn the head into a breech position with feet first and
demonstrate how a breech baby also turns and rotates to
pass through.

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BirthWorks with Birthpedia Conference – highlights

Our conferences are being described by attendees as, “The BirthWorks Experience” and this is different from other conferences they have attended.   Our program is based on the practice of human values along with integration of the mind, body, and spirit.  This is experienced in all of our conferences and workshops as well as in our training programs. The setting of the Lakeside Inn overlooking the lake was infused with peace itself, thus enhancing the theme of our conference, “Peace in Birth.”

All keynote speakers and presenters focused their talks on the theme of how birthing families and health care professionals can have more peace in birth.  They addressed this in a multitude of ways ranging from birthing vocabulary, to mother/baby skin-to-skin contact, to empowering high risk moms, to the importance of comprehensive childbirth education, to avoiding birth-worker burnout, to healing through birth stories and finding peace after experiencing birth trauma to name a few. I will touch on some of the keynote lectures here.

Nancy Wainer explored the world of birthing vocabulary and its effects on pregnancy, labor, and birth.  She made distinctions such as “We don’t catch babies, we receive them.”  The Bag of waters becomes the “amniotic release.”  The mucous plug becomes “Baby Gel.”  Is there such a thing as a “Natural Cesarean?” or a “Gentle Cesarean?”

Michel Odent MD discussed how the human placenta transfers antibodies to the mother so that the mother’s microbiota is friendly to the baby. Today most women give birth where there are unfriendly microbes, not colonized in the same way. Today we must ask, “How is our health to be organized?” He said, there are only two kinds of birth: birth at home, and birth elsewhere.  Today, we have dysregulation of the immune system comparing only with hospital birth.   We need to find new ways to adapt.   He went on to say that too often we associate stress as a negative way of thinking, but there are times when we need stress hormones. In a pre-labor cesarean section, babies are not being exposed to fetal stress hormones. For example, corticosteroids are needed for maturation of the baby’s lungs.  Also, understanding the birth process means understanding “Neocortical inhibition” which should become part of the birth vocabulary.  We need to wonder why birth is so difficult for some women and not for others.  It has to do with “Neocortical inhibition.”  The neocortex must stop working in labor.”  Women need to be protected against key inhibitory functions.

Michel made the trip across the Atlantic at the age of 88.  We gave him a tribute slide show of his work through the years, including pictures as a child, and also gave him a journal in which everyone at the conference wrote words of gratitude to him for his lifelong work in birth.  When asked the question, “What made you become interested in birth?”  he answered, “Oh, I’m not interested in birth – I’m interested in humans but of course birth is a part of human existence.”

Brad Bootstaylor MD:  Is one of three obstetricians in Georgia performing vaginal breeches in a hospital setting.  His Dads catch babies 90% of the time. He sees birth as a natural event that may or may not need managing. He emphasized the need to always have a conversation with birthing parents in shared decision making, hearing their needs and then discussing how they can work together. Even in an emergency cesarean, the process is important.  He said, “I help her to remember that her job is to bring her baby here to the earth.”  He shared seven pearls of care some of which were respecting a patient’s values, enhancing physical comfort, providing emotional support, involving the family and especially listening to the mother.

Dr. Bootstaylor said he enjoys his work and brings a positive attitude to women giving birth and their families. He doesn’t think, “Oh my, she’s still here!” He has assisted many women in vaginal breech births thus helping to avoid the major surgery of a cesarean.  Above all, he feels a trusting relationship is essential to any birth.

Lewis Mehl Madrona:  Being a board certified family physician and psychiatrist of the native Lakota American Indian background, Lewis brings storytelling as a form of healing in his culture and he has applied that to birth over much of his life. He acknowledged that there are both good and bad stories but they are the glue that hold people together.  Every story we hear affects our physiology whether we like it or not.  If we use it, it grows up; if not used, it fades away.  How do we make sense of story trauma?  Know that even in the worst trauma, good comes out of bad.  This transforms the victim into a hero.   What makes people feel better is giving meaning to what happened.    You can’t erase a story once it is told.  We can also strengthen good stories by retelling them over and over again. Lewis said story-based medicine may treat pain.  Listening without interruption and judgment is the greatest gift we can give anyone.

Mary Renfrew:  is a leading health researcher and midwife.  She has conducted research in maternity care and in infant feeding for over 30 years and her work has informed and helped to shape policy and practice in those fields both nationally and internationally.  Her work has a core focus on improving health and care for women, babies, and families and reducing the impact of inequalities.   Due to ankle surgery, her fascinating lecture was presented through skype.  She spoke about global challenges and developments in midwifery and how to tackle those through evidence and through education thereby moving evidence into policy and practice.

Amber Price: As the only CEO in the country who is also a midwife, Amber had much to share with us about how she is making changes to help pregnant women and women in labor at the Tristar Centennial Women’s and Children’s Hospital in Nashville TN. She said as a society, we dictate behavior for mothers and babies, but instead, we need to teach and not mandate. Below are just a few of the points she made in her talk.  View her entire fascinating talk by purchasing it at birthpedia.net/learn

  • 52% of pregnant women in the US are obese with BMIs over 50. Hospitals need equipment to meet their needs. If women don’t get what they need, they won’t come back.
  • Women think they are going to be treated like a queen in the hospital, but are often disappointed.
  • Both women and health care providers feel alone and largely unsupported.
  • There is mutual distrust between women and healthcare providers, exacerbated by word of mouth and the media.
  • Procedure rather than patient centered care is prioritized by healthcare providers. Women’s reports of care indicate that interventions are routinely imposed on them without meaningful informed consent.
  • The difference between home and hospital birth is that birthing women take on guest status. People are in control in their own homes,  however, when walking into the hospital, the minute they ask “May I use the bathroom?” or “May I have something to eat,” someone has power over them.

See our next E-news for the Professional Forums held at our conference.