Throughout this class I have said that you must listen to your body in order to know how to have a safe, satisfying birth. But what language does the body use to communicate with you?
Your body can use pain or a sense of unrest to convey to you the need for change. For instance, it is generally recognized that one should change positions often during labor. You will often feel a sense of unrest when a position change is needed, like something is not right in your body, but you don’t know what it is. The thought of changing positions usually feels right emotionally, which is another confirmation that you should do it. Sometimes a position will even cause pain. I have known many women whose labors were going along fine until a medical person asked them to lie down on their backs to be monitored. At that point, they began having pain and instinctively felt this position was dangerous and they should get up. However, they were not allowed to by medical personnel. Many of these women showed dropping fetal heart rates and ended up with cesarean sections. However, those who chose to get up in spite of medical objections found that the pain went away and their sense of well-being returned.
Pain or a sense of unrest can often mean that you need to be more relaxed. The muscles of the lower half of your body should not be used at all. Make sure you empty your bowels and bladder every hour and a half to two hours. When you relax, you need to relax even the muscles responsible for keeping urine and feces inside, because those same muscles that cause the flow of urine to stop also cause the vagina to tighten. If there is tension in the muscles of the upper thigh, there will also usually be tension in the vagina. The same goes for the neck and shoulder area as well as your jaw. Tension in these areas indicates tension in the vagina as well. Any time you are moving, the vagina will also be tense and not relaxed. You need to find a comfortable position, totally open yourself and relax, and then DON’T MOVE until your body tells you to by creating a sense of unrest again.
Hunger and thirst are also sensations the body uses to make sure you stay hydrated and have enough energy to do the work you need to do. You wouldn't try to run a marathon without drinking fluids from time to time, and without ingesting some easily digested energy food. Suggestions for this are filtered water, non-acidic fruit juices, herbal teas with honey in them, or just plain eating a spoonful of unheated honey for energy. Sometimes you will not necessarily feel thirsty, but you will be working hard and sweating. If you notice perspiration, stop and ask yourself if a drink sounds good. Sometimes we get so busy we forget to pay attention to our body’s signals.
Things that can cause emotional unrest are: too many people in the room, too much talking, too much activity going on, too much light in the room, not being able or allowed to change positions, deferring to someone else’s idea of how the birth should be, being told you are not doing well, or anything else which upsets you emotionally. If you are birthing alone, none of these things will get in the way. If you are not birthing alone, your birth partner or labor support person should be the thermostat of the emotional atmosphere in the room. If something is bothering you, the support people should see that it is changed. Hopefully your birth partner knows you well and is in tune with the things that tend to bother you in the first place. If this is not the case, be sure to communicate with them your needs. During the latter stages of labor, you will often be concentrating so deeply that when you feel emotional unrest, you don’t communicate it, but instead internalize it. Please try not to do this. I would suggest that the birth partner ask how you are feeling from time to time to prompt you to clear any emotional baggage you are carrying. For instance, you may feel that you want your other children to be at your birth. Perhaps you know the time is near and are upset by the fact that they aren't in the room. By all means bring them in if that will set you at ease emotionally. Or perhaps there is someone who you invited to the birth, but you now feel uncomfortable and inhibited with them there. Don’t be afraid to ask people to step outside. I would be very cautious about inviting anyone other than a husband or children to my birth. I know that if I had invited someone and had to ask them to step outside, then I would be worrying about whether I hurt their feelings. I would then carry this with me throughout the birth, and it could get in the way of me totally relaxing. That is why I prefer to birth totally alone.
Sometimes you will receive intuitive impressions from the baby, or from your body, communicating a certain state of being or situation that needs changing. There is nothing to say about this except pay attention to those impressions. Perhaps you are getting the impression that you need a change of surroundings to stimulate the right emotional state for birth. Perhaps you need to go outside so that you can feel the expansiveness of the wide open spaces, and therefore open up for birth. Or perhaps you need to go to a quiet, secluded place to get ready for the actual delivery. It will depend on your personality and your emotional needs. Perhaps you don’t have pain or unrest, but you simply feel an impression that the baby is trying to pass under the pubic bone and needs more room, so a position change is necessary.
Perhaps you feel the need to make sounds that help produce the energy to move the baby down the birth canal. You should feel free to moan, groan, hum, howl, or make any sound that does not get high pitched. High pitched sounds tend to produce or be produced by tension, and are not productive. From somewhere deep within you, you will simply feel this sound emerging. If you feel inhibited by your birthing environment, you may not feel comfortable making sounds. You may worry that hospital personnel or other patients might be disturbed. That is another reason to birth away from the hospital. If you do choose to birth in the hospital, prepare the staff ahead of time by telling them that you may need to make noise, that the noise doesn't mean you are in pain or need help, it is just part of the way you birth.
Your body will guide you in the right kinds of breathing. Usually, slow deep breathing is best - in through your nose, out through your mouth. Knowing about different breathing patterns are not required.
This was brought home to me one night as I left the building where I had just finished teaching a class. It was dark outside, and I was carrying a lot of books. I didn't see a small step down that I was supposed to take, and I ended up falling, dropping all the books, and skinning my knees pretty badly. I remember lying on the sidewalk, feeling the pain, and I couldn't help but sit up straight, start to breathe very forcefully in through my nose, and out through my mouth. I found myself concentrating on the breathing to cope with the pain. I didn't consciously think about doing it....my body made sure I did it. I couldn't help but do it.
You won’t be able to help it either. My only advice is to stay relaxed, no matter what breathing pattern your body suggests to you. When doing very forceful breathing, make sure you don’t tense up. Relax all your muscles with each exhalation.
I find it helpful to visualize air going in through my nose, going down and surrounding the baby, and then going out the vagina, creating a clear passage for birth. Then, with each exhalation, I let go of those pelvic floor muscles - the ones that hold urine and feces in - and as I exhale, I visualize that clear passage and the baby coming down. I totally open myself up. A good position for this is the standing supported squat.
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