The Trap of Idealizing the Quiet Birther (Part 3)

Last April, I wrote a short Birth Idealization Traps series.  I would actually like to continue that series now, with  some new perspective on The Trap of Idealizing the Quiet Birther (Click to read Part 1 and Part 2) that I gained from my third birth.

In my third birth, my midwives acted as lifeguards, watching carefully (using some technology as tools to assist in watching) to make sure nothing pathological was happening, and encouraging me to do some preventative measures due to the risk factor of pre-labor rupture of membranes.  Because of PROM, risk of infection was a good reason to limit/avoid cervical checks, and it turns out that there wasn't any reason to do them. 

My midwives saw no need to check to "make sure I was complete" before pushing.  They encouraged me to follow my instincts and push only when I had no other choice but to push.  I instinctively bore down at the peaks of the pressure waves for a while, until I felt an unmistakable urge to push.  "Urge" isn't even the right word.  "Takeover" describes it better.  I couldn't do anything but push.

Like I suspected when I wrote my other two posts, during my third birth, I was, in fact, a very vocal pusher.  Unlike in my second birth, I was not told to hold my breath and put my chin to my chest to push.  In following my instincts, I did not hold my breath or curl my head forward.  I opened my mouth and let sound escape my body, and boy, did it!  Watching the video now, I am even a little surprised with how loud I was.  I have some technical difficulties with my digital camcorder (I think I need software to load the video, but I must have lost the CD), so I don't have the video to share, but believe me when I say I was LOUD. And no, I was not screaming in pain.  Hypnobabies was absolutely working for me.  There may have been some pain when I lost my rhythm in reaction to changes in how things felt as my body first began pushing, but I experienced the sensations of my baby emerging as mostly stretching and fullness, and  I did not experience burning or a "ring of fire" sensation at crowning.  It was really like I couldn't help making noise.  It was what came naturally to me, and I wouldn't change a thing about it.  

Hypnobabies Certified!

I received word a few days ago that my certification as a Hypnobabies Childbirth Hypnosis Instructor (HCHI) and Hypnobabies Certified Hypno-Doula (HCHD) is official! Yesterday, my information was posted on the Hypnobabies Instructor listing. If you are local and interested in joining my first class (most likely stating in late September or early October) please contact me here or through my website (link on sidebar). If you are not local, check out the link above for an instructor in your area.

Back from the Hypnobabies Training!

I had a great time at the Hypnobabies Instructor Training! It was so fun rooming with Felice. She had the manuscript of the book with her and was editing it. I got to see the piece I wrote as a guest post for the blog in print among articles written by many amazing women. Now to get all of the Hypnobabies final certification requirements finished up so that I can have letters after my name when the book goes to print!

We had the opportunity to have dinner with Sheridan and Malia, who are both working with Felice on the book, one night after training had ended for the day. I have been reading Sheridan's blog for a long time, and "knew" her from the Hypnobabies yahoo group before that, and it was fun to finally meet her in person.

Felice taught me some interesting theories about relationships that she learned in hypnotherapy school. She also taught me a technique for asking questions of my subconsious mind. We asked mine the sex of my baby, and it told us (in kind of a round-about way). It was the same answer I have been feeling all along. We are waiting until the baby is born to find out, so I will let you know if it was right when that happens!

I met a lot of other wonderful ladies at the training, who I hope will all be keeping in touch! Good luck to all of you ladies on completing your certification and beginning to teach your classes! I love this program and am so excited to be a part of helping women enjoy their births!

What makes Hypnobabies special

Hypnobabies has a lot to offer. I have decided to compile a list of unique advantages of the Hypnobabies program.

• Hypnobabies is comprehensive childbirth education. The founder of Hypnobabies comes from a childbirth education background and brought together her knowledge of childbirth with hypnosis in Hypnobabies. Hypnobabies includes information on the physiology of birth, nutrition and exercise, evidence-based pros and cons of interventions, making sure you have the right caregiver, and more! It is the only hypnosis for childbirth method that meets the requirements of DONA International for DONA doulas to observe for their certification.
• Hypnobabies not only teaches women how to relax, it also teaches them to enter a relaxed state at will, using a self-hypnosis technique called the "finger drop." This relaxation response is embedded in her subconscious through practice and post-hypnotic suggestion.
• The same relaxation response can also be activated by the mother's birth partner, doula, or maternity provider, with the "release" and "relax" cues, empowering them to help her better make use of her training.
• Hypnobabies helps women look forward to birth by releasing fear and learning to expect the birth to be an experience that can be enjoyed, undoing all of the negative ideas about birth they may have absorbed through the media and stories told by others.
• Hypnobabies teaches women that birth is a powerful and intense thing happening in their bodies, and helps them embrace that power instead of trying to run away from it.
  
• Hypnobabies teaches women how to have more comfortable childbirths, both by interpreting the sensations of birth as "pressure" or "tightening" AND by learning to increase and direct their bodies' endorphins with Hypno-anesthesia, using the "peace" cue.
  
• Hypnobabies encourages mobility during labor, which helps with positioning and descent (and may be a comfort measure if other techniques aren't working as the mother would like) and teaches a technique that allows them to use their relaxation and Hypno-anesthesia while upright or moving, called "eyes open childbirth hypnosis"
• Hypnobabies offers a large assortment of materials for women to practice with during pregnancy, allowing them to practice daily without getting tired of listening to the same few CD tracks over and over.
• Hypnobabies teaches about optimal fetal positioning and techniques to relieve back labor.
  
• Hypnobabies gives women a wide variety of tools to pick from to use during their births--moving while using eyes-open childbirth hypnosis, going "off" and relaxing completely, listening to their CDs, having a birth partner read mini-scripts, using cues (relax, release, and peace), vocalizing, visualizing their "special place," chanting mantras from the scripts ("open, open, open"), or counting down from 5-1 (which also activates automatic relaxation). Women have the freedom to use as many or as few of these tools that feel right to them at different points during their births, and may integrate them with their own unique strategies.
• Hypnobabies teaches instinctive mother-directed pushing (referred to as "gentle ahhh pushing") and encourages women to use upright pushing positions and listen for their bodies to tell them when and how to push.
• For those for whom the wonderful Hypnobabies live course is not an option, Hypnobabies offers a homestudy course, the content of which is based on their live course and significantly more in-depth than any other hypnosis for childbirth self-study option available.
  

For more information,

• Read Hypnobabies instructor and Hypno-doula Sheridan's post How is Hypnobabies different?, as well as her personal experience with taking HypnoBirthing with her second baby and Hypnobabies with her third.
  
• Check out this comparison from Laura, who has used and taught both HypnoBirthing and Hypnobabies.
  
• Stephanie, a homebirth midwife in Arizona, wrote about how impressed she was with Hypnobabies clients after some previous negative experiences with women who had done other hypnosis for childbirth preparation methods.
  
• The Hypnobabies website has a great list of unique advantages of Hypnobabies, with testimonials from five women who have used both Hypnobabies and other hypnosis methods.
• From the Hypnobabies blog: UNIQUE Benefits of Hypnobabies: "What makes Hypnobabies different from other Childbirth Hypnosis programs?"
  

There's More to Back Labor than Fetal Positioning! (Review of "Back Labor No More")

I recently read the book Back Labor No More by Janie McCoy King as part of the required reading for the Hypnobabies Instructor training. I didn't need any more reasons that Hypnobabies is the right childbirth education method for me to teach, but the inclusion of this obscure-but-downright-amazing book in the training requirements is another one. I have never seen this information anywhere else (in my 3+ years of reading books and websites on natural childbirth) or heard of any other childbirth education method teaching it.

Most people with a basic education in natural childbirth know that having a baby in the Occiput Posterior ("sunny side up"--facing the mother's pubic bone instead of her spine) position can cause back labor. I've never had back labor, but I've heard it can be excruciating. You hear a lot about optimal fetal positioning in the natural childbirth community, and if the techniques on the Spinning Babies Site work to get your baby in a better position, that is great for you. However, some babies will stay posterior no matter what, and, what's more...

Not all back labor is caused by the baby's position

Some women will have back labor even with a perfectly positioned baby. I have two good friends who both have had intense back labor despite having anterior babies. Back Labor No More explains that women may experience back labor if they have:

• A "short rise" (short torso)
• A swayed back (tends to stand with knees locked and pelvis tilted so that her rear-end sticks out)
• pelvic abnormality
  
• back injury

The author, Ms. King, has a short rise herself, and experienced painful back labor during her first three births. At the admonition of her father, King had majored in math in college. In her book, she applies her mathematical understanding of vectors to the process of childbirth. The book, which is short, fun, and easy-to-read, explains the concepts in ways that are easy to understand and internalize, with lots of drawings and activities that involve learning with your whole body. If you really want to be able to use the technique, you really need a good understanding of why it works, and to really understand, you will have to read the book.

A simplified explanation is that, in back labor, the force of the contraction (the vector) is directed at the woman's spine. You can solve this problem by changing the direction of the vector, which is done using a relatively simple technique called the belly lift. King is not the first to use this technique and have it work, but she is the first to explain why it works. Vectors. Read the book. You'll get it.

Misty used Hypnobabies and the belly lift to have an easier birth with her posterior baby. This video was uploaded two years ago. In the comments section, Missy explains that she had a wonderful experience using hypnosis with her third baby (anterior), but then her fourth baby was posterior, and she found that hypnosis didn't help as much with the back labor as she wanted. After that birth she found out about the belly lift, and used it for the birth of her fifth baby, from which this footage comes.


This technique is not only reported to get rid of the back pain (though apparently it may have to get worse before it gets better), it also sometimes speeds dilation significantly. It has also been reported to help women have faster births who don't have back labor. I believe this may have been the case in the video below, which I saw on Bellies and Babies, who posted it because she liked the way it was edited, with the music, narration, and combination of still shots and video footage. In it, Jodi explains that her midwife recommended the belly lift to her because of her posture (possibly she was sway-backed?), and it shows her husband helping her with the lift.



I'm serious when I say that Back Labor No More is a must-read for all doulas, childbirth educators, doctors, midwives, maternity nurses, and pregnant women, especially pregnant women who have had back labor before, think that one of the categories above may describe them, or have a baby who tends to hang out in the posterior position (or the right occiput transverse position, since these often rotate to posterior). Although you won't find this book in your bookstore or local library, the information makes it worth ordering. It is very easy to pay for it through PayPal on the author's website, and if you are paying with a credit card, you don't even need a PayPal account. You can also order it through Amazon.

The Trap of Idealizing the Quiet Birther (part 2)

I think it is a common misconception that a goal of using hypnosis is to have a quiet birth. I think many natural birthers are quieter using hypnosis than they would be without it. Partly I think this is because they often experience less pain because of the high endorphin levels they are able to create for themselves. I think many women not using hypnosis get too caught up in pain and tension to get to a place where they can birth in a focused state that may be natural for them. Sometimes, the screaming or moaning is a response to pain (and its not a bad response, if the woman finds it helpful), but not always. I have read many birth stories where Hypnobabies mamas have said that they reassured their birth companions that the noises they were making were not because of pain. Less pain may often equal less noise, but it does not always equal no noise.

The clear impression I got when I was studying Hypnobabies is that instinctive vocalization is good if it helps you. They actually call the type of pushing they advocate "Gentle Ahhhh Pushing," which is not the"Breathing the Baby Out" that I read about in Hypnobirthing by Marie Mongan (which I, for one, find confusing) nor is it the provider-directed prolonged breath holding of the Valsalva("purple pushing") method. Hypnobabies advocates pushing when and as long as feels right, and says that your instincts will guide you to you use breathing, vocalizing, holding your breath, or some combination of these. The Hypnobabies materials explain that many women instinctively vocalize with an "ahhhhh" sound when they start to feel their babies moving down. This is what I did, and having read that, I was not afraid to do so.

Hypnobabies actually doesn't teach that being quiet is the only way to have a good birth, but I think there may be some contribution to the idealization of quiet birth with the videos that are used to promote it. While videos of quiet birthers do a good job of showing one type of birth that is possible with hypnosis (and I believe possibly more common with hypnosis than without it), they may not necessarily show the whole spectrum of what a good birth with hypnosis can look like. I looked through the Hypnobabies birth videos that I could find online. A few did not include video of pushing (totally understandable if the video shows the baby emerging and you don't want your "bits" on the internet!). Of those that did, there were some where the mama was mostly quiet during pushing, but they were not all like that.

Sierra's Hypnobabies Homebirth video shows her "ahhh" moaning transforming into a powerful roar as the baby is born, and is beautiful.

I think that if I had the freedom to follow my body's instincts instead of being instructed to not push and later, to hold my breath, I can see how making birthing sounds similar to Sierra's would likely have come quite naturally to me. I hope that when I am a Hypnobabies instructor, that I will be able to help my students know that being loud (or having the expulsive reflex trigger an "out of control" feeling, like I talked about in Part 1) is not failure. I want then to know that what happens to your body when you give birth is incredibly powerful. While for some women, the best way to respond to the power may be to be quiet and focused the whole time, others may find at some point that it helps to release some of the power with their voices (I would be surprised if I am not one of these!), and this is okay. In fact, it is more than okay. It is another wonderful way to give birth.

The Trap of Idealizing the Quiet Birther (part 1)

Rachel, a midwife in Australia who writes the blog, Midwife Thinking, recently shared her thoughts on the habit our society has of Judging Birth. I really liked the second section where she talked about judging birth choices. My last post, The Trap of Idealizing the Intervention-free Birth covers some of the same ideas. I also generally agree with the ideas of the part about judging women's behavior in birth, though at first I wasn't sure I did. As I was looking through the comments on the post, I came across this:

I find the general rule of thumb for making noise has to do with a woman’s sexual style. If she is a noisy lovemaking person, then chances are it will feel natural for her to express herself loudly while in labour. If she is a quiet lovaking [sic] person, then she will follow suit when she is in labour. We birth in accordance with the way that we live.

My reaction was, "There are really women who can be quiet during sex?" (I guess that shows what my "sexual style" is!) At first, I didn't think this rule of thumb applied to me, because, using Hypnobabies, I was rather quiet. But then I remembered that wasn't exactly true. I began to spontaneously vocalize as I felt the pressure of my baby beginning to come down. I wasn't moaning in pain, it actually felt better to make noise, and I remember saying so. I was also very vocal while trying to wait for the cervical lip to move.

At first, I was a bit put off by a mention in the post of feelings of failure caused by "childbirth preparation programs aimed at learning how to be quiet and in control during birth" and some more direct implications of hypnosis for childbirth by some people in the comments. I went back to the post later and saw some new comments and a discussion between Rachel and a mom who used Hypnobabies that clarified some things. Here is part of one of Rachel's comments.

You did something based on your prior birth experience that worked for you… an individual… which may, or may not work for another woman. There is nothing wrong with learning to relax during birth with the help of breathing or any other technique. These techniques are extremely helpful for many women. However, if they become prescriptive and women feel like that is the only way, or that they must not lose control then they can cause harm. As you found in your own experience the techniques can work up to a point for some women. You did not worry that your body took over at the end of labour. However I know some women how consider their body taking over at the end as a failure to remain in control. It makes me sad when women express disappointment because they ‘lost it’ just at the end.

I also had a "losing it" experience at the end of my birth with hypnosis. I still attribute some of that feeling to confusion about not knowing whether to listen to the instructions on pushing (and on "not pushing yet") or to try to do what I had learned about in Hypnobabies and my own research. However, I now realize that it is highly possible that the panic, that feeling like I was drowning, at the very end might just be the way birth happens for me. That sudden "swept under" feeling might be just what I needed to...push me into pushing, I guess. I don't think it is that way for everyone. But it being that way for me doesn't mean there was anything wrong with me or with my level of preparation. It doesn't mean that I failed to use hypnosis correctly during that part of my birth. I had kind of hoped that I would be able to "calmly breathe the baby out" thing with my next birth, but maybe I will and maybe I won't. If I don't, then maybe that is the way it needs to be for me.

My thoughts will continue in Part 2.

Marwa's Hypnobabies Birth Story--a must read!

Check out Marwa's Birth Story on the Hypnobabies Blog. Her story is just full of surprises!

Did someone say something to you that had an impact on your birth?

One of the important messages taught in hypnosis for childbirth is that words have power. The President and Vice President of Hypnobabies are creating a presentation for the birth mega conference put on by Lamaze and ICEA about how things care providers say influence women during pregnancy and birth, and they need your personal examples. Here is the original request from Kerry Tuschhoff, in her words:

Hi Everyone,

First of all, just a reminder that Kerry and Carole are speaking at the"Uniting for the Future of Birth" Mega Conference in Milwaukee in early October! http://www.futureofbirthconference.org/ Our session is called, TheTransformative Language of Birth and will allow us to teach birthprofessionals how to alter their thinking and use positive wording which canpositively affect birth outcomes. Please post and e-mail this to EVERYONE!

Since our session at the Mega Conference is all about helping birthprofessionals learn positive language that is extremely helpful to all pregnant and birthing moms, we would like to ask for everyone's input! Thisincludes moms and birth care professionals.Please call our toll-free hotline at 800-350-2204 and complete any or all ofthe following:

"When I was pregnant my (caregiver) said ...to me and then I felt....aboutchildbirth". (Doulas, doctors, midwives, nurses; any caregiver)

"My birth was awesome (or whatever adjective you'd like to use) because my(caregiver) said..."

"My birth was going very well (or however you'd like to describe it) until my (caregiver said ..."

If you are a birth professional, you can complete the following:

"I attended a birth where a (medical caregiver) said....to the birthing momand it changed....in her birth experience (explain what happened, positiveor negative).

Please forward this to anyone who would like t be part of the process ofchanging birth language. Thanks so much for helping us educate birth careprofessionals how to become more positive and effective!

Kerry

Kerry Tuschhoff, HCHI, CHt, CI

I think I have some things I can share. During my son's birth my OB said both some wonderful things and one or two things that could have been said in better ways ("Try not to push" was a big one for me) If you have an experience, whether it was related to a birth with hypnosis or not, they would love to hear from you.

I'm in!

It's official! I got the e-mail today saying I've been accepted into the Hypnobabies Instructor training program! Now I have to register, do book reviews, and do the Introduction to Hypnosis Course, as well as finish my doula training. If all goes according to my plans, in about 10 months, I will have both CD(CBI) and HCHI after my name.

Hypnobabies Instructor Training Info & FAQ Webinar Today!

The Hypnobabies Instructor Trainign Info & FAQ Webinar is today from 11:00 a.m-12:00 pm Pacific Time. There is still time to sign up, if you are interested in becoming an instructor. If you can't make it, you'll be able to listen to a recording of it afterwards.

I will be listening live. I am so excited to start this process!

Hypno-anesthesiology 101, with Dr. Seuss

Now the news has arrived
From the Valley of Vail
That a Chippendale Mupp has just bitten his tail,
Which he does every night before shutting his eyes
Such nipping sounds silly, but, really, it's wise.
He has no alarm clock. So this is the way
He make sure that he'll wake at the right time of day.
His tail is so long, he won't feel any pain
'Till the nip makes the trip and gets up to his brain.
In exactly eight hours, the Chippendale Mupp
Will, at last, feel the bite, and yell "Ouch!" and wake up.

This passage is from Dr. Seuss's Sleep Book, which I read to my two year old daughter to help her fall asleep. Although the Chippendale Mupp's eight hour lag in pain perception is an exaggeration, the passage illustrates an important fact about pain. Pain signals from the body have to travel along the nervous system to the brain before we actually recognize pain. Therefore, it could be said that pain happens in the brain. The following quote from the article Replacing Painkillers With Hypnosis explains how a pain test performed under hypnosis looks on an fMRI:

New imaging techniques have recently started to reveal what occurs under hypnosis, and why pain that would otherwise lead to severe discomfort becomes bearable. Using functional magnetic resonance imaging (fMRI) scans, Sebastian Schulz-Stubner and his team at Aachen University in Germany measured the brain activity of 12 healthy volunteers who received repeated heat stimulation to their skin. The researchers found that hypnosis interrupted the pain signals that normally travel from the nerve cells to the primary somatosensory cortex, where the sensation of pain is elicited. Instead, the signals fizzled out in the subcortical region, failing to produce the normal ouch effect.

The article also goes into detail describing a dental procedure using hypnosis for pain relief, using a "Special Place" like the one taught in Hypnobabies. One thing I love about the Hypnobabies method is that is uses medical hypnoanesthesia techniques, just like the ones this article is talking about.

What is Hypnoanesthesia?

Hypnoanesthesia is simply the body's own endorphins, which are released by the brain. Endorphins are said to be ten times stronger than morphine. We experience rushes of endorphins in response to pain, but also during exercise and after good sex. Hypnosis allows us to control the release of endorphins with our thoughts. One of my friends was telling me recently about Candace Pert's Molecules Of Emotion, which explains the scientific basis of how our thoughts have physical effects on our bodies. I haven't read it yet, but it's on my list.

But wait, if birth isn't inherently painful, why do I need anesthesia for it?

Birth is not inherently painful, though that may depend on your definition of pain. However, birth can become painful when other factors are introduced. Things like stress, fear, distraction, and not being able to follow to your instincts can create pain.

During natural labor, a woman will usually instinctively disconnect from her surroundings and her conscious thoughts and enter a state of deep focus. This state triggers her brain to bathe her body with endorphins and continues the flow of oxytocin. These hormones promote relaxation in the woman, which allows her body to birth her baby without her resistance.

The problem is that if a woman is unable to enter this state, or is distracted from it and can't get back to it, her birthing will become painful and she may fight her body. Knowing hypnoanesthesia techniques allows women to remove pain that is created by forces outside the birthing process. These forces can stop the flow of endorphins from her brain, resulting in pain caused by a level of endorphins lower than should naturally be present during birth. Hypnosis is a way to enter a state of deep relaxation and calmness quickly, which can get a woman back on track if she is thrown off. Hypnoanesthesia allows women to release endorphins on demand to get them back to the state they should be in during birthing. They are also able to get to this state faster when labor begins.

Distractions are a part of modern birth, even if it is just a quick check on the baby's heart rate. Women who use hypnosis have the advantage of being able to refocus quickly when distractions occur. It is natural for a woman to give birth in a place she feels safe, since giving birth makes her vulnerable to attack (several natural childbirth books discuss this concept, including Ina May's Guide to Childbirth and Birthing from Within). In antiquity, women could give birth in privacy, like animals do. Hypnosis actually allows modern birth, regardless of setting or attendant, to be more natural and instinctive, because it allows women to go within and be in a safe place in their minds. So, whether it's on a train, in the rain, in a house, with a mouse, here or there, or anywhere, you can give birth in comfort and peace.

Childbirth Show Proposal Needs Your Votes!

Wouldn't it be wonderful if there was a show on TV that gave women evidence-based information about the risks and benefits of various pregnancy and birth options and empowered them to make informed decisions about their care?

Oprah is currently searching for contestants for her "Your Own Show" reality series, which will be a competition to win their show idea a spot on Oprah's new network. Kerry Tuschhoff, founder and president of Hypnobabies, submitted her audition video to the contest, but the video must makes it into the top 5 most voted-for videos for her to be considered for the realityshow. Please watch her video and vote for her show idea, Every Mother, Every Baby. If you don't mind registering for the site, comments on the video would also be helpful so that everyone can know why you support the idea. Voting lasts until July 3rd!

The more votes the audition video gets, the more attention this issue will gather, so please pass the link on!

More on Overcomming Fears: The OCD Project

Recently, my husband and I were watching VH1's "The OCD Project," which documents a 21 day treatment camp for people with obsessive-compulsive disorder run by Dr. David Tolin. OCD actually has a lot to do with extreme irrational fear. Much of the therapy in the show involves them facing their fears.

The OCD Project Supertrailer

In the tailor, you see a clip where the patients are writing down their fears about what might happen if they don't do their OCD rituals. On the episode, Dr. Tolin has them read what they wrote into a tape recorder. He then uses these recordings as voice-overs for videos he makes called "fear movies"--images depicting their worst fears. He has them watch these films wearing a heartrate monitor, as increases in heartrate indicate anxiety. The films play twice, and during the first run, all of the patients had increases in heart rate in response to seeing their fears. Their rates stabilized when the film ended and then when it played again, their heartrates remained stable because it became less scary after they had seen it--exposure decreased anxiety.

This exercise reminded me of the Fear Release exercise in Hypnobabies, which involves visualizing watching your fears on a screen. I realized that part of how this exercise works is that by seeing our fears, we become less afraid of them.

The Fear Problem

Fear of the Unknown

It is normal to fear the unknown. For most first time pregnant women, birth is a huge unknown. Not only have we never done it, we may not even have ever seen it done. In North America today, I think it's highly unlikely that the average woman has ever been at a birth before giving birth. She also won't see uncensored images of vaginal birth in any public media. So, unless her school showed birth films in health class (mine didn't) or she takes a childbirth education class, seeks out birth videos on the internet, or watches a birth documentary such as The Business of Being Born, she may not even have seen a baby birthed before she is expected to do it. As I discussed in a prior post, some women seem to think that viewing a birth would disturb them, so they don't seek out any birth videos.

Add this that the fact that virtually every pregnant woman reaches a point in her pregnancy where, looking at her much-changed body, she realizes her baby is going to have to come out, but to her it just seems impossible that it could. It really is an unbelievable thing, even for those who have seen it and done it. That's kind of the miracle of it. Much of the medical system, however, seems to believe that it really is impossible without their help, and they are also afraid of the rare and very scary things they've seen or heard of going wrong, and they pass that fear on to women to add to their fear of never having done it and thinking there is no way her body can do something that seems impossible. Medicalization of birth also increases the "unknown" factor--it is something for educated doctors and nurses to know about, not average women.

Fear of Pain

It is also normal to fear pain, because pain is usually an indication that something is wrong, and we find it unpleasant. Our young pregnant women has heard others talk about how birth was painful for them and that they would never think about doing it without medication (or they did and it was a bad experience), and this just compounds the fear. She has probably seen birth shows on cable TV, which edit birth footage in ways that focus on the dramatic, because they are in the business of making exciting television, not of educating women about what birth is and can be. She probably has also heard a few stories of births where there were complications--maybe a vacuum delivery or an unplanned cesarean. She may fear something going wrong or having something strange done to her. Many women also feel fearful when they are in an unfamiliar place, surrounded by strangers, as is often the case with birth today.

Effects of Fear on Birth

We know that fear causes the body to release chemicals that can stop the birth process. This makes sense from an evolutionary perspective--a tribal woman wouldn't want to give birth if a tiger was chasing her, but as is explained in the book Birthing From Within (not a hypno-friendly book, by the way), the body doesn't know how to distinguish between real and imaginary tigers, it only knows fear. Fear also increases our perception of pain and prevents us from enjoying birth.

So, what is our average (and now thoroughly terrified) first-time pregnant woman to do?

Most likely, she'll figure that she has a highly-skilled doctor and well-equipped hospital that will keep her and her baby safe because they're the experts, and she'll decide she will get an epidural, so she won't need to worry about pain. It is likely that her preparation won't go much beyond this. She will still have other fears to deal with, though. For example, what if she's afraid of needles?

Fear of Needles

Fear of needles is pretty common. I see nothing unreasonable about having a fear about a sharp object penetrating one's skin to introduce foreign substances into one's body. I realize that needles do a lot of good in medicine, but the idea of them is just disturbing to me. It is sometimes fear of needles that leads women to seek out natural childbirth.

My Answer?

The best answer to the fear problem is childbirth education. And by childbirth education I don't mean most hospital-sponsored classes where the woman learns a little (but usually not enough) about what is going on in her body, what routine medical procedures to expect (without letting her know she has the right to refuse all of them), and that epidurals are usually safe and not anything to worry about. I mean childbirth education that is free to tell you what the hospital doesn't want you to know.

Most natural childbirth classes address fear in two ways. They tell women that they can give birth without medication, just like women did before medication existed, and teach them pain coping techniques which helps increase their confidence and overcome their fears about pain. Some of these techniques rely on freedom of movement, so these classes usually encourage women to consider declining unnecessary routine medical procedures that interfere with movement (such as IV fluids and continuous monitoring). They also address fear of the unknown by teaching about the natural process of birth, as well as explaining how medical interventions might affect the process and giving information about the risks and benefits of these procedures and encouraging women to choose for themselves whether to accept them or not. Feeling like they are involved in decisions about birth helps women feel less afraid.

Fear of Medical Interventions

However, the downside to teaching about medical interventions (both in classes and other places such as books/films/internet groups) is that sometimes this education has the unfortunate side effect of creating fear of medical interventions. So, fear of pain, birth, and the unknown, are replaced by fear of hospitals, pitocin, and iatrogenic complications. Remember, fear interferes with birth, no matter what the source or intention. Going into birthing with any kind of fear is not healthy. And there is always a possibility that a woman will need medical intervention in her birth, and if that happens, we don't want her to be afraid of it. I recognize that fear of pitocin had negative effects in my own first birth.

I want women to be able to make birth decisions without fear. The presence of fear makes it difficult to use the other things we need to make decisions--our logic and our intuition. Sometimes natural childbirth sources are guilty of some of the same fallacies as the medical side of things. Those who believe in liberal use of medical technology in birth will focus on a few rare complications as reason why a woman shouldn't choose a homebirth, a VBAC, minimal monitoring, no IV or heplock, etc, while ignoring the majority of births that go right. Natural birth advocates sometimes focus on the rare scary complications of epidurals and cesareans, without mentioning that the majority of women who choose an epidural or need a cesarean have no major problems. It is important for women to understand the risks of interventions, while at the same time understanding that there are times when the benefits of these interventions clearly outweigh the risks.

Overcoming Fear

I feel that the best type of childbirth education would present information in a way that doesn't scare women, but provides them with unbiased information that allows them to make informed, and not fearful, choices. Good childbirth education also has ways of helping women overcome their fears. Hypnobabies includes a fear-clearing exercise that works very well for this. Some other ideas can be found in this post by Felice at The Gift of Giving Life.

Spirituality of my Birth Experiences

Some blogs I read have mentioned the recent Lamaze press release, New Data Show Connection Between Childbirth and Spirituality. After my second birth, I was introduced to The Gift of Giving Life, a blog that explores the spirituality of childbirth in depth, and focuses primarily on women who are Latter-day Saints like me. I kind of thought that I didn't really have spiritual birth experiences because I didn't write about my births in a spiritual context when I wrote my birth stories, but with some more thought, I recognized that there were things about both that were very spiritually significant for me, and I'd like to write about them here.

I don't think I realized it at the time, but it is likely that the Lord led me on my quest of knowledge during my first pregnancy. The motto for BYU, the church-owned university I attended, is "The glory of God is intelligence" (from D&C 93:36). I believe that my desire to find greater knowledge and truth about birth was directed by the Spirit, since all light and truth come from God. Looking at it now, it's hard to see how the Lord could not be involved in such a drastic transformation.

My first birth itself had some very spiritual moments. I remember feeling kind of sad after the epidural was in because it wasn't what I planned, though I realize that, under the circumstances, it was really a blessing that I could get the epidural and get some rest. I listened to my iPod after I got the epidural, and chose at that time to listen to a collection of instrumental arrangements of hymns by Lex De Azevedo. I remember the soothing music giving me peace and helping me sleep despite my conflicted feelings about the situation. Because the birth took place on a Saturday at a small hospital, we got our pick of the rooms on the floor, and chose the one with a great view of the Mt. Timpanogos Temple. There are large windows in the maternity rooms, and the drapes were open when I gave birth at 9:52 pm and the temple was all lit up. I looked at the window while I held my daughter on my belly with the cord still attached, the delivery lights in the darkened room lit us up in the glass, and the temple glowed on the other side. I think it will be very special to tell my daughter that she was born under the glow of the temple.

Mt. Timpanogos Temple at night (source: wikipedea commons)

During my second pregnancy, I did some journaling, and in explaining why I wanted a natural birth, it came together to me that I feel that God designed the birth process with perfection, and that interference in the process causes trouble. I realized, while studying Hypnobabies, that the Lord has given us everything we need to create comfortable childbirth within our own minds and bodies. I found ways to tie the Hypnobabies philosophies in with my religious beliefs and even found some hymns that had the word "peace" (a cue used for comfort in Hypnobabies) in them. I thought it would be a nice option to have hymns to sing during my birthing time. I didn't end up doing that, but tying the hypnosis tools to a religious idea was good for me.

During my second birth, I did not think much about spiritual matters. I focused on listening to my Hypnobabies tracks and using my hypnosis techniques. For much of my first stage, I feel Hypnobabies helped the atmosphere be more reverent because it kept me calm. Second stage was very intense, but the sudden change from feeling overwhelmed by the intensity to the complete joy of having my baby in my hands and knowing I had done it was very similar to how some people describe spiritual events like conversion or repentance/forgiveness.

17 And it came to pass that as I was thus ^aracked with torment, while I was ^bharrowed up by the ^cmemory of my many sins, behold, I ^dremembered also to have heard my father prophesy unto the people concerning the coming of one Jesus Christ, a Son of God, to atone for the sins of the world.

18 Now, as my mind caught hold upon this thought, I cried within my heart: O Jesus, thou Son of God, ^ahave mercy on me, who am ^bin the ^cgall of bitterness, and am encircled about by the everlasting ^dchains of ^edeath.

19 And now, behold, when I thought this, I could remember my ^apains ^bno more; yea, I was harrowed up by the memory of my sins no more.

20 And oh, what ^ajoy, and what marvelous light I did behold; yea, my soul was filled with joy as exceeding as was my pain!

21 Yea, I say unto you, my son, that there could be nothing so exquisite and so bitter as were my pains. Yea, and again I say unto you, my son, that on the other hand, there can be nothing so exquisite and sweet as was my joy.
(Alma 36:17-20)

This passage from the Book of Mormon illustrates being "born again," which I think may be just as much like giving birth as it is like being born (the latter is something I'd like to explore more in a future post). I saw, in giving birth naturally, a metaphor for what it feels like when we allow Christ to take our burdens. Although I didn't recognize it at the time, this was something I learned a lot spiritually by experiencing.

I believe that all pregnancy and birth is spiritual. It involves working with God to bring a new soul into this life so that an individual can progress on the path to exaltation. It is the expanding of a family unit and, in the case of first births, it is the moment when people become parents. These are very spiritually significant things. I feel we can make birth more of a spiritual experience for us if we try, and I hope to do so even more with my future pregnancies and births.

Understanding "Painless" Childbirth

This post is inspired by a recent conversation on my natural childbirth forum, as well as a few birth stories I have read from Hypnobabies moms who were surprised to find that their pressure waves felt "painful" to them. It also is a response to something I stumbled upon while browsing the archives of a natural childbirth blog, in which the author said she would not want to have a painless birth.

So, what is up with "painless" childbirth?

A few women are rumored to have "painless" births without special preparation. I think this is probably pretty rare, but the fact that it happens is notable. The majority of women who refer to their births ans "painless" or "pain-free" are women who used hypnosis.

I think this is something that is commonly misunderstood, and I admit I didn't understand it when I was preparing for my first birth. I read the book Hypnobirthing by Marie Mongan, and listened to the CD that came with it a few times. As I understood it, Mongan was teaching that all "pain" in childbirth was a result of the fear/tension/pain cycle, meaning birth will not be painful if you are not afraid of it. I believed that what we experience in birth is a direct result of what we expect, so I chose not to expect pain. I was really oversimplifying things, and I was in for a rude awakening.

When I started having contractions (I refer to them as "contractions" here because that is what I called them at the time--I didn't buy into the idea of changing the words then) I admitted that "they hurt," but it was very manageable. They went on for quite a long time, going away and coming back, and then I was given a very low dose of pitocin, and those contractions really hurt. I was still able to cope using movement and deep breathing for a while, but I was really miserable. I do recognize that there was a psychological element to this pain. In my mind, something external (pitocin) was inflicting pain upon me, instead of it being caused by my own uterine muscles contracting. This, as well as exhaustion and pressure to dilate due to risk of infection, made it much harder for me to cope.

I think that I, as a first timer, espoused a common misconception about painless birth: believing that your birth will be painless just because you've heard of it and believe it's possible. I didn't think I needed to do anything to have a painless birth; I thought it would just happen because birth is not "meant" to be painful (right, Dr. Dick-Read?)

My understanding of this changed when I did the Hypnobabies program for my second birth. I don't know if there is really a difference in the two programs' views or if my experiences caused me to have this new understanding. I don't know if birth is really "meant" to be painful or not, but I do know that it involves a stimulus that the majority (at least in our culture) of women's brains interpret as "pain," which is generally experienced as a negative thing. Good hypnosis for childbirth provides a system for changing your mind so that the stimulus is interpreted as not painful, so that it can be experienced more positively. For me, with my second birth, experiencing it positively involved a conscious choice on my part.

Both Hypnobirthing and Hypnobabies use a technique of renaming some of the words commonly used in childbirth. This is a strange practice and, I admit, it's a little cumbersome at times, but many women find it helpful to avoid negative associations their subconscious may have with the words. One example is avoiding use of the word "pain" and using "discomfort" instead, because it is not as negative of a word. Some could argue that "painless childbirth" is about semantics, but it's really about what you choose to believe.

I believe that most women who have unmedicated births are able to find a way to experience the stimulus of the sensations of childbirth as not a bad thing, even if they do experience them as painful. In embracing a "pain with a purpose" ideology, women are choosing to tweak their understanding of the word "pain" (which is usually a negative word to describe a sensation that occurs when the body is being harmed) to include a kind of pain that is good. This essentially means changing the negative connotation of the word "pain" to be positive in this particular circumstance, while with hypnosis, we simply change the word, eliminating the negative connotation altogether.

I think some people, when they hear "painless," assume that means not feeling anything--that the "hypno-anesthesia" would be like an epidural and make them numb. It doesn't work this way. Hypno-anesthesia is very strong endorphins. It's like when you cut yourself or you twist your ankle and at first it hurts a lot, but then it doesn't hurt as much, that's endorphins. They soothe and dull pain, but they don't take away sensation. With a pain-free unmedicated birth with hypnosis, you would still feel your baby being born, it just wouldn't feel like pain to you.

Sometimes the talk of feeling "only pressure and tightening" in Hypnobabies leads women to expect that birthing waves will feel just like Braxton-Hicks waves. This is not true either. Braxtion-Hicks are just tightening sensations, for me, birthing waves (and also the pre-birth waves that can occur irregularly for weeks before the actual birth) have an extra level of intensity--what I now call a "downward pressure" which signaled to me that my uterus was now working to begin moving my baby down instead of just flexing itself for the exercise.

One of the changes in the new 6th edition of Hypnobabies is the re-recording and re-naming of a track that used to be called "Painless Childbirth" to "Easy, Comfortable Childbirth." Hypnobabies appears to be moving away from using the word "painless," which, considering all of the misconceptions about it, I think is a good move. I feel like "comfortable" is a more accurate description of how Hypnobabies helped me. Whatever sensations I felt (some of which I may have called "painful" under other circumstances), I knew they were normal and was able to not be afraid of them, which allowed me to feel calm and confident and not out-of-control or panicky (except during the cervical lip and the pushing, but I have theories about that). I wouldn't say I was "in pain," because for me, being "in pain" never involves that degree of serenity and self-composure.

I know there are some women for whom surviving the pain of childbirth provides a sense of accomplishment. It makes them feel like they are "hardcore." I, on the other hand, am not "hardcore," nor do I want to be. I can get a sense of accomplishment from seeing that I did something most people experience as very painful, and it was mostly comfortable to me, and I did it with my mind!

Birth Attendant as Lifeguard

Clarification: I use the term "birth attendant" here to describe a maternity care provider such as a physician or midwife, not a doula. I don't often use this term, but I must have subconsciously chosen to use it while writing this post because it is most appropriate for the role I was trying to describe, the midwifery model's idea of a caregiver who "attends births" rather than "delivers babies."

Since writing my last post about lessons from the freebirth movement, I have been thinking more about the roles of birth attendants. A guest post at The Gift of Giving Life (one of my favorite blogs) written by Heatherlady called On Cows and Chickens, got me thinking even more.

I believe that women are created to be able to birth their babies. I have read a lot about how hormones control birth and how negative emotions affect hormones and thus interfere with birth. I think that when a birth attendant interferes with the delicately balanced natural process of birth, they risk doing more harm than good. And interfering can probably happen easier than we sometimes realize.

People who believe strongly in the natural process of birth, including unassisted birthers, often compare birth to other normal activities that have some small level of risk associated with them, such as driving a car, playing a sport, etc. They argue that we don't need immediate access to medical technology while doing these things, so we shouldn't need it for birth.

My husband hates analogies because people sometimes use things that are not similar enough to make a good comparison, and I often agree (for example, unmedicated childbirth is not like getting teeth drilled and has nothing to do with hitting yourself with a hammer). However, occasionally, I find a good anaolgy. One such analogy, which I originally got from the Hypnobabies program, compares the birth attendant to a lifeguard.

Although birthing is instinctual and swimming is a learned behavior for humans, there are still a lot of similarities between the two. Swimming is an everyday activity, and the risk of drowning is quite low. The website for the International Life Saving Foundation(ILS) cites a drowning rate of 1.2 million people per year. Worldwide, swimming is statistically safer than childbirth, as the World Health Organization statistics from 2005 give a stillbirth rate of about 3.3 million, and a neonatal death rate (during the first 28 days of life) of over 4 million (WHO World Health Report). Worldwide maternal mortality for 2005 was 536,000 (WHO maternal mortality)

Most people who know how to swim feel confident and comfortable doing so freely without immediate access to medical technology. We are cautious with our young children, for whom the risk of death is greater ( the ILS website states that children make up more than 50% of drowning victims). But with the proper precautions (such as careful supervision and use of flotation devices), swimming can be safe and enjoyable for young children as well.

Despite the relative safety of swimming, we have people trained to attempt to make it safer. According to the ILS website:

The terms “lifesaver” and “lifeguard” are used around the world to describe individuals with special training who are stationed to prevent accidents and to respond to life-threatening emergencies in the aquatic environment.

My older brother used to work summers as a lifeguard at one of the community pools in the area we lived. His job involved watching swimmers to make sure they were safe and reminding them the rules that would could protect them from danger (things like no running, no diving in the shallow end, and making sure the area below the diving board is clear before diving). He had special training and certifications for the job, and was paid for it. Life guarding is often over-dramatized in movies and television, where they are always jumping in to save people and doing CPR. My brother never had to rescue anyone, he mostly sat on his tower all day and worked on his tan, but he could have saved someone if he needed to.

The ILS website estimates that those trained in their lifesaving skills make over 1 million rescues a year. Considering the drowning rate of 1.2 million per year, that means they cause a significant reduction. Parents who take their children to a pool with a lifeguard might feel some assurance knowing that there is an extra layer of safety there--an extra pair of eyes watching for danger, someone who is trained in rescue swimming and has current CPR certification.

I like to think of a good birth attendant as being like a lifeguard. They are specially trained professionals who have the skills to save lives when things go wrong. Occasionally, they may remind a birthing mom to breathe deeply or help her relax, but mostly they should sit and watch for signs of problems. "Watching" could possibly include a variety of things (checking hearttones, recognizing pathological labors, checking for tears, monitoring blood loss, ect.), but it should not include routine unnecessary medical intervention (e.g. elective induction, IV drips, pitocin augmentation, artificial rupture of membranes, etc), telling the mother how to birth her baby, or making decisions for her. In the event that there are complications, birth attendants can save lives (by helping get shoulders unstuck, giving pitocin for bleeding, resuscitating an oxygen-deprived newborn, ect.) much like a lifeguard, but if lifeguards were to jump in and pull people out of the water who didn't need saving, they would likely interfere with people learning to swim on their own and ruin people's swimming experiences.

My Son's Birth

I did the homestudy program from Hypnobabies to prepare for this birth. I really enjoyed Hypnobabies during my pregnancy. It includes daily relaxation practice, which I often used to help me relax and fall asleep. It helped me bond with my baby and look forward to his birth. It also had tools for helping me get rid of my fears and helped me have more confidence in myself.

For those reading this who are unfamiliar with Hypnobabies, one of the concepts taught in it is that words have power. Many words commonly used in pregnancy and birth have negative associations in many people’s minds. Hypnobababies replaces these words with other words, in an effort to help you be more positive. I will be using these words during my story. Instead of “contraction,” I use “pressure waves.” I also avoid using the words “labor” and “delivery,” calling it “birthing” instead, and I try to avoid using the word “pain” when talking about birth.

For those reading who are studying Hypnobabies, you may or may not need to use your bubble of peace. I would label my birth “mostly comfortable.” Hypnobabies definitely worked for me, but there were times when I got off track and had discomfort, and I really struggled a lot during the pushing phase. Honestly, there were times during my birthing when if someone asked at the time if I was having “pain,” I probably would have said yes, but most of the time I was comfortable and felt very calm and relaxed.

On Friday, March 5, 2010, I woke up around 4:00 a.m. having pressure waves. I tried listening to my Hypnobabies tracks to see if I could fall back asleep, but after about an hour, I decided to get up because if the baby was going to come today, I was going to need to get a few last minute things together for my hospital bag. I found the charger for my digital camera battery, and I sat on my birth ball at the computer, printed out some extra copies of my birth preferences, and plugged in my ipod so it could charge. I got on the internet and did some stuff and tried to time the pressure waves with the “contraction master” website, but they seemed to weaken while I was on the ball and were sort of hard to time.

A couple hours later, my husband Tiatia got up to go to work, and then my 2 year old daughter got up. My pressure waves had pretty much stopped by this point. My daughter and I had breakfast. I think we ate some of the blueberry muffins we had made as a project the day before. I put on a few shows for her on the DVR and I did some cleaning. I loaded the dishwasher and cleaned the kitchen, including mopping the floor. Then I felt tired, so I sat down and folded a load of laundry that I’d washed the day before. My daughter and I had some chicken noodle soup for lunch.

Around 1:00 p.m., after starting a load of laundry, I read my daughter some books and then I put a Hypnobabies track on out loud and I laid down with her and we both had a nap. I woke once during the nap to a pressure wave but went back to sleep and then had another one when I woke up around 2:30 and I think one or two more while I was lying down. My pre-birth waves mostly came at night or early in the morning, so having waves during the day was unusual for me. They were also strong enough that I was wondering if hypnosis was going to work. I used my lightswitch and peace cue and it really helped me feel more comfortable during them. I suspected that it would soon be time to meet my baby. I got up and put on my headphones and listened to Birthing Day affirmations while I did some more cleaning and preparing. I moved the load of laundry to the dryer, straightened up the living room, and got together My daughter’s clothes and things she would need for staying with friends while we were at the hospital.

My daughter woke up and I think she played with toys for a little while. I hadn’t had any cervical checks from my doctor, but I had tried to feel my cervix myself. It had felt soft and slightly open about a week before. I decided to check it again and it felt softer and more open now, if I had to guess, I’d say about 3 cm, and I could feel how The baby’s head was now against it. I had noticed that he felt lower on Thursday morning, and at my appointment that day, Dr. I. felt my belly and said that his head was engaged. A piece of brown-tinged mucus plug came out on my fingers when I checked myself. I started to finish packing my hospital bag, but all the stuff I needed would not fit in the bag I had already started to pack. I tried transferring it to another bag, but it wouldn’t all fit in that one either.

I realized the waves were coming pretty frequently, so I decided to time them. I got on the computer on the birth ball. Pressure waves were about every 6 minutes apart. I knew it was the real thing now. My phone rang during a pressure wave and I wasn’t able to answer it. I was Tiatia. He was probably calling to tell me he was getting off work and would be home soon. I called him back, but he didn’t answer. I sent him a text saying I thought we’d be going to the hospital tonight, but I don’t think he got it. The idea of getting in the bath sounded really good to me. I put on a DVD for My daughter (I normally try to limit her TV viewing, but I made an exception that day) and I filled the tub and put in a few drops of lavender oil, which I had been putting in my scent diffuser during my Hypnobabies practice to help with relaxation. I put my laptop in the bathroom so I could play my Hypnobabies tracks while I was in the tub. I put on “Painless Childbirth” (which I think is called “Comfortable Childbirth” in the 6^th edition) and lied down in the tub and relaxed.

I’d brought my phone in the bathroom and Tiatia called again. He could tell I sounded different and I told him I was having pressure waves that were pretty intense. He asked when I thought the baby was coming, and I told him either late that night or early the next morning. I told him I was in the tub. It turns out he had stopped at the Redbox on his way home and picked up a movie for us to watch that night. Yeah, that didn’t end up happening. He got home a few minutes later and came in the bathroom to check on me and I told him I was coping fine. He watched Our daughter for a while and I guess he fed her macaroni and cheese and he also got together a bag with clothes and toiletries for himself and packed phone chargers, the video camera, the laptop, and the digital camera with it’s now fully charged battery.

I listened to “Deepening” next, and continued to handle the pressure waves very well. I really wouldn’t describe what I was experiencing as painful, and I felt really in-control. Doing the deep slow breathing and using the “peace” cue while imagining anesthesia going to my lower belly (where I felt the majority of the sensation of the waves) really helped. I got into some different positions in the tub. I sat cross-legged and I also kneeled . After “Deepening” I listened to “Special Place” and I felt my baby move around during it, just like he did the first time I listened to it when I felt so connected to him that I got tears in my eyes.

Towards the end of the track, I lost my focus during a few waves and they started feeling really uncomfortable. I called out that I needed help and Tiatia came in. I told him it was really intense and I didn’t know if I could do it. I almost started crying. I was scared. He asked if I wanted to go to the hospital, and I said I did. He started making phone calls to get our daughter taken care of. I got out of the tub and got dressed. I divided the stuff I needed to take to the hospital between my two bags and put my lavender oil and my phone in one of them. Then I got my ipod and my headphones, and realizing that I needed something more than the regular tracks, I put on the Birth Guide. I regained my focus and was once again able to handle the waves. I sat on the birth ball in the living room and leaned forward on the arm of the couch. I told Tiatia I needed a drink, so he gave me a little bottle of apple juice and I took sips of it between waves.

A friend came to get our daughter who and really did not want to leave. I went over to her and gave her a hug and told her it would be okay, but she didn’t believe me. The friend asked if my water had broken and I told her it hadn’t yet, then a pressure wave started, while I was still kneeling on the kitchen floor, and I had to close my eyes and do my deep breathing. She asked, “How far apart are they?” and I couldn’t answer her, both because I was still having the wave and because I didn’t know, I hadn’t been timing them. Somehow Tiatia got into our friend’s car. He came back and asked me how I was doing and I said I was feeling more in-control now. I told him I wanted him to help me time the waves. We went in the bedroom and I turned on a lamp instead of the light so that it wouldn’t be too bright. I sat on the birth ball and put pillows on the bed and leaned forward on the pillows. Tiatia timed the waves with the stopwatch on his phone. I told him I also wanted him to use the “relax” cue on my shoulder. I once again lost focus during a few of the waves and made some noise, but the “relax” helped me relax and focus and I got back to feeling like the waves were only pressure and my anesthesia was working. We discovered that the waves were between 2 and 3 minutes apart and were all lasting over a minute. I was still able to talk calmly between the waves. We decided it was probably a good time to head to the hospital. I said we needed to call Dr. I. and told Tiatia where her number was. At first, he wanted me to call her, but I told him to do it. He called and told her we were going in and how close together the waves were. She said she’d meet us there.

Tiatia loaded everything into the car, and I made sure we got the extra pillows and the birth ball. I also brought my apple juice. I got in the back seat of our mini SUV and we took the headrest off the front seat put a pillow on top of it and leaned forward. I continued listening to the “Easy First Stage” track. I was actually quite comfortable during the 25 minute car ride, which was amazing because I remembered being very uncomfortable in the car last time. When we left the house it was around 9:00 pm.

We parked and Tiatia carried a bunch of our stuff in. We walked in and Tiatia told the receptionist at the ER admitting desk who we were. She called the maternity center and told us they’d be coming to get us. She asked if I wanted to walk or ride in the wheelchair, and I said I thought I’d be fine walking. She put a hospital bracelet on me, during a wave, of course. While we waited for them to come get us, I was standing there, drinking sips of juice between waves, and during them I’d lean on Tiatia and he’d say “relax” to me. It felt wonderful to feel so relaxed and in control. I remember telling Tiatia that they felt like they were coming right on top of each other now, since they were so close together and lasting so long, but I didn’t say it like I was afraid, it was just an observation. It seemed like it was taking a long time for them to come and we started to wonder what the hold up was. The receptionist called them again.

When they finally came for us, they asked again if I wanted the wheelchair and I decided to get it because I remembered from when we came to preregister that it was a pretty long way and the waves were so close together I’d have to stop a lot. Riding in the chair, I was able to keep doing what I had been doing. We got to the LDRP room (not a triage room like I went to first at the hospital where I had my daughter, which I was glad of), and they already had the lights dimmed for us and Dr. I. was there. Once the pressure wave I was having was over, I got out of the chair and our nurse, Dianne, gave me instructions on giving a urine sample and how to wear the hospital gown. I had another pressure wave and leaned forward on the cabinet that contained the fetal monitor machine. Then I said I brought my own nightgown to wear, and she said that said was fine. I told Tiatia which bag it was in, and he gave the bag to me. I took the cup and my bag and gave the sample and got changed.

Dr. I. had me get in the bed so they could put the monitors on me and she could check me. She said that if I needed to move during waves, I could. It turned out I was able to use my hypnosis to stay comfortable in the bed (with the head of it raised) during pressure waves, which is something I couldn’t do during the unmedicated part of my first birthing. Dr. I. checked me and, drum roll, please…I was 8 centimeters! I looked at Tiatia and said how happy I was to be so far along. He had a big smile on his face. Dr. I. showed me how big that was on the dilation chart. She asked Dianne to get a birth ball (we’d left mine in the car—one man can only carry so much) so I could sit on it, which sounded great to me. I sat on the ball and leaned forward on the bed.

Dr. I. asked what the results of my GBS culture had been and I said she’d never told me, so I’d assumed negative. Someone came to take my blood, and I barely felt it. Then Dr. I. said they were going to need to give me an IV for antibiotics because it turns out I tested positive for GBS . At first I said “okay,” but then I said I wasn’t sure if I wanted the antibiotics because I’d done reading on it and there are risks to the antibiotic use, too. Dr. I. said that the antibiotic they use is mild and that it would be to protect the baby. I agreed to get it, and now I do think that was the right decision because had I known I was positive beforehand, I would have done natural remedies to make it less likely for the baby to be infected. Dr. I. said that it was good that my water hadn't broken yet, since the membranes being intact for longer reduces the risk of infection, and she said it would be best to (as I'd requested) wait until it broke on its own.

It took at least 4 tries and 3 different people to get an IV in me. Apparently the veins in my hands are deceptive—they look great, but when you try to put the needle in, it doesn’t work. They ended up putting it on my left forearm. Getting stuck multiple times was really uncomfortable and quite frustrating, so I was relieved when they got it in.

After that, the memories are not completely clear. I remember Dr. I. suggested some different positions. I know I stood leaning forward for a few waves. Someone was behind me with their hands on my hips, but I have no idea who it was. I think after that she wanted me to try kneeling, so she adjusted the bed so that I could kneel on the foot of it and rest my head and arms on the middle part. I think that when I went to get into that position is when I vomited all over the floor, but I knew that was a good sign, a sign that I was nearing full dilation, and I also had read that the act of throwing up can help your body open up faster. I remember saying that I felt better after throwing up. I also remember saying I felt shaky, and Dianne said that meant I might be in transition. The kneeling position was comfortable, and I was still very focused and relaxed, using my hypnosis, restarting the “Easy First Stage” track on my ipod whenever it ended. I think Dr. I. checked me in this position and I was 9 cm.

Soon I started to say “Ah” at the peaks of the pressure waves, and Dr. I. asked if I was feeling rectal pressure and I wasn’t yet. Then a few waves later I said I was starting to feel it. Sometime around this time, “Easy First Stage” ended again and I let “Pushing Baby Out” start playing. Dr. I. had me get back in the semi-seated position and checked me again, and she said there was a lip on my cervix and the baby’s head needed to rotate a little more. I continued to “Ah” all through the waves, and that felt good. I think Dr. I. had me get on my side. She told me that if I really felt I needed to push at the peaks of the waves, I could.

After a while, she checked again, and the lip was still there, so she tried having me push while she held back the lip. That was very uncomfortable and it didn’t work. It was during this that my water finally broke. She told me to try not to push for a while. Now that I had pushed, I felt like I needed to keep pushing. From this point on, I was never able to really get back in the peaceful place I had been before. It also didn’t help that I had never actually listened to “Pushing Baby Out” all the way through to make sure it was okay and it turns out the track on my iPod was incomplete, so it would just stop in the middle of something. I felt panicked and very out of control and was not comfortable at all. As the waves would peak, I’d yell “I CAN’T NOT PUSH!” and would try to push only as much as I absolutely had to. Dianne had to tell me to slow down my breathing so I wouldn’t hyperventilate. At one point, Tiatia kissed me (if you’re unfamiliar with why this is helpful, read Ina May’s Guide to Childbirth by Ina May Gaskin), and that did help me relax some. I was touched that he thought to do that, that he actually had paid attention to some of the stuff I’d shared with him from my reading. I also switched from “Pushing Baby Out” to “Deepening” because I wasn’t supposed to push yet, and then I never went back to “Pushing Baby Out.”

Somehow I got past the really intense part of not being able to push and moved on to the really intense part of trying to push. Dr. I. said I could change positions if I wanted (I was now back to semi-seated), but I didn’t want to move. Dianne pulled some handles up from underneath the bed and told me I could hold on to them while I pushed. I started pushing, but the way I was pushing wasn’t working. Dr. I. noticed I was tightening my pelvic floor, so she and Dianne had to tell me to relax that area and focus on pushing with my abdominal muscles. Dianne got right in my face and Dr. I. told me to look at her. She told me to hold my breath and push. She did count to 10 during some of the pushes, but for most of them she didn’t count and I only pushed as long as I felt I could, and for some of them I did breathe out instead of holding my breath. Dianne also told me not to start pushing when the wave started, but to wait until it built. I was not able to relax the rest of my body while pushing, and as a result, I was very sore the next day. I also burst a blood vessel in my eye.

At some point during the pushing phase, Dr. I. said something about wanting to put in an internal fetal monitor because the external one wasn’t doing a good job of tracking his heart rate. At first I said “okay,” but then my inner advocate kicked in and I said I didn’t want the monitor screwed on my baby’s head. Dr. I. told Dianne to adjust the external monitor and it picked his heart rate up better. I was glad I stood up for my baby.

Once I got pushing figured out, it wasn’t too long before I felt him in the birth canal. The feeling when he crowned was very, very intense. It didn’t feel like burning to me, though, it felt like the perineal massage (a gentle version) I had done a few times, only about 10 times more intense. Looking back on it, the feeling was kind of cool, but at the moment I really wanted it to be over. I wanted to keep pushing, but Dr. I. told me that my perineum would stretch better if I waited for the next pressure wave. His head was out with the next wave and I had to keep pushing his body. I remember Tiatia reminding me to breathe in, because I just wanted to keep pushing.

Our son was born at 1:47 am. I reached down and pulled him up onto my own belly, which is something I had wanted to do ever since I’d seen it on a video. They put a towel on him and I talked to him and rubbed is back. He was a little purple and not crying. The other nurse, whose name I didn’t get, told me she was going to have to take him. Dr. I. clamped the cord and Tiatia cut it. Tiatia later told me that the nurse had suctioned The baby and given him oxygen. He took a video and some pictures. Dr. I. had me push out the placenta. Then, she and Dianne started doing uterine massage, and my uterus wasn’t firming up and I was bleeding too much. The baby wasn’t ready to breastfeed yet, so they put pitocin in my IV. Dr. I asked if I wanted it in a shot instead, but since the IV was already running, I said it was fine to do it that way. A little while later, I was still bleeding more than they like to see, so Dianne gave me a shot of methergine in my thigh.

When the baby was ready, the nurse brought him back to me before dressing him so I could hold him skin-to-skin. He latched right on and has done a great job nursing ever since. After we had some time to nurse and bond, the nurse weighed him and he was 7 lbs 10 oz—7 oz bigger than his sister was. She diapered, dressed, and swaddled him. Dr. I. showed me the placenta, which was really cool. She showed the maternal side and the membranes that held my baby as he grew. This was really interesting to me.

I felt amazing after the birth. The hormone rush was really awesome feeling. I was so proud of myself for doing it unmedicated and for feeling so in control for much of the time. I really believe I couldn’t have done it without Hynobabies. Dr. I. told me that she thought I should get certified to teach the program like I had told her I was considering doing if I found it helpful during my birth. I was up taking a shower soon after. It felt really good to be able to shower. It was a little difficult still having the IV attached because I wasn’t wearing a hospital gown, so I had to leave one strap of my nightgown around the IV line, and when I tried to put the nightgown back on, it got all tangled around the line and Dianne had to help me fix it.

Because of my positive GBS status and only getting one dose of antibiotics (you’re supposed to get 2 doses, 4 hours apart, but I wasn’t at the hospital long enough), they wanted to keep The baby in the hospital for 48 hours to watch him for signs of infection, since about 80 percent of newborn GBS infections show up during that time period. I loved that I didn’t have to switch rooms at all during my hospital stay and that, because the same nurses who help with the births also do postpartum care, on our last night we got to see Dianne again.

Dianne said she had read my birth preferences and I could tell she really made an effort to follow them. She told us that the reason she left us in the ER waiting room so long was because my birth preferences said I didn’t want it loud and she wanted to do all the noisy room set up before they brought me in. She also said how surprised she was when Dr. I. said I was 8 centimeters, because I wasn’t acting like it. We talked about how difficult my pushing phase was, and Dianne said that it looked like I was actually pushing right, and The baby just wasn’t coming down. She said normally women don’t need to push with their abdominal muscles. She said she was actually thinking they were going to need to use the vacuum extractor, but she hadn’t suggested it because she knew I wanted minimal intervention. Tiatia mentioned that he’d actually yelled “relax” at me when I was panicking, and Dianne said that caused me to suddenly focus. I don’t even remember that, but I guess my subconscious recognized the cue, so my hypnosis training did help more than I thought it did during pushing.

Our son is a very cute and so far is a good baby. His birth was an amazing experience that taught me so much about the capabilities of my mind and body.