I &hearts Dancing for Birth&trade!

The Dancing for Birth™ training was awesome! I learned so much! I am currently planning on finishing up certification and teaching the classes, in addition to my Hypnobabies courses, but we will see if it works out.

In a nutshell, Dancing for Birth™ is a prenatal and postpartum fitness class and a birth and new motherhood support circle, with bits of birth empowerment and childbirth education incorporated into it. There is a basic flow to the structure of the classes, but the content is flexible--instructors can choose what to include each week based on the needs of their students. There is a huge list of benefits to dancing during pregnancy, birthing itself, and the postpartum time. Not to mention it is a whole lot of fun!

I had a wonderful time bonding with all of the other women who were at the training. It was a very passionate group, and the nature of the workshop allowed us all to become close very fast. Most of the other trainees were doulas, but we also had some midwives and belly dancers. One thing I really liked about the workshop was the opportunity to practice some comfort techniques, including the double hip-squeeze and several rebozo techniques.

I found that the vast majority of what was taught was very compatible with Hypnobabies. We talked about how having "sensation" is necessary to follow your instincts in childbirth, but there was not talk of "preparing for pain." There was some of the idea that "you don't birth in your brain, you birth in your body," which is not what we teach in Hypnobabies, because we teach that you most definitely do use your mind during birth--it is where your birthing hormones come from. However, I think "birthing in your body," it is just different wording for a concept that is taught in Hypnobabies--birthing in a state where our conscious, analytical thinking is pushed aside, a state we call hypnosis, but other people have different words for it. Dancing is a naturally hypnotic activity, so it makes sense that dancing during your birthing time would promote the ideal mental state.

We also did a game where music plays and everyone dances, then the music fades and people pretend to be having pressure waves (most people chose to stop dancing and lean forward onto something, which would work with using the Hypnobabies lighswitch), then the music fades back in and everyone gets up and dances again. This exercise reminded me a lot of something we do in Hypnobabies called a "birth rehearsal," and I could see how the techniques of both programs could work together as we did it.

We did another exercise where we compared the measurements of the pelvic outlet (from pubic bone to tail bone) in a deep squat (with hips below knees) versus a standing squat (hips above knees, pelvis tilted back, upper body leaning forward). I recommend trying this yourself--you may be surprised at what you find!

All instructor training workshop participants take home a copy of the Dancing for Birth™ DVD, and I have been practicing with it every other day since I got back. I have difficulty sticking to exercise routines, but since dancing is so fun, I'm more likely to do it (plus, I'm trying to get a good grasp on the moves for teaching it, if that works out) I am looking forward to having dance to use along with my hypnosis during this baby's birth!

The Trap of Idealizing the Intervention-free Birth

Sometimes we get caught in a trap of holding up a spontaneous, drug-free vaginal birth as an ideal, because, well, most women should be able to give birth without interventions, right? Then, we end up comparing an individual birth to this standard. I doubt anyone would actually say this out loud, but I think something like the following happens in some women's minds, though it is probably not this specific.

• Completely intervention-free vaginal birth? A+! Great job!
  
• Vaginal birth with IV and artificial rupture of membranes? B. Good effort!
  
• Induction and epidural? C. Mediocre.
  
• Epidural, episiotomy and vacuum extractor? D. It could have been worse.
  
• Cesarean? F. Better luck next time.
  

But this is not how it works. Your childbirth educator isn't going to give you a grade, because your baby's birth is not an exam! You are not "most women" and every birth is different. It is not your responsibility to prove that birth with minimal interventions is best. As a wise woman once said, "that's a pretty freakin' huge burden to put on one vagina." Interventions are sometimes needed. You can't know in advance that you won't need medical help, so it doesn't do any good to believe that getting it is a negative reflection on you.

After my first birth, I did feel like a C student. I felt like I hadn't done a good enough job at practicing tools for reducing or coping with pain. I thought that if I had prepared better, I possibly could have avoided the epidural. But how in the world can a woman expect to know how to prepare for something she has never done, having no real way of really knowing what it is going to be like for her? Can someone who has never given birth before really prepare for a long, slow, sleep-depriving early labor? An intense, lightening-fast, precipitous labor? Constant pain in her lower back that gives her no break? An emergency cesarean? How can we expect a first time mother to predict what techniques might be helpful for her so that she can practice them? How is she to know how much time she needs to put into practicing so as not to forget everything she practiced immediately when her birthing starts? And how is she supposed to devote any time at all to it when society tells her to "just enjoy the pregnancy" and "don't worry about the birth" until it is less than three months away?

I wish we could irradiate the word "failure" from our vocabulary in conversations about childbirth. I do not call doing something differently from what you wrote on your birth plan failure, I call that a change of plans. Changes of plans can be in response to medical necessity (because intervention sometimes does save lives and improve outcomes), or they can be for psychological reasons. If a woman who wanted a natural childbirth has crossed over from "coping" to "suffering," and nothing is working to bring her back, the decision to use pain medication is not failure. In that kind of situation, medication is probably the best choice to avoid trauma and allow the birth to be a good experience for the mom. As many have pointed out, a traumatized mom is not a "healthy mom."

If a woman had interventions in her birth she wouldn't have chosen with more information or if her options had been presented in a different way, it is not her fault. I hear a lot that a woman has a responsibility to inform herself, but the problem with not knowing is that we don't know what we don't know. Can we really expect a woman to be responsible for understanding all of the situations that may come up in her pregnancy and birth and all of the benefits and risks of available medical procedures? In an ideal world, her care provider (whose job it is to know these things) would present the facts about her choices as objectively as possible, and leave the decision to the woman. In most cases, reality is pretty far from this ideal, but I don't believe in blaming women for not finding out for themselves what their doctors should have told them. (Though getting angry about what doctors should do doesn't do us any good--Felice recently posted about this here.)

As always, the language we use is important. We have to pay attention to the implications of what we say--what a woman may read between the lines of our words. The phrase"sucessful VBAC," implies that a planned-VBAC-turned-repeat-cesarean is a "failed VBAC." Criticizing high rates of medical intervention by saying things like "I find it hard to believe that X percent of women's bodies are broken" implies that the body of a woman who has an honest medical need for that intervention is broken, and "Your body is broken" is not an empowering message. Besides, we don't consider it failure for our bodies to not function optimally all the time in life--I don't usually think my immune system failed me if I get a cold or stomach virus--I usually attribute that to bad luck. I think sometimes birth is the same way. Preparation plays a role in whether or not you get the birth you planned for, but so does chance.

Maybe those of us who have had that idealized birth shouldn't get cocky and maybe need to recognize that it didn't happen all because of what we did, and hopefully those of us who had a birth other than that one can recognize that it didn't happen all because of what we did either. At the same time, I do not wish to invalidate other women's feelings. If "failure" is the word you choose to describe how you feel, then that is your reality. If reading my thoughts on this does not bring you any healing, I wish you healing wherever you find it.

Stay tuned for the next post in the series!

The Myth of "Early Labor"

Expecting Mother By Petercantfail at en.wikipedia [Public domain], from Wikimedia Commons

As a science, medicine seeks to define things in specific terms. As a natural process, childbirth doesn't always fit into perfect little boxes. Childbirth education often uses the explanations from medicine in attempts to help women understand the birth process. However, based on my own observations, the "textbook labor" does not apply to the experiences of a very large proportion of birthing women, and I wonder if we are, by using it, doing women a disservice by creating false expectations.

The general model that is taught is that there are three stages of birth: dilation, pushing, and birth of the placenta. Within the dilation stage, three phases are taught: the early/latent phase, active phase, and "transition."

• Early phase is usually defined the time when the cervix is going from 0-3 cm dilation, and is characterized by pressure waves that are spaced far apart and my be irregular.
• Active phase is defined as cervical dilation from about 4-7 cm, and is when the waves get regular and increase in intensity and frequency and cause measurable cervical change.
• "Transition" is when the cervix goes from 8-10 cm, and is usually explained by its physical and emotional intensity and the presence of symptoms such as shaking, nausea, and vomiting.

There are a few problems with this construction.

• If this is the "normal" birthing women whose births do not fit this pattern may consider what they experience as "abnormal."
  
• It relies very heavily on measuring the cervix as a basis for knowing how far along a woman is.
• Some women's cervices will be reach dilations where thy should be in "active phase" but stay there for days or weeks before the baby is born, and there is nothing pathological going on
  
• I specifically disagree with the way "early/latent phase" is characterized.

The impression that this model gives is that from "not in labor" to "in labor" is a one way street; once "labor" begins, you are "in labor" until your baby is born. I feel that this construct, together with unrealistic media portrayals of childbirth (where it always seems like a woman is going along minding her own business, suddenly her water breaks, chaos and rushing ensues, as well as some screaming, and then someone is handing her a "newborn" the size of a 3 month old), encourages women to head to the hospital as soon as they have contracting sensations that they can tell are more intense than the Braxton Hick's they have been having.

I have been participating in an online support forum for women who are planning natural births for about 3 years now. On our group, we have a fun tradition called Lodges, which are a sort of journal for pregnant women that lasts from 36 weeks to about 1 month postpartum. I have followed many lodges in the past three years, so I have read updates from women as they are nearing the births of their babies. From my own informal observations, it appears to me that a majority of women experience periods of regular and intense pressure waves (not Braxton Hicks, but the same kind you have during birthing) on and off for days, weeks, and in some cases months, before giving birth. They will go long periods with no pressure waves, then have them start again for a few hours, then they'll go away. So, does early labor stop? Can early labor last for two weeks? Or is our idea of "early labor" a myth?

Some people would call the off-and on periods of pressure waves "false labor," but I really dislike that language because it implies that the woman doesn't know what she's feeling. In many cases, the only way to tell the difference is in retrospect: sometimes they go away and sometimes they continue to the birth of a baby, they usually don't really feel much different from each other, contrary to what some will tell you. "False labor" also implies that it is not doing anything, and I am of the opinion all pressure waves do something, even if it is not causing measurable dilation. It could be effacing the cervix or encouraging the baby to rotate into a better position. In some cases, dilation is occurring, just not quickly enough for it to be measurable. For women who have "false labor," it may just be that their body does the "early labor" work incrementally, with long periods of rest.

The problem is that I suspect that the majority of women don't know how common start-stop labor (as I like to call it) really is. I recently read a blog post by a nurse (shared on facebook by The Deranged Housewife) who blamed the "need" for hospitals to use pitocin on women going to the hosptial and getting epidurals too early. Comments on the facebook link suggested that the problem is not the patients themselves, but that someone is failing to adequately inform them what the end of pregnancy is really like. The nurse's post really made me wonder how many women are getting pitocin for "stalled labor" when actually they were having an episode of pressure waves that would have gone away? How many of these babies would actually have come days or weeks later without the pitocin?

(On a similar note, I also love this post by midwife Stephanie of Vita Mutari questioning the logic that it is "safe" to "labor at home as long as possible" in order to avoid crowding the labor and delivery floor and avoid interventions, yet "unsafe" to plan a homebirth with a midwife.)

The concept of "early labor" is misleading because it is so easy to mistake start-stop labor for "early labor," and if women assume "this is it"and run to the hospital at the first sign of a pressure wave, they are guaranteed to either be sent home disappointed or have a whole lot of interventions, and neither of those is a desirable thing. I know I fell into the "early labor" trap myself with my first birth--I remember thinking "I've been in early labor for two days and I'm only 1 centimeter?"

For real, human women, not mythical "textbook" ones, the onset of the birthing time is a fluid process that they may move in and out of at their own unique pace. The last few weeks of pregnancy are the orchestra tuning up before the concerto, the engines revving before the race.

How Midwifery Care Can Reduce Racial Disparities In Birth Outcomes

At the request of Courtroom Mama posting at The Unnecessarean, I watched the documentary Crisis in the Crib: Saving Our Nations Babies. I think the film does a great job of raising awareness on the issue of racial disparities in birth outcomes and infant mortality in the United States. It really got me thinking about what factors contribute to this disparity. I think it is a very complex problem, and it can be difficult to pinpoint all of the causes. Poor nutrition, lack of exercise, and lack of access to care are all factors, but they don't explain why there is still a disparity for babies of college educated black women. The film suggests higher stress levels and the lack of presence of a supportive partner as possible additional factors that could influence middle class populations. There are also some life-course factors.

As I was considering these factors and trying to decide what to write this blog post about, I remembered this video from last year's The Big Push for Midwives Issue Briefing for members of Congress showing Jennie Joseph, LM, CPM talking about her birth center, The Birth Place, in Orlando, Florida.

It's pretty clear that The Birth Place has drastically fewer racial disparities than her area's average. She attributes the difference to their care being more accessible to the uninsured, but I think that is only part of the story. I believe that the obstetric model of care, which is the norm in the U.S., is failing black women. Here are some components of the midwifery model that I believe may better meet their needs:

• Focus on Preventing Complications with Healthy Lifestyle - While obstetric practices generally focus mostly on screening for pathology, midwifery care includes extensive counseling on nutrition and exercise during pregnancy. This approach integrates prevention of problems.

• Individualized Care - Midwives strive to make their care specific to the needs of individual women instead of providing one-size-fits-all care that may be more suited to one race than another.

• Holistic Treatment - Midwifery care treats the whole woman, not just her body. Prenatal care that is only a medical check up is a missed opportunity to resolve other issues that could contribute to disparities, including social and emotional stresses in the woman's life.

• Longer Prenatal Visits - The average length of a midwife visit is significantly longer than one with a physician. This allows more time to focus on these issues and develop a trusting caregiver/client relationship.
  

• Relaxation Practice - Birth centers do not offer epidurals, so midwives at a birth center would encourage women to prepare for a natural birth. In fact, State of Florida Law requires that birth centers counsel their clients to receive appropriate childbirth education. This preparation usually involves relaxation practice, which can be helpful for dealing with stress.

• Empowering Education - Midwifery supports women in being educated and involved in decisions about their care instead of letting the birth professional make most of the choices for them. This can help them learn to take responsibility for themselves and their babies, both during and after the childbearing cycle.

I believe that the caring, sensitive, woman-centered model of midwifery care may be exactly what is needed to reverse the terrible trends we see in maternity care today and make great bounds in resolving the disparity we see between races in maternity care in the U.S.

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.

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 Trauma and Birth Disappointment

I've been reading the book Birth Crisis by Sheila Kitzinger. This book deals with the subject of birth trauma and PTSD following traumatic births--recognizing it, healing from it, and preventing it. It is a great book for birth professionals to help them know how to support women--either in recovering from birth trauma or giving birth following trauma, including some non-birth trauma. A lot of what is in the book relates to this blog, in that she discusses how over-medicalization and loss of personal control in childbirth can negatively impact women. The image on the cover depicts "birth-by-machine," though here, the "machine" refers to the entire maternity system.

Interestingly, I've also seen a lot of posts on blogs about birth trauma lately. One example is this post from Descent into Motherhood. Also, this recent post from Jill at the Unnecessarean talks about how ludicrous a comment was that was made on one of her posts. I find her Glenn Beck example humerous, though I am actually a fan of Glenn Beck and tend to agree with most of what he says. As someone with an education background, I have a lot of respect for his talent as a teacher, shown in his ability to make boring, political and economic topics interesting to people like me. But Glenn Beck is so not the point. I completely agree with Jill that trying to blame birth trauma on "culture" does not make any sense. Disrespect is disrespect. Violence is violence. Violation is violation. It doesn't matter what you "expect" or "value." When women are mistreated in childbirth and don't recognize it as mistreatment, is it not still mistreatment? In cultures where spouse abuse is culturally acceptable, are the battered women not still being abused?

There is a difference between trauma and disappointment. Birth trauma refers to experiences where the woman feels degraded, disrespected, assaulted and/or very afraid, usually involving some sort of breech of trust on the part of her caregiver, but not always. Birth disappointment occurs when the experience the woman gets is different than the experience she hoped for, even if she recognizes that the change of plans was for the best. During pregnancy, I try to live by the mantra "hope for the best, prepare for the worst," but I find it is not really possible to be fully prepared for every possibility in childbirth. Its also not possible to enter childbirth with absolutely no expectations. We can be flexible, but we can't control how what happens in childbirth affects us any more than we can control what happens in childbirth. We can, however, choose to heal, whatever healing means for us.