Gentle Birth, Home Birth, Empowered Birth

My second son was born at home.  During each contraction of early into active labor, I silently performed a breathing practice I’d learned during my birth hypnotherapy sessions.  I released tension from specific parts of my body with every exhalation.  Early in labor I was usually standing and would lean onto whatever piece of furniture was closest.  Later I sat for hours on my birth ball, which was the only place I found comfortable for sitting.  Often my doula or husband would run a back massager along my spine.  This coping strategy wasn’t a plan, but I had been using that breathing practice every night for weeks to help myself fall asleep, so it came easily to mind.  The back massaging was my doula’s idea.  She always had great ideas of things I didn’t even know I wanted during labor.

I took a couple of baths followed by naps.  Sometimes women find a bath or shower can kick labor into high gear.  For me, each bath slowed my contractions from about 4-5 minutes apart to about 7 minutes apart.  The longer pauses allowed me to rest for the long night ahead.  When I was preparing to enter my bathtub the first time, I was just a few hours into early labor.  I remember being overwhelmed by fear of the pain that might be ahead.  Suddenly, contractions that had been totally manageable, even mild, were excruciating.  The terror only lasted a few moments.  Thankfully, I was able to let go of those debilitating fears and continue down the path of the gentle, calm, even sensual birth, I’d prepared for.  But in that instant I understood how women in our culture who are unprepared for the intensity of labor often experience birth and why they choose medications to remove the pain.

After 16.5 hours, my midwife performed my first (and I think only) internal exam.  She found I was 7+cm.  My doula and I were both surprised I was already in transition labor because the sensations had not appeared to increase in intensity and they were still 4-5 minutes apart as they had been most of the day.  My midwife then suggested I focus my mind during each contraction on opening my birth canal and encouraging my baby to move down.  I trusted my midwife, so followed her advice.  This wasn’t something I’d practiced before, so it took a lot of mental focus during a stage of labor when it is often better to surrender to your body and instinct rather than activate your mind.  In hindsight, I wish I’d ignored her, or that I’d practiced that visualization during pregnancy so it was something I could do easily.  I never did reach that Gate of Great Doubt that most women pass through on their journey.  Perhaps it was the hypnosis where I learned the mantra, My body and my baby know how to birth, and I am safe.

About 20 hours into my labor there was a long pause between contractions.  By this point I’d been in the birth tub for a few hours, napping between contractions.  My husband and doula made sure my head didn’t slip below water, but that I still got much needed rest.  Following that long pause, was a giant burst.  My water broke.  Eight minutes later, while I sat on a birthing stool in the tub, my baby boy swam into my arms.

Levon, two days old

My little fella had passed through the birth canal so quickly, he remained blue for a day.  I experienced a couple of tiny tears.  My midwife recommended not sewing them up due to their location, as long as I agreed not to leave the second floor of my home at least until she visited me two days later.  That sequestering was a gift.  Even now, my heart sings at the memories of those first days snuggling, feeding, and loving my newborn.

Labor is Intense: How to Naturally Respond to Sensations and Help Labor Progress

Throughout nearly all of human history, women learned how to prepare for and cope with the intensity of labor, by witnessing and supporting other women during birth.  Today very few women ever attend a birth until they are having their own child.  Most of the images and birth stories women see in the media depict either excruciating, hysterical agony accentuated by anger and vulgarity, or quiet medicated births.

Today nearly all media depictions of birth represent a patriarchal system with a practitioner directing the birth.  Until recently, nearly all births followed a matriarchal system with the laboring mother guiding the birth.  The role of her support team is to respond to her signals.  Every form of medical support exists because it can make instances of birth safer for the mother or baby.  Relatively few of the instances when medical support is implemented today serve to improve the health or safety of the mother or baby.

The sensations of labor can sometimes be orgasmic, and most always are more intense than any prior physical, emotional or spiritual experience.  Even a woman who has an epidural can experience labor for several hours.  The growing practice among doctors today is to delay administering an epidural until a woman’s cervix is 5cm dilated because waiting until labor progresses to this point significantly reduces the chance of a cesarean birth.

A woman who prepares for labor confident that her body and baby know how to birth, may draw from a range of coping practices.  Different practices will work at different stages of labor, and what works best during one birth will be different from the next.  Birth is most likely to be perceived as a positive experience among women who prepare for the depth of intensity birth, and have faith that they will find the right path for their birth—one breath at a time.

Birth is not a medical event, even when medical support is part of her journey.  When a woman copes with the intensity of labor naturally, she eliminates the risk of the unknown response her body may have to medication or medical intervention.  There may come a time when medical support is the best, safest or most compassionate next step.  This piece focuses on how to naturally manage the sensations of labor during a normal, healthy birth.

A partial list of methods for managing the intensity of labor includes:

Mindfulness & Breathing Practices

Movement & Positioning

Water Therapy

Massage, Acupuncture & Acupressure

Mindfulness & Breathing Practices

A woman who has incorporated breathing practices into her daily life will have a wealth of options to draw on as she progresses through her labor.  Breathing and meditation quiet the mind and bring focus to the moment—helping women experience labor one breath at a time.  A laboring woman may most easily cope with her labor by doing exactly and only what is necessary in that moment, nothing more.  And then do it again and again.

Below are some of the mindfulness practices couples learn during one of the Birthing From Within classes I teach.  This list was developed initially as review for couples who have completed my BFW childbirth preparation course.  Explanations of some of these practices may be found in Pam England’s book Birthing From Within:

Breath Awareness

The simple act of focusing on each outward breath is a powerful first step toward quieting a mind that has grown anxious about what unknown pain might lie ahead.

This is a helpful reminder that just as your body knows how to breathe, your body knows how to birth.

Non-Focused Awareness

This may be practiced alone or with a partner’s prompts of seeing, hearing, touch, breath.

This may be conveniently practiced anywhere anytime, bringing your focus to all that is happening in your world at that moment without judgment.

Ovarian Breathing 

This may be practiced alone or with a partner.

This may be done walking or stationary or while tracing a labyrinth with eyes or finger.

It is both relaxing and rejuvenating, making it an especially helpful practice after many hours of tiring labor.

If it is done with a partner, be sure the front hand pauses just above the pubic bone to draw energy down the birth canal.

A prayer/intention/heart question/mantra may be repeated silently or audibly with each exhale.

Because it may be done while walking, a helpful time to prompt a mother to do ovarian breathing is while transitioning between physical locations which often be stressful and thus slow labor.

Head-to-Toe

This practice is a helpful reminder of the power your mind has over your body.

Following prompts in your mind to methodically release tension from the whole body from head to toe is a helpful practice when transitioning from daily life to sleep, especially during the third trimester.

When practiced during an intense labor sensation, a woman will likely only get as far as her arms or spine.

Sacral Breathing

A partner’s presence, deliberate touch, and perhaps slightly slower breath can connect the couple to each other and the baby, as well as invite a mother down from her head to her body.

Moan, Growl & Entrain

A study by a midwife in AZ found that among women who wanted to make noise during labor, those who were discouraged from being loud had labors an average of 2 hours longer than those who were either encouraged to make noise, or neither encouraged nor discouraged.

Many labor and delivery hallways in hospitals today are quiet because such a large number of women have medicated births.  Partners can make a mother feel safe in her noise making by co-chanting/moaning/growling.

Entrainment is an effective way for partners to help labor progress by inviting a laboring woman out a place of fear where her voice is coming from a place physically high in her body, causing her muscles to close and grow tense, to a place of openness where her voice vibrates down and out her bottom.

Building a Partnership with Your Baby

Many women talk to their babies during pregnancy, sharing hopes and fears about the birth, or dreams of their life together.

If a mother already has a foundation for communicating with her baby, the act of talking with or praying for her baby in a given moment may help her make difficult choices when facing a gate of great doubt, for example.

Remembering that her baby is also experiencing labor may be inspirational during challenging moments or if a mother ever feels disconnected from her birth experience.

Meditation & Visual Focus

Following the path of a labyrinth with her eyes or finger quiets a woman’s mind and lowers her heart rate.

Movement, Positioning & Tools

During a hospital/birth center tour parents may ask what tools are available on site to support a laboring mother.  It can help to ask specifically about a birth ball, shower, tub, hot tub, birth bar, labor stool, labor chair…  Parents birthing at home may purchase, borrow or rent many of labor support items.

Birth Ball

A not-fully inflated exercise ball provides what may be the only comfortable seat for a laboring woman whose baby is putting pressure on her perineum.

The action of rocking her hips back, forth and around opens the birth canal and invites the baby to progress downward.

Massager

A partner or doula running a handheld manual massager up and down a laboring woman’s spine during an intense labor sensation can help her feel calm, especially during early stages of labor.

Rebozo Hammock

A partner or doula that provides a supportive rocking hammock for a laboring woman on all fours may alleviate discomfort during “back labor”.

The hammock may also shift the configuration of the womb enough to invite a baby to move into a more optimal position.

Tennis Balls

Tennis balls or the heels of a partner or doula’s hands around a laboring woman’s sacrum can provide relief during or between intense labor sensations.

Ice Pack or Ice Filled Washcloth

Holding a freezing cold pack on a woman’s neck during especially intense labor sensations may overwhelm her senses, diminishing discomfort in her birth canal.

Walking, Squatting, Dancing

Any movement where a laboring mother is alternately moving her hips opens the birth canal, allowing labor to progress as her baby has room to move down.

Slow dancing with arms wrapped around a partner’s neck and with the partner’s arms supporting the laboring woman under her shoulders, may be especially helpful when a mother has grown tired of walking independently.

Supported squatting with her back against a wall, and/or while seated on a birthing stool or a yoga block, may provide a laboring mother with a comfortable position that also encourages labor to progress.

All Fours, Kneeling, On Her Side

There are as many variations of supportive laboring and birthing positions as there are births.  None of them involve a woman lying on her back.

Mothering magazine recently ran a guide to positions for labor and birth that provides a good foundation of options.

Even if a woman has an epidural, her partner or doula prop her on her side with her legs supported by pillows in a runners stance to give birth.

Women who give birth lying on their backs often describe birth as “pushing up hill”.

Upright birthing positions use gravity, create a birth canal up to 25% larger, reduce the likelihood of tearing, episiotomy and cesarean birth.

A baby is less likely to “get stuck” if (s)he has as wide a pathway as possible.

Drink & Pee

A full bladder is an obstruction to labor progress.  A partner or doula can prevent this by supporting a laboring mother to the bathroom hourly.

A partner who offers a laboring mother a sip of water (especially with a splash of juice), after each intense labor sensation, is increasing the likelihood of a normal birth.  Bendy straws can be especially helpful.

A woman who stays hydrated during labor is better able to endure a long labor without medical support.  IV fluids may provide rejuvenation and strength after a prolonged labor or if a mother is vomiting too much to remain hydrated.

(Please note:  IV fluids do carry increased risks of postpartum recovery issues such as bloating, engorgement, and an artificially elevated birth weight, which can undermine a successful introduction to breastfeeding.  Meeting with a lactation consultant can be extremely beneficial for all breastfeeding mothers.)

Water Therapy

Studies have shown that water therapy can be as effective at alleviating discomfort during labor as drugs—without the risk, and while maintaining the ability to sense and guide her birth.

Tubs, Birth Tubs, Hot Tubs & Showers

Taking a warm bath, perhaps with candles, a glass of wine and soothing music, can be especially wise for a woman whose labor begins late in the day.  This action may invite her to sleep so she can build strength for the labor ahead.

Birth tubs usually have a system for maintaining the water at a comfortable temperature for hours.  Periodically adding pots of boiling water can turn any inflatable tub into a birth tub at home.

Some hospitals have at least one hot tub available to laboring mothers.  Sitting with her back to a water jet can offer relief during intense labor sensations.

Showers with a handheld extension allow a partner or doula to alleviate discomfort during intense labor sensations by pointing the spray toward particular spots on a laboring mother’s back.

Many people believe giving birth in a warm tub provides the newborn baby with a gentler transition from the womb.  Remember that a baby whose cord is pulsing does not need any other access to oxygen.

If a woman’s water has broken, some practitioners may discourage her from sitting in a tub because it may introduce a risk of infection.  Some people believe it is safe for a woman to take a bath in her tub at home because the bacteria present is already part of her system.

Massage, Acupressure, Acupuncture

Doulas bring tools, training and experience to your labor including the ability to relieve discomfort with massage and acupressure.

Partners who hesitate while touching a laboring woman may be met with resistance.  If instead a partner touches her with confidence that the touch will feel good, it will likely be better received and appreciated.

Some hospitals have an acupuncturist available to laboring mothers who arrange in advance for this service.  Phelps in Sleepy Hollow is one hospital in our area with an acupuncturist on staff to support laboring mothers.

Acupuncture is often used to kick start labor in women eager for the birth to begin.

Chiropractors trained in Webster Technique have also been shown to help labor begin in women with full term pregnancies.

Prenatal massage therapists are trained to avoid inspiring labor for most pregnant women, but a woman having a prenatal massage at 40+ weeks may want to ask if her therapist has any techniques for inspiring labor.

A women who feels safe and well supported is able to surrender her mind to the wisdom of her body and her baby.  If she can feel and intuit her way through labor she can open her mind, spirit, and body and greet her baby with joy, confidence, and awareness.