A guide to pregnancy and childbirth

Chapter 7

The Birthing Journey

Our deepest fear is not that we are inadequate.

Our deepest fear is that we are powerful beyond measure.

It is our light, not our darkness, that most frightens us. . . .

And as we let our own light shine,

We unconsciously give other people

Permission to do the same.

As we are liberated from our own fear,

Our presence automatically liberates others.

—MARIANNE WILLIAMSON

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We believe that pregnancy and birth are natural processes and that whenever possible, less medical intervention is preferable to more. We also recognize and support the reality that each birth is a very personal event, reflecting the perceptions, beliefs, experiences, and choices of the pregnant mom. Our bottom line is that the ultimate measurement of a successful pregnancy and birth is not how much or how little technological intervention is brought to bear; rather, it is a birth that results in the healthiest possible baby and mom.

You have spent the past nine months preparing for this momentous event. Your regular meditation practice has established your connection to the essence of your being—your spirit that is beyond time and space. Yoga has helped you develop flexibility in both your mind and body. You have used soothing aromas to create the association between your sense of smell and relaxation. Your daily massage has ensured that your tissues are lubricated and pliable. You have worked with your breath and experienced how it can bring you into a deep place of inner quietness. You are prepared in your body, mind, and spirit to birth your baby.

Birthing a baby is probably the most powerful physical and emotional experience of a woman’s life. After nine months of development, your unborn baby is ready to leave the loving cocoon of your womb and enter the world through your body. A conscious birth recognizes and honors the spiritual significance of bringing this being into the world. Working in consort with the powerful forces of nature, you give birth to your baby.

Conception, pregnancy, and childbirth are natural events, which express life’s creative power on physical, emotional, and spiritual levels. Your and your family’s perceptions, interpretations, and expectations play an important role in achieving a successful birthing experience. We believe you should be empowered with knowledge that enables you to make informed choices regarding the labor and birth of your baby.

Understanding life as an expression of a deeper non-local field of intelligence has profound effects on the way in which you experience yourself and others. Living your life from a consciousness-based perspective implies that you view every aspect of your life as meaningful, even sacred. A consciousness-based approach applied to pregnancy and birth means that the vision of your baby-to-be encompasses physical, emotional, and spiritual domains.

Whatever your powerful mind believes will come to pass.

—PARAMHANSA YOGANANDA

Awaken to the beauty and power inside your body. Pregnancy and labor are times to turn within. They are times of profound transition and transformation. While traveling this journey you are required to embrace fear and trepidation along with wisdom and strength. Each stage of labor brings growth and change.

Exploring Your Fears

As a woman, you have been accumulating ideas about birthing since your childhood. You may have observed your mother pregnant with a younger sibling and her changing body and mind. You probably heard stories about labor and birth and may have seen movies of women in labor. You may have been present at the birth of a younger sibling, niece, or nephew.

At time these stories and images may have portrayed the birthing process as agonizing. If you have been exposed to frightening birthing stories, you may fear that labor will cause unbearable pain and be terrified at the thought of losing control. If these are the deep-rooted messages you have accepted, you may think of labor as an experience you need to be rescued from rather than one that empowers you. Fear of pain has resulted in many women losing sight of birth as normal and natural, and of themselves as powerful and capable. Labor is an opportunity for women to learn about themselves and discover the strength and wisdom inherent in their bodies.

Facing Your Fears

Bringing unconscious fears out into the open is the best way to dissipate the influence they have over you. Like the boogeyman you may have imagined living in your closet as a child, most fears lose their power when exposed to the light of awareness. We encourage you to perform the following exercise to become more aware of the positive and negative thoughts, words, and images about labor and birth that dwell within your mind. Becoming more aware of your inner conversation about birthing will enable you to make more conscious choices that accurately reflect your values.

Exercise

Sit for a few minutes with your eyes closed and envision the process of giving birth to your baby. Imagine the process from the first contractions to holding your baby in your arms.

Now, focus on your concerns. What are you afraid of with regard to labor and birth? On a sheet of paper write down the fearful words that come to mind.

Once you have listed these words describing your anxiety, take a few moments to create a separate list describing the feelings these expressions generate within your body (these fearful words generate the following emotions and sensations within me).

Now, again, close your eyes and envision your labor and birth. This time focus on your positive expectations. Make a list of the empowering words that come into your mind when you think about labor and birth.

As you review these positive empowering words, describe the feelings that these words generate (these empowering words generate the following emotions and sensations within me).

It is completely natural when thinking about labor to have feelings of both fear and excitement. Wisdom is recognizing that life involves the coexistence of opposites. When a woman surrounds herself with supportive people and creates a safe space around her, she is able to connect with her inner wisdom. By setting aside self-judgment, you can embrace your strength and your vulnerability, your determination and your inclination to surrender.

Stay present to your body and your baby. A conscious birth can be medicated or unmedicated, in a hospital or at home, by cesarean or vaginal birth. It is your powerful, beautiful body that is opening to bring new life into the world. Accept the power that comes from recognizing that your body is an inextricable expression of the universal body. Your mind is a reflection of the cosmic mind. In your willingness to accept the contradictions of birthing a new baby, you gain the opportunity to participate fully in the age-old experience of giving birth to a new life. You are participating in the primordial creative event and will look back on this experience with awe and wonder for the rest of your life.

Exercise

Draw a figure image of yourself as a powerful birthing woman. Show your facial expression and the position you imagine yourself to be in when you birth your baby.

Write the words from your empowering word list many times around the portrait of yourself as a powerful birthing woman. Add whatever additional words you choose from your fearful list, one time each. Hang this picture somewhere in your home where you will see it regularly.

Checklist for a Conscious Birth

Check to see if you are completely comfortable with the following aspects of your birthing experience. If you recognize there is more work required on your part to feel fully prepared, commit to taking the steps to be as ready as possible for your labor and birth.

• I have all the information I need about my birthing site.

• I am aware of and capable of expressing my fears and concerns to my health provider, family, and self.

• I have identified and enrolled my support crew.

• I deeply trust the people who will be supporting me during labor and birth.

• I recognize and accept the fact that there will be times during my labor when I will need to relinquish control of the situation.

• I know it is okay to be noisy during childbirth.

• I know I can work with my body during contractions.

• I know my health care provider will work with me to help create the birth I desire.

• I know I can request pain medications if I need them.

Exercise

Sitting quietly with your eyes closed, center your awareness in the region of your heart. After a few minutes of silence, begin asking yourself the question “What more do I need in order to be fully present and connected to my birthing process?” Continue repeating this question, listening to the messages that emerge from your inner mind. The more innocently you can listen for rather than force a response, the more readily your inner wisdom will make itself known. Take some time to reflect and journal about what you learned.

The Birthing Experience

A woman learns many things about herself during the amazing process of pregnancy and birth. As you reach the end of your pregnancy, approaching labor and birth, envision the process as you would ideally like it to unfold. Seek out the information you need to make fully informed choices.

Imagine yourself standing at the bottom of a mountain with two paths to the top. One path takes you to a chairlift that goes up the mountain, while the other path leads to a hiking trail. Both will get you to the top of the mountain, and each provides you with a unique and memorable experience. The chairlift provides an enjoyable and thrilling ride with little effort or pain. On the chairlift, you will be looking down at the experience and enjoying the scenery. The hike up will be strenuous and challenging, as you are intensely involved with every aspect of the journey. Upon reaching the summit, you will experience a sense of accomplishment.

These are, of course, metaphors for labor. One woman may relish the challenge of giving birth naturally. Another may have no qualms about taking full advantage of modern medical technology. A third woman may be conflicted about the right path for her. The key is to make your choice consciously by using all the information you have gathered, while remaining open to the possibility that sometimes the birthing process takes on a life of its own. There is an Ayurvedic expression that goes “Infinite flexibility is the secret to immortality.” We encourage you to have clear intentions for your birth while remaining flexible to all possibilities.

Exercise

Think about your ideal labor. Think about yourself in labor.

Is there a difference between the ideal labor and envisioning yourself in labor? Write a few sentences about what you discover. What more would you need to create your ideal labor?

Moving Through Labor

As you approach the final stages of pregnancy you will naturally have many questions about labor and birth. These are some of the common ones:

How will my contractions feel? Can I handle the pain? How long will I be in labor? Will my partner support me? Will I know how to breathe? Can I trust my body? Will I require medication? Will I need an epidural? Will I have an episiotomy? Will I be able to birth my baby vaginally? Will I need a cesarean? Will my baby be okay?

In this chapter we will explore the process of labor and its many variations to help you prepare for the many possible answers to the many questions in your mind. Let’s begin with an overview of the stages of labor.

First Stage of Labor

The onset of progressive mild contractions signals the beginning of the first stage of labor. Each woman experiences these contractions differently. They are mild for some and more intense for others. As the muscles of your uterus contract, the cervix begins to thin (efface) and open (dilate) so your baby can pass through it. During this stage your body will release endorphins to help reduce the sensations of pain as contractions become stronger and closer together.

During early labor your cervix will dilate from 0 to 4 centimeters as a result of mild to moderate contractions. These typically last thirty to sixty seconds and may be five to twenty minutes apart. The rest period between contractions varies, lasting from several hours to a day or more.

Perform your normal activities for as long as possible during this period. If it is nighttime, see if you can sleep. You will help your labor to progress by alternating between periods of rest and movement. Trust your instincts to guide you. Relax and follow with your breath. Take walks outdoors or relax in a warm aroma bath if your water has not broken.

As labor progresses into the active phase, uterine contractions increase in strength and duration, lasting about sixty seconds and occurring every two to five minutes. During this stage your cervix dilates from 4 to 8 centimeters. As your cervix dilates your baby descends into the pelvic cavity. Contractions become more intense and consume most of your attention. Your awareness shifts inward as your body works harder to open. Endorphins continue to be released throughout your body and your consciousness may slip into an “endorphin haze.”

Prepare ahead of time to surround yourself with people who believe in you, so that you are surrounded by safety and love. Breathing, walking, changing positions, making sound, being held, and getting in water will all help you stay as centered as possible.

During the transition phase your cervix fully opens as your body prepares to birth your baby. During this phase the sensations in your body become much stronger and more intense. You may feel very vulnerable and doubt that you can go on. The contractions are faster and stronger now as your uterus works to open your cervix from 8 to 10 centimeters. Each contraction may last up to two minutes and occur as frequently as every minute. You may feel you cannot survive the intense experience in one second and then be completely absorbed in it the next. You are at the threshold of bringing your baby into the world.

Second Stage

The second stage begins when the cervix is fully dilated at about 10 centimeters and ends when your baby is born. During this stage your contractions will probably slow down a bit and become less intense, occurring about every three minutes and lasting sixty to ninety seconds. Each contraction helps move your baby down through your birth canal toward your pelvic floor. The urge to push with these contractions may begin before you are fully dilated or it may start five to ten minutes later, although some women never feel a strong urge to push.

CERVICAL DILATION CHART

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The sensations of these contractions are powerful. Tiny receptors in the cervical tissues alert your body to release oxytocin in this stage, which facilitates these contractions continuing. The purpose of the contractions shifts from opening your cervix to pushing out your baby. It is common to shift from feelings of exhilaration to exhaustion and back again during this stage. Work with your uterus by bearing down when you feel the urge. Follow the signals from your body and take your time. Have the intention to relax and soften your pelvic floor muscles with each push.

UNDERSTANDING CONTRACTIONS

Each uterine contraction begins at the top of your uterus (fundus), where there is the greatest number of muscle cells. The contraction moves down through the center of your uterus toward your cervix. Throughout labor the upper portion of the uterus is more active and contracts more intensely for a longer period of time than the lower portion of the uterus. The upper uterine segment becomes thicker, while the more passive lower segment becomes thinner.

Contractions are typically mild in early labor and become progressively stronger through active labor and transition. The pain from contractions is due in part to the reduced availability of oxygen to contracted muscle cells, and to the compression of nerves in the lower uterine segment as the cervix is stretched open.

Contractions are the primary power behind the work of labor and birth. You can think of them as waves that start at a lull, build up to a peak, and slowly come back down. They form a regular pattern throughout labor with rest periods in between. The rest periods are important for the laboring woman as well as the unborn baby. Blood flow from the placenta to the womb diminishes with each contraction, but rapidly returns to normal during each rest period. When a woman learns to relax and breathe during rest periods, her baby receives essential nourishment and oxygen.

Exercise

SIMULATING A CONTRACTION

Allow about ten minutes for this exercise. Sit comfortably on the edge of a folded blanket or pillow. Turn on some soothing music and have a clock with a second hand in sight. Now, close your eyes and focus on your breath. Feel the space inside your body and see if you can find your center. Observe your breath entering and leaving your body. Once you have observed your breath for a few cycles, extend your arms out to your sides at about shoulder height with your palms facing down. Begin to flap your arms up and down a few inches about every second or two, keeping your shoulders as soft as you can. Send sound through your body as you breathe out, consciously relaxing the muscles that are not required to perform the exercise. Breathe out through your mouth on your exhalations. Notice what happens to your mind as your arms begin to tire. Keep coming back to your breath and use your sounds. After ninety seconds rest your arms at your sides for about a minute, then repeat the flapping for another ninety seconds. Notice what helps you to relax during the rest periods. Remember to take long, easy breaths to nourish and oxygenate you and your baby. Continue for five to ten cycles, extending and flapping your arms for ninety seconds and then resting for a minute.

CROWNING

Once your baby’s head slides under your pubic bone, your perineum will begin to stretch and bulge around your baby’s head. This is known as crowning. You may feel a burning sensation, sometimes referred to as “the ring of fire,” as a result of the tissues stretching. The burning sensation will subside within a few minutes as the pressure from your baby’s head numbs the nerves in your perineum. This feeling is a signal for you to slow down your pushing and begin to ease your baby out slowly. Another push or two and your baby’s head will be out of your body. At this point, your baby will turn so that his shoulders can pass under your pubic bone. Your doctor or birthing assistant may help to maneuver your baby’s body. Once your baby’s shoulders are free, he will slide out of your body and into the world.

PREPARING YOUR PERINEUM

Massaging your perineum with oil weeks before your birth date may help soften the tissues. Use only natural vegetable-based oils, such as sesame, almond, or coconut. During labor, explore different positions that feel comfortable for you and that allow you to stay centered during the final phase of birth. Communicate your needs to your health provider and support team. If it is comfortable, your partner can apply warm cloths with gentle pressure to your perineum during crowning, which may help reduce the chances of your perineal tissues tearing as they stretch. Ask your partner or health care provider to lubricate your perineum with warm oil as your baby is crowning. Push gently to slowly ease your baby out of your body, and if possible, reach down to feel his head so you can stay connected as he emerges from your body.

BIRTHING YOUR BABY

Your body has protected your baby for nine months inside your womb. As he moves through you into the world, do your best to keep him feeling safe, warm, and protected. Have the lights turned down low to give his eyes time to adjust. Keep the room warm so he feels comfortable. Surround him with soft sounds and pleasing aromas. Have him placed immediately on your belly or bring him into your arms so he continues to feel your loving presence. Talk softly to him so that he knows you are there and he is safe. Postpone any necessary invasive procedures for as long as possible.

Third Stage

The surge of emotions you feel holding your newborn baby encourages the release of hormones that stimulate your uterus to contract so you can birth the placenta. Take your time. The umbilical cord and placenta will continue to pulse and bring oxygen to your baby while he is learning to take his first breaths. The cord can be clamped and cut once it has stopped pulsing. After the birth of your baby the placenta begins to slowly separate from your uterine wall. This usually takes about ten to thirty minutes but can sometimes take longer. In a short time your uterus will begin contracting to expel the placenta. The placenta is much smaller than your baby and it usually feels good to push it out of your body.

After You Give Birth

You will have gone through one of the most intense experiences of your life. You will have worked hard for many long hours or even days to bring your baby into the world. You will probably be feeling sweaty, sticky, bloody, exhausted, and ecstatic. Your whole being has been engaged in your baby’s birth. Plan ahead to have someone available for you in the first minutes and hours after birth to nurture and protect you. It will take some time for you to recover from the rigors of labor and begin feeling centered again. Your focus shifts from nurturing your baby on the inside to nurturing your baby on the outside. You will need some nutritious food, something replenishing to drink, and a warm washcloth to wipe your face and body.

Strengthening the Bond

In many cultures around the world (and increasingly in the West) babies are placed on their mothers’ bellies immediately after birth so Mother and Baby can feel, smell, and touch each other. Parents and babies are meant to be together from birth. Research has shown that important bonding begins within the first minutes and hours after birth, as parents and babies connect with each other through holding, talking, seeing, and touching.

The minutes and hours after birth are magical. Most new parents have difficulty finding the words to describe the depth and intensity of their feelings as they interact with their baby for the first time. As you hold your baby and look into his eyes, you will find yourself falling in love and not wanting to let him go. During the first couple of hours your baby will settle into a “quiet alert state” as he transitions from the womb to the world. He will be awake with his eyes open. After a few hours he will settle into a deep sleep period. Regardless of where you are giving birth, do your best to be with your baby during the first hour or two after birth so you can enjoy these earliest precious experiences with your baby.

Recording Your Experience

If you have the energy during a quiet moment, journal your experiences of labor and birth while they are fresh in your mind. Not only will you enjoy reading these early impressions later on, but years from now your child will have access to your most intimate thoughts and feelings around his arrival. The following is an example of a woman’s record of her birthing experience.

The pain of birth is in a completely different category than a broken arm or a toothache. As I journeyed through labor I knew that I was supposed to be feeling these sensations. They were unlike anything I had ever experienced before. I felt like I was working with my body from the first contractions, and as they became stronger, I drifted deeper inside myself. Although I maintained awareness, my mind became completely quiet, and I felt immersed in my own familiar semidarkness.

As I was breathing and moaning, the sounds felt as if they were coming from a deep ancient place inside me. I was on my hands and knees and immersed in warm water. I was able to relax between contractions and let my head hang forward. Sometimes the contractions felt overwhelming and I would moan louder and deeper to release them. I was working hard to stay with the sensations of my body. Opening, breathing, and resting, my body and mind were one. My inner space was my whole reality. I moved and swayed in whatever way felt good.

After a while the contractions got harder and I used my breath and moans to stay with it. As the sensations intensified I started to feel like maybe I couldn’t do it. I leaned into the support of my partner and swayed from side to side with my body. My whole being became the contraction.

And then it was time to push. At first little pushes and then all of me was pushing, pushing my baby down through my body. My body was making way. I heard myself moaning. I reached down to feel for my baby’s head and there it was, bulging from my body. There was a burning sensation and I breathed into it and then with the next push my baby’s head was out, and I was holding and feeling it in my hands. It was so soft and round. My eyes were still closed and I was deep inside feeling everything. I pushed again and my baby came sliding out of me. I opened my eyes and reached down to bring her up into my arms. My eyes closed again. Still deep in the experience I heard my partner say with complete awe and delight, “Oh my God, oh my God! She’s here!”

Preparing Yourself

Labor and birth are intense experiences, and having some anxiety as you prepare to birth your baby is completely natural. Acknowledging fears and doubts helps dissipate the power they have over you. Take a few moments now to feel your body and see if you can identify uncomfortable sensations and notice where you are holding apprehension and worry. With your attention on these sensations, use your words to bring to the surface the trepidations you are feeling. Make three lists in your journal, one for the things you are worried about, one for the things you are uncertain about, and one for the things you are doubtful about.

Fear sets into motion the physiology of stress resulting in the release of the powerful chemicals of the fight-or-flight response. Neither the impulse to fight nor the one to run from your contractions serves you well during labor. The hormones of stress constrict the arteries to the uterus and reduce the effectiveness of your contractions. The physiology of fear also has been shown to lower your threshold for pain. Learning to bring yourself from a state of apprehension to one of inner centeredness is a valuable skill that will be of tremendous benefit to you during your birthing experience and throughout your life. Fortunately, you have a precious ally to accomplish this, which is your breath. When you feel out of control, you can come back to your center through conscious breathing.

Using Your Breath

Breathing is the bridge between your mind, body, and baby. As you inhale deeply, you bring nourishment and oxygen into your and your baby’s body. As you exhale, you release carbon dioxide and stress. The nourishment of your breath moves deeply into each of your cells and promotes relaxation. Deep, slow breathing can help you release tension from every part of your body. During labor your breath will be your intimate friend, helping you to stay centered, calm, and energized.

These following exercises have been created to bring you a greater awareness of your breath. Become familiar with these simple breathing techniques, which help integrate your mind and body. Choose the exercises that feel right for you and practice them for five to ten minutes per day.

Breathing Exercise #1

ENTRY AND EXIT POINT

As you inhale, imagine your breath as a relaxing mist, calmly coming into your body and filling you with oxygen and nourishment.

As you exhale, imagine your breath releasing slowly down through your body. Feel it helping you to let go of tightness, pain, and tension as it flows out through you. Focus on long, slow exhalations.

Now imagine that you have nostrils somewhere on your belly. Let these imaginary nostrils be your entry and exit point. Close your eyes and rest your hands on your belly. For the next few minutes focus on breathing in and out through your belly nostrils. Allow each in-breath to enter and fill your belly, encircling your baby. As you breathe out, feel your belly muscles soften and allow each out-breath to be long and slow, releasing tension and tightness from your body.

Now imagine your entry and exit point to be your pelvic floor. Closing your eyes, breathe in through your pelvic floor and feel your breath flowing up through your body. Allow it to fill your belly, chest, lungs, and brain with a nourishing mist. As you exhale, allow your breath to gently release and slowly spread down through your body, removing any tension and softening your pelvic floor as it flows out.

Now imagine your entry nostrils to be in a place where you feel most grounded in your body. Let your exit point be through your mouth. As you breathe in, send your breath up through your body toward your throat. As you breathe out, feel the vibration of your breath flowing along your throat and release it with a sigh. Allow your neck and head to hang forward. Soften your shoulders and feel your body becoming loose and limp. Be aware of your chest relaxing and let your belly muscles release.

Try envisioning your entry nostrils at the base of your spine and your exit nostrils at the crown of your head. Bring your breath in through the base of your tailbone and let it slowly flow up along your spine, through the back of your neck, along your head to your crown. As you breath out, send your breath slowly down through your center. Feel it pass through your heart, allowing it to flow around your baby and out your pelvic floor. Focus on long, slow exhalations.

Breathing Exercise #2

ENERGY BREATH

This breath helps bring energy into your body and is beneficial anytime you feel fatigued. It can be helpful throughout the pushing stage of labor and at any other times when you feel tired or need more energy.

As your mind quiets, your body takes over.

As you inhale, imagine your breath to be pure energy entering and filling every cell in your body. Envision each cell tapping from this source the vital energy as your breath expands inside you. As you exhale, allow this energy to flow through you, feeling it revitalize every cell, tissue, and organ in your body.

Breathing Exercise #3

SLOWING DOWN

Close your eyes and take a few minutes to follow and feel your breath as it moves in and out of your body. After a few minutes, have the intention for your breathing to slow down. Do not force any change in your breath. With each inhalation silently repeat the word “slow.” With each exhalation, think the word “down.” Continue to breathe like this for five to ten minutes, as you mentally repeat the words, “slow down . . . slow down . . . slow down.”

Breathing Exercise #4

COUNTING BACKWARD

Close your eyes and focus on your breath. With each successive inhalation, count backward from 10 to 1. With each exhalation breath, bring an empowering or affirming word into your mind. For example, it may go like this:

10 . . . centering

         9 . . . relaxing

         8 . . . releasing

         7 . . . opening

         6 . . . accepting

         5 . . . surrendering

         4 . . . trusting

         3 . . . succeeding

         2 . . . empowering

         1 . . . allowing

Choose the words that work for you. You’ll find that this process quickly brings you back when your mind begins to race with apprehensions and concerns.

Breathing Exercise #5

HEAD TO TOE

Create a space for yourself with blankets or pillows where you can comfortably lie down. Once you are comfortable, close your eyes and allow your body to begin to relax. Feel your breath moving through you. On your next inhalation bring your breath up through the bottoms of your feet to the top of your head. As you exhale, scan your body from your head to your toes, releasing any tension you may be retaining as you breath out. Repeat this process for five to ten minutes.

Breathing Exercise #6

BREATHING WITH SOUND

Making sounds can help your body relax and open. Moaning, sighing, or groaning with the outflow of your breath creates a soothing vibration that moves through and resonates with your whole body. Find a tone or sound that feels right for you. Many women choose an “ahhh” sound to start. As you exhale, allow your breath to vibrate along your throat and resonate down through your body and out your pelvic floor. Focus on long and slow exhalations. Try sounds that are low pitched and deeply resonant. Continue for five to ten minutes, trying different sounds.

Practice moaning. Let yourself moan. Moaning feels great when you are in labor. There are no fixed rules. There is no one who is going to tell you that you cannot make noise. When contractions get strong, allow yourself to moan and groan. Let it be soft and let it be loud. Close your eyes and go with the sound. Let it feel primitive and let it feel real. Let it be deep and let it feel right. Let it infuse you and let it absorb you. Let it help you open and let it help you soften. Let it help you release and let it help you sink inside. Let it help you move your baby down and let it help you move your baby through.

Staying in Touch

The sense of touch is one of the most important sensory portals to your inner pharmacy. Conscious, nourishing touch can reduce discomfort and calm anxiety. We encourage you to experiment with different touching techniques to learn which ones are most comforting for you.

Your birth partner will be an essential ally to help you stay centered. Explore a variety of styles and pressures with your spouse or partner so you can communicate your needs during labor.

SOFT HANDS

Create a space with blankets and pillows where you can comfortably lie down with your partner sitting beside you. Close your eyes and focus on your breath. After a little while, have your partner gently place his hands over your heart. The touch should be calming and reassuring. As your partner gently lays his hands on you, allow your awareness to receive the love and nurturing that is being sent to you through his hands.

After a few minutes, have your partner move his hands to your belly. As they gently rest on your body, synchronize your breathing together and allow soothing, calming energy to flow from his hands into your body.

Now have your partner place his hands on your head and repeat the process again for several minutes. If there are other places in your body that you would like to be touched, tell your partner to place his hands there. Make a mental note of those places that feel most comforting for you.

Try reversing roles with your partner so you are doing the touching and he is on the receiving end. Touch him in the way that you would like to be touched. Teach your partner how he can be of greatest help to you.

LIGHT TOUCH

Constance Palinsky developed this light-touch technique during her research into pain management and relaxation. It can be used to reduce discomfort in labor and enhance relaxation by invoking pleasure through the surface of the skin. The light-touch technique can also normalize heart rate and blood pressure.

Light touch involves a featherlike massage that may cause goosebumps to arise. Research has shown that this technique enhances the release of oxytocin, the hormone that facilitates labor.

Practice this light-touch massage with your partner during the last month of pregnancy. Notice how it supports deep relaxation and helps you and your partner deepen your connection in preparation for labor.

To practice, lie down with your partner sitting comfortably beside you. After a few moments with your eyes closed, your partner begins stroking the inner surface of your arm from your hand to your underarm. The stroke is very light and is done with either fingernails or fingertips.

After about five minutes, have your partner switch to the other arm. Although the light touch is on the arms, you will find that it has a relaxing effect on your whole body. This technique can also be applied to other parts of the body, including the palms of the hands, the neck and shoulders, and the thighs.

The light-touch technique is very effective when applied to the back. Lie on your side or in Child’s Pose leaning over a few pillows. Beginning at your neck, your partner strokes you in a V formation outward from the neck down the back toward the outer edges of the ribs. The strokes continue the entire way down the back to the sacrum. Relax and enjoy the sensations.

Your partner can deepen the calming effect by offer-ing relaxing suggestions as he is lightly stroking you. For example, he might say, “As I stroke your arm, allow your body to soften and relax,” or “As you feel each stroke, imagine pain-relieving endorphins releasing and flowing through you.”

Lower-Back Counterpressure

As the baby moves deeper into the pelvis during labor, women often experience low-back pressure or deep aching in the lower back. Lower-back discomfort may increase during contractions due to traction on the broad ligaments of the uterus attached to the lower spine. Massage and counterpressure may help to ease this discomfort.

Practice this procedure during the last few weeks of pregnancy so both you and your partner are familiar with the technique and its effects. He can use the heel of his hand, his fist, or a tennis ball.

Lie on your side or rest in Child’s Pose with your eyes closed, focusing on your breath.

Tell your partner where you think the pressure would feel the best, which is usually between the lower back and the tailbone. Your partner then presses his hand or tennis ball into your lower back and rotates it in an unhurried circular motion. This is a deep-pressure massage performed slowly with very little movement. Again, switch roles with your partner so he can feel the direct effects and respond to your requests for adjustment. Show your partner how to perform this procedure to provide you with maximum benefit.

STROKING THE SPINE

In this massage, your partner begins by placing the palm of his right hand on your neck along the right side of your spine and slowly slides his hand down your back to your tailbone. He then alternates with his left hand, slowly sliding it down the left side of your spine. This process is repeated several times for about five minutes. Performed with a firm, soothing stroke, this massage can help to ease pain or discomfort during or between contractions.

Creating a Supportive Environment

There are many simple things you can do to make yourself a little more comfortable during your labor. Try some of these suggestions at home, and prepare your “labor support kit” in advance so it will be available to you when you begin having contractions.

AROMA WARM PACK

Warm packs can help relax achy and tense areas in your body. Throughout labor the warmth may be comforting during and in between contractions. Make your own warm pack by filling a clean tube sock with ordinary white rice about three-quarters of the way full. Add half a cup of dried lavender leaves or flowers to the rice, then sew the top of the sock closed. Place the stuffed sock in the microwave for two to three minutes. The sock will remain warm while releasing its aroma scent for about half an hour.

WATER AND JUICE

It is important to stay hydrated while in labor, as dehydration can cause labor to slow down or stall. You will be working hard throughout labor, and it may feel like you are running a marathon. Have plenty of water and fruit juices available. Take a few sips of fluid in between each contraction. Have some liquids with sugar and electrolytes such as Gatorade available to help maintain your energy level, or allow ice chips to melt in your mouth.

FOOD

Eat lightly in early labor so that your body has energy to sustain you throughout birth. If your labor is long and you find that you are hungry, snack on easily digestible foods such as soup, crackers, or frozen fruit ice pops. If you are in a hospital birthing center, be certain to check in with your caregivers and let them know what you feel like eating.

AROMA

Diffuse the aromas that were calming to you throughout pregnancy. The aromas you have associated with relaxation and comfort over the past many months will help calm and soothe you during labor.

DIM LIGHTS

Most mammals seek out dimly lit spaces for the birthing process. A dimly lit room encourages feelings of relaxation and safety. When a woman feels safe and relaxed during labor, oxytocin, the hormone that facilitates contractions, is released and adrenaline, which inhibits contractions, is reduced. A dimly lit room creates an atmosphere conducive to inward focusing.

TUB OR SHOWER

Immersion in warm water can help a laboring woman relax and reduce the level of pain. Similarly, standing or sitting in a warm shower with the rhythmic water spraying on your belly or aching back can help ease your pain so you can flow more easily with your contractions.

MUSIC AND SOUNDS OF NATURE

Listening to soothing music or a recording of sounds from nature can help you relax while in labor. Play music that is soothing and inspiring for you. Try listening to sounds of the ocean, a river, or a waterfall and have tapes and CDs available if they have a calming effect on you.

BIRTHING BALL

Some women find that the use of a large exercise ball about 24 inches in diameter can be helpful during labor. You can purchase one at most health clubs or back stores. Sit on the ball with your feet flat on the floor, and make large circular motions with your hips and pelvis. This movement helps relax the muscles in your back and pelvis. Some women use the ball throughout their entire labor.

Message to Your Birthing Partner

Ask your labor partner to read this next section.

You play an essential role in the birthing process. It is your job to unconditionally support your partner and demonstrate through your words and actions that you believe in her. Stay at your partner’s side so she can feel you protecting her birth space. Dim the lights, talk softly, diffuse pleasing aromas, give her water, use warm packs, gently touch her, breathe with her, talk with nurses, handle visitors, and tell her you love her. As labor progresses, continue to look for ways to comfort her.

Have food and drinks available to replenish yourself so that you can stay strong for her throughout the many hours of labor. Draw on other people for support and rest when you need to. Develop a support card so you can continually review opportunities to enhance her comfort level. It may look like the following:

I Will Remind Myself to

•                  offer her a drink between contractions

•                  encourage her to empty her bladder

•                  suggest she try a shower or warm tub bath

•                  breathe slowly and deeply with her

•                  make sounds with her

•                  try using a warm pack

•                  offer a cold washcloth for her forehead

•                  walk with her

•                  suggest touch relaxation

•                  see if light touch on her arm or back feels good

•                  apply pressure to her lower back if it is aching

•                  give her space

•                  protect her privacy

Birthing Your Way

There is no right or wrong way to birth your baby. As you move into the rigor of contractions, relinquish your attachment to how things should be and simply allow what is unfolding to occur. Be in your body and listen to what it needs. Flow with your breath and slow down. Take one contraction at a time and stay connected with your baby. Feel your support system around you. Listen to your needs, trust your instincts, and release into the process. Release your worries and release your fears. Stay present and trust that your birthing experience is unfolding exactly as it should.

Find Your Birthing Position

Women have different bodies and different needs when it comes to birthing their babies. One position does not fit all. If you move around during labor, you will instinctively find the positions that feel best for you. Although it may not be the norm in your community, upright positions can strengthen uterine contractions and help shorten labor.

We encourage you to try standing, squatting, kneeling, sitting, and getting on your hands and knees. Each of these positions uses gravity to help birth your baby and is worth experimenting with during labor. They may help your baby maneuver his way more easily through your pelvis and birth canal. In between contractions find positions that naturally help you to relax, such as kneeling, leaning forward, Child’s Pose, or lying on your side.

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STANDING

During early labor you may find you can continue with your normal activities and may benefit from taking a walk. Walking helps your baby descend through your pelvis and encourages efficient contractions. If you are standing while a contraction begins, lean forward and sink into your partner, bed, or the back of a chair. As you bend forward try rocking your pelvis from side to side or move in slow circular motions.

KNEELING

Kneeling can be a useful position throughout labor. Try kneeling with your torso at an upright angle, leaning into your partner. You can also try kneeling and leaning all the way forward into some pillows or blankets. Kneeling is particularly helpful if you are experiencing back labor. While kneeling on your hands and knees, you can easily circle your pelvis or rock it from side to side. This often helps to turn a posterior baby to an anterior position.

SQUATTING

This pose may feel good on and off throughout labor, and can be helpful in speeding up contractions. Some women find squatting to be the most comfortable position and others find that it makes contractions too intense. Squatting encourages the descent of your baby and increases pressure on your cervix. Listen to your body and use this pose only if it feels good. Move out of the squatting position and rest between contractions. Squatting can be helpful during the pushing stage of labor. Making good use of gravity, it creates an effective angle for your baby to descend through your birth canal.

SITTING

Similar to squatting, sitting helps widen your pelvis but usually stimulates less intense contractions. Try sitting facing backward on a chair and lean into the back support. Alternatively, sit at the edge of a chair and relax forward with your arms resting on your thighs. Some women find that sitting on a toilet helps them to relax and soften their pelvic floor muscles.

SIDE LYING

Side lying enables you to be horizontal without having to be on your back. This position can help slow down labor that is going too fast. Place pillows beneath your head, belly, and between your knees for added comfort.

Following your instincts is the most important thing you can do during labor. You may move in and out of many positions during labor, or you might find you primarily use just one. Listen to and trust your body to find the positions that are most effective and comfortable for you.

Affirmations

There may be times during your labor where your thoughts become unconstructive because you are tired, anxious, frustrated, or discouraged. Developing a repertoire of positive affirmations can help you transform negative thoughts into positive ones. Use your affirmations as you exhale, almost like a mantra, to keep your mind focused on thoughts and images that are helpful to your process. These are examples of affirmations that women in labor find useful:

As I release my breath, my cervix softens.

Each contraction is helping me open.

Breathing out, I trust my body.

I inhale strength. I exhale resistance.

Energy comes in. Tension moves out.

Find your own affirmations and write them down. Practice them for a few minutes each day by closing your eyes and thinking of your affirmations as you breathe.

Honoring the Wisdom Within

To accomplish the physiological miracle of labor and birth, your body accesses an inner intelligence that has developed over millions of years of evolutionary time. An essential part of this ancient process is the production and release of natural chemical messengers that facilitate the birthing of your baby. Endorphins and oxytocin are among the most important natural medicines of your inner pharmacy.

ENDORPHINS

Endorphins were discovered as scientists sought to understand why people respond to powerful pain-relieving medications such as codeine or morphine. It was learned that these drugs are effective because they mimic the body’s natural pain relievers, known as endorphins. The word endorphin is derived from the phrase “endogenous morphine.” Endorphins are released when the body needs to alleviate pain, during exercise, during relaxation, and during any activity that generates feelings of comfort, pleasure, or enthusiasm. As a woman progresses through labor, endorphins build in her body to help alleviate discomfort and enhance relaxation. They are more readily released when a woman feels safe and supported.

OXYTOCIN

Oxytocin is a hormone that is produced in the hypothalamus of the brain and released into the bloodstream from the back portion of the pituitary gland. It is secreted during labor when the fetus stimulates the cervix, causing the uterine muscles to contract. In addition to its effect on the uterus, oxytocin is also important in stimulating the release of milk from your breasts. The most important trigger for the release of oxytocin is physical stimulation of the nipples. There is evidence that oxytocin is also important in mother-baby bonding, as there are brain receptors for oxytocin, which is believed to serve as a facilitating hormone for maternal behavior. Oxytocin is released in short bursts rather than a steady stream and may be inhibited by fear or stress.

When labor is not progressing your doctor may prescribe oxytocin to stimulate your uterus. Stimulating your own nipples may help to increase the strength or frequency of your contractions by naturally enhancing the release of oxytocin.

Honoring Time

In this technological age of nearly instantaneous information, it is easy to forget that natural physiological processes have their own rhythm. Birth has its own clock, and it is important to remember that your baby will be born when your body and baby are ready. Your due date is an approximation, not the final bell at a sporting event. Most people do not birth on their designated day and it is not uncommon to go into labor one to two weeks before or after your due date. Honor the process of your baby coming into the world by allowing your labor and birth to unfold naturally.

The Medical Safety Net

A woman can be connected to her body and baby during birth whether or not she receives medication. The decision to receive medical intervention does not imply that you become a passive participant in your birthing experience. Even if you require medicines during labor and delivery, you can be powerfully present as you birth your baby.

Human beings have been birthing babies for hundreds and thousands of years. With the advent of modern obstetrical care, there has been an increased tendency to intervene sooner, which may not always be in the best interest of Mother and Baby. The safety net provided by modern medicine is invaluable; and yet, a worthy goal is to reduce the need for medical intervention.

Education and preparation enable women to have expanded choices in the birth process, allowing them to make informed decisions for themselves and their babies. It is helpful that you understand the possible challenges that may arise during labor so that you can be an active participant in your own care. If labor fails to progress, if the pain becomes unbearable, if exhaustion takes over, or if there are signs that the baby is in distress, the medical safety net is there for you. Let’s review the most common medical interventions that may arise during the birthing process.

External Fetal Monitoring

External fetal monitoring is routinely used in most hospitals to keep track of fetal heart rate and uterine contractions. A monitor may be strapped around your belly for twenty minutes of every hour in a hospital setting. During normal contractions there is a temporary decline in oxygen delivery to the baby, resulting in a slight drop in your baby’s heart rate, which returns to normal during rest periods. The monitor records these patterns for your care provider with the goal of reducing the risk of problems with the baby, while maintaining the lowest possible rate of medical intervention.

Unfortunately, there are studies showing that close monitoring leads to increased rates of cesarean deliveries, which is not always beneficial to Mother or Baby. If your labor is monitored, play an active role in the decision-making process. If monitoring shows that your baby is in distress, try potentially helpful measures such as changing your position, turning from side to side, receiving supplemental oxygen, and, if you are receiving Pitocin, asking for it to be turned off. Clearly, if these simple measures do not relieve the problem, be open to whatever is necessary to have the best outcome for you and your baby.

Intravenous Access

Intravenous (IV) access through a catheter is considered routine at many hospitals in order to keep the laboring mother hydrated and to provide access for other fluids and medication should the need arise. If you are birthing in a hospital setting, discuss the IV policy with your health care provider. There are studies showing that women who are well hydrated have faster labors than those who are not. If it is an option, see if you can maintain the necessary hydration by drinking water and juices during labor. An IV can always be started if at some point you need to receive medications. Our experience is that mothers empowered to trust the wisdom of their birthing bodies will drink adequate fluids throughout labor, particularly if their partners remind them.

Pitocin to Induce or Augment Labor

To assist in the stimulation of contractions or to advance labor that is slow to progress, Pitocin, a synthetic form of the pituitary hormone oxytocin, may be given intravenously. Your body naturally produces oxytocin in short bursts during labor to facilitate contractions, but Pitocin is administered intravenously in a continuous flow. As a consequence, it may produce unusually strong contractions. Continuous monitoring is required with Pitocin to be certain that the strong contractions are not restricting blood flow to the baby. Due to the strength of the Pitocin-induced contractions, women who receive it more commonly require stronger pain medications, including epidural anesthesia.

There are clearly times when Pitocin is required to stimulate labor, and its appropriate use may reduce the need for a cesarean delivery. On the other hand, it is not a drug that should be used casually. It is difficult to support the increasingly commonplace choice to induce labor with Pitocin merely for convenience’ sake. Electively induced labors are associated with a higher incidence of cesarean deliveries, forceps deliveries, and epidural anesthesia. Become informed about the benefits and the risks before you allow a drug to be administered to your body.

Natural Alternatives to Stimulate Labor

If labor progress is slow, it’s worth trying to enhance your contractions with natural approaches before proceeding with Pitocin. Check with your care provider before using these techniques to stimulate your labor.

ACUPUNCTURE AND ACUPRESSURE

A number of reports have suggested that acupuncture, acupuncture electrostimulation, and acupressure may stimulate labor if your cervix has begun to soften and thin. Although the science is still in its infancy, there is no risk to stimulating a few acupuncture points. Two points have been reported to enhance labor, one on the hands and another above the ankles. Large Intestines 4 (Ho-Ku) is located on the back of the hand in the muscular web between the thumb and index finger; Spleen 6 (San-Yin-Chiao) is on the inner surface of the lower leg, about 3 inches above the major protruding bone on the inner surface of the ankle.

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Have your partner stimulate these points by firmly massaging them with his thumb for a minute at a time. The pressure should verge on feeling uncomfortable. He should alternate stimulating the points on your upper and lower extremities on both the left and right sides.

MAKING LOVE

It has been said, “What got the baby in can help get the baby out.” Oxytocin is released during a woman’s orgasm, and prostaglandins are contained in a man’s semen. Both of these chemicals help stimulate contractions and soften the cervix. Do not have sex if your water has broken.

NIPPLE STIMULATION

Nipple stimulation results in the release of the hormone oxytocin from your pituitary gland, which facilitates contractions to begin or continue. Lightly caress your nipples or have your partner lick or suck on them. You want to be careful not to overstimulate your uterus, so begin by stimulating only one nipple at a time for a few minutes every few hours.

Prostaglandin Gel

A gel made up of a synthetic prostaglandin has been shown to ripen the cervix and induce labor when applied to the vagina. In a number of studies, women receiving this prostaglandin gel calledmisoprostol had less need for epidural analgesia, Pitocin stimulation, and cesarean delivery. It can cause uterine stimulation. If you are considering inducing your labor, discuss the possibility of using this prostaglandin gel as an option.

Epidural Analgesia

The epidural space is a little gap between the bones of your spine and the sack that holds the spinal cord and nerves. Pain-relieving medication is administered into the epidural space through a thin plastic catheter, placed by an anesthesiologist through a needle. The needle is removed and the catheter is left in place. The tubing is connected to a pump, which continuously infuses the medication. When anesthetic medication is dripped around the spinal nerves, pain signals from the body are blunted.

A woman usually begins feeling numb within five to ten minutes after the medication is infused. An intravenous line is required and her mobility is limited. Because epidural analgesia may slow labor, Pitocin is more commonly required. Although epidural analgesia is routine in many birthing centers and there is a trend toward lower doses of medicine, this procedure is associated with longer labors and a greater chance of requiring instruments during the birth. In large studies, babies born to women receiving epidural analgesia have lower Apgar scores, a measurement of newborn health. However, babies whose mothers received epidural analgesia generally are healthier at birth than those whose mothers received narcotic medications.

There is not a clear right or wrong answer to the question of epidural analgesia. For many women, the pain relief is worth the small increased risks. Others choose to handle the pain of labor through natural means. We encourage you to inform yourself of the pros and cons of epidural analgesia, so you can make a conscious choice for yourself and your baby.

Narcotics

A narcotic will take the edge off your pain, although it will seldom eliminate it altogether. These strong pain-relieving medicines are given either intravenously or into a muscle. Intravenous medication takes effect faster but does not last as long as intramuscularly administered narcotic medications. It is common to feel drowsy and queasy for a while after receiving narcotics.

Narcotic medications enter your baby’s bloodstream soon after you receive them and, at high levels, can affect your baby’s blood pressure and breathing. If there are residues of narcotic medications in your baby’s body at birth, he may have a weak sucking response for a few days. Try using the least amount of narcotic drugs necessary to provide adequate pain control, and try limiting narcotics as you get closer to birthing your baby.

Episiotomy

An episiotomy is a 1⁄2- to 1-inch incision made in the perineum during crowning to enlarge the opening through which your baby passes. The incidence of this surgical procedure varies widely. In some birthing centers episiotomies are performed in as few as 20 percent of births, whereas in other units the procedure is used in more than 70 percent of births. Although overall rates have been dropping over the past twenty years, a report from Thomas Jefferson University in Philadelphia suggested that this procedure should be required in less than one in five vaginal births. Rather than reducing the chance for more serious tears, most surveys have actually suggested a higher risk in women undergoing episiotomies.

Studies have suggested that the position of a woman at the time of birth correlates with the risk of perineal tearing. The most important issue is that a woman listens to her body and finds the position that feels right to her. Rather than accepting the view that one position fits all, we encourage you to move around until you find the best one for you. In some studies, giving birth in a side position had the lowest risk of injury.

Well in advance of your birth, have a conversation with your health care provider about his or her usual practice regarding routine episiotomies and your personal preferences. When women are encouraged to push at their own pace and assume a pushing position that feels comfortable for them, the incidence of tearing or requiring an episiotomy is reduced. A recent report from Australia found that the episiotomy rate among obstetricians was five times higher than the rate among midwives, suggesting that allowing labor to unfold at its own pace can reduce the need for medical intervention.

Cesarean Birth

Cesarean section (c-section) is the surgical delivery of a baby through an incision in a woman’s abdomen and uterus. Almost one in four babies in America are born through cesarean section, although it is generally accepted that in low-risk pregnancies, the rate should be closer to one in seven. The term cesarean comes from the belief that Julius Caesar was born that way.

If, for a number of reasons, a baby cannot safely be birthed vaginally, cesarean delivery may be indicated. If the baby’s head is too large, the placenta is blocking the cervix, or labor fails to progress, for example, a c-section may be the best option. Cesarean birth rates vary widely across the world, highlighting the different thresholds for resorting to a surgical delivery. Although in the past it was believed that “once a cesarean, always a cesarean,” there is now good evidence that 60 percent to 80 percent of women who previously delivered by c-section are capable of a safe subsequent vaginal birth. There are many advantages to going the vaginal route, including shorter hospital stays, faster recovery, lower infection risk, and less need for blood transfusions.

If despite your best intentions and efforts, it is determined that a c-section is necessary, the procedure will take place using either spinal or epidural anesthesia, and you will be awake for your baby’s birth. If the cesarean is an emergency, you may be given general anesthesia to put you to sleep. A nurse will shave your abdominal and upper pubic area, and an IV will be started in your arm to give you fluids and necessary medications. You will also have a urinary catheter inserted to keep your bladder empty.

Once you have received this initial preparation, you will be taken into the delivery room where your abdomen will be washed with antiseptic solution and covered with sterile drapes. The surgeon will then make an incision in your abdomen. You might feel some pressure and hear some unfamiliar sounds as this is done, but should not feel any pain. Your baby will then be lifted out of your body and into the world. The time from incision to the birth of your baby is usually about ten minutes. Repair of your incision will take another thirty to forty-five minutes.

Ask your doctor if the drapes can be lowered so you can see your baby coming into the world. Upon arrival your baby’s mouth and nose will be suctioned and then he will be brought over to a warming table to be checked. Your partner can be right there with him. After these initial procedures, your baby will be snuggled up in a blanket and brought to you for a few minutes. While your placenta is being removed and your wound is being closed, your baby may be brought to a warming bed or another room for additional observation. Your partner can stay with your baby during these procedures. Once your surgery is completed, you will be brought to another room where you will recover.

Consider the possibility of having a cesarean delivery and think about how you can make this experience as positive as possible. You are not just having surgery; you are giving birth to your baby. If you are having an elective cesarean, create a special ritual for the morning of your baby’s birth. Place candles around you and your partner, connecting with each other and your baby on this day of his birth. Read a poem or say a few words to invite your baby into the world. Sleep with one of his baby blankets against your body the night before your cesarean so that it smells like you on the morning of his arrival. Bring this blanket with you to the hospital and have him snuggled in it once he is born. See if your partner can take pictures and ask for your baby to be brought to you as soon as possible.

The most important aspect of your recovery from a c-section is having people to support you. Surround yourself at the hospital and home with people who can mother you. Most women stay in the hospital for two to four days and require several weeks to fully recover from the surgery. Your baby will be looking for his connection to you, listening for your voice, and seeking the comfort of your familiar smell. Keep him close by as you recuperate.

The Amazing Story of Birth

Birth is a time of power and surrender, of beginnings and endings, of primordial feelings and absolute novelty. Your personal birth story echoes the stories of women since the beginning of humankind, yet it can be entirely unique. Allow yourself to be present for the most amazing experience of your life. Here is one woman’s story:

After hours of early labor, my contractions escalate. As they continue to build, the waves of sensations become stronger and there are only a few minutes’ rest period between each one. I begin thinking to myself, “This is really hard, maybe I can’t do this.”

As I breathe through another contraction, I feel my body leaning into my partner’s. I look up into his eyes and I see that he is here with me, and I think to myself, “I can do this.”

I change positions, following my breath as I settle back inside. I listen to my body, and as I feel myself breathing, I let go into the sensations. As the pain intensifies, doubt comes up again and I think, “This is much harder than I remember . . . I can’t do it.”

My partner holds me in his arms and I hear my health provider say, “I know it’s hard, but you’re doing great. Everything is fine and your body is working perfectly.”

I go back inside my body, feeling each contraction taking me beyond the boundary where I thought I couldn’t go. I’m moaning and breathing as my body opens. I begin to cry and I let myself lose control as I groan. I think, “I don’t know how much longer I can keep this up.”

The sensations are overwhelming. I feel like I want to throw up and my lower back is aching. My partner presses his hand into my back to help ease the pain and I feel the first urge to push. I soften my body and begin bearing down. The sensations are powerful and the urge is strong. With each push I feel my baby moving deeper.

After a while, my health provider tenderly strokes my hair and says, “Little pushes now. Your baby’s head is right here. Reach down and feel her. Just a few more pushes and she will be here.”

And I can feel my baby’s head at the threshold of birth. Another push and she comes through me into the world. I cuddle her to my chest and hold her in my arms for the first time. As I look into her eyes, I think, “This is the most amazing thing I have ever done. I gave birth to this beautiful baby!”

Enliven Through Your Attention

• Place your hands on your belly a few times throughout the day and send loving thoughts to your unborn baby.

• Journal each day about your experiences.

• Early in your pregnancy, plant a tree or flowering bush to symbolize the growth of your baby in the womb. After your child is born, you can take care of the plant together.

• Read enchanting stories and heartfelt poetry aloud to your baby and listen to beautiful, relaxing music each day.

• Perform a daily oil massage on yourself before you bathe or shower.

• Diffuse an aroma while listening to music, while soaking in a tub, or while meditating to create the association between the fragrance and the relaxed state of awareness.

• Ensure that you have all six tastes available during your meals throughout the day.

• Choose to eat meals that are rich in color, aroma, and texture.

• Be mindful as you eat your meals. Eat at least one meal each week in silence with your full awareness.

• Practice meditation for twenty to thirty minutes twice daily.

• Pay attention to signals of stress that you experience during the day and employ stress-reducing behaviors to minimize the harmful effects of stress on you and your unborn baby.

• Perform yoga postures with awareness on a regular basis, being gentle and respectful of your body.

• Embrace your pregnancy as an opportunity to experience more natural healing approaches to common minor health concerns.

• Whenever an uncomfortable symptom arises, go through a mental checklist to ensure that you are taking time to relax, eating properly, drinking enough fluids, and exercising regularly.

• Develop an open line of communication with your health care provider and have a low threshold for calling about any emotional or physical concern that may arise.

• Commit to improving your conscious communication skills. When you are feeling upset, determine what you really need and ask for the behavior that will fulfill your need.

• Practice the seven steps for emotional clearing when you are experiencing emotional turbulence. Notice how empowering the process can be when you take responsibility for your feelings.

• Whenever you are finding it difficult to communicate with your partner about your feelings, create the opportunity to practice conscious listening.

• Become familiar with the stages and phases of labor and birth. Knowing the map will increase the likelihood that you get to where you want to go.

• Practice your breathing exercises so you can draw upon a wide range of centering techniques during labor.

• Explore with your birthing partner various massage, pressure, and breathing practices so you can build confidence that he will be there for you when you need his assistance.