Tuesday, May 24, 2011

10 Simple Truths About Childbirth ~ #4

"Men fear most what they cannot see" ~ perhaps that is why they fear childbirth? But all they really have to do is....look.

Fear is by far one of the driving forces behind the increase in medical intervention in childbirth.  "Men" meaning humankind, fear what they cannot see.  And since a good visual is not available for what is happening in the uterus and in the most dangerous 4 inches in an infant's life - the journey through the birth canal - then fear takes over.

Yet as much as we intervene in childbirth in the U.S., research continues to show with the rise in intervention rates, the rate of maternal morbidity and mortality/infant morbidity and mortality is still extremely poor.  In fact, 40 other countries have better statistics than the US in spite of the fact that the US spends more money on maternity health care.

But as the quotation says,  perhaps all one has to do is to look and they can "read" a laboring women.

I am not talking about EFMs or vaginal exams.  

I am talking about physical presence, verbal cues and emotional signals from women in labor.  

Study how she moves - left alone, a labor woman moves in perfect syncrony with her body to promote the cardinal movements of the baby: those miraculous movements that the baby initiates as the journey of birth begins.  Not signaled by the mother or caregiver, the baby instinctually knows how to move, bend and extend in order to fit through the tight spaces of the pelvis.  The mother will also move, bend and extend, crouch, squat, stand, sit, kneel, sway, lean and walk as if listening to a birth song...dancing to this song to bring her baby into the world.

Likewise, she may also "sing" along with this birth song...verbalizing as best as she can the effort going into this work.  It may be in the form of talking, moaning, singing, yelling, groaning, or talking in soft, loud or angry tones.  With each phase/stage of labor, her verbalizing changes, signalling the change from one phase to another.  Her verbalizing tries to match the intensity of the contractions and the work her body does.

As her verbalizing changes in intensity, so do her emotions.  From calm and expecting, to intense and working, to fierce and with effort, a laboring woman's emotions also change to match the work she does.  As the contractions become stronger in an effort to push the baby from the uterus to the loving arms on the outside, the emotions (and endorphins) match this strength.  With the protective fierceness that exists down deep in all mothers, a laboring woman expresses her emotions verbally, on her face, in the tone of her words and in her physical actions.

If we as caregivers take the time (albeit precious) to be fully present at a birth and watch with careful eyes the emotions, movement and verbal cues given by laboring mothers, then as we learn what is normal (and what isn't), birth will no longer be a fearful experience.  But we absolutely must know the normal before we can truly deal with the abnormal.  Then our morbidity and mortality statistics will be more reflective of the maternity care we all want to achieve.

While this has spoken more about the fear that caregivers have of birth, I will soon write Simple Truth #4a - about the fear that pregnant women have surrounding birth.  That also must be addressed.

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