Wednesday, August 28, 2013

Fundamentals of Relaxation Part 7 - Music

Music.

Music is a powerful element.  Music sets the tone for parties and attitudes.  It can energize, relax, invigorate, and invoke so many other emotional responses.

Music has been shown to promote relaxation of tense, aching muscles and carry a person away from a stressful situation.  With many medical conditions, research shows us that music can lower blood pressure, decrease anxiety and stress (Mandel).  

For childbirth, the research demonstrates that women feel that music reduces perception of pain, increases concentration on positive techniques such as relaxation, cues breathing and distracts attention away from the pain associated with contractions(Hanser).

Music that has been used throughout the pregnancy can set the stage for the mind to be in a relaxed and meditative state, releasing stress and allowing the hormones of labor, such as oxytocin to do the work.  Endorphins are released in greater quantity when a person is relaxed!


Childbirth educators say expectant women and their support partners are increasingly making music a part of their births and to even put together playlists for different stages of birth.

Tina Cassidy, author of "Birth: The Surprising History of How We Are Born," (Atlantic Monthly Press, 2006) said it's natural for women to want music around them during labor.

"If you go way back into history, singing was always a part of giving birth," Cassidy said.  Today's moms are using music in a variety of ways in the delivery room, bringing everything from meditative CDs or relaxation music on iPods to help them relax, to Salt-N-Pepa to help them, literally, "Push It."

“It has been known for several decades that music in childbirth can promote relaxation, especially if the mother and her partner practice with the music during the pregnancy,” says Regina, a nurse who teaches childbirth classes.  “When you practice the techniques covered in class with the same music week after week, you condition yourself to automatically relax when you hear that music.   Other music energizes you and that type of music is perfect for the second stage of labor…better known as pushing phase.”

If a mother is relaxed during labor and birth, logic and research shows that labor outcomes are better, with less stress for both mother and baby.  Less stress means more oxygen available and therefore less fetal distress and higher Apgar scores.

If you are considering making a play list, here are some songs that already DO appear on expectant mothers’ playlists.  Of course, you can find your own, but this is a good place to begin! Click here for a Childbirth Playlist!  Most are available on iTunes.

The video below is a great video created by Julie Samms RN and blends music with birth art to share the benefits of music during labor and birth.  This would be an ideal video to give to your clients as homework for deeper understanding.





References: 


Hanser, S. et al  (1983).  The effect of music on relaxation of expectant mothers during labor.  Journal of Music Therapy, 20(2), 50-58.

Mandel et al.  (2013) Effects of music therapy and music assisted relaxation and imagery on health - related outcomes in diabetes education: a feasibility study. Diabetes Education  July.

Smith et al. (2006) Complementary and alternative therapies for pain management in labour. Cochrane Database Systematic Review.

Monday, August 19, 2013

Fundamentals of Relaxation - Part 6 - Yoga

One of the CAMs (complementary and alternative medicines) used in pregnancy is yoga.  Research demonstrates that yoga improves birth weight, decreases preterm labor, and decreases IUGR either in isolation or associated with PIH, with no increased complications.  The various styles of yoga used for health purposes typically combine physical postures or movement, breathing techniques, and meditation.  Ranked in the top 10 of CAMs used by adults, yoga enjoys a strong following around the world ~ especially with expectant and new mothers.

I had the opportunity to email with Cheryl MacDonald, BA (Hons) CYT E-RPYT Principal Yoga Teacher Glasgow West Studio: YogaBellies Women Baby & Yoga Centre.  I asked her some questions as she is the Director of YogaBellies, an international yoga training and certification organization.


Connie: Briefly, what are the benefits of prenatal yoga for the mother?


Cheryl: As much as mum may have wanted to become pregnant, it can still create a number of conflicting emotions when those two little lines appear on the pregnancy test. Practicing yoga during pregnancy can help mum work through these emotions, stay flexible and healthy and become positive about birth and parenting.

Yoga during pregnancy is about so much more than safe asanas (postures), it’s about bonding with baby, staying strong and flexible for birthing and accepting where you are at and that life isn't just about you any more. It's a valuable life lesson.

Connie: Are there benefits of prenatal yoga for the baby?

Cheryl: Absolutely! A happy and relaxed mum equals a happy and relaxed baby. Every time mum stops to take care of herself, to relax and renew and become strong and healthy, this makes her baby's chances of health and happiness even better. The fact is that yoga actually makes you happier. The ‘love hormone’ Oxytocin helps you to relax and reduces blood pressure and cortisol levels. This is the hormone we produce during birth, breasfeeding and love making. The most important things is not to force yourself (or baby) to do anything you don't feel comfortable with. It's important to listen to your body's signals.

Also, in a study of 65 women with depression and anxiety, the 34 women who took a yoga class twice a week for two months showed a significant decrease in depression and anxiety symptoms, compared to the 31 women who were not in the class.


Connie: If someone has already had their baby, what are the benefits of yoga during the postpartum?


Cheryl: From a purely physical perspective, post natal yoga helps to rebuild the pelvic floor and abdominal muscles and to ease any lower back pain in a gentle but effective way.

Yoga helps to balance hormones and stabilizes the endocrine system. By practicing yogic relaxation techniques, we can balance cortical activities and the nervous and endocrine systems, reducing the body`s reaction to stress. As a result, the body produces less adrenaline, noradrenaline and cortisol, (all stress hormones) and mum feels much more balanced and stress free.

Also, prenatal depression studies indicate clinical depression alleviates by half if only we can talk to a friend who listens to us and oxytocin is shown to increase when we receive empathy.  The social aspects of getting out to perinatal yoga classes either before or with baby help mum and baby socialize with other mums around them.

Remember oxytocin is about being personal in ways that give our time together significance and shape moments of laughter and pleasure.  Follow the instinct to reach out and strengthen ties with invitations to share together and enjoy your pregnancy and life.  
There is ample evidence, that oxytocin and another hormone known as vasopressin are critical for the bonding process, especially as it relates to social and reproductive behaviour. Both chemicals help encourage bonding and maternal behaviour.


Connie: Can prenatal yoga be modified if a mom has a complicated pregnancy or is on bedrest?

Cheryl: Absolutely. But it is very important to make sure your yoga teacher has a credible qualification in specialist perinatal yoga. It's important to find a yoga teacher that's right for you and if you're new to yoga, YogaBellies classes cater for all levels and make you feel comfortable wherever you are in your pregnancy or your yoga journey. Our teachers are fully qualified in teaching yoga for pregnant women accredited by the IYN and IPTI. If your prospective teacher does not hold a reputable Yoga Teacher Training qualification, look elsewhere!


 This is a video of me and a bit about what we do. 




Connie: Now, talk a little about you and your company and bringing YogaBellies to the US/Canada!

Cheryl: We have almost 100 franchised YogaBellies teachers across the world - but not yet in Canada or the USA! We are always looking for inspiring women to spread the YogaBellies message of women helping women. We offering training in four main paths: Yoga for women at every stage of life, yoga for children (YogaBelliesKidz), Birth ROCKS (our birth preparation program) and YogaBellies Mummy therapies (our specialist perinatal massage therapists.) You can find out more about YogaBellies and joing us here www.yogabellies.co.uk or find us on facebook at www.facebook.com/yogabellies.

Sunday, August 11, 2013

Fundamentals of Relaxation Part 5 - Breathing

In spite of the new technology associated with labor and birth, women are still fearful.  Fear may come from hearing stories, reading articles, or simply by not knowing the full truth about the events of the birthing process.  An important aspect of relaxation for fear is breathing.

Any source that addresses fear, stress or anxiety will also address breathing.  Breathing is an effective and easy way to reduce stress and fear by decreasing the body’s reaction to the stress.  Slow, rhythmic breathing has been shown to lower blood pressure, reduce heart rate, and reduce the secretion of stress hormones such as cortisol. Relaxed breathing also balances O2 and CO2 levels and decrease muscle tension.

Behaviors for coping with severe fear of childbirth or SFOC were related to six domains of childbirth education relaxation: concentration or focusing, support from family or doula, breathing, relaxation and perception of control.  Since breathing helps to maintain focus and relaxation and hence perception of control, breathing seems to be a foundational skill to learn.

For decades, Lamaze has taught patterned breathing to offset the intensity of the contractions. Since Lamaze has become as synonymous to breathing as Kleenex is to tissues, many expectant parents come to childbirth class, regardless of the method, to learning breathing.  While Lamaze still offers instruction on breathing, it is not so much how one breathes as that one does breathing effectively.

In a 2011 article in the Journal of Perinatal Education, author Judith Lothian gives these guidelines for using breathing in labor:

  • Breathing is easily subject to conscious control. Therefore, controlled breathing is easy to learn.
  • Slow, deep breathing is particularly effective. The “right” way to breathe is whatever feels right. There are no rules related to how many breaths per minute, whether to breathe through the mouth or nose, or whether to make sounds. The key here is that the breathing is conscious, not automatic.
  • As labor contractions get stronger and the work of labor gets harder, speeding up the breathing and making it shallower is sometimes, but not always, more effective.
  • Focusing on something, either with eyes closed \or open, can help maintain the rhythm of the breathing.
  • Using conscious breathing in everyday life, either to relieve stress or to increase body awareness and mindfulness, is excellent practice for labor. It is an excellent life skill.
  • Conscious breathing works best in combination with many other comfort strategies. In Lamaze classes, women no longer spend large amounts of time practicing breathing. Women move, change position, slow dance, sway on birth balls, learn massage, and identify the countless other ways they normally relax and find comfort. Each of these comfort strategies can be used in combination with breathing.
  • In restrictive environments, breathing may be one of very few comfort strategies available for women in labor. It is one coping strategy that cannot be taken away.





References:
Lothian, J. (2011) Lamaze Breathing: What Every Pregnant Woman Needs to Know.  Journal of Perinatal Education.  20(2), 118-120.

Salomonsson, B.  (2013). Self-efficacy in pregnant women with severe fear of childbirth.  Journal of Obstetrics, Gynecologic and Neonatal Nursing. 42(2): 191-202.


Turankar, A. et al (2013) Effects of slow breathing exercise on cardiovascular functions, pulmonary functions and galvanic skin resistance in healthy human volunteers – a pilot study.  The Indian Journal of Medical Research.  May 137(5): 916-21. 

Monday, August 05, 2013

Fundamentals of Relaxation Part 4 - Mindfulness

Our culture is so busy.  Instant news on TV.  Instant communication via cell phones.  Instant food either through drive-thru or by microwave.  We are just busy, and juggling several things all at once!

But are we really enjoying the moment?  Are we at peace?

The answer to both questions is probably “no”.  How can we enjoy the moment when there are 10,000 thoughts going through our minds?  How can we be at peace when we are either living in the past (thinking about what has happened) or living in the future (thinking about what will happen)?

According to the website, Franticworld.com, “mindfulness has now become one of the hottest topics in mental health. One study, in the Journal of Clinical Psychology, has shown that it increases happiness and well-being, while a major study in Psychological Science revealed such changes help regular meditators live longer, healthier lives. Other research has shown that it improves memory, creativity, and reaction times. It also boosts the immune system and lowers blood pressure.”

What is mindfulness?  Originally from the Sanskrit meaning awareness, mindfulness practice or meditation is a way to slow the brain chatter, stop juggling life, reduce stress and improve overall mental health.  In 2011, the National Institute of Health’s National Center for Complementary and Alternative Medicine released a study showing improvement in overall brain function (via MRI) in the participants of mindfulness  meditation.  Being mindful means to observe thoughts and feelings almost as if from a distance, without judging.  It means to live in the moment and be aware of all of your senses.  Mindfulness also involves quieting the “monkey mind” (bouncing from one thought to another).  Quiet moments and meditation can increase mindfulness significantly.  With eyes closed, focusing on just one thing, such as the breath, can calm the mind and body and bring on the sense of mindfulness.

Think it sounds very “crunchy” and “granola”?  In a January 23, 2013 Associated Pressarticle, a pilot program for mindfulness meditation was highlighted.  Who is in this pilot program for stress reduction? US Marines!  

"Some people might say these are Eastern-based religious practices but this goes way beyond that," said Jeffery Bearor, the executive deputy of the Marine Corps training and education command at its headquarters in Quantico, Va.. "This is not tied to any religious practice. This is about mental preparation to better handle stress."

What role does mindfulness play in pregnancy and childbirth?  The adrenal glands provide the hormones (adrenaline- triggers the "fight-or-flight" response, cortisol-promotes natural resistance and longevity, and DHEA-improves physical condition) necessary to deal with the day-to-day experiences. However, when we allow the stresses to become extreme, the adrenal glands become overworked, thus causing a cascade of physical and emotional trauma to the body. This can be even worse for the pregnant body!  A study from 2009 reported that women practicing mindful yoga in their second trimester reported significant reductions in physical pain.    


The University of Oxford Medical Sciences Division is currently involved in a study exploring a Mindfulness Based Childbirth and Parentingprogram

There is even an app for that!  Be sure to check out the Mindfulness for Pregnancy app on iTunes for $2.99.

When teaching about birth, explore teaching from a mind/body/spirit perspective.  Childbirth class becomes the perfect launching pad to teach mindfulness not only for pregnancy and birth but also as a continued lifestyle.  Peace, rebalancing, and inner wisdom have been shown to reduce both physical and emotional complications.  In many countries that have better maternal/infant outcome rates than the US, the midwifery model of care dominates – midwives do provide care based on the mind/body/spirit perspective.  Perhaps we need to learn from our history and from the present of others, to improve our future.

Follow Jon Kabat Zinn, who wrote the forward for Mindful Birthing: Training the mind, body and heart for childbirth and beyond,  through Breathscape Guided Meditation.




References:
Bardacke, N. Mindful Birthing: Training the mind, body and heart for childbirth and beyond.  HarperOne Publisher.

Beddoe et al.  (2009)  The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress.  Journal of Obstetric, Gynecologic and Neonatal Nursing.

Vieten, C. and Astin, J.  (2008) Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study.  Archives of Women’s Mental Health.

Uvnäs Moberg, K. The Oxytocin Factor: Tapping the hormone of Calm, Love and Healing.  Da Capo Press.

Vieten, C. (2011) Mindfulness for Moms: The Basics.  Psychology Today Webblog. http://www.psychologytoday.com/blog/mindful-motherhood/201105/mindfulness-moms-the-basics