The Fetal Biome: The Beginnings of Prenatal Parenting

In 2001, I was reading a book titled Prenatal Parenting.  The author was Dr. Fred Wirth, a staff neonatologist at Reading Hospital and Medical Center in Reading, Pennsylvania. 

Wirth brought to light communication with the unborn child and called the womb the “intrauterine temple of learning”.  He believed in the empowerment of women and that they should take charge of their health care, not only as a means to a more satisfying birth experience, but as an optimal pregnancy and birth outcome catalyst.

“Faith and prayer are pivotal to my belief that you can increase the safety of your pregnancy by taking more responsibility for its outcome.  Thinking you are incapable of handling such responsibility will only work against you.  You must have faith in your ability to do this.”

And why not? Women are creating a wonderful environment both physically and emotionally for this baby.  The “faith” and “prayer” do not have to be religious.  But faith and prayer in a higher power or meditation and relaxation can help alleviate fear – and fear begets tension and tension begets stress hormones, which can have multiple negative effects on the growing baby and the pregnancy.

 

Fear is a huge topic today – with media input such as television views of childbirth and certain books and embellished stories from friends!  Fear of childbirth or tocophobia may include nightmares, panic attacks and psychosomatic symptoms.  The fear may be rooted in the misunderstanding of the pain in childbirth or apprehension in being at the hospital during the birth.  In our society hospitals are the place of illness and death – not the ideal location for pregnancy which is mostly a situation of health and wellness.  Again with the media, we have created a culture of avoiding pain: this medication for a headache, this medication for arthritis, this medication for menstrual cramps – we don’t have time for the pain.  And why should we – just take medication.

Therefore protecting the fetal biome is more than eating the right foods or consuming enough liquid to avoid dehydration.  It is a psychosocial journey of learning about the roots of fear, education on methods of comfort measures for the tension, as well as understanding the mechanism of pain and how to use the pain to the advantage of both the mother and baby.

When the above skill set is in process of being mastered, a powerful emotional bond begins to take place between the mother and child.  As childbirth educators and doulas, we can help mothers establish this reverence for the fetal biome and facilitate prenatal bonding.  What we teach our expectant clients has an impact on their relationship with their baby and may greatly influence the pregnancy.  Focus education not only on the expectant mother or the growing baby but the two as a dynamic dyad where love flows back and forth.

Want to read Dr. Wirth’s book Prenatal Parenting?  There are copies available on Amazon: click here.  And as former US Surgeon General C. Everett Koop said, “Read this book!  You will learn how to improve your birthing experience, as well as the health and happiness of your unborn child.”

When a Professional Gets Burnt Out: Rediscovering What We Preach Part 2

Meditation and relaxation go hand in hand, however they are learned arts.  In our hectic world, many of us feel stressed out and over worked.  Meditation gives the mind a break and makes thoughts calmer and better focused.  Spending quiet time in meditation also teaches about overcoming stress and finding inner peace and balance.  Many individuals overcome negative thoughts through meditation and also, some individuals also utilize prayer during quiet time or meditation.

In a 2013 Huffington Post article, author Amanda Chan identified many benefits of meditation.  The benefits include:

Lowers stress.  A person not only feels less stressed but also decreases levels of the stress hormone cortisol.

Lets us know our true selves by having the time to objectively analyze ourselves.

Promotes better focus ~ with working adults as well as students, cognitive function is improved.

Allows for better performance, better ability to handle and recover from stress.

Changes the brain in a protective way – for more positive thoughts.

Works as the brain’s volume knob, keeping negativity at a minimum.

Improves focus on music by improving focus.

Promotes sleep through relaxation. 

Lowers depression

Boosts health by reducing the expression of genes linked with inflammation.

Meditation needs only to last 10 – 15 minutes to be effective.  Sitting in a comfortable position to meditate is best, although there is no prescribed position.   While being quiet in meditation, don’t try to eliminate thoughts or resist them.  Let them come and go freely. You may experience a dream-like state during meditation and not be conscious of noises or sounds.  Some people fall asleep while meditating, while others experience strong emotions.  Should you experience any strong thoughts or emotions, try to come back to breathing and focus on that.

The Cleveland Clinic has a unique take on mindfulness and meditation.  Code Lavender is a holistic care response serving both patients and providers in need of emotional or spiritual support.  Through the program, a provider who summons emotional support is met by a team of holistic nurses within 30 minutes of a call. The team provides Reiki* and massage, health snacks and water, and lavender arm bands to remind the individual to relax for the rest of the day. The Holistic Services Team also offers a variety of other methods, including spiritual support, mindfulness training, counseling and yoga. According to the Huffington Post, the Cleveland Clinic is one of a growing number of hospitals and health systems that are integrating holistic therapies into their services. A 2011 American Hospital Association report found that 42% of hospitals surveyed offer one or more Complementary and Alternative Medicine therapies, including acupuncture, homeotherapy, and herbal medicine—up from 37% in 2007.

I have included a sample meditation from Meditation Oasis.  It is an eight minute Mandela Meditation, with beautiful music and mandalas.

*Reiki is a Japanese technique for stress reduction, relaxation and promoting healing.  It is a method of “laying on of hands” and is based on the idea that an unseen life energy force flows through us and is what causes to be alive. If the life energy force is low, a person is more likely to feel ill, stressed or unhappy.

References:

Ainsworth, B. et al. (2013) The effect of focused attention and open monitiroing meditation on attention network function in healthy volunteers.  Psychiatry Research, 210(3):1226-31.

Foureur, M. et al. (2013)  Enhancing the resilience of nurses and midwives: pilot of a mindfulness-based program for increased health, sense of coherence and decreased depression, anxiety and stress.  Contemporary Nurse, 45(1):114-25.

Goyal, M. et al. (2014) Meditation programs for psychological stress and well-being: A systematic review and meta-analysis.  JAMA Internal Medicine, Jan 6.

Singh, Y. et al. (2012) Immediate and long-term effects of meditation on acute stress reactivity, cognitive funcitions and intelligence.  Alternative Therapies in Health and Medicine. 18(6): 46-53.

Fundamentals of Relaxation Part 1

In this 8 part series , we are going to explore the fundamentals of relaxation, how each type works, the benefits and a little history.  We humans do not relax enough – we believe that sleeping or watching television is relaxation….nothing could be farther from the truth.  And it is so important to both mother and baby during pregnancy!

"Tension is part and parcel of what we call the mind. Tension does not exist by itself, but is reflexively integrated into the total organism. The patterns in our muscles vary from moment to moment, constituting in part the modus operandi of our thinking and engage muscles variously all over our body, just as do our grossly visible movements. If a patient imagines he is rowing a boat, we see rhythmic patterns from the arms, shoulders, back and legs as he engages in this act of imagination. The movements…are miniscule".

~ Edmond Jacobson, 1927

Progressive Relaxation

The deep muscle relaxation technique of progressive relaxation was developed by Edmond Jacobson PhD, MD  around  1910.  Jacobson believed that our bodies responded to anxious thoughts and events with muscle tension.  Tension in those muscles increased the feeling of anxiety (much like the Fear-Tension-Pain Cycle).  Deep muscle relaxation reduces physiologic tension, lowers blood pressure and pulse, and produces a general sense of calm.  Researchers have noted that progressive relaxation is effective in treating general anxiety, insomnia, depression, fatigue, hypertension, and

some phobias.  It has been an integral part of prepared childbirth methods since the 1950s.  It is also part of some Yoga methods.

With the publication of The Technic of Progressive Relaxation in 1924, Jacobson gave the world an answer to rising stress. His method is quite simple.  And there are many pre-written scripts available for you to use in your practice.  Below are just a few:

This beautiful handout is from Hartford Hospital in Connecticut Click here

From Baylor Univesity in Texas: click here.
From Australia: click here.

Try this one from the University of Houston at Clear Lake in Texas:  click here.

Sample this Relaxation Meditation yourself.  For some, it can be difficult to teach a technique if they have not experienced it themselves.

References: 

1. DiPietro, J. Et al. (2008) Fetal responses to induced maternal relaxation during pregnancy. Biological Psychology.  January 77(1): 11-19
2. Field, T. et al. (2004) Massage therapy effects on depressed pregnant women. Journal  of Psychosomatic Obstetrics and Gynecology. June 25(2): 115-22.
3. Fink, NS. Et al. (2011) Fetal response to abbreviated relaxation techniques. A randomized controlled study.  Early Human Development. 87(2):121-7.
4. Janke, J. (1999) The effect of relaxation therapy on preterm labor outcomes.  Journal  of Obstetrics, Gynecology and Neonatal Nursing. May –June 28(3): 255-63.
5. Lothian, J. (2011) Lamaze breathing: What every pregnant woman needs to know. Journal of Perinatal Education.  Spring 20(2):118-20.
6. Lothian J. A., DeVries C. (2010) The official Lamaze guide: Giving birth with confidence.2nd ed. Minnetonka,MN: Meadowbrook Press.
7. Smith, C. et al. (2007) A randomized comparative trial of yoga and relaxation to reduce stress and anxiety.  Complementary Theories in Medicine. June 15(2) 77-83.
8. Smith, C.A. et al. (2011) Relaxation techniques for pain management in labor.  Cochrane Summary Review retrieved 6/26/13 http://summaries.cochrane.org/CD009514/relaxation-techniques-for-pain-management-in-labour

Extreme Self-Care for the Busy Birth Professional

Usually, my blog posts are more evidence-based and researchy.  Today, I want to share with you 10 quick extreme self-care ideas.  

Not stressed?  Don't need self-care?  Sorry, I don't believe you.

Each of us has too much on our plates: family stresses, children, financial considerations, clients,

births, classes, marketing, success.....the list is endless.  And if we first don't recognize this stress, then we will become victims of the very stress hormones that we help our clients to guard against.  Stress puts stress on our bodies and lowers our immune system. Extreme stress begins to put strain on organ systems.  It can affect your hair, skin, digestive system, urinary tract, muscles and so much more.  Headaches, muscle aches and grumpy outlooks may all become part of the over-stressed menu.

Here are my top 10 go-to stress busters.  In the event of extreme stress, you may need to do ALL of these in one day!

In no particular order: 

1) First and foremost, meditate.  This is more than just sitting silently thinking or praying.  For some, it involves being in a relaxing locations or listening to relaxing meditative music.  Add a soothing scent (such as incense or lavender essential oil) for even more impact.

2) Get a massage.

3) Go sit by a body of water (lake, river, ocean).  Enjoy the sunshine and solitude of nature. Listen with intention to all of the sounds - going so far as to closing your eyes and trying to identify sounds.

4) Find a cuddly old quilt and lay on the ground and watch the clouds.

5) Have an appliance-free day - this means no TV, radio, computers, cell phone or tablet for 24 hours.

6) Do some Zentangling.

7) Relax!  Relaxing is not sleeping...it is an active form of stress release.  You may do Yoga positions to facilitate relaxation or practice what you preach in your business - progressive muscle relaxation visualization, breathing or even Tai Chi.

8) Cuddle with your partner....and if that leads to sex, then you both can benefit from the oxytocin rush!

9) Get an ice cream or coffee, preferably use a drive thru, and pay $5 towards the bill of the car behind you.

10) Take a walk through an arboretum.

Taking time for yourself fills your heart with so much positive energy!  Be ware of the temptation to short change yourself, with mental messages such as "I have too much to do - don't have time for pleasure now." or "This stuff won't work."  You must make time for you and yes this stuff does indeed work - there are plenty of evidence-based research articles that show the benefits.

Now...ready, set...RELAX!

Taking A Look At Mindfulness Guided Imagery as an Add-on to Relaxation

Research shows that relaxation during labor and birth allows for a dramatic reduction in the stress reaction.  When subjected to stress (of any kind) or fear, be it real or anticipated, body changes take place that trigger a defense mechanism and institutes the fight or flight mechanism.  The fight or flight mechanism is started by the autonomic (or involuntary) nervous system and includes body changes such as an increase in respirations and mild/moderate rapid heart rate.  With this stress response, females have a strong tendency to take flight or flee.  Obviously this is not practical during labor/birth.

Most of us teach about the Fear-Tension-Pain Cycle as first described by Dr. Grantly Dick-Read in the late 1950s.  Fear (due to lack of education and practical knowledge), leads to tension in the body – tension in the muscles of the body uses oxygen that would have normally been made available to the fetus and the uterus.  This, in turn, decreases the efficiency of the uterine contractions and thus slows or in some cases, stops the labor process.  Tense striated muscles contribute to an increased in lactic acid build up that impinges on pain receptors, magnifies pain perception and increases fatigue. Fatigue decreases the pain threshold, further increasing pain perception and reduces the laboring mother’s ability to conserve energy for the expulsive efforts needed during the second stage of labor.

Conscious relaxation and practicing coping techniques may be some of the first items removed from childbirth education curricula when timing in the class becomes an issue.  However, initiating a relaxation response to contractions or pain stimuli can decrease metabolism, slow down the heart rate, calm breathing, reduce blood pressure and relax muscles – all of which has a positive effect on the baby, mother and labor.   Click here to read entire article