Ricki Lake has made a birth related documentary Movie called the Business of Being Born.

Synopsis
Birth: it’s a miracle. A rite of passage. A natural part of life. But more than anything, birth is a business. Compelled to find answers after a disappointing birth experience with her first child, actress Ricki Lake recruits filmmaker Abby Epstein to examine and question the way American women have babies. The film interlaces intimate birth stories with surprising historical, political and scientific insights and shocking statistics about the current maternity care system. When director Epstein discovers she is pregnant during the making of the film, the journey becomes even more personal. Should most births be viewed as a natural life process, or should every delivery be treated as a potentially catastrophic medical emergency?

Watch the trailer here:
http://www.thebusinessofbeingborn.com/trailer.htm

The below link is to watch the whole documentary for free (1h24m).
http://quicksilverscreen.com/watch?video=45525

It is about America, but it closely parallels the recent trends in SA.

Do yourself a favour and check it out for yourself. Loads of food for thought!

“The Business of Being Born is a joy to watch—engaging, funny, extremely enlightening, and yes, disturbing—just as childbirth has become so disturbing. It is a kind of film that will get through to women and men in ways others have not—perfect for our culture right now.”
Kyndal - Boise, ID

What is labour like? Useful Analogies
By Jane Weideman

The I am often asked by friends & clients what labour (birth) is really like. Having birthed 2 LARGE babies naturally myself, they want to know how I did it? What does it feel like? How does one cope with it? What if the baby is large? Do you have to have a super human pain threshold? How do I know if I can do it? What will happen to me afterwards? Questions, questions….

It is hard to describe something to someone when they have no frame of reference. How can you really describe a contraction to someone who has never felt one? Or to a partner who never will feel one, and possibly can’t relate to it at all?

Over time I have developed a few analogies which help to illustrate the process of labour/birth, and the experience of feeling and dealing with contractions. I hope my descriptions help to make it clearer and more understandable. As well as less intimidating and less scary, to those who have the fear of the unknown.

“Nothing in life is to be feared. It is only to be understood.”
~Marie Curie~

The best analogy I can give you for birth, and what it is like, is that is it like running a marathon or climbing a mountain.

Take Cape Town’s Table Mountain for instance, there are many different ways to get to the top. None more right or valid than the others, they are just different. And those different ways suit different people better. So the best way for one person, may not be the best (or even a good) way for someone else, depending on each person’s circumstances and motivations. So while you may want to climb it, someone else may think you are crazy for wanting to do that! Why go through all that pain, sweat & exhaustion when you could take the cable car? Someone else might think that even the cable car is risky, or a waste of time, and would rather pay to get a quick & easy helicopter trip up there. I mean the end result is being at the top right?? Doesn’t matter how you got there….

Well yes & no. Sure that’s the end goal, but for some the journey of getting there is as much part of the experience and memory as the summit, and being at the top can feel that much more of an achievement and high if you got there yourself. Plus it is healthy for you, it is exercise and fresh air.

Then of course , there are different ways of climbing, there are long slow winding paths, more steep and intense direct routes, and then even scary but exhilarating real rock - face climbing options. There are loads of options and only you would know which you would want to do, and which is right for you.

Make sense?

Birth is VERY similar.

If you chose the climb option in the analogy, it doesn’t mean the journey won’t be hard and tiring. You might even think “What the hell am I doing!? Why didn’t I just catch the cable car??”, while you are plodding along, and as it starts getting steep . But you keep going one step at a time, and get into a rhythm, and before you know it you are there at the top. You did it, and you feel fantastic!! Like you can do anything. You are proud of yourself, exhilarated and the experience has been unforgettable. And the view from the top is so worth it because you really worked for it, and earned it. Your endorphins are rushing and you have never felt as good, or moved, or emotional before. Nothing compares to that.

So what you need to work out for yourself is. What option do you really want? For YOU. No one else can, or should, make that decision for you. It is a very personal choice, and you are the one who will need to do the work, and feel the feelings and really LIVE the experience.

Do I have a high pain threshold? …. um, I think mine is probably average, but I think I am very logical and rational. So I hate having a pimple squeezed. It hurts like hell and just feels WRONG to me. But the ‘pain’ of birth is not just pain. It is a combination of factors, all of which make sense. (I will send you some attachments later with some more info on this). So I can deal with it, using my rationalisation skills. A male friend asked me about labour once and said, ‘Ok so it like slamming your hand in the door and staying there for 12 hours!?’ NO!!!
Firstly it’s nothing like that. It’s not ‘oh my god I am being damaged and having nerves severed and am about it die!!’ pain. It is a pressure, dull ache, muscle working burn kind of pain. Secondly it’s not continuous. Contractions come and go. They build up and dissipate, and mostly, the gaps between them are longer than the length of the contraction itself.

Imagine this scenario. You have an strict instructor (or a $1M prize or something) and have do a yoga-type squat/lunge for a full minute every 5 minutes for a few hours. It starts off fine, and then after 30 sec or so your thighs start burning and feeling tired and you want to get up. You’re not dying, but you feel uncomfortable. You can’t just stand up though, you have to stay there for a full minute. You could cry, panic, scream etc, but that wouldn’t help, it would feel worse, and you would just waste energy and upset and tire yourself. What you need to do is relax, zone out, breathe slowly and deeply, and just try to forget about it. Before you know it the minute is up and you can stand. You then have a few minutes to rest move around, breathe, have a sip of water, whatever you want to. Then you start again.

The thing is each one is bearable, but you need to prepare your mind and your attitude, that’s the main thing. You need to not panic and you need to just accept it work with it, and only think in the moment. Each one you finish is one that is gone and done, don’t dwell on it. Don’t think or worry about how many more you have, or how much worse it might feel. All there is, is here and now, and each one you finish is one step closer to the end… You can get into a rhythm and find ways which help you relax quickly and easily in between. You’ll find you can finish the minute with 4 or 5 long slow breaths. Or perhaps someone encouraging you or rubbing your back through the hardest part helps you to get through it. Or closing your eyes, or day dreaming or focusing on a spot on the floor etc, whatever you need to do. Sooner or later your endorphins kick in and suddenly its not so bad, you can do it, you ARE doing it.

The other way to imagine a contraction is like you are floating on the ocean and each on is a wave. As it comes you can kick and fight and try to stop it affecting you, or you can simply relax as it comes and allow yourself to be lifted up and over the wave. Ride it, don’t fight it. You can’t stop a wave in the ocean, you will exhaust yourself or be dumped by it. Work with it and just surrender to it, and then you can relax and even enjoy it.

Basically your body knows what to do, and will do it regardless. Even if you went into a coma your body would birth the baby without you. In fact it would do a pretty good job of it. So your role in the birth is actually just to not get in the way. You need to learn how to relax and surrender and breathe through it, and not hold back and resist and impede the progress.

Does that help?

In general a vaginal birth (and particularly a natural one where mom is up and active) is much safer for the mom and baby. The ’stress’ of natural birth is actually very good and healthy for the baby. It stimulates the baby and prepares it for life outside the womb. Far more Caesarean babies have breathing and lung difficulties (pneumonia etc) because they have not had the fluid squeezed out of their lungs by the passage through the birth canal (and the adrenaline etc they have during birth too). It’s not to say a Caesarean is a BAD way to birth, but natural birth is arguably the best way to birth.

Also even if a Caesarean birth is necessary, or selected, it is still better to allow the baby to be fully ready (not at 38 weeks) and even allow labour to start, before performing the Caesarean, and let the baby get the benefit of:
1) Being born of it’s actual intended birth date, when it was ready to be born and
2) The stimulation of the contractions. Labour is good for the baby (unless there are issues like with the cord or placenta etc when it’s not, but that’s what the intermittent monitoring is for, to make sure baby is fine with the labour).

Are my pelvic muscles damaged? No. Sure they are not 100% the same as they were, but they work completely fine, and honestly I am far more comfortable with my body and my sexuality now than before I had my babies. Somehow growing and birthing them really put me in touch and in awe with myself. And orgasming is in some sense rather like giving birth. It is a complete surrender, release, expulsion followed by a hormone rush & elation…

Honestly my experiences of giving birth are some of the highlights of my life, and I regard them as my greatest achievements. I wouldn’t change that for the world.

So the choice really is yours, but I hope some of the above can help with your decision.

All the best!
Jane

Remember:
The power and intensity of your contractions cannot be stronger than you, because it is you.
The contractions come from and are YOU. So they can not overwhelm, or be bigger than you, as they are only as strong as you are!

This article was published in the New Zealand Herald. More clinical proof of the increased danger to mom & baby, with unnecessary Caesareans.

Caesarean births twice as risky as natural deliveries

10:00AM Wednesday October 31, 2007
By Jeremy Laurance

Women who choose a Caesarean delivery, sometimes described as “too posh to push”, are increasing the risk to themselves and their baby.

Surprise results from an international study of 97,000 deliveries show that a routine Caesarean puts a woman at twice the risk of illness or death compared to a vaginal birth.

And babies born by Caesarean had a 70 per cent higher risk of dying before discharge from hospital if they were lying normally head first in the womb than if delivered vaginally.

A Caesarean delivery was, however, found to be safer for babies lying in the less common and riskier breech position - feet first.

The findings are from eight randomly selected countries in Latin America, where Caesarean rates are higher than in the UK, at an average of 33 per cent of all births.

Well-heeled Latin American women are more anxious about the potential effects of a vaginal birth on their sex lives and in some private hospitals the Caesarean rate is up to 60 per cent.

In Britain, the Caesarean rate has doubled in the past 20 years to 22 per cent, driven in part by the demand of some women for what is perceived as a convenient and pain-free method of delivery.

Obstetricians too have seen it as safer - and as a way of reducing risks of litigation.

The latest study, published online in the British Medical Journal, suggests the safety of Caesareans may have been overstated.

Jose Villar, former director of maternal health at the World Health Organisation and now a senior research fellow at the University of Oxford, who led the study, said there was no benefit from the very liberal use of Caesareans, either for mothers or babies, and they could even do harm.

Caesareans led to longer hospital stays for mothers and babies, increased the risk of readmission and increased the risk to subsequent pregnancies.

The only exception was that babies in the breech position did better and women had fewer severe vaginal complications.

Dr Villar said the findings should be applicable to Europe and the UK because of the large number of deliveries surveyed, the comparability of outcomes to those in Europe and because the overall Caesarean rate was not dissimilar.

“The message is that a woman thinking of having a Caesarean because it is safer should think again,” he said.

“It is a question of balancing the risks and benefits. She should sit down with her care provider and consider the options. We think this is the most comprehensive study that has been done.”

In a commentary on the findings, Alison Shorten, of the School of Midwifery at the University of Wollongong, New South Wales, Australia, said an important reason why women chose Caesareans was because of worries about damage to the pelvic floor from a vaginal birth, which could lead to sex and bladder problems.

“Women need to weigh up the possible but uncertain benefit of preventing urinary problems against the increased chance of problems related to surgery in themselves or their baby,” she said.

Pat O’Brien, consultant obstetrician at University College Hospital, London, and a spokesman for the Royal College of Obstetricians and Gynaecologists, said: “We have always known from the mother’s point of view a planned Caesarean was slightly riskier…. Recent research from the US has suggested the risks of the two approaches were getting closer and closer. This latest study pushes that back a bit.”

More evidence and research findings here:
- C Sections Raise Health Risks
- Complications, Safety and Caesarian section rates
- C-section facts from the March of Dimes
- Cesarean birth in a culture of fear: a scathing indictment of the failure of technological birth in the US
- Caesarean Section Risks and Complications
- More done than ever before …C-SECTION RISKS: What Every Woman Needs to Know
- Risks of a Cesarean Procedure
- New Study Confirms Cesarean Risks

The bottom line. In most cases (i.e. other than true medically indicated Caesareans) a Caesarean IS more dangerous for you and your baby. However the choice of how YOU would like to birth remains yours. Get educated and make an informed choice for yourself, and have a happy, memorable birth expereince.

A fantastic new American site has launched recently called:
Pushed Birth - What to expect. Really.

It is an anti-intervention (so tending to pro-natural) site, questioning routine medical intervention in labour and birth.

The site is here: http://pushedbirth.com/

This awesome website features news and articles debunking the ‘medical necessity’ of many of the pregnancy, labour and birth interventions, in a frank, slightly sarcastic & humorous, but very easy to read and digest format. It just makes sense!

It explains many of the interventions and why you should want to avoid them, and basically how and why to generally avoid having a medically ‘Pushed Birth’.

There’s a section on Previous Caesareans and VBACs here (including a summarised explanation of the recently published RCOG VBAC study risk stats in there):

If you’ve already given birth by cesarean section, you’ve probably heard the term VBAC (vee-back). It stands for, you guessed it, vaginal birth after cesarean.

And if you know that lingo, you probably know how controversial VBACs are. Your provider may be discouraging it, the hospital may not allow it, and your family and friends may be begging you not to do it.

Follow the link to find out the truth about VBAC: Previous C-section?

Another section deals with Inductions:

“It seems to make more sense in a lot of ways: your doctor or midwife may not be on call when you go into labor, your mom wants to buy her plane ticket, your office wants to plan for your absence, you’re worried about your water breaking while you’re in line at the post office. . . And now there are drugs to induce labor so that you can just set the date. Plus, maybe you’ve heard that it won’t really make a difference.”

So why not have an induction? Follow the link before now to find out: Why Not Schedule It?

Can you actually avoid Routine Medical Intervention?

Normally, women experience a host of routine medical interventions. But research shows that what a woman needs most in labor is support. Childbirth is a process that normally starts and progresses all on its own — the cervix begins to open, the uterus begins to contract, the baby begins to descend, and each of these accelerate until you can’t help but push the baby out. The body does this all by itself. Evidence-based care is essentially when the labor process is watched, supported, and protected with the least medical interference possible.

Follow the link below to find out ways to reduce your risk of being pushed: Can I Avoid It?

——————————————————

Find out about what and who Pushed Birth is here: About Pushed Birth

by Jane Weideman

Are doulas and partners mutually exclusive? Read on and then you can decide…

It is true, that the birth of your baby is a very private event, so you might be wondering if a doula will replace or exclude your partner and his (or her)* role.

I think, especially first time moms, have a concern that their birth will not be the intimate and bonding affair, they have dreamed about, if there is a doula present. However most moms having their second or more babies understand that they are actually more likely to achieve that intimate and calm birth with the help of a doula.

So while it is common for partners, and mothers-to-be, to be concerned that a doula will be a “third wheel” or will exclude the partner from sharing in the birth, in reality the opposite usually turns out to be true. A good doula knows how to support your wishes and help the two of you to maintain your physical and emotional resources to share the birth together.

The doula is not meant to sideline or replace the partner - unless no other partner is present. The role of the partner and doula are similar, but the differences are fundamental. The partner may be very emotionally attuned to the mother, but may be distressed by ’seeing the mother in pain’ and unable to stay calm through, what is to him a new and frightening expereince. He may be well prepared and able to provide good

continuous support, but typically has little actual experience in dealing with the often-subtle forces of the labour process. Even those partners who have prepared well are often surprised at the amount of work involved (more than enough for two people) - the process isn’t called “labour” for nothing! Even more important, many fathers experience the birth as an emotional journey of their own and find it hard to be objective in such a

situation. Studies have shown that partners usually participate more actively during labour with the presence of a doula than without one. A responsible doula supports and encourages the partner in his support style rather than replaces him.

According to studies, rather than reducing the father’s participation in the process, a doula’s support complemented and reinforced the partner’s role. Partners felt more enthusiastic and that their contribution to the labour and birth was meaningful and helpful. Not only did partners report higher levels of satisfaction after the birth, but mothers reported feeling more satisfied with their partner’s role at birth too.

- 71% of moms were satisfied with their partner’s role in birth - with a doula present
- 30% of moms were satisfied with their partner’s role in birth - without a doula present

The partner and doula are complementary to one another in providing optimal support to the labouring mother. A doula can never love the labouring mom as much or in the same way as her partner can. He knows her and loves her intimately, he is the father of the baby she is working to birth, and he is one of the main figures in the event taking place - his role is vital. However, her partner has never given birth, nor is he usually very experienced in providing labour support in the same way a doula is.

Through the presence of a doula, the partner is freed from needing to remember every idea mentioned in childbirth class. The doula is able to help him to help his beloved. He can relax into experiencing his journey into parenthood, because the doula is there to support both parents. Working together, the father’s knowledge of the mother, and the doula’s knowledge of birth, can give the ultimate level of comfort and support to the labouring woman and best provide her with the opportunity for a birth experience she will

remember with joy for the rest of her life.

As Penny Simkin states, “While the doula probably knows more than the partner about birth, hospitals and maternity care, the partner knows more about the woman’s personality, likes and dislikes,and needs. Moreover, he or she loves the woman more than anyone else there.”

If you and your partner feels unsure about having a doula, talk about it together. Be honest about what you are feeling. If your partner wants to be your only birth companion, he may feel that if you want a doula, it must mean you don’t think he will do a good job supporting you. Usually that’s not at all true, but it helps to talk it through. As mentioned many partners actually find they are more actively involved in the birth when an experienced professional supporter is present.

If, however, your partner feels uncomfortable about being present at the birth - he may be squeamish or just plain scared - a doula’s presence means you will have continuous support while your partner is free to respect his own limits and be as involved as he can manage, but will be free to take a break if he needs to - and you won’t have to worry whether HE is ok.

When you first meet with your prospective doula, discuss any specific expectations you have for the birth, or things you want her to do or not to do. Be clear about what you want her role to be so there are no misunderstandings on the day. This is your birth and you are paying for a service. Make sure it is what you want!

During the birth, if you see something the doula is doing that you want to be able to do — maybe massage or a pressure technique, ask her to show you how. She will gladly involve you as much or as little as you like… don’t feel timid.

Don’t be afraid to ask for some privacy if you would like, at any time during your labour. Privacy and intimacy helps labour progress! And a good doula respects your needs and won’t feel put out in the slightest.

Some of the ways that doulas can help partners:

• Stepping in to help when the partner needs a short break. Labour is hard work, not just for the woman, but for those supporting her!
• Offering suggestions, when asked, about strategies that might be comforting or helpful during labour and possibly role-modelling or demonstrating these.
• Freeing the partner to take photos, or taking photos for the couple while the partner supports mom.
• Providing reassurance to the partner as well as the woman giving birth. If a partner has never seen a woman in labour before, it can be very reassuring to have someone focused on his needs to answer questions, give an encouraging smile, and put everything into context! This is an amazing journey for partners too!
• Providing information and an objective sounding board when you have questions or decisions to make.
• and more.

The choice is yours to make but doulas and partners can and do work very well together.
*Note that this article refers to the partner as he, for simplicity sake, but the partner could of course be female too.

Technology in Birth: First Do No Harm

By Marsden Wagner, MD. Article from Midwifery Today

There is a very good, detailed article on this topic on the Midwifery today web site. Follow the links below to read more…

• How to Get the Right Technology
• Choosing Your Maternity Care Provider
• Choosing the Right Place to Give Birth
• Getting Information on the Technologies
• Why the Unnecessary Use of Technology?
• What You Can Do
• Sources of Information for Technology in Birth

© 2000 Midwifery Today, Inc. *

Excerpts:

“Caesarean section can save the life of the mother or her baby. Caesarean section can also kill a mother or her baby. How can this be? Because every single procedure or technology used during pregnancy and birth carries risks, both for mother and baby. The decision to use technology is a judgement call—it may make things either better or worse.”

“There is not a single report in the scientific literature that shows obstetricians to be safer than midwives for low-risk or normal pregnancy and birth. So if you are among the more than 75 percent of all women with a normal pregnancy, the safest birth attendant for you is not a doctor but a midwife.”

Copyright © (2007) Midwifery Today, Inc. All rights reserved.

Midwifery Today

By Anastasia Stephens

London - For Katrina Caslake, giving birth was not the terrifying, painful ordeal most women experience. Far from it. The midwife, from Wallington, south London, says she found it blissful, even orgasmic. “I found giving birth very sensual,” says Caslake, 44, who didn’t take painkillers for the birth of either of her sons, Aaron and Tomas, now 18 and 17.

“All my erogenous zones were stimulated. I was making sounds very similar to a sexual climax. And it was a very definite climax. I was doing the most feminine thing a woman can do and it felt fantastic.”

It’s a sentiment with which Frederika Deera, a PR officer at John Lewis in London, would agree. She had a similar experience giving birth to her two-year-old daughter Delphine.

“Giving birth filled me with the most indescribable euphoria,” says Deera, who gave birth at a midwife-led unit in Portsmouth. “Of course there was pain, but my overall sense was of peace and happiness. I was on a complete high, so much that even having a major suturing afterwards did not bother me at all.”

It was her “pleasurable experience” that led Caslake to train as a midwife. “I knew I wasn’t unique,” says Caslake, who helps run Yours Maternally, an independent midwifery service. “By encouraging other women to trust and relax in their bodies, I felt I could help them experience less painful, more pleasurable births.”

It’s an approach that’s also encouraged at the Birth Centre in south London where midwife Nathalie Mottershead actively encourages sensual birth.

“If couples are willing, nipple and clitoral massage can be used to bring on labour contractions, open the cervix and vagina and help with pain relief,” she says.

More to the point, the approach is capable of transforming birth - perceived by most women to be terrifyingly painful - into a pleasurable, even, ecstatic experience. “We work closely with women so they can give birth at home, in intimate surroundings. If mothers-to-be are open to feeling sexy, labour can be pleasurable, not painful, and it sometimes builds up to a crescendo at birth.”

It’s not as if the techniques used at the Birth Centre are isolated or rare.

“If a woman is comfortable enough to do nipple or clitoral stimulation during birth, it’s a useful trick for pain relief and inducing labour,” says Andrya Prescott, spokesperson for the Independent Midwives Association.

A visit to the Unassisted Childbirth Organisation’s US website confirms just how erotic childbirth can be. The site describes in graphic detail women’s fantasies in which romantic and sexual union leads to “blissful waves of pleasure”, and “cosmic orgasms” at the point of birth. More women, it seems, get turned on by birth than you’d think. When Ina May Gaskin, a US midwife, conducted a poll of 151 women, 32 reported experiencing at least one orgasmic birth. Admittedly, these were home births by women who were “open” to the experience. The plus points are pretty significant - a single orgasm is thought to be 22 times as relaxing as the average tranquilliser, while sexual arousal widens the vagina significantly.

“Women might think twice about having an epidural if they knew that, but nobody talks about these things,” points out Gaskin, a natural childbirth pioneer who was the first midwife to openly acknowledge that women could climax at birth. It almost sounds too good to be true: a touchy-feely labour followed by an earth-shattering orgasm at the moment of birth.

Unfortunately, this is very far removed from most women’s description of childbirth. A major hitch is that, as with any sexual activity, the amount of pleasure gained - for women at least - is closely related to the degree of relaxation, trust and safety she feels.

Most women anticipate with dread the “birth ordeal”, a state of mind that will make muscles contract and adrenalin levels rise before it even begins. And then, most women can only feel sexy in intimate surroundings, with people they know well. Hospitals and doctors don’t really do the trick.

“Adrenalin inhibits sex drive and labour contractions,” says midwife Andrya Prescott. “You become tense and are more prone to feeling pain. It’s why women can have trouble with labour and birth at hospital. Surrounded by strangers, their adrenalin levels are high. They can’t relax. Even if they were open to getting aroused, at a hospital, they may as well forget it.”

Part of the problem, it seems, is the way sexuality around childbirth has been denied. In her book, Ina May’s Guide To Childbirth, Gaskin points out that doctors had to downplay female sexuality for medical men to be admitted to the birth chambers of women in the 18th and 19th centuries. This “denial” was later institutionalised when hospital births became routine.

Even today, it’s a pretty taboo subject. “Lots of women would worry they’d be seen as abnormal or deviant if they admitted to feeling sexual at birth,” says Carolyn Cowan, a yoga teacher and doula based in south London, who herself had an ecstatic birth. “It’s something lots of women feel ashamed to talk about,” she adds. “I run erotic dance classes for pregnant women to try to get rid of these inhibitions. I should know a thing or two - it took giving birth to my son to discover my G-spot.”

The tide is clearly turning. A growing number of obstetricians and midwives point out what seems pretty obvious, yet has been somehow forgotten - that since sex leads to pregnancy and birth, they’re pretty closely linked.

“When you look at sex, birth and lactation, the same hormones are involved,” says Michel Odent, the obstetrician who pioneered the use of birthing pools in the Seventies. “It seems obvious that childbirth is a part of a woman’s sexuality.”

Many parents-to-be, for example, find that making love and nipple stimulation are one of the best ways to get labour going. That’s because sexual arousal releases oxytocin, a love and bonding hormone, which triggers orgasmic and labour contractions in the uterus. Conveniently, this hormone is an endorphin, meaning it has an opiate-like effect - inducing pleasure while acting as a highly effective painkiller.

Aside from the pleasure and pain relief, the advantage of a sensual birth is less physical damage. “Women who are relaxed and feel good, undergo easier, smoother births, so suffer less tearing and bruising,” says Caslake. “Fear makes a woman more tense and this holds the baby back.”

The baby gets a pleasure hit too - bathed in “feel-good” hormones, they’re more likely to come out feeling relaxed and content.
Further reading:www.michelodent.com (for more information on love hormones); www.unassistedchildbirth.com (for more info on sensual birth); www.birthcentre.com ; www.independentmidwives.org.uk; For sensual prenatal exercises contact Carolyn Cowan ; www.mooncycles.co.uk); Yours Maternally Independent Midwives, Wallington, south London (www.yoursmaternally.co.uk )

How to have a sensual birth

Why some women achieve a “birth climax” while others endure excruciating pain is likely to be due to differences in environment, genetics, expectations, and psychological factors. Trust and the level of emotional support you feel from your husband is critical in inducing a feeling of safety and relaxation needed to get the “pleasure hormones” going.Women are generally more likely to have sensual birth experiences during home deliveries in an intimate environment.

Midwives who have witnessed women who’ve been physically aroused during childbirth believe the following techniques could make the experience more likely:Before and during childbirth, become intimate with your body. Look at yourself naked in the mirror, noticing any areas that trigger uncomfortable emotions. Send loving thoughts to that area until the difficult feelings pass. Ask your partner to look at your body and compliment you.If you feel comfortable with it, aim for a home birth.

Work closely with a doula or midwife to build up a sense of trust with her, in your body and in the birth process.Ask yourself if you can believe that your body will be doing the right thing, to the best of its ability, to give birth successfully. The more you can believe this, the more you’ll be able to trust yourself and relax.

Pick a special room or area where you want to give birth. Light candles to create atmosphere and evaporate lavender essential oil in an oil burner to induce relaxation.Learn a relaxation method such as abdominal breathing to use during childbirth to curb the release of stress hormones.

Create the expectation that childbirth could be pleasurable, even if there is pain: while pregnant, spend time imagining how it could trigger warm tingling sensations in your body along with feelings of love.

If you feel it is appropriate, ask your partner to kiss you, stroke you gently or even caress your nipples as labour contractions come on.

Water birth is the process of giving birth in warm water.

Relaxing in a warm bath to relieve pain has been used for everything from backache, aching muscles, strenuous exercise, or menstrual pain. More and more women are discovering how wonderful a pool of warm water can be during labour and birth.

Some women choose to labour in the water and get out for delivery. Other women decide to stay in the water for the delivery as well. Note that whether or not you chose to give birth in the water, water can provide wonderful relief during labour.
The theory behind water birth is that the baby has been in the amniotic sac for 9 months and birthing into a similar environment is both gentler for the baby as well as less stressful for the mother.
It is the belief of midwives, birthing centres and a growing number of obstetricians, that reducing the stress during labour and delivery also reduces foetal complications.

History of water births

The use of warm-water pools for labour and childbirth is a relatively recent phenomenon in Western culture. During the 1960s, Russian researcher Igor Charkovsky undertook considerable research into the safety and benefits of waterbirth in the Soviet Union. In the late 1960s, French obstetrician Frederick Leboyer developed the practice of immersing newly-born infants in warm water to help ease the transition from the womb to the outside world, and to mitigate the effects of any possible birth trauma.

Another French obstetrician, Michel Odent, took Leboyer’s work further and used the warm-water birth pool for pain relief for the mother, and as a way to normalize the birth process. When some women refused to get out of the water to give birth, Odent started researching the benefits for the baby of being born under water — and the potential problems in such births. By the late 1990s, thousands of women had given birth at Odent’s birth centre at Pithiviers, and the notion of water birth had spread to many other western countries.

What are the potential benefits of water birth and water labour?

* Speeds up labour
* Reduces blood pressure but increases oxygenation in the blood- additionally the buoyancy promotes more efficient uterine contractions and better blood circulation, resulting in better oxygenation of the uterine muscles, less pain for the mother, and more oxygen for the baby.
* Gives mother more feelings of control
* Provides significant pain relief - Water seems to alleviate stress-related hormones, allowing the mother’s body to produce endorphins, which are pain-inhibitors.
* Promotes relaxation - Water is soothing, comforting, relaxing.
* Enables the mother to assume any position which is comfortable for labour and birth - The buoyancy lessens her body weight, allows free movement and new positioning.
* Conserves her energy - In the later stages of labour, the water seems to increase the woman’s energy.
* Reduces the need for drugs and interventions - As the labouring women relaxes physically she is able to relax mentally, concentrating her efforts inward on the birth process.
* Gives mother a private protected space -
* The water provides a sense of privacy, which releases inhibitions, anxiety, and fears.
* Reduces perineal trauma and eliminates episiotomies - Water causes the perineum to become more elastic and relaxed, which reduces the incidence and severity of tearing and the need for an episiotomy and stitches.
* Reduces caesarean section rates
* Is highly rated by mothers - typically stating they would consider giving birth in water again
* Is highly rated by experienced providers
* Encourages an easier birth for mother and a gentler welcome for baby - Provides a similar environment as the amniotic sac. Eases the stress of the birth, providing reassurance and security.

Won’t my baby inhale water?

In short NO.

There are 5 inhibitory factors, which prevent a baby from inhaling water when born:

1. The baby in utero is oxygenated through the umbilical cord via the placenta. When a baby breathes air, the intercostal muscles and diaphragm move in a regular and rhythmic pattern. 24 to 48 hours before the onset of labor the prostaglandin E2 levels form the placenta cause a slowing down or stopping in the fetal breathing movements (FBM). The diaphragm and intercostal muscles become suspended and there is a decrease in the FBM. At the birth, the baby’s muscles for breathing simply don’t work.

2. Babies are born experiencing acute hypoxia or lack of oxygen. This is built in response to the birth process. Hypoxia causes apnea and swallowing, not breathing or gasping.

3. The temperature differential is another factor. When a baby is born into water so close to maternal temperature the baby doesn’t detect a change so no breathing is initiated. In some places where an oceanbirth occurs, the water is much cooler than maternal temperature. This is an area for reconsideration since lower temperatures do not seem to stimulate the baby to breathe while immersed either.

4. Water is a hypotonic solution and lung fluids present in the fetus are hypertonic. Hypertonic solutions are denser and prevent hypotonic solutions from merging or coming into their presence. Thus, as water passes through the larynx it does not pass into the lungs.

5. The ‘mammalian dive or autonomic reflex’ built into all newborns is present at birth and mysteriously disappears around 6 to 8 months. This reflex is associated with the taste buds along the larynx. When a solution hits the back of the throat and crosses the larynx, the taste buds interpret what substance it is and the glottis automatically closes: the solution is then swallowed, not inhaled.

(*These five inhibitory factors are from Waterbirth Basics, From Newborn Breathing to Hospital Protocols by Barbara Harper, Midwifery Today with International Midwife, Summer 2000, Number 54. www.midwiferytoday.com)

What situations are not ideal for water birth?

* If you have Herpes: Herpes transfers easily in water, so you will want to discuss this thoroughly with your health care provider.
* If your baby is breech: Though water birth has been done with bottom or feet first presentations you will want to discuss this thoroughly with your health care provider.
* If you have been diagnosed with one of the following: excessive bleeding or maternal infection.
* If you are having multiples: Though water births have been successful with twins around the world, you will want to discuss this thoroughly with your health care provider.
* If preterm labour is expected: If a baby is pre-term, two weeks or more prior to due date, water birth is not recommended.
* If there is severe meconium: Mild to moderate meconium is fairly normal. Since meconium floats to the surface in a tub, your health care provider will watch for it and remove it immediately, or help you out of the tub. Meconium usually washes off the face of the baby and even comes out of the nose and mouth while the baby is still under water. If the water is stained and birth is imminent, the woman can lift her pelvis out of the water to birth the infant.
* If you have toxemia or preeclampsia: You will want to thoroughly discuss this with your health care provider.

How do I prepare for a water birth?***

First, ask some questions about yourself:
- How did you decide on a waterbirth?
- Was this a decision you came to on your own?
- Who else impacted your decision for a waterbirth?
- How did they impact your decision?

Picture yourself labouring and giving birth immersed in water.
- What about this picture comforts you and what about this picture makes you uncomfortable?
- How do you feel about nudity? (You do not necessarily need to be nude in the tub; it is possible to wear a large t-shirt.)
- Which scenario makes you most comfortable?

Then think about how you might react to various situations:
- Plan for the possibility of a birth different from your current expectations. Are you comfortable releasing some control? It is key to remain flexible.
- Prepare yourself mentally to go with your instincts at the time and to accept the decisions you make during the birth.
- For instance, think about how you might feel if the baby was not born into water or if you decided to get out of the tub before the actual birth.

Personal and practical preparation of body/mind/spirit:
Spend time in the water, swimming for fun, or join a water exercise class. Mothers have greater mobility, increased endurance, feel virtually weightless, stay cool, feel a decrease in fluid retention and feel better emotionally. It is also a great networking environment.

Feel free to engage in nightly warm, not hot baths. Light some candles; drop in 8 drops of lavender essence oil. Massage your belly and breasts with pure almond oil. Talk to your baby. Prenatal bonding is as important as postnatal bonding.

It is important to identify your fears about labour and birth.
- Educate yourself by gathering as much BALANCED information as possible.
- Examine the various viewpoints and various “sides” to an issue.
- Read books and articles, watch videos of actual births, peruse the Internet and talk to people you trust.
- Set-up a consultation with a waterbirth consultant.
- Finally, make sure that your birth attendant (whether a midwife or a physician) and labour support people are both supportive of and knowledgeable about waterbirth.

Finally, make the necessary preparations:

* Check first with your health care provider. They may already be equipped for water birth with a special tub, or know where to refer you in your area.
* If you plan to give birth at a hospital, make sure their policies are water birth friendly. More and more hospitals are welcoming parents who want to try water birth.
* You can rent a birthing tub. Check online or in the phone book. Be sure to ask if fees include delivery and collection and any other extras to make your birth experience more enjoyable. Check with your insurance company to see if they will reimburse the expense of the rental.
* Contact a local birth centre to see if they provide water birth options.

Jane had a midwife assisted waterbirth with her son Quinn, and thoroughly enjoyed the experience.

Waterbirth Video Clips:

• ‘Waterbirth of Isabel Jean’ - a photo video of a natural water-birth in the states, with support of dad and a doula.

• ‘Welcome Henry’ - a photo video of a home water-birth.

• ‘Lyle’s Birth’ - mom labours and gives birth - catching the baby herself - in a birth pool at home, with dad in the pool with her. The mid-wife hasn’t even arrived yet and gets told the baby is born on the phone. Your body really does know what to do!

• ‘Birth1′ - a very short video of a mom giving birth in water, without making any noise at all.

• ‘WATER BABY: Experiences Of Waterbirth’ - various clips of babies birthing in water.

• ‘Jenna’s Home Waterbirth’ - a beautiful photo video of a home water-birth with dad, doula and big brother to help.

• ‘Christian’ - This is the water-birth of a Spanish speaking mum. She vocalises a lot through the birth (not a BAD thing at all, it helps a lot). See how the contractions come and go and her body tells her what to do as each contraction starts and relaxes completely after each one finishes. The mid-wife helps her to birth the head slowly, so she doesn’t tear.

• ‘Olive’s Birth’ - a beautiful photo video of a home water-birth of a second child.

References:
- Waterbirth International
- Gentle Birth Org - Waterbirth
- Waterbirth Info

*** Medical disclaimer: Note that this web site is not a substitute for medical advice. The content provided here is for informational and educational purposes, and is not intended as advice or instruction. It is provided to help you to make informed choices for yourself. You should consult your primary care provider regarding your specific medical symptoms or advice. Birth Buddies is not engaged in rendering medical advice, diagnosis or treatment. Any medical decisions should be made in consultation with your caregiver or other trained medical personnel. We will not be liable for any complications, injuries, loss, or other medical problems arising from, or in connection with, the use of, or reliance upon any information or products on this web site.

By Paula Pedersen

What causes pain in labour?
During labour and birth, there are several physical processes occurring that lead to childbirth pain: the strong uterine contractions and the tension they place on supporting ligaments; pressure of the baby on the cervix, vagina, urethra, bladder, and rectum; stretching of the cervix, pelvic floor muscles, and vagina.

These processes are unavoidable, and the pain caused by them is a positive sign that labour is progressing. We don’t want to stop these processes from happening, we just have to figure out how to minimize the pain we experience as a result.

Pain-intensifying factors that we can influence:

- The stretching of the pelvic floor muscles can cause pain; it helps if you’ve been doing your Kegel exercises in advance.
- Pressure on bladder causes pain, going for a wee regularly during labour helps.
- Reduced oxygen to uterine muscle increases pain; breathing techniques help.
- Muscle tension increases pain, fear and anxiety make you more sensitive to pain; relaxation can help with these.

Your body is AMAZING! It has nurtured another human being for 40 weeks, and is beautifully well equipped to birth your baby into the world. Endorphins are natures own pain killers and are naturally released into the blood stream when the body is physically stressed beyond its normal limits (think of an athlete running a marathon!).

The endorphins increase as your labour does – so the key here is to ensure that you are mentally and physically in a state that will encourage endorphins to be released at all times. Your endorphins will modify pain, create a feeling of well-being as well as alter your perception of time and place. The endorphins peak at the transition stage, giving you that extra energy for birth and amnesic effect (forgetting about the pain afterwards). They are at their highest during the pushing stage, which then gives rise to the elation you feel after the birth and encourages bonding with your new baby.

Ways to enhance natural pain killers include:

Position
If you are free to move around and get comfortable, your labour may even speed up. Use gravity to its maximum benefit and try to remain upright as that will encourage your baby’s head to come down. Change positions every 30 minutes or so. Try standing, walking, slow dancing, lunging, sitting upright on a chair, sitting on a birth ball, kneeling, on your hands and knees, sidelying, squatting…the list is endless – find a comfy position that feels good for you.
See some great labour position suggestions in this slide show.

Support
Do not labour alone, surround yourself with positive and encouraging support people. Your partner (and a doula) will help you immensely. Anxiety increases the amount of adrenaline in your body, which in turn reduces the release of endorphins and oxytocin and will slow labour down considerably.

Avoid unnecessary procedures
Procedures with scientific evidence of benefit to you and your baby should be promoted and those without scientific evidence of benefit should be avoided. Avoid the following ‘routine procedures’: pubic shaving, enemas, early artificial rupture of membranes, restriction to bed, intravenous fluids.

Safe Environment
Ideally you want to labour and give birth in a safe and non threatening environment. If you are giving birth in a hospital, make the room your own by bringing flowers, candles, music and turn the lights down or off.

Comfort measures
These include breathing and relaxation techniques to help reduce anxiety and tension. Water (bath, shower or Jacuzzi) is a very effective comfort measure and it encourages you to relax. The best time to get into a bath for pain relief is between 5-6 cm. Sit of stand in the shower and allow the jets of water to massage your back or tummy.

Heat and cold
Alternate between heat and cold to relieve pain or tension. A hot water-bottle, microwave bean bag or warm face cloth. Then try an ice pack, chilled cooldrink can or a cold cloth on your neck, back, shoulders or under your tummy – wherever you need it!

Massage and touch
A massage can do wonders for pain. It conveys a comforting message to you that you are loved and being cared for. If you transmit pleasurable impulses (such as light, soft touch), those will reach the brain first and that can modulate, or interfere with, the pain sensations. Firm massage on your back or soft fingertips (called effleurage) over your tummy can all ease the pain of your contractions. Even a foot, hand, leg or shoulder massage can help! In general, sensory input can distract us from pain perception.

TENS machine.
T.E.N.S stands for Transcutaneous Electrical Nerve Stimulation. A TENS machine is quite a nifty little gadget. The unit consists of four flexible, band-aid-size pads connected by wires to a small battery operated generator of electric impulses. The pads stick to the mothers back alongside her lower spine. The mother can regulate the impulses during a contraction. The pulses prevent the pain signals from the contracting uterus and cervix from reaching your brain and also stimulate your body to release its own, natural “feel good” substances, (endorphins.) (Not easily available in SA though…)

Your attitude is very important in labour. Try to relax and believe in yourself and your ability to do something miraculous. Tell yourself, “I AM STRONG. MY BODY KNOWS WHAT IT NEEDS TO DO.”

If you aren’t able to cope and feel overwhelmed by the intensity of your contractions – medicated pain relief is available. You will have made your educated decision beforehand as to what type of pain relief you are willing to accept. Labour and childbirth is not an endurance test – it is a beautiful occasion when a new family is born and an event that you will remember for the rest of YOUR life.

Below are links to movie clips on Doulas and Midwives:

Like Heaven into My Hands - A midwife Story
This is a beautiful orated slide show by an experienced midwife. It is well worth watching.

Quotable quote:

“I have more grey hairs after some births and I feel like I deserve at least a million dollars for being there … other births are so smooth and so beautiful and I feel like I owe them a million dollars for witnessing it”

What is a doula Movie clip

This movie clip shows moms and couples talking about their experiences with having a doula attending them at their births and discussing what a doula does and how it helps.

Home Delivery

This narrated photo movie shows midwife Nancy Harman in NC, USA, working and talking and attending a beautiful home water birth.

3D Medical Animation of Normal Vaginal Birth (Childbirth)

This animated movie clip shows the anatomy and physiology of a normal vaginal childbirth - how the cervix effaces (thin) and the dilates (opens) and then how the baby moves down and rotates to emerge to be born. The design is incredible and always fascinating to see!

We’ll add more midwife and doula movie clips here as we find them, if you know of any feel free to let us know, we’d love to link to them!