The Power of Birth Comes from Within, The Knowledge of Birth Comes from Support.

Saturday, December 18, 2010

The 'P's' of Birth

There are so many factors that effect the labor and birth process.  For those of us who like being in 'control' (or at least the illusion of being in control) there are quite a number of things that a laboring woman and her partner(s) can do to help in the process.  There will come a time however, when all women need to let go and let birth happen.  When we discuss this in childbirth eduction class, we generally refer to the 'P's' of Birth.  Many believe there are 4 of them: the passage, the passenger, the powers and the psyche.  I actually believe that there are 5.  The last one being the people who are there to support the laboring woman and welcome the baby.

The Passage:
We are born with the pelvis that we have.  No getting around that one.  But the pelvis, cervical opening, and birth canal are more than capable of letting a baby out.   As the end of pregnancy nears, a hormone helps to soften the cartilage in the pelvis to allow the pelvis to open more and give the baby more room.  The passage can be a tight one but allowing a women to move about freely and work with her body, changing positions at least every 30 minutes, assists with the baby finding the right position to pass through the passage to loving arms.

The Passenger: 
This is the baby.  This is about their size and their position especially as labor progresses.  During labor the baby will need to make some twists and turns.  These are called the Cardinal Movements.  During the hugs of contractions the mother is supplying oxygen for the baby as she breaths at a level that is comfortable to her.   The baby will move through the passage as the mother moves, at least - that's the plan and there need not be a hurry.  Labor is good for babies. 

The Powers:
These are the uterine contractions.  The uterine contractions are caused from the release of oxytocin, the 'love hormone' from the posterior pituitary.  It acts like a neurotransmitter in the brain.  As labor progresses (without any help from artificial means) the woman's body also starts to produce endorphins, natural pain relief.  As the contractions become longer, stronger, and closer together, oxytocin flows, endorphins are available, and the laboring woman is working with her body and her baby - together.  As Penny Simkin, one of the founders of DONA International states, 'The contractions cannot be stronger than you, because they are you'.  Oh, how I love that affirmation. 

The Psyche:
I never understood why there are so many people who like to scare pregnant women talking about the pain in labor.  Yes, there will be pain and the pain is from a variety of sources:  contractions, dilation, bones spreading to give the baby more room, etc.  We all need to empower women as they anticipate labor and birth.   Women must prepare mentally for the journey.  Contractions need to be taken one at a time as each one brings the woman closer to the baby in arms.  She needs support and a welcoming environment where she feels safe and loved.

The People:
The support team that is there for the labor and birth are essential. The support team needs to be loving, kind, encouraging and occasionally, even firm.  I have seen many labors stall if there is someone in a room that may be causing the laboring mother anxiety or telling her what to do when it is going against what her brain and her body are telling her to do.   As we talk about people we also need to talk about the birth environment:  the lighting in the room, does the woman feel too exposed, is the temperature comfortable for her, is there music playing that is helping her let go?  A woman in labor should not be left alone.  There are times when she may not want hands on massage or care but just the presence of a loving heart and soul.

All of these are interconnected.  One will effect another.   Even doing everything that a woman can do in labor, the process can be long.  One of the most important things to keep in mind is that she will always remember how she was treated in labor.

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