One of the big misconceptions about HypnoBirthing is the assumption that we are militantly anti-intervention, anti-Pitocin, and anti-epidural. This couldn’t be further from the truth, actually, and actually missed the whole point of HypnoBirthing.
As a comprehensive childbirth preparation course, we do talk about special circumstances that can occur in labor. And we believe that, there being a time and place for everything, interventions are clearly warranted in some cases. The problem is that some practices are mainstreaming interventions to the point that the majority of Mums they serve are subjected to interventions as a matter of policy.
To illustrate, right at this particular time, I feel happen to feel fine. No headache, throat feels great, no fever or aches to speak of anywhere. Although I am grateful they exist, I am not in need of an antibiotic at the present time. When all is going well, why would I want to expose myself to antibiotics, and perhaps suffer the side effects when I am not in need? If I wake up tomorrow or next week and truly need an antibiotic, well, my doctor better be there with his prescription pad in hand and the pharmacy had better be well-stocked!
If a woman is laboring along fine, managing and coping well, and no special circumstances are on the horizon, why on earth would anyone want to take Pitocin or an epidural ‘just because it’s policy?’
Having had five babies myself, I have to say that each and every labor was different. One was incredibly long—2- ½ days, the next one snuck up on me, and I literally almost had that one while standing on line in the butcher store. The rest were more in the center of the spectrum, time-wise. One of my labors involved Pitocin and an epidural, and the others were totally natural. The interventions were there if I needed them, and for that I am thankful.
The point of HypnoBirthing is not a militantly anti-medical stance. The point is to learn to tune in to one’s body, trust the process, and most importantly, to be calm and in control throughout the process. Pandemonium should not be reigning, whatever the circumstances. Mums are encouraged to use the prenatal office visits to build a trusting relationship with their healthcare provider, communicating with their healthcare provider.
Special circumstances can and sometimes do happen, and HypnoBirthing is of immense benefit to Mums and babies in these cases. Take the story of Pearl, who had had 4 c-sections, and took my class because she wanted to have a VBaC. She was using a high risk OB in Manhattan who was incredibly supportive, and open to HypnoBirthing to the point that he called me to ask for a copy of the book. Pearl ‘got’ the concept of HypnoBirthing, and practiced diligently. She called me after she had her baby, and reported that she had had a 5th c-section. “This experience was totally different than my other births. I was calm, I was able to think clearly, and I was able to hear what my doctor was saying and be a part of the decision-making process. I was not terrified, and I had a great experience. The outcome was not what I had hoped for, but I am OK with it, because I felt so calm throughout. Not being scared made all the difference in the world.”
Guess what? That is successful HypnoBirthing!! A calm Mum, and qualified medical support, open to trusting the process without ‘interventive policies,’ and technology on hand in the event it is needed.
HypnoBirthing is not about creating this picture perfect non-medical fantasy for every single birth; as much as we could want that, the reality is that a small percentage of births may present challenges. HypnoBirthing helps Mums to meet those challenges calmly and bravely.
Doulas, as we all know, must be prepared to shelve our own selves and focus solely on Mum and Baby. We become adept at compartmentalizing those daily annoyances, but what happens when we are obligated to share in one family’s joy while our own hearts are newly breaking?
Just three days ago, an 8 year old boy from my community got lost walking to meet his mother after daycamp. Happenstance led him to ask directions from a sick man who brutally murdered and dismembered him.
Although I don’t know the family personally, they live on the block where I work, and I have in fact x-rayed his sisters. His mother was waiting in vain for him in front of the store next door to my home, while my own children played happily outside. The daycamp he was walking from is on the same block that my daughter walks to for her own daycamp.
Mine is an intensely close-knit community, with an insularity and connection that extends to and connects us with other Hasidic communities. Literally thousands of volunteers were bused in to walk the streets in search of the boy. I also entered basements and alleyways on my way to and from work, calling his name. Just 20 hours after he went missing, his gruesome remains were discovered early yesterday morning.
Jewish tradition has funerals held within hours of death, so I, as everyone, waited the day for an announcement of the funeral. Grim anticipation and despair were the face of everyone I saw, until it was announced that the funeral would begin at 8:30 pm.
My phone rang at 7:30, as I was tucking in my children for the night and giving instructions to my 12 year old, who would babysit while my husband and I joined the mourners. “Yael, I’m in labor. How soon can you come…..”
This was the second birth I have attended with this Mum, and I have never seen a more picture perfect HypnoBirth. Mum was 8cm and completely relaxed as she walked into the hospital at 8:30. At 10:30, Baby slid out so quietly that I wondered if she even realized she had been born.
Such a bizarre twist of fate that led me, mentally braced to mourn tragedy, to witness such profound joy. Bittersweet tears, as I was honored with cutting the cord after pulsation has ceased. Mental flashes of dismembered children had haunted me as I tried to focus on the arrival of this baby. An estimated 8,000 members of my community accompanied a little boy on his final journey, while three of us quietly welcomed a new little girl.
Circle of life notwithstanding, I will never forget this birth.
.דור הלך, דור בא. ברוך ד”ן אמת
The Feminism in Birth Activism
If you liked this post, please visit www.mother-of-life.com to learn more about this project. The site will soon be an online birth resource for Jewish women with articles by rabbis, educators, midwives and doctors - in both Hebrew and English. Contact firstname.lastname@example.org with questions, concerns and comments.
A few weeks ago I sat with a Jewish feminist I have admired for years. I was initially scared to tell her what was on my mind.
“I’ve become really interested in the issue of birth.”
I know that traditional women, whose efforts are largely focused on cooking, cleaning, child-rearing and other “traditional” female roles, will be open to discussing birth stories and the possibility of a spiritual birth experience. They are often excited about my project: a site that will bring together a wide range of Jewish voices on birth and be an online resource for Jewish women seeking to infuse their birth experience with a dimension of spirituality/Jewish awareness.
I was scared to ask a woman, who had spent much of her life fighting for gender equality, about birth activism. It seemed so passe: what about the women who never marry or who choose to never have children? What about the infertile women who try? Are they not important? Is focusing on birth as a possibly empowering moment for women just reverting to an out-dated model of womanhood that placed her birthing experiences as central to her psyche?
I have realized that in my own mind I see birth activism as categorically feminist. Although not all women actually give birth, the birth act itself is a uniquely female experience. If a society upholds birth as a beautiful empowering experience, any woman who passes through it will feel holy, strong, divine, beautiful. Enough woman pass through the experience of birth in a lifetime, that—as a woman and a feminist—I find it sufficiently important to help transform that exprience for them.
I am afraid that today birth is instead see as gross, painful, scary and a medical emergency best left to doctors. Birth is a burden a woman must endure as shouting medical professionals scream at her to push. As a doula, I have seen several women disgusted by their own bodies, their secretions, and by the very act of birth.
So, where does that leave the feminists?
To my surprise, this feminist mentor was extremely encouraging of my project. She noted that birth was a very important moment in women’s lives and that it could have enormous impacts on a woman’s self-esteem and self-confidence. She noted that, in particular, the experience of a C-section can be very overwhelming and that certain communities do not appreciate the hardships involved.
Indeed, for a woman to feel respected and empowered in birth she does not have to have an orgasmic waterbirth at home. She needs to be empowered and respected by her care providers and community, whether they are in a hospital or at home and whether she is delivering vaginally or through surgery. She needs to be viewed as an autonomous responsible adult with full capability to decide what should happen to her body.
I have seen births in which doctors and nurses treat women like annoying screaming brats: they totally ignore their wishes, scream at them to follow orders and cut or perform procedures without obtaining consent.
In most hospitals, laboring women are required to sign a form that gives the hospital permission to do anything it would like at any point during the stay. The rationale provided is that birth is a long unpredictable process in which neccesary procedures cannot neccesarily be forseen from the start. Because there is no point of comparison, men never have to “commit” themselves to such an experience (of totally giving up their rights to an institution) unless they are imprisoned (in such cases, they generally don’t have a choice.)
In cases where women are “given choice,” doctors, anesthesiologists and nurses often pressure women to accept certain procedures. For a laboring woman who might be scared or in pain, this bullying is not only extremely unfair, but often very effective. Women acquiese quite easily to the more powerful person’s wishes.
The result: hands are shoved in unwanted places, drugs are given, skin is cut, surgeries are performed, often with women deeply unconvinced that the procedures are neccesary and deeply torn between pleasing others and following their gut instincts.
At a birthing center birth I attended, with midwives as caregivers, the laboring woman was the queen. She was like the popular girl in high school, or a bride on her wedding day. Her wishes were our (the doula and her midwives) command.
“Press here, press there,” she would say as particularly strong contractions pressed her uterus. When the midwife tried to listen to the fetal heartbeat, but the woman was in middle of a strong contraction, she pushed the midwife’s hand away. The midwife didn’t take it personally (recognizing the reality of the situation) and simply waited a few minutes till the contraction was finished to check the fetal heartrate.
This kind of patience is not easy, especially in the middle of a long sleepless night. I have heard countless stories of doctors screaming at patients that they are tired and that its their patient’s fault. I personally was insulted by a doctor who informed me that he was “awake all night.” He didn’t seem to consider the fact that I also had been awake all night with his client. The patience, love, kindness and empathy that is required for a birth practitioner to continuously respect and empower the birthing woman is extremely unique. It is why only very special people can be birth professionals.
“YOUR FATIGUE from births is NOT your other clients’ problem. You are still accountable to them and if you are too tired to function, you must have a kindred partner whom your clients will know will cover you, and her,” one NYC homebirth midwife wrote to me in an e-mail.
As a feminist, I hope that women can learn to expect respect from their care providers and demand it when it is not provided. Walk out on an insulting doctor and refuse care from him or her. Refuse to accept bullying and acknowledge that you are an adult with full mental capabilities who can make your own decisions.
Much easier said than done! In many cases, women need to be actively defended from bullies and are not capable of standing up for themselves. In these cases, we, the community, friends and partners, need to be at women’s sides, telling them that we believe in them, that they are strong and powerful and capable and special and beautiful and that their wishes are our command.
How can a feminist argue with that?
"The first intervention in natural childbirth is the one that a healthy
woman does herself when she walks out the front door of her own home in labour.”
~ Michael Rosenthal, OB/GYN
From Reuters Health Information
Valsalva Pushing of Questionable Value in Second Stage of Labor
By Will Boggs, MD
NEW YORK (Reuters Health) Mar 24 - Valsalva pushing is not superior to spontaneous pushing in the second stage of labor, according to findings published in the March 10th online issue of BJOG: An International Journal of Obstetrics & Gynaecology.
“I was surprised, because Valsalva pushing is recommended by many midwives and obstetricians,” Dr. Marianne Prins from VU University Medical Center, Amsterdam, the Netherlands, told Reuters Health by email. “I thought there must be a reason to do so. Especially I thought the duration of labor would be much longer in the spontaneous pushing group.”
Instead, Dr. Prins and colleagues found in their systematic review and meta-analysis of the literature that the duration of the second stage of labor was only 18.59 minutes shorter with Valsalva pushing than with spontaneous pushing, a difference that was statistically significant but questionably clinically meaningful.
In fact, when one small study with the biggest difference was excluded, the mean difference in the duration of the second stage was only 9.75 minutes.
“We are uncertain of the clinical relevance of a shorter second stage of labor because no significant difference was found in operative/instrumental deliveries or in fetal condition,” the researchers note.
Moreover, in one study of 128 women, Valsalva pushing was associated with a significantly lower bladder capacity and a decreased first urge to void on urodynamic tests, suggesting that this technique may have harmful effects on pelvic floor function.
The pushing technique had no influence on Apgar scores, mean umbilical artery or vein pH, or the need for resuscitation of the neonate.
“The sparse evidence from our review does not support the routine use of Valsalva pushing in the second stage of labor for women who deliver without epidural analgesia, but the studies were too small to report on the important outcomes,” the investigators conclude.
“I hope physicians support women in finding out their own way of pushing and encourage women they are doing right, if there is no reason for hastening labor,” Dr. Prins said.
“I would like to study the optimal pushing approach and find out if Valsalva pushing compared to spontaneous pushing has any harm for the fetus or mother,” Dr. Prins added. “We need bigger studies to properly measure the rare adverse events. Also we need to find out what pushing method women prefer.”
Reuters Health Information © 2011
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