Holding the Space for Human Birth
TED Talk by Saraswati Vedam:
Holding the Space for Human Birth
“WHO Safe Childbirth Checklist” has been developed to support the delivery of essential maternal and perinatal care practices. The Checklist addresses the major causes of maternal death (haemorrhage, infection, obstructed labour and hypertensive disorders), intrapartum-related stillbirths (inadequate intrapartum care), and neonatal deaths (birth asphyxia, infection and complications related to prematurity). It was developed following a rigorous methodology and tested for usability in ten countries across Africa and Asia.
An implementation guide for health facilities has been developed to help birth attendants and health-care leaders successfully launch and sustain use of the WHO Safe Childbirth Checklist. The simple document lists basic interventions. Amongst the six instructions: “Encourage birth companion to be present at birth”.
Birth companions provide support to the mother during birthing and in the postpartum period. They can also recognise danger signs, alert health care workers in case of emergency and care for the baby. Possible birth companions are the spouse, a family member, friend, health worker or doula.
Evidence shows that birth companions can help to improve health outcomes. The emotional and psychological benefit cannot be emphasised enough. The presence of birth companions increases the likelihood that the mother will have a spontaneous vaginal delivery instead of caesarian, vacuum or forceps birth. Mothers with birth companions have also been shown to need fewer pain medication, to have shorter birthing process and be better satisfied with their delivery experience.
This is great news for doulas as they receive validation from the most influential health organisation in the world.
Of the more than 130 million births occurring each year, an estimated 303 000 result in the mother’s death, 2.6 million in stillbirth, and another 2.7 million in a newborn death within the first 28 days of birth. The majority of these deaths occur in low-resource settings and most could be prevented.
Since 2012, WHO has been supporting a multi-centred randomized controlled trial in more than 100 hospitals in Uttar Pradesh, India, to test whether adoption of the Checklist improves health outcomes for mothers and newborns.
The trial is being conducted by the Ariadne Labs, a joint centre of Boston’s Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health, with support from the Bill & Melinda Gates Foundation.
Giving birth with ease and grace
1.) Birthing can be calm, gentle, painless and even pleasant for a woman.
2.) A woman and her baby have their own timing which is perfect for them. No “pushing” is needed and no nurse or doctor should interfere, know better and try to shortcut the individual birthing process (“Let me give you an injection and your out of here in no time.”).
3.) If a woman gets her time, space and support, which means she feels safe and can move as she wants, and if she is mentally well prepared (positive affirmations, visualisations, hypnosis, relaxation training and breathing techniques) she can give birth without any synthetic hormones (epidural etc) and without getting her perineum cut.
4.) After the baby arrived “outside” it is best to place the child immediately on the mother’s chest – without slapping its backside, without much wiping, without sucking out liquids from its nose/mouth and without cutting the umbilical chord. The baby will do what is called “breastcrawl”, which means it will find its own way in its own time to the breast of the mother.
5.) Once the newborn latches on mum’s breast another wave of hormones surges within the mother which helps to release the placenta.
6.) When the pulsation of the umbilical chord stops, the baby is able to breath on its own and only then the chord should be cut.
7.) If doctors interfere with the natural process e.g. “forcefully break the water” or introduce artifical hormones, the whole natural cycle is destroyed, especially the mother’s sensitive/delicate yet powerful hormone production which is required for a smooth delivery, and birthing has to be continued and finished with the artificial procedures.
8.) The birthing partner (e.g. husband, friend, mother) plays an important supportive role to the mother during the birth preparation and the actual delivery.
Learn about doulas, how labor works and how our ideas about birth can shape our experience of birthing in this awesome talk by Ginny Phang:
Ginny Phang is passionate about enriching a woman’s child birth experience, supporting couples through their choices and helping them to achieve the best possible birth experience. As a Doula, she has supported over 300 births and taught antenatal classes to hundreds of couples.
She’s been speaking all over the world in front of audiences ranging from small groups of single pregnant women to the Singapore International Congress of Obstetrics & Gynecology. She’s been trained by pioneers in childbirth education and labor support. She’s been quoted all over the place, including TIME magazine and other publications.
Information on Doula training:
So called modern societies have dramatically disturbed women during the child birth process and these days we seem to have not only a lack of an appropriate cultural model for childbirth but also a lack of time, patience and trust in a woman’s body, and the natural orchestration of mother and baby during birthing.
It seems standard to replace natural oxytocin with drips of synthetic oxytocin and natural endorphins by epidural anaesthesia. So most women give birth without relying on the release of their own natural hormones. The downside of the readily available synthetic hormones is, that they do not have the same behavioural effects as the natural ones. Synthetic oxytocin for example inhibits the release of natural oxytocin from the woman’s pituitary gland. The artifical drug will be effective at stimulating uterine contractions, but it will not reach the brain, meaning it will not have the ‘bonding effect’ as the natural hormone.
Mechanised, rushed birthing ‘appointments’ really have a vast array of side effects. To name a few: physical and emotional trauma (in mother and baby, as well as father), mothers’ and fathers’ sense of disempowerment, mums’ struggle with depression and feelings of disconnection towards their babies. And a baby’s anesthetised body which is forced to exit from the womb has manifold implications as therapy work with adults reveals again and again.
Last but not least, there is a the spiritual side to childbirth. This is rarely featured in mainstream media although even scientific research shows that hormones of love and transcendence are released in peak doses during labor, birth and breastfeeding.
Now, this raises several big questions:
What effect has birthing on a baby’s life and the individual relationship of mother and child?
How will humanity evolve over generations of women giving birth under unnatural conditions? And where does it leave the father?
And how will women ever get back their sense of ease, grace and ownership for childbirth, and her their own bodies?
It is more urgent than ever to become aware and understand women’s physiological processes and emotional needs, to ensure the fullfillment of (at least) the basic requirements of women giving birth and to give them more knowledge and freedom of choice.
“How a baby is born and how well a woman is treated when she gives birth sets the tone and is the matrix from which a child will grow into a future we have not yet imagined. (…) f each pregnant woman were well nourished and supported in her community, each birth was attended by a skilled and loving attendant and each child had an enriched loving environment, we could change our world into a world of peace, not war.” – Marianne Littlejohn (professional nurse and midwife, and ambassador for natural birth)
Similar to fast food, fast birth is neither nourishing, empowering nor sustainable in the long term.
“As a reaction to industrial agriculture and food marketing, the Slow Food and locavore movements have recently been born. If de-escalation of our food production practices is healthier or more humane, why is intensification of our child production practices better than sustainable childbirth? I’m waiting for the birth of the revolution, or at least, the revolution of birth. Will women who are interested in Slow Food or cage-free eggs find their way to a Slow Childbirth movement? Imagine: educated upper-middle-class women who buy songbird-certified organic coffee and worry about their carbon footprint, just saying no to the quick-fix cesarean culture. If they’re not part of the problem, maybe they can be part of the solution. But the impetus must come from women themselves. Do we really believe that industrial obstetrics is the best model for ourselves and our children? We must clearly understand that real autonomy does not mean cesarean on request, but instead a spectrum of birth options that honor women’s authentic choices. Real autonomy also means, to borrow a sentiment from Gandhi, that women should bring forth the change they wish to see in the world.” – Excerpt from “Mommy, What Did You Do in the Industrial Revolution? Meditations on the Rising Cesarean Rate” by Lauren A. Plante
The key role for an amazing experience in the birthing process plays oxytocin, the „love hormone“ involved in bonding, sex, childbirth, breast-feeding as well as feelings of peace and calm. Those who meditate regularly might know that also meditation can increase oxytocin’s effect. The deep state of rest produced during meditation triggers the brain to release neurotransmitters, including dopamine, serotonin, oxytocin, and endorphins. Ingredients that have vital roles for emotional awareness, attention, perception, self-recognition, decision making and stress regulation.
Dr. Michel Odent talks about the biochemical explanation for why birth is and should be an erotic and sometimes orgasmic event: the main hormone in both sex and birth is the same (oxycontin). And we need as good conditions for good labour as we need good conditions for good lovemaking. Because if a woman produces adrenaline (related to fear) she cannot produce oxyocin, which is the hormone not only needed to deliver the baby but also to deliver the placenta.
It is absolutely necessary for a woman during labour to feel at ease and comfortable (unobserved and not judged), that she is uninhibited to follow intuitively her blue print for labour and encouraged to trust her body to complete this ancient and mystic process. Unfortunately, few women ever have such conditions of privacy, safety and non-disturbance, which is the fundamental problem for why women need so much help when giving birth.
These days it seems more “natural” to replace natural oxytocin with drips of synthetic oxytocin and natural endorphins by epidural anaesthesia. So most women give birth without relying on the release of their own natural hormones. The downside of the readily available synthetic hormones is, that they do not have the same behavioural effects as the natural ones. Synthetic oxytocin for example inhibits the release of natural oxytocin from the woman’s pituitary gland. And the artifical drug will be effective at stimulating uterine contractions, but it will not reach the brain, meaning it will not have the „bonding effect“ as the natural hormone.
Natural methods also require the woman to be an active participant in the birthing process, which involves empowering her to listen to her body and being able to change positions (walking, squatting, rolling, hovering in water or just resting) – in contrast to a woman being stuck in a hospital bed on her back with feet strapped, which has consistently been shown to slow down and complicate labor.
“The same movements that get the baby in, get the baby out.”
From Birthing From Within