A guiding STARR

One of the most challenging situations during birth is when something unexpected happens that necessitates a radical re-think of approach. I have heard so many examples of this in birth stories – and the way in which labouring women and their partners are able to negotiate these twists and turns in the birth journey seems to have a significant impact on their birth experience, both in the moment and in their memories of the event.

I’m not just talking about the big dramatic denouements – the unexpected breech baby who prompts a dilemma about c-section versus vaginal breech birth – the very quick labour with a baby who arrives before the midwife does – the labour that starts spontaneously hours before a planned c-section. It’s also the seemingly smaller events that nonetheless change the course of a labour, or introduce elements the mother wasn’t expecting – a birth pool that can’t be filled for some reason, meaning the mother must seek alternative sources of comfort – a labour that is proceeding so quickly and smoothly as to make a planned epidural pointless – a partner stuck in traffic on the way home from work – a chosen birth centre that happens to be full on the night.

Almost anything could happen – and most probably won’t. It would be impossible and even counter-productive to try to prepare for every possible situation, and perhaps what is more useful is the ability to stay flexible with the unfolding of events, adapting to the circumstances as they arise in the moment while staying true to the spirit of our wishes for this birth. In Mindful Mamma courses we do a visualisation based on the idea of a tree, which represents a woman’s wishes for her birth experience – firmly rooted in well-practised mindful hypnobirthing techniques, able to bend and sway with whatever the weather happens to be on the day, but remaining its essential self.

What can help us to harness this mental flexibility when it’s most needed? I’ve been thinking about a way to capture the steps involved in this kind of mental manoeuvre that’s practical and easy to remember. Maybe what we need when everything is at sea – when we seem to be pulled away from familiar shores on tides we didn’t know were there – is a guiding star: something we can re-set our co-ordinates by, a light in the fog.

This approach is loosely based on the RAIN acronym, suggested by various mindfulness teachers for dealing with difficult emotions (explained here by Tara Brach). But these steps are specific to a mindful hypnobirth, and expressed as STARR.

Stop – the first step is to stop and acknowledge the situation – step outside it for a second to recognize that in this moment, something unexpected is happening. It can be tempting in such moments to rush forward with some kind of action. Instead, take a moment to press pause, and label the situation as an event we weren’t expecting but still have a choice in how to respond. This step might also involve asking others who are involved to press pause – for example asking the midwife or obstetrician for some time, to let this turn of events sink in, before you continue the discussion.

Techniques – use your practised techniques to calm your body and mind. Unexpected events often create anxiety, but any decision is better faced from a place of calm and focus. Perhaps 321 Relax, the lengthening breath, or the shoulder anchor.

Allow – accept that this situation, whether we like it or not, is happening right now. As Tara Brach puts it, “allow life to be exactly the way it is” – because it’s already that way. When we allow a situation we can bring our full attention to it, seeing clearly how best to respond.

Re-plan – it’s time for plan B. How can you adapt your birth preferences in light of what’s happening now? You may well find that many of your wishes can be carried out in a slightly different way. Even in the most medical of birth scenarios there is room for negotiation and choice. Small changes to the atmosphere in the birth room (lighting, sounds, the way people speak or stay quiet, how the baby is greeted and welcomed once born) can make a big difference to the parents’ experience of their baby’s birth. This is the moment for BRAINS – you may need to gather more information (for example to make a decision on a suggested intervention) and for re-planning. If you could summarise your key birth preferences in one or two bullet points, what would they be? Now express that to the people who can help you achieve them. As Sophie Fletcher writes in Mindful Hypnobirthing (p.195), it can help to clarify the following three points (and write them down if possible): ‘1. These are the facts I was given. 2. This is the choice I made. 3. These are the reasons I made that choice.’

Relax – use your mindful hypnobirthing practice to help you through this twist in the journey. What techniques will work in harmony with any interventions you choose to accept? What techniques can you use in place of something you’d planned that is no longer available to you? Using your skills can help you stay calm and focused, enabling you to get the best you can out of any situation.

Women deep in the zone of labour probably won’t be thinking about what all the letters of an acronym represent. This one’s for birth partners – as the labouring woman’s supporter you’re ideally placed to pull this out of your back pocket if it turns out it’s needed. ‘Ok – let’s do STARR’ – you can guide your birthing woman through each step.

There is little point spending a pregnancy preparing for all sorts of birth scenarios that are unlikely to happen to you. But some forethought on the steps you would go through in any situation that requires a change of tack is time well spent.

 

 

 

Loving means letting go – Babyloss Awareness Week 2016

dandelion-wind-blown-seeds-333093We are not on this earth to accumulate victories, or trophies, or experiences, or even to avoid failures, but to be whittled and sandpapered down until what’s left is who we truly are. This is the only way we can find purpose in pain and loss, the only way to begin to mend a broken dream, and the only way to keep returning to gratitude and grace.

 

This insight from Arianna Huffington, whose son was stillborn, brought me strength and solace after losing my baby girl at 15 weeks of pregnancy last year.

At the time of writing, I have sought and celebrated nine pregnancies, felt nauseated during six, formed a tiny but recognizable human in five, and brought a baby to birth in three. I have taken on board myriad suggestions for improving my childbearing fitness, and found that with pregnancy, trying harder bears little relationship to success. I have come to rely much more on the wisdom and information from within my own body, mind and heart, than on the ultrasound screen’s cold staring black eye, or the well-intentioned advice of people who don’t really know, because there is no answer to be known. I am deeply grateful to everyone who was willing to see my suffering and offered me kindness, whether expressed in words or otherwise.

 

It may feel an intensely private grief – the loss of this child who was known only to us. For many families this is a lonely and isolating experience, something that is difficult to share or talk about, perhaps even more so for fathers and partners as Mark Zuckerberg has pointed out. But pregnancy loss is incredibly commonplace. While stillbirth (the loss of a baby after 24 weeks’ gestation) is much rarer, miscarriage is estimated to occur in at least 1 in 6 pregnancies. Some parents find comfort in connecting with others who have had similar experiences, via the Miscarriage Association or SANDS for example.

The term ‘babyloss’ includes pregnancy loss as well as neonatal and infant death. ‘Pregnancy loss’ refers to both miscarriage and stillbirth because while the physical experiences differ, research in this area suggests that there is no linear relationship between length of gestation and depth of grief (Moulder, 2001) and it is important not to make assumptions about how parents may feel after the loss of a pregnancy at any stage. People deal with these events in different ways, and the same parents may have different feelings about different pregnancy losses. I hope that these words may be a source of comfort to some who are going through the pain of losing a baby. I know they are also likely to strike some wrong notes with others. In the end we can only speak our own truth, and listen carefully to others speaking theirs.

 

To begin with, mothering seems to be all about holding close. ‘I can’t believe my baby needs me so much!’ ‘When will she sleep through the night?’ ‘How can I get time to have a shower?’ ‘Can he really be hungry again?’ Mothers often find it difficult to imagine how and when their babies might begin to develop some independence, and may feel pressure to push them towards faster progress with sleep consolidation, developmental milestones, and moving on from the sources of emotional comfort enjoyed in babyhood.

Eventually there is a subtle shifting of gears and we begin to realize that our job as parents is gradually to let our children go. It can be startling to feel the strength of our child’s will to follow their own destiny, of them pulling away from us towards the future. How to continue loving while allowing and encouraging growth out of the family?

Our job, as Goethe said, is to give our children ‘roots and wings’. Scientific explanation of how this works can be found in Why Love Matters and The Psychology of Babies. It seems clear that the more children’s needs are responded to in infancy (thereby giving them firm emotional roots) the more confident they are to spread their wings and fly out into the world when the time comes.

 

The paradox of parenting is that in order to let go, we must first hold close. The shock of pregnancy loss is that this letting go happens just at the very earliest time when we are starting to learn to hold on. In fact we may not realize how much we have begun to hold this baby close in our hearts until we are suddenly forced to switch gears and find a way to let go.

The physical letting-go of pregnancy loss may feel brutal, and something our bodies are struggling to do. The emotional letting-go may feel almost impossible as we acknowledge the depth of our inner connection to this person we know both on the most intimate level and also not at all. The yearning to meet this baby face-to-face may be unbearably strong, and the deepest sense of loss may result from the knowledge that this can never happen.

 

However intense the pain of the loss, the tender shoots of love for our babies endure. Throughout our lives we feel the imprint of this baby on our hearts, and a lasting connection with this person known so briefly. Fascinating research indicates that there is a physical element to this felt connection: pregnancies of any length give the mother a lasting gift of healing cells https://lauragraceweldon.com/2012/06/12/mother-child-are-linked-at-the-cellular-level/

Both my grandmothers suffered stillbirths and miscarriage at a time when the emotional pain of this was often unacknowledged, but it was clear that they carried this with them throughout their lives. In her eighties my father’s mother was able to travel to Wales (where she had been evacuated during the Second World War) to find her stillborn son’s grave, which at the time she had been discouraged from visiting. My mother’s mother died aged 95, and as she was dying spoke of her joy at preparing to be reunited with her late husband and their lost babies.

 

Times have changed and although the pain and grief of pregnancy loss remains just as powerful, we now have greater resources and support to enable us to grieve and say goodbye. Many parents find it helpful to have a way to acknowledge the emotional upheaval they have been through in letting go of a pregnancy, even when their feelings about the pregnancy were more hesitant or ambivalent.

In an increasingly secular society it isn’t always obvious how we might acknowledge the passing of babies lost in pregnancy with some degree of ceremony or ritual. If we have a religious or spiritual faith we can draw on its support and customs. Otherwise, we may wish to create our own ceremony, however simple, perhaps on our own or maybe with the support of a celebrant. Many families find comfort in simple rituals such as lighting candles, reading a poem or text, singing or music, creating artwork, or planting a tree, and naming the baby. Jackie Singer’s book Birthrites is one of the few to address this subject and contains some rich ideas for simple but beautiful ceremonies for marking pregnancy loss.

 

My physical terrain has been changed forever by my children’s passage into the world, bearing the scars of their birth journeys. Some of these changes weren’t ones I wished for, but since having children I appreciate what my body can do – how it works – in ways I couldn’t before.

In the same way, my emotional landscape also bears the wounds of my babies’ losses – scars of pain, anger and sorrow that are slow to heal, and will never completely fade. There will always be empty spaces around our kitchen table, tears in the fabric of our family that gape wider every time someone comments on the age gaps between our children or asks whether we thought about having a fourth. Perhaps these numb areas, ridges of hurt and bitterness, will be part of me forever. But I can also accept the possibility that these scars might change my capacity to love – for the better. In stretching against this scar tissue, my heart may open wider.

While I realize with deep gratitude how fortunate I am to have three children, I’ve learned the hard way that one child does not replace another. Each one is uniquely his or her own self. So I really know how amazing it is when a baby forms, grows, journeys through birth and arrives into the world. What a miracle each child is. And how lucky I am in the work that I do to witness each day this miracle in its countless forms.

 

Moulder, C. (2001) Miscarriage: Women’s experiences and needs. London: Routledge.

Special thanks to Becca Bevis for her thoughtful comments on a working draft.

Picture credit: Blickpixel (Creative Commons)

Micro Birth afterthoughts

Earlier this month I attended a screening of MicroBirth – this film highlights the importance of the way in which a baby is colonised by its mother’s bacteria during and after birth, and emerging research into the impact of this on the baby’s future health. Something that is almost incomprehensible in its complexity of function in the body and possible future ramifications for long-term health, and that has been unwittingly tampered with by so many common practices in our culture during childbearing and the early postnatal period. At the same time it is amazingly simple: a mother gives birth and instinctively picks her baby up, cuddling her precious newborn against her skin and helping her baby find the way to the breast. When birth is undisturbed, the microbes take care of themselves.

There is a fantastically comprehensive summary of the research in this area by Midwife Thinking here, along with many useful practical suggestions for applying the findings of this emerging field during pregnancy, birth and the postnatal period.

What many of us watching the film were wondering afterwards, was how to take on board this information when we have experienced a less straightforward birth. My eldest child was born by caesarean a decade ago and I had never heard of the microbiome or the need to ‘seed’ the baby with the mother’s bacteria. There are several things I could and would have done to mitigate the effects of my daughter’s birth on her microbiome, had I known what I know now. Scientific discoveries advance constantly, and we never know when we may be faced with new information that calls into question decisions and choices made years earlier.

I am reminded of the quote by Maya Angelou – ‘I did then what I knew how to do. Now that I know better, I do better.’ This is surely all that we can ask of ourselves. But it can be incredibly painful to confront the gap between our past knowledge, and our current knowledge. The pain of regret can cloud our vision, interfering with our ability to learn from experience and put our new knowledge to good use. When we are able to bring mindful awareness to our regrets, rather than avoiding or trying to suppress these feelings, we can hold them in clear-seeing and self-compassion. This allows us to move beyond the pain and sadness, able to respond more skilfully to use the wisdom we have gained.

Stoning plums

OLYMPUS DIGITAL CAMERAMy mum and dad have a plum tree that produces tiny and very delicious plums. They are a beautiful mottled indigo on the outside and green inside, a little smaller than cherries, with a similar-sized stone. They make wonderful jam, so today I decided to make some out of the big bag of plums I’d brought back from visiting my parents.

The first thing I had to do was stone the plums. This isn’t an easy job, when the fruits are so small. It took a while to work out how to get the stone out without mashing the plum to bits – eventually I worked out a twisting manoeuvre which was mostly successful. As I contemplated the huge pile of plums in the colander, I felt daunted, wondering how long it would take to get through it all, and whether I really wanted the jam enough to make the effort worthwhile. I kept on stoning plums but the pile didn’t seem to get smaller. My fingers were starting to hurt from tensing around the knife I was using. The more I looked at the pile of plums the less it seemed to be diminishing and the more my fingers ached.

Then I remembered something from my mindfulness practice – I only need to stone one plum at a time. Bringing my awareness into my hands, the feeling of the knife cutting into the plum’s skin and hitting the stone, the green revealed as I twisted the plum apart, I was able to be with just that one plum instead of thinking ahead to all the others. Stoning one plum isn’t a problem at all! I started to notice how different they were in appearance, and how some stones stuck to the flesh while others popped out cleanly. I relaxed into the job and stopped worrying about how long it would take. Eventually I did get to the end of the bowl, and the jam got made.

During Mindful Mamma classes I am often asked about the timing of labour – the length of contractions and the spaces in between, how this changes as labour progresses, how long each stage of labour lasts. When we approach labour in the mindset of clock-time, the lack of one definitive answer to these questions can be frustrating and anxiety-provoking. Another way is to use the framework of what Nancy Bardacke, author of Mindful Birthing, calls ‘horticultural time’. Clock-time can’t tell us exactly when the plums will be ripe enough to drop from the tree – plum-ripening works on horticultural time.

In the framework of horticultural time, we trust that our labour will progress in its own good time. We can relax into the rhythm of our contractions and pauses, working with our body’s unique timing. As labour builds, we start to get a feel for how the rhythm of our breathing carries us up and over the crest of each contraction wave, easing us down the other side. Using mindfulness to stay in the present moment, we are only ever dealing with one contraction at a time, breath by breath. We are able to focus on that one contraction, perhaps noticing what is unique about it as we tune into the fine detail of the sensations we experience – what is here, right now? Each wave ebbs away and is gone, never to be repeated. Each wave brings our babies closer.

 

Setting sail across the ocean of birth

Kym's boatPreviously I’ve compared labour to a voyage into uncharted waters. Birth preparation is making sure our ship is strong, sound and seaworthy – ready for the adventure. Of course what every ocean journey needs is a good send-off – crowds cheering, rousing sea-shanties, champagne smashed against the ship’s prow. How can we give a pregnant woman a fitting celebratory send-off for her maiden voyage on the tides of birth?

Antenatal care in western industrialised culture tends towards the rational and functional, with a focus on the physical aspects of pregnancy and birth. This may well be necessary and expedient, but carries a risk that the emotional, social and spiritual dimensions of impending parenthood become overlooked. Sheila Kitzinger in her book Rediscovering Birth details the rituals and celebrations that other cultures engage in as a way of supporting women through the transitions of birth and motherhood.

Baby showers are an example of a social celebration of the upcoming birth – but they tend to be mainly about the baby, with a materialistic or practical focus on the ‘stuff’ that may be useful in the early weeks.

A mother blessing or ‘blessingway’ ceremony is a pre-birth celebration that focuses on the mother and the emotional and spiritual preparations she is making, acknowledging the pregnancy and birth as a significant rite of passage in her life. This is a westernised adaptation of Navajo traditional practices for celebrating rites of passage, and generally involves bringing together the pregnant woman’s close friends and female relatives to offer their emotional support and collective wisdom as she prepares to birth her baby. Traditionally they are a female gathering, but a pregnant woman may choose to have her partner or male friends and family present. Typically there is some kind of shared activity, for instance making a string of beads, quilt or wall hanging, symbolising everyone’s good wishes for the birth and creating a lasting artwork or memento for the mother-to-be’s birth space. There may be singing, dancing, nourishing the pregnant woman with a massage or decorating her belly with henna. Mother blessings often conclude with ‘weaving the red thread’ to symbolise the connections between the women there and the support they are offering the mother-to-be, and a shared meal afterwards. Mother Rising is a wonderful book with a compendium of ideas for creating a mother blessing ceremony.

In Oxfordshire I know of two wonderful practitioners who lead mother blessing ceremonies – Liz Nightingale at Purple Walnut Midwife, and Jackie Singer who has written a great book on rituals for motherhood, Birthrites. I have also been part of several lovely ceremonies organised by a close friend of the mother-to-be.

Mother blessings are as individual as the mothers they celebrate, but their aim is to nurture the mother-to-be, surrounding her with love and support, and filling her with confidence for the journey she is about to make.

Picture credit: Visual affirmation by Sophie Fletcher, founder of Mindful Mamma

Acceptance in action

To_let_go_by_thiselenaFor my brand new nephew Edward, born this month, and his wonderful mum and dad

When pregnant with my third baby, I had a very specific awareness of my ideal birth, and spent much time visualising this. I was conscious that this would most likely be the last time I gave birth, which deepened my wishes for a straightforward water birth at home.  If I could have ordered my birth experience off a menu it would have been ‘One orgasmic birth please, and make it snappy!’

Tennis players, footballers, gymnasts – it’s well known that visualising a perfect move helps many sportspeople improve their performance. Athlete Jessica Ennis-Hill described using visualisation to prepare for the 2012 Olympics: ‘I use visualisation to think about the perfect technique. If I can get that perfect image in my head, then hopefully it’ll affect my physical performance.’

And when it comes to birth, part of effective birth preparation is to home in on what we most want for the birth. Pregnant women using hypnobirthing often spend time each day visualising their perfect or ideal birth. In contrast, just ‘going with the flow’, when this means avoiding aiming for anything particular, can mean missing an opportunity to captain our own ship across the ocean of birth, as this article explains.

It’s less commonly that I hear women describe their actual birth experiences as ‘perfect’. Some do though, and lately I’ve heard several birth stories where women said just that.

Kathryn Los wrote in 2011 about her sixth baby Alexander’s freebirth at home in water, saying ‘This truly was the perfect birth experience for me’. She described how she had resolved during her labour to ‘set the tone’ for a joyful birth experience, and found herself singing a favourite song through her contractions. Kathryn is a doula and supported me during my second baby’s birth; this birth story was a huge inspiration to me when I found myself pregnant the following year. It opened up for me the potential of what birth could be.

Katja, a Mindful Mamma hypnobirthing client, told her first baby Flo’s birth story at our local NCT home birth group meeting. Flo was born at home in water, and her father Oly has written a wonderful blog about it here. Katja joked with me ‘You said it probably wouldn’t be perfect, but it really was!’ Katja had had a clear idea of the most important aspects of her birth preferences, her deepest hopes and wishes, and these had happened for her.

Lauren, another Mindful Mamma client, wrote to me with the birth story of her first baby Joshua, who was born in a birth pool at a midwife-led unit after a straightforward labour mostly at home (Lauren found she was fully dilated on arrival at the unit): ‘It was a completely incredible experience, I have tried to capture it here but words cannot describe it really. I feel incredibly humbled to have had such a wonderful experience. I wouldn’t change it for the world and feel somehow more whole having been through it together with Gary. I am also incredibly thankful that I was able to have the birth I wanted, for me and for Gary and for Joshua. It was exactly as my birth plan was written, the only difference being that I chose to birth in the water instead of getting out. I am so glad that I didn’t have any intervention and that I didn’t have any pain relief, I wanted to fully experience the birth without any haziness and I was able to do that. Our baby was so alert when he was born, I wouldn’t have had it any other way.’

It’s spine-tinglingly wonderful to hear a new mother describe her baby’s birth with such undiluted joy. But in my experience most women, however straightforward and positive the birth, are unlikely to describe their birth experience as perfect, and will express mild regret at some niggle, or surprise that something unexpected happened, or rueful amusement at some unintended development. The surprises are not necessarily negative – the most joyous moment of my son’s birth was the feeling of his head crowning. I’d been expecting the ‘ring of fire’ but instead I felt a huge stretch and pure pleasure as he surged into the world, I knew I’d done it! But niggles and minor regrets appear to be a common feature of sifting through the events of a birth afterwards – perhaps the iPod playlist kept jumping to an unwanted song, or the birth pool wasn’t ready in time, or the baby’s cord turned out to be too short for immediate skin-to-skin on the mother’s chest so it was her tummy instead. These niggles don’t detract from the joy and wonder of the birth, but are part of the process of a mother coming to own how her experience really was.

Emma’s third baby Nina was born at home in water, without the need for intervention of any kind, not even a vaginal examination. Despite Nina being the biggest baby of the family, it was the first time Emma had given birth with an intact perineum and she found this made a huge difference to her recovery. Although this was a completely straightforward birth physically, Emma’s emotional experience of Nina’s birth was more complex. Emma talked to me about her feelings during labour and how her emotional response developed in the following weeks, as she gradually took on board the events of the birth.

‘I was aiming for a repeat of Orla’s birth because it was so easy and so fast – I had a baby before I really knew it and I thought ‘Sure I’ll have another one of them!’ But I was very aware that I needed to prepare myself for the fact it might not be because every birth is different and third labours are notorious for being unpredictable. I do remember an awareness of it passing the time when Orla was born and slight disappointment that it’s not going to be that straightforward, it’s going to take longer. Then Orla woke up.  I had prepared myself for that but hadn’t prepared myself for the fact that she might just cry for a long time. I hadn’t realised how upset she’d be and how much that would affect me. It really stopped me from being able to go as fully into another world and totally surrendering – I was much more present than I ideally would have been. I remember saying to my midwife at one point ‘Both my babies need me now’. At one point I was pushing earlier than I needed to and I said ‘Should I be pushing now?’ She said ‘Just do what your body tells you to’ – I realised I was consciously pushing and that realisation helped me. It was a more difficult and longer labour. My body was far enough along that it didn’t totally stop labour, and in the end it was a very straightforward birth, no tearing… On paper it was very straightforward, brilliant, but in reality it was more difficult because I hadn’t anticipated how I’d be affected by that scenario.

‘After the birth I was a bit disappointed. It was hard feeling torn and hearing Orla so upset. I felt positive about the third stage as that was the first time I’d had a totally normal third stage – that was the one thing I’d been worrying about beforehand. Once I moved on and thought about it a bit more rationally I realised this ticks all the boxes for a wonderful birth. Certainly having no stitches or tear made an amazing difference. In those early days, I was processing it by talking it through with friends and my midwife. I also wrote my birth story and shared it with friends. Now I’d describe it as it was a very good birth and it was all straightforward.’

A few days before my son was born, when I was nearing 42 weeks and feeling as if the pregnancy might go on forever, it dawned on me that to get my labour started I would need to let go of the ideal birth I had been visualising, and welcome the real experience I was about to have, however that unfolded. As Milli Hill, founder of the Positive Birth Movement, says in her article Don’t be afraid to plan for the birth you want, ‘What’s needed is balance – a way for women to find that half way point between throwing their hands up in defeat, and being so rigidly stuck to their hopes that they can’t face the idea of any kind of compromise.’

How can this balance be found? Mindful acceptance is the key – an acceptance that is not passive, resigned, fatalistic or detached, but active and positive. Mark Williams, world expert on mindfulness and director of Oxford Mindfulness Centre, explains it like this:

‘The root of the word (the same root as the words ‘capture’ and ‘perception’) means to receive or take hold of something – and through this, it also means to grasp or understand. Acceptance, in this sense, allows the mind to embrace the true, deep understanding of how things really are. Acceptance is a pause, a period of allowing, of letting be, of clear seeing. Acceptance takes us off the hair trigger, so that we’re less likely to make a knee-jerk reaction. It allows us to become fully aware of difficulties, with all of their painful nuances, and to respond to them in the most skilful way possible. It gives us more time and space to respond… In short, mindful acceptance gives us choices.’ (Mindfulness: A practical guide to finding peace in a frantic world, p.163)

What does this kind of acceptance look like in birth? Recently I was reading about the way mothers are able to move from openness to the myriad possible characteristics of the mysterious baby-in-the-womb, to acceptance of the particular baby that is born, and I saw some parallels with how this works for feelings about birth. Naomi Stadlen, author of two of the most important books on new motherhood, describes the process of ‘making heartroom’ that pregnant women go through as they open up a space in their minds and hearts as well as a physical space for their growing babies:

‘After a mother has created an inner hiatus during pregnancy, however tentative, it seems possible for her love to flow into the empty space after the birth. The early act of making heartroom seems to prepare for the act of loving. Making heartroom is expansive. It’s like a pair of arms stretching out to welcome a variety of possible babies. When a mother feels the huge opening and melting of her heart towards her particular baby, her feelings seem to close around him, loving him, and him alone, for being exactly the baby that he is’ (How Mothers Love, p.16)

It seems as though something similar is happening with a woman’s feelings about the birth. During pregnancy, a woman may be holding on to her wishes, hopes and dreams for the birth, visualising the best that it could be. At some point, whether later in the pregnancy, as the first signs of labour begin, or during the birth as events unfold, this hold becomes looser and a space opens up to make room for the unknown – the variety of possible circumstances that may develop. Later, the mother’s feelings close around the birth as it really was, accepting every last detail. This closing can take some time, just as the mother’s body takes time to close and heal after the awesome opening up of birth. As a mother tells her birth story she recalls different moments each time, and each telling may reflect a subtly different emotional nuance.

Some women find that birth takes a completely different course than the one they may have expected or hoped for. Sometimes this may result in a sense of failure or overwhelming grief, burdening the new mother with a heavy load to carry into the postnatal year. But this isn’t inevitable, and often a sense of personal strength and achievement is the dominant response to a challenging birth. Research exploring new mothers’ emotional responses shows that feeling in charge, supported and actively involved in the decision-making process during the birth help them begin motherhood feeling positive about themselves and their babies.

Claire, who participated in the Mindful Mamma course with me last year, wrote to me about the birth of her baby Alfie: ‘Well, the labour process was interesting and ended up being quite far removed from the natural birth I wanted, but I felt so positive about the whole experience and that the right decisions were made at the right times. I remained in control, relaxed and calm throughout even when it became apparent the outcome was going to be different to what I had wanted and planned. We were able to communicate our thoughts and feelings to the hospital staff and they were wonderful in complying with our wishes and ensuring all the other medical team also kept calm and didn’t rush anything.’

This is not the passive resignation of coming to terms with something unwished for, but an active, dynamic acceptance that builds a bridge between the ideal and the real; gently letting go of hopes that didn’t materialise, working through challenging events, and savouring all that is good in the birth experience.

 

Picture credit: Letting Go by thiselena on deviantART thiselena.deviantart.com 

Sweet surrender

Someone asked me recently how mindfulness and self-hypnosis could work together, as at first glance they seem to be rather different. There is a great explanation of how this works in Mindful Hypnobirthing by Sophie Fletcher. Mindfulness and self-hypnosis are both ways of practising the skill of letting go. Self-hypnosis is working particularly at an unconscious level, releasing deep-seated fears around birth, opening up space for new beliefs and experiences. Mindfulness meditation operates on a more conscious level, but similarly enables us to let go of tightly held ideas or unhelpful beliefs and emotional responses. During labour, both practices work harmoniously to allow us to let go physically, able to work with our bodies and relax into the sensations of childbirth, rather than bracing against them.

This conversation reminded me of these thoughts on the idea of surrender in birth, which were previously published on the Mindful Mamma blog.

 

In one of my recent classes we were talking about the idea of surrender in labour and birth. Many pregnant women are fearful of losing control during birth, and we may feel uncomfortable with the idea of surrendering to the birth process. Surrender carries connotations of giving up, waving the white flag in hopeless resignation. This kind of surrender in birth is described by Naomi Wolf in her book Misconceptions: an emergency caesarean left her feeling she had ‘almost no role’ in her baby’s birth, as if the epidural had numbed her will as well as her body. With this kind of loss of control, women are more likely to have a negative birth experience, and are at increased risk of emotional problems afterwards.

 

So it’s interesting that women who describe positive experiences of birth also talk about surrender: letting go, going with the flow, being carried on the waves of the contractions, letting the birth unfold.

 

These two birth stories from Ina May Gaskin’s Guide to Childbirth describe this:

 

‘Things were happening quickly. I didn’t try to hold any of the contractions back. I just let them come as fast as they wanted to, knowing that would help the birth happen without delay. It all felt very natural. I just went with it.’

 

‘I fastened on a particular word and meaning: surrender. I began having contractions and feeling big waves of energy moving. I visualised my yoni as a big, open, cave beneath the surface of the ocean, with huge, surging currents sweeping in and out. As the wave of water rushed into my cave, my contraction would grow and swell and fill, reach a full peak, then ebb smoothly back out. I surrendered over and over to the great oceanic, engulfing waves.’

 

In Gentle Birth, Gentle Mothering Sarah J. Buckley talks of her initial shock at going into labour with her first baby at 36 weeks:

 

‘I still had baby clothes to wash and sort, and hadn’t put the second coat of paint in the spare room… but here was our baby, eager to come.. Our task was to accept this time, this labor, in the present moment. With this surrender, labor really began for me… There was an oceanic feeling; I felt like I was riding the waves, challenged but exhilarated as I came down each time.’

 

Her second birth was demanding as her baby was posterior and slow to move down because of an anterior cervical lip:

 

‘Through this intense time, sound was a strong ally, helping me to express my body’s feelings and to find my surrender into the unknown.. She was born, face up with relief and only a few pushes.. I felt enormous surprise and pleasure, merging into ecstasy, as I held my warm, wet, soft, new baby.’

 

This kind of surrender in birth is more like giving into passion, losing ourselves in ecstasy, being carried on a tide of feeling. Surrendering in this way involves a positive choice to embrace the unknown – an opening of the heart that accepts and welcomes the events of labour and birth however they unfold. In order to let down our guard and surrender to the moment we need to feel safe – private and unselfconscious, uninhibited, accepted and loved. This allows us to trust in our bodies, our babies, and the birth process.

 

But does this mean losing control? Perhaps it’s a bit like captaining a ship in uncharted waters – we don’t know the exact route our journey will take, so we surrender to the voyage of discovery, but we are still in charge of the ship. In the same way, surrendering during the birth doesn’t remove the need to put thought, care and effort into preparation before the birth: the ship needs to be well maintained, stocked and ready for the voyage. By preparing we get ourselves in the best possible physical and mental condition to launch onto the seas of labour and birth. So releasing control, but not resigning control: choosing to release control and open to the unpredictable birth process is very different from feeling that control has been taken from us against our will, that we have been hijacked and can no longer steer our own course.

 

Mindfulness helps us to bring acceptance to the birth process, and events as they unfold – and also to ourselves: our feelings and reactions. Mindful acceptance is deliberate, intentional: noticing and embracing the way things are in each moment, without judging whether this is how they ‘should’ be. Acceptance is not about ‘put up and shut up’, but opening up. Perhaps the journey through labour and birth is very like how we imagined it – or perhaps it’s very different. Releasing control and accepting our real experience, just as it is in each moment, allows us to trust, relax and surrender.

 

Once our babies are born, we surrender all over again – to falling in love, and to the ups and downs of the postnatal weeks. Surrendering to a newborn’s needs and rhythms, we open our hearts to our babies.

 

 

 

 

Peace is every step

Peace is every stepThis Thich Nhat Hanh quotation hangs on the wall of Peace House, where I lead mindful hypnobirthing classes. At the class last week we put this idea into action practising a lovely technique called Mindful Movements. This is new to the Mindful Mamma class, along with the book Mindful Hypnobirthing published last month.

 

Mindful Movements is based on walking meditation, a mindfulness practice that involves bringing awareness to the sensations of walking. As with many mindfulness meditation practices such as breath awareness, the intention is to bring awareness to a simple aspect of our physical lives – one that is always with us and easily accessed, but often by its very ordinariness overlooked. Walking mindfully, we notice the weight rolling from heel to toe and shifting from one foot to the other, feeling the points of contact between feet and floor. We may be aware of the rocking of our hips, our arms swinging, our balance, our pace and rhythm, and the thoughts wandering through our mind. Noticing each detail, tuning in to each moment. Like breathing, walking is something we usually take for granted, and it can be a revealing practice to bring awareness to this everyday activity. The first time I tried this practice, I was struck by a feeling of immense gratitude for my ability to walk, as I remembered my previous job in spinal cord injury rehab and all the people I met who had lost this ability.

 

Being upright and active during labour is known to be beneficial – as Janet Balaskas explains, research studies show that contractions are stronger and more regular, cervical dilation is more efficient, resulting in shorter labours, less use of analgesia, and babies born in better condition. However it’s a common misconception that hypnobirthing isn’t compatible with active birth. Perhaps this is something to do with the many beautiful hypnobirth videos showing women looking very relaxed, lying comfortably on a sofa or floating in a birth pool, and it’s true that many women find calm and relaxation in a comfortable restful position even during intense labour. But other women feel the need to be upright and moving during their labour, and for many women it’s a combination of phases of activity and phases of rest.

 

So it was great to practise Mindful Movements with the class, showing how self-hypnosis and mindfulness work in harmony with movement. As the class rocked their hips and swayed from side to side, some of the women practising movements they had learned at aquanatal or pregnancy yoga, I reminded them of how this rocking motion would help to rock their babies down, finding the perfect position in the pelvis, making the journey through the birth canal quicker and easier. There is a wealth of information on Spinning Babies for ways of using movement and positioning to encourage your baby into an optimal position for birth.

 

And the second-time parents in the class remembered this familiar rocking motion from the hours spent walking and swaying with a fretful newborn. New babies are often soothed by being lovingly held or carried in a sling while their mother or father walks, rocks, sways or bounces gently – or in the case of one of my children, vacuums the floor (this technique had the added benefits of white noise which is often soothing, and a clean floor once the baby was asleep!). The combination of close contact and warmth in the loving arms of a parent, prompting oxytocin release to calm the baby’s system, and the rocking motion familiar from life in the womb, has the power to calm and comfort many a baby, as this study shows.

 

Sometimes whatever we do to soothe a colicky baby the crying continues, and it’s well known that this can be one of the hardest aspects of life with a newborn. Tuning in to our own movements, our breathing, becoming mindful of the thoughts and emotions passing across our mental sky, can help us to work with the pain of our crying babies, acknowledging their distress and our discomfort while knowing that ‘this too shall pass’.

 

Using Mindful Movements we can bring peace to every step of an active labour, and peace to every step of our journey through the early weeks with our babies.

A new moon

OLYMPUS DIGITAL CAMERAA new moon teaches gradualness and deliberation and how one gives birth to oneself slowly. Patience with small details makes perfect a large work, like the universe.

What nine months of attention does for an embryo forty early mornings will do for your gradually growing wholeness.   – Rumi

The new moon signifies a time of transition – the passing of how things were before and the beginning of something new. Every new moon also reminds us that these continual transitions are how life is – however much we carry a notion of things being fixed, change and impermanence keep bubbling up. Sometimes we resist, clinging to the old and familiar, and sometimes we open up and embrace the new and uncertain. With the birth of a baby comes the birth of a mother, and a brand new family. But this beginning carries inside it the endings of the old life – the woman on her own, the couple before parenthood, the connection with the baby in the womb.

Mindfulness teaches us a way to navigate the transitions of new parenthood. Tuning in to the ebb and flow of our breathing, we dwell in the present moment. As we breathe our babies into the world, we accept the new and release the old with each breath.

Every inbreath a new beginning, every outbreath a letting-go   – Mark Williams