March 12, 2010

How We See Birth: Changing Our Perceptions

"Women are being convinced that their births are a medical incident... to surrender their experience to someone else..."

"When you change the way you view birth, the way you birth will change."

- Marie Mongan, founder of HypnoBirthing

How We View Birth

Something is wrong with the way we view birth in this country. That is a conclusion I came to much before I'd ever started taking a HypnoBirthing class. Not only is something wrong with the way we view birth, but with the way we handle it. In terms of developed countries, the infant mortality rate in the US leaves a lot to be desired. In other countries, many, many more women deliver with midwives. Why? Because if you have a 'normal', not high risk pregnancy, you don't really NEED a doctor to deliver your baby.

It seems like there is a perception that's grown that a woman's body is not good enough to handle having a baby. That she will certainly not be able to get through it on her own, and will need to be in a hospital with medical interventions. Half the time when I tell people I am planning on a natural birth, they look at me like I am crazy. But women have been having babies on their own for thousands of years, and been fine. Still, I am asked why I would WANT to have my baby without drugs when they are so readily available.

The thing is? Those drugs do take away pain. But they also take away other feelings, they override your body's natural hormones and feelings and change the experience completely. For some women, this might not matter. But for me... I want to have my baby and feel that connection, I want to feel my baby coming to me and feel the full strength of holding him in my arms for the first time. I wonder how different it will be from the first time. I don't know what to expect, and maybe it will be very similar. But maybe it won't, and that's not a chance I want to miss out on.

When Marie Mongan, the founder of HypnoBirthing, found herself pregnant with her first child in 1954, she wanted something different. She would be going through her labor and delivery in a time when husbands were not allowed in the birthing room. This was a time when by the time women were dilated fully, they were put under general anesthesia or "twilight sleep" to wake up no longer pregnant with their baby in a nursery somewhere else in the hospital. Here is a passage from the book HypnoBirthing that really stuck with me:

"My birthing was not going to be one of drugged compliance with no recollection of the experience. the premise that birthing, by nature, had to be a painful ordeal was totally unacceptable to me. I could not believe that a God who had created the body with such perfection could have designed a system of procreation that was flawed. So many questions prevented me from accepting the concept of pain in birthing. why are the two sets of muscles of the uterus the only muscles that do not perform well under normal conditions? Why are the lesser animals blessed with smooth, easy birthing while we, the very highest of creatures, made in the image and likeness of God, are destined to suffer? And why are women in some cultures able to have gentle, comfortable births? Are we women in the Western world less loved, less indulged, less blessed than they? It didn't make sense to me logically or physiologically."

Birth in the Media

Imagine the last time you saw a woman in labor in a TV show or movie. What was it like? Most likely she went into painful labor immediately, perhaps with her water breaking and contractions immediately doubling her over in pain. Rushed to the hospital, she was immediately in hard labor, covered in sweat and screaming as she pushed her baby out.

What is wrong with this picture? So many things. At our first HypnoBirthing class, our teacher told us about a study that was done at a conference with healthcare providers like nurses and doctors who attend births. They were shown 179 clips from various movies & television shows of women giving birth. Across the board, how many did they rate as REALISTIC portrayals? ONE. That's because, if I can just venture a generalization based on the women I have met, that's not how birth usually is.

Most of the women I know did not scream during labor. Less than 20% of women have their labor start with their water breaking. The average labor lasts 12 hours, and there is plenty of time to get used to the contractions before they overtake you. Plenty of time to talk around and mosey on over to the hospital. But a quiet, slowly laboring woman doesn't really make for good drama, does she?

Unfortunately, that means that the images that women and young girls are exposed to are highly negative. By the time girls become women able to reproduce, they've been exposed to these dramatized accounts, and maybe one birth video in health class, whose close up shot of a baby crowning most likely becomes their only memory of the whole thing. Because really, who wouldn't remember that?!

Even on reality shows like "A Baby Story" on TLC, they rarely show home births or births at birth centers. Generally when these types of births are portrayed on television, the parents are portrayed as being hippies, or slightly off. The reality is that anyone can choose a birth center or home birth regardless of their background.

Other media isn't always much better. At our first class, our instructor read us an article from WebMD about HypnoBirthing. While it started out positive, in the end the last two paragraphs that might stick with you? Not so positive:

"But some experts warn that hypnotism may not be enough to help everyone endure the powerful pains of labor. Yvonne Thornton, MD, PhD, a senior perinatologist at St. Luke's Roosevelt Hospital Center in New York, says she would counsel women to think long and hard before they decide to try hypnobirthing or any other method of drug-free delivery.

"If you really want to have a drug-free birth, you have to be committed to the program or technique because if you are not really committed, it's a farce," she tells WebMD. "Some people have a fairy-tale idea about the true nature of labor, but it is painful. It is one of the most painful crisises that the woman has to endure."'

So basically, they write an article supposedly about the positives, and end it by telling you that you should really think about it before you decide to try this. To me, it implies that you have to be some kind of superwoman to really do a drug free birth, but normal women? Should really think about it, because they probably can't handle it. Then it refers to pregnancy as a crisis instead of as a wonderful, NATURAL event that has been happening for years. Why is this doctor considering birth a crisis when it's a natural, physiological process? You got me.

Since I've been pregnant, and in HypnoBirthing, I've watched many videos. There are tons of videos to be found on YouTube, the Hypnobirthing website, and other various places of amazing, empowering births. I'll post a few in one of my HypnoBbirthing themed posts. The bottom line is that these videos are amazing. They give me confidence, and it's a big shame that young women are not exposed to these kinds of videos that show what birth CAN be.

Fear, Tension and Pain

In our first class, we talked about the cycle of fear, tension and pain. In my opinion, the way that birth is portrayed in our media and the lack of realistic and positive information available for women feeds directly into the fact that myself and many women I know went into our first childbirth experiences full of fear.

I was terrified of labor. The stories I'd heard, the way that I'd seen birth portrayed... it all lead to this huge fear. How much would it hurt? Would I be able to handle the pain? And mainly, what would it be like afterward? I heard it described in more than one place as being "like hamburger down there." If that just horrified you and you're NOT pregnant, imagine how much it freaked me out! By the way, I assure you, it wasn't like that at all in my experience.

What happens to us when we are afraid? Our body secretes hormones meant to do certain things. In our first hypnobirthing class, we talked about the cycle of fear --> tension --> pain. We talked about how fear affects labor:

Fear creates stress hormones.
These hormones cause our arteries to constrict.
Less blood and oxygen is able to reach our uterus/baby.
The circular muscle fibers in the uterus constrict, fighting against the longitudinal muscles, which continue to contract, trying to draw the baby down.
This muscle tension leads to pain.
The mother may then experience a failure to progress.
The baby may experience distress because of the tension, and the pain the mother is feeling.
And we end up with some kind of medical intervention.

When you think about it this way, concretely, it makes sense why it is so important to think about how your birth is going to be, to realize what it CAN be. Going into the labor and delivery room afraid affects your whole birth experience. Unfortunately for many women, that's all they know.

What if? What if we could break this cycle for the majority of women who are going to have babies? What if instead of scaring them and telling them horror stories and showing them images of screaming women, we nurtured them and the lives growing inside them? What if, as pregnant women, we learned to love our bodies the way we love our babies and to trust ourselves?

That's really what I'm trying to do this time around. And you know what? I'm not afraid. I know that it's going to be intense. I know that it's going to be work, and it's not going to be easy. But I feel so much joy at the thought of bringing my baby into this world that I know it's going to be amazing.

What was your birth experience like? Were you afraid? Was there a difference for you in the fear level between your first and subsequent deliveries?

This is post 2 in a series about HypnoBirthing and my experiences learning the method. Part 1 is here. The next installment will be about HypnoBirthing and the Mind Body Connection. Or, see Part 4 about my experience.


marslo said...

This is a really great post Rachael. I admire you for being so well informed and taking charge of your birthing experience.

Mandy said...

This is a really good post. I do regret at times not using a midwife for my deliveries. However, I have a very relaxed doctor who prefers things the natural way. The hospital where I delivered was very much the same way and the nurse I had was spectacular. She coached me through every thing this last delivery. My SIL uses a midwife and a birthing center. She has said some of the same things as you have here. Kinda convinces me should #4 come along (no, not yet!), I may go that route as well.

Audrey at Barking Mad! said...

Rachael this is a wonderful post. I wish more people would really examine "How we see birth..." because I think we'd have healthier moms and babies in the long run!

Mama Seoul said...

I used Hypnobabies for my VBAC and it was awesome and very easy. I have noticed a correlation between how well the program was followed and how well it worked for the mom. Also, if you start to lose your focus, turn towards the program and choose to use your hypnosis to get back your control.
My birth story:

I do agree with the first part of what Dr. Thornton says and that is that you need to be committed to natural birth and to your method. I don't agree that birth is a crisis, but I do agree that you need to prepare. Most people spend more time and money choosing crib bedding than they do on labor preparation.

Have a beautiful birthing!

Jessica said...

I don't really know if it is much help but I birthed a 100% natural birth - no drugs to "take the edge off" or interventions of any kind. I did deliver in a hospital with a Dr. that I loved and would totally use again. Really, if you want to talk let me know. It was amazing and I would do it the same way (hopefully not so l o n g! 27 hours) next time!

Sheridan said...

Great post! I love seeing moms spread the news that birth can be pleasant instead of scary!


Also for those who are interested I have gathered over 250 birth stories from moms who used hypnosis for birth. All are positive stories!


Lojo said...

Excellent post!

I am not a mother and have not endured labor, but as a former sociology grad I studied birthing practices a lot as a student and I am well versed on our somewhat upside perception of birth. Great to see people discussing it!

A great book on this topic is Misconceptions by Naomi Wolf.


Liza said...

Hey Rachael, you were on my blog last night (gracias!) and I know you commented on the last part of my FOUR PART (I know, crazy long) labor story saying, "Yay for short labors." Did you know that I was trying Hypnobirthing as well? I talked about it in Part I and in a post before that. Unfortunately, I didn't jump on the Hypno bandwagon until a whopping three weeks before I was, so I gave myself a crash course. I wish I had done it properly, with the class and everything, like you are. I read the book, listened to the CDs and read other books about our society's perception of the "painful" birth. I read in detail about all of the points you make above. And they are awesome points. And, you can totally do it if you're 110% committed. I still had fear and that's what got me. When my first contraction hit after having my water totally emptied slowly over the few days beforehand, I got scared. Feel free to read the full story (if you didn't already - and if you didn't, I totally understand, it's long). I need to go read your birth story now to find out what happened!!!

Rachael1013 said...

@ Lojo - I haven't read Naomi Wolf's book yet, but it's definitely on my