November 17, 2016

Does Birth Happen In the Brain?

“You birth between your ears, not your legs”, a statement made by internationally recognized expert on water birth and gentle birth, Barbara Harper, rang in my head long after our podcast interview was over.  For years, I subscribed to midwife, Ina May Gaskin’s theory “Let your monkey do it!”  Meaning monkeys don’t over think their birth.  Monkeys don’t do the labor math.  Monkeys listen to their inner instincts for birthing positions and primal sounds. I have come to recognize and appreciate in order for your inner monkey to have the freedom and space to birth, the gates of inhibition need to be thrown open first in the brain.  Upon feeling safe and secure, the mother can then allow her body to open for birth.  Time and time again, as I have the fortunate chance to speak with birth experts, the idea of fear in childbirth continues to float to the top as a barrier of functional births, blocking the monkey from running loose.

Dr. Sarah Buckley is well known for her deep understanding of the hormonal blueprint of labor and its function of an undisturbed birth.  In order for labor to naturally swing into full gear, the mother’s production of oxytocin must be undisturbed.  If she is feeling fear, unsafe, shame, anxiety, judgement or pressure, the body moves from the parasympathetic nervous system which supports the flow of oxytocin, to the sympathetic nervous system- the fight or flight mode.  In this state of being, the brain signals the release of adrenalin and noradrenaline which will diminish the release of oxytocin, ultimately inhibiting labor.  Also, when in the fight or flight response, the blood is directed away from the placenta and uterus and redirected to the major muscles.  This could affect the blood flow to the baby.  

It is natural to have some fear and apprehension around birth.  The way it will unfold is a huge unknown.  Even for birth attendants, we never know exactly what we will see.  So it is no surprise that there will be some anxiety.  However, even with the expected unknown of labor, a mother can still feel safe and secure in the situation.  It is when the mother feels disturbed, unsafe and harboring deep fears that the chance of labor stalling increases.  So Barbara is right, the mother could move, make sounds and not try to predict the hours left in labor, but if she hasn’t acknowledged and cared for the “birth brain” then things may go quite awry.

Here are some questions to ask yourself to help remove unnecessary and obstructing fear from your upcoming birth.

What are my underlying fears?

Pam England, author of Birthing From Within, invites women to acknowledge that “even paper tigers can bite”, meaning that the sympathetic nervous system is not able to discriminate between real or imagined “tigers”.  The deeper fears that may not even be present during the birth can still steer the birth in an undesirable direction.  England recommends for those scaring themselves or facing overwhelming fear, ask yourself “What am I telling myself” and “Is this actually happening, or am I fantasizing it?”  

Much like Pam England, I believe in taking time to thoroughly examine your underlying fears.  I call this “looking at your skeletons”.  While you may not resolve the particular issue or fear, uncovering it and acknowledging their presence can soften the fear.  As I came closer to the due date with my second child, I had to face the fact that I was terrified of repeating the long, arduous birth of my first child.  As I adamantly protested I just couldn’t do that again, my midwife gently and kindly asked me, “Ok- What would you do if it does turn out just as long as before?”  After a sulky moment, I answered, “Nothing, I would just have to birth my baby as the situation presents itself.”  While it was hard to swallow the possibility of repeating my first birth, admitting my fear helped lessen its grip on me. (p.s.- my second birth was 1/8 of the time of  my first!)

Have I aligned myself with a care provider I trust and a birth posse that will support me?

Hopefully you have aligned yourself with a care provider whose birth philosophy matches yours.  Just knowing that you do not feel you have to defend your birth choices and your care provider respects and supports your birth wishes will take a huge burden off your shoulders.  

Next, take look at the special group of people you invite into your birth space.  When I interviewed homebirth Midwife, Tanya Wills, she said one important criteria to move forward with a homebirth was to have everyone on the birth team supportive of the mother’s choice.  If the partner disagrees with the homebirth scenario, the quiet insecurity and disapproval will be present and disturb the mother’s ability to completely let go.  So while the approval of a homebirth may not be your issue, it is important for the mother to feel secure and un-self conscious with those present to move, act and sound however she needs, to be able to find her inner monkey to birth.

Do you feel safe and confident in the place of birth you have chosen?

As Debra Pascali-Bonaro says, “If your birth plan is your sword and your doula is your shield, you are probably birthing in the wrong place.”  If a mother is walking into her birth with her guard up and trying to defend her way through the rules and protocols of the hospital she chose, she is going to fight an uphill battle.  In situations like these, it will be much harder to let go of these underlying concerns and let labor unfold.  As a doula, I have been asked to be the guardian of the birth space for mothers who did not trust or feel supported in their birth space.  Scenarios like this put the birthing team at odds with the hospital staff who often becomes defensive and can create unnecessary friction and animosity.  It is better to plan from the beginning of the pregnancy to find a place where the mother doesn’t fear her place of birth.

Have you educated yourself about birth, pain management techniques, the process of birth and the interventions and complications that could arise?

While education alone can certainly not predict the resolution of a birth plan, it will allow you to make informed decision and take agency and autonomy of your birth as it reveals itself.  We should not delude ourselves that this knowledge will help us “control” labor- which by nature is it’s own powerful force”, but education can create confidence and remove the fear of what birth looks like and help to build life long coping skills.  

Photo credit: Adelaide Birth Photographer

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