The woman who taught my Doulas of North America (DONA) training course was kind enough to allow me to post this to our blog. She is an accomplished doula, doula trainer, and author. Besides her passion around childbirth, she is also a dedicated state representative for District 16 in Arizona. She sent this message to an SPB student who she knows through her political career.
GUEST BLOG POST
by Kelly Townsend, CD (DONA)
There is a psychosomatic approach to childbirth that is often ignored in the United States. Over in Sweden and other parts of Europe, Psychosomatic Obstetrics and Gynecology is pretty big, and it’s no surprise that they also have the best maternal and fetal outcomes over there.
The thing is, the uterus is affected like the heart is during stressful situations. When you are startled, your heart beats faster, right? Much the same, when there is any stress, fear, tension in the muscles, etc., it sends a message to the sympathetic nervous system that there is danger present (not really, but this is the response to fear during birth) and the body goes into an effort to "protect the baby."
The myometrium is the muscle of the uterus. It is one muscle with three distinct layers, each with its own responsibility.
BUT – the inner layer also becomes rigid during times of stress. Like the heart beating faster, the inner layer fights the outer layer and tries to stall the birth, protecting the baby from whatever is causing the mother to worry or be tense. Thus, labor takes longer.
This is the only time in the human body when there are opposing muscles working against each other. All other muscles work in tangent, one relaxes while the other contracts (think biceps and triceps). When opposition happens within the uterus it slows down labor, and it also causes pain.
Try this example: Have someone try to extend your arm while you are making a muscle. If they have any strength, it would start to hurt after a short while because you have resistance on your muscles.
Just the same, the uterus starts to hurt quickly after this process starts. So then contractions become painful. And the laboring woman gets scared and tenses up because it hurts. And that tension continues the inner layer's resistance because the "danger" is intensifying. It’s not really danger, it's the fear+tension. Since the body doesn't know the difference, it causes the inner layer to get rigid. And so begins the vicious fear-tension-pain cycle.
How to fix it? Well, first: what do you do to counteract the heart beating fast? Slow deep breaths! Hence, this is why we breathe deep and slow from the abdomen during birth to enter a state of deep relaxation. Childbirth classes will tell you that this is important, but during labor, if the woman doesn't know why it is so important on the inner layer of the uterus, she can be tempted to throw it out the window. So it is a fantastic incentive to remain very relaxed and calm, with tranquility as the goal.
Second, the positions she uses and the environment she is laboring in can influence her feeling of safety. She can use upright positions, total relaxation, the tub, soft music, dim lights, etc., whatever it takes so that she can feel safe.
And let me say this now, if she doesn't feel safe where she is – whether it be on a physical, mental or emotional level, that inner layer is one heck of a fighter and will stall the birth. My hunch is it can even prevent someone from going into labor.
A woman has to be safe and secure in order for that inner layer to relax so the outer layer can be relaxed. Something as simple as a loved one not being in town yet can keep that inner layer rigid. And something as emotional as prior abuse, or some kind of relationship conflict with the husband or other family dynamics; really any emotional "hurdle" that has to be overcome can cause a mental hold on labor and delivery.
If you are Christians, I can also provide you with a ton of spiritual ideas to help in this area. There are scriptures and/or prayers during birth that help.
Anyway, as the coach your job is to help her stay as calm and secure as possible. Use as few words as possible during active labor/transition, because hearing and absorbing words takes effort and that distracts from her staying in a tranquil state. Instead, tell her before hand if she tenses muscles, you will gently touch them and that is a signal to her to release the muscle. Tense muscles = tense inner layer of the myometrium. So a wet noodle kind of approach if at all possible.
If you find that labor is slow to start, ask her if there is something that she is worried about or not yet ready for. And then at the end of the day, ask her to tell you when she is ready to surrender to the process. That word surrender - it is the one word that sums up childbirth on her part. Many things you cannot control during birth, but that is the one thing you can control and that is surrendering. Kind of paradoxical.
Blessings to you and happy birthing!
You can check out Kelly’s book on Christian Childbirth HERE.
What has been your experience with your uterus, safety and surrender in childbirth?
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