Wednesday, April 15, 2015

Don't Give Me My Baby: Bonding After Normal Birth

There is an old video from Brazil called "Birth in the Squatting Position".  This video, made in the 70's, got under my skin in a huge way and took my studies, explorations, and ruminations upon birth to a whole new level.



It is not the squatting aspect of the mothers delivering their babies that is so fascinating to me.  As a long time doula, I have witnessed many women squat to give birth. I squatted myself (for many hours) to birth my first child, who remained stubbornly face-up (babies normally emerge face-down).  What excited me and moved me to a whole new level of appreciation for the team effort between Birth Giver and Baby were the things we do NOT see in this video.

The birth giver and the baby are undisturbed in the second stage of labour.  However, they are in a clinical setting, which needs to be clear.  This is a medical birthing centre, not just women squatting willy nilly in the woods.  I actually LOVE this aspect.  It demonstrates the possibility that birth givers and babies can have their cake and eat it too, meaning they can be trusted to do their work together without unnecessary distraction AND have the clinical safety net the majority of families want for those times surprises happens.  When disruptions in the normal process are radically minimized, we will likely see an increase in uncomplicated births and a decrease in the births that require a need to get the birth/baby dyad out of a potentially iatrogenic pickle.

So let's look at what we don't see:

1) Nobody is telling the birth givers to lie on their backs.  The intro to the video states that many of the women this clinic supports are very active, and when they get the opportunity to chill out, they so by squatting.  They traditionally birth in the squatting position.  So these women are doing what comes naturally, or are at least being guided to do something that is more ergonomic than the medically preferred semi-reclining (or even lithotomy) position.

2) Nobody is coaching them.  Now granted, most of these are probably not first time birth givers.  Subsequent babies do tend to come out with much greater ease.  However, in my doula practice which consists mainly of people having subsequent babies, the surge of "rush" energy rises in the room like a tidal wave, people charge in, and many voices often help them to "remember how to push".  The squatting birth givers in this video have their need for quiet and concentration respected.   I have no doubt there are some loving murmers going on that we don't hear over the flute-y music, but I highly doubt the "push harder...NO..slow down...NO push more" during the crowning/expulsion phase is going on.

Some people give birth in near silence with great focus simply breathing their babies out, and others give a high pitched shriek, often referred to as the "perineal cry".  If things are moving along well, it is probably unnecessary to tell them to do other than they are doing.  I have seen many birthers told not to scream, directed to bear down and push through that pain even when it is clear Baby is emerging without a hitch.  I wonder if that final shriek often given at the end isn't a natural way for some of the powerful energy to be dispersed, like steam from a kettle, with the result minimizing the force with which Baby comes through, and perhaps reducing tearing.

3) The birth giver's genitals and the baby's emerging head are not touched.  
It is not unusual in a hospital to see a lot of perineal and vaginal manipulation throughout the pushing phase.  It is most certainly with the kind intention to help.  But what we know about stretching things out or fiddling as a default rather than just when there is evidence it is necessary, is that it brings extra blood flow to the area.  This means it can potentially make the area thicker.  For a perineum to slip as gently over the baby's emerging head as possible, a thinner quality of tissue is likely more acceptable (Thank you, Gloria Lemay).  I wonder, though these things are hard to know for sure, if we would have LESS tearing if there were LESS touching.

I have a feeling Baby is often not happy about having its tender, oh so squished little cranium touched while trying like a little trooper to crawl out of the smallest space they will ever be in.  They are working hard.  I imagine it could be very distracting for them.

4)   The baby is not delivered by anyone but the birth giver.
There are supportive hands available to prevent any bumpy landings, as well as to intervene quickly if necessary, and perhaps to provide a little positioning help if a baby has landed on their face.  But given that squatting brings birthing bottoms close to the surface the feet are grounded, a soft place for Baby to land seems to be what's most needed.  Babies do tend to come out, even if there is nobody to "catch" them.

5) Nobody interferes with the birth givers' instincts.
In a lovely effort to get them participating with the delivery of their babies, many birth givers are encouraged to "touch their baby's heads" or to "reach down and take their babies".  This is actually a sweet gesture that many people who birth in a highly clinical setting with monitors, strangers, prescribed positions, etc. appreciate.  I used to encourage this too....until I realized as I observed (which I get to do, not having to worry about anyone's clinical safety) that most people appeared shocked and pulled out of the deep space they were in to follow my direction.

There are deep resources and motherwit within that rich inner wold of the birth giver.  Brain waves shift.  Hormones flow.  There is a primordial blueprint.  The shrieking (if there is shrieking), or thrown back head, closed eyes and perhaps the clinging tightly to someone or something are not generally signs of terror and disassociation.  Rather, they are usually signs that the birth giver is tapping into and riding a massive flow of power.

In this video, we see the women left to their own motherwit, bringing forth life without the external world assuming to know better and exerting pressure upon the experience.

6) and this is my favourite thing of all....nobody hands the birth givers their babies!

The "Birth in the Squatting Position" video suggests, as well as other studies that have observed what humans tend to do on  a primal level when left to birth undisturbed, that placing Baby directly upon the chest or abdomen is NOT "natural".  It is done in the name of "immediate skin to skin" if the hospital wants to appear progressive or simply because the bottom of the hospital birthing bed is removed, so right after birth there is nowhere else for the baby to safely go.

This is a very accepted part of our birth culture.

If you observe, though, which I have, as well as having experienced this myself, there is something that happens when someone claims their own baby.

What generally happens, is that the birth giver goes to a peak level of human experience.  As has the baby.  They are off in realms that are not akin to our normal, every day brain waves.  This is a consciousness that cannot quite be described.  If they are left undisturbed, they will stay in that space for a little while.  I have a belief that in this space, subtle "information" is being downloaded.  Genes are being activated.   Ancestral memories are being evoked. Neural pathways are being forged.  Something is being shaped. It seems like there might be some really important stuff going on that we should probably think twice about messing with.

Watch the women in this video.  They take a few deep breaths, slowly coming back to themselves a little.  When they are ready, they look kind of sideways at their babies.  With one hand first (likely their dominant hand), they touch and stroke one side of the baby (who is to say this type of touching is not part of some kind of important human activating system), and then with the other hand they stroke the other side of the baby.  Within a minute or so, these women are not handed their babies to them, they CLAIM THEM, and when they have emerged from wherever it is they went, they emerge with their babies, stepping into their identities as new parents.

When I teach prenatal classes, I let parents know that likely, unless they say otherwise, their babies will be put immediately onto their abdomens or chests.  Most of them will likely love it and grasp enthusiastically for their babies.  And some will feel shocked.  Why?  Because they are being pulled prematurely from that important place.  If birth givers are not told about this, they sometimes feel guilty, as if they are lacking in parental instinct.  They are "supposed" to want their babies plopped onto their chests by an external source.  I tell them they are simply demonstrating normal mammalian behaviour.  It is perfectly fine for them to wait until they are ready to claim their babies on their own terms (if possible), having the baby supported at their thigh while the cord remains intact, or perhaps handed over to the partner for a few moments.  Or...what if...what if...we did nothing at all but wait and have a little trust?  But definitely not handed over to someone for weighing and examinations unless necessary.

Not all births unfold in such a way that this way of welcoming Baby is possible.  I don't think it's something to worry about if it doesn't happen.  Parents have enough pressure for "perfection" on them, and it is not my intention to add further duress.  I am simply looking at a wider scope of possibility and wondering what could happen on a biological and cultural level if birth were left to unfold with less ownership from external sources when it comes to "delivery",  "placing" the baby on the parent, or "initiating" skin to skin and seeing how beautifully that dyad usually works together to the beat of internal rhythms.  It can totally be done within a highly clinical context if that is important to the parents.

A dream of mine is to see these few precious moments before Birth Giver claims Baby restored to human birth.  I want to see it as understood, honoured, and protected as the important concept of skin to skin has been.  I am excited to explore the impact this could potentially have upon humanity as a whole.  So may it be.

Lesley