Sm(all) Blessings Blog

The only thing about birth you can really control - your inner atttitude

Jai Ram Kaur Hergo - Wednesday, July 16, 2014

 

The previous post I wrote on this blog was about choosing your care provider for birth. There's much that can be done to create an EXTERNAL context which is as supportive as possible to you during pregnancy, birth and beyond. In fact, in life in general, right? Genuine, caring relationships in life, an occupation that is meaningful, a physical environment that lets you relax and feel secure on a material level. All these and more are factors which are supportive to happiness and contentment.

 

But are they the CAUSE of happiness and contentment? Is it also possible to feel happy when the outer circumstances are not ideal? I certainly hope so, since how often do we experience “perfection” in our life circumstances? How much is life rather more a coming and going, in a state of perpetual change and flux? Whether it's things like losing a job, a friend, moving house or challenges in relationships or as a woman the effects of the continual cycling of the moon and your menstrual cycle, or during pregnancy the wilder flux of emotions.... change is the only constant. And yet, don't we invest energy into trying to make things stable? Trying to bring about more of what we like and less of what we don't like? How successful are we ultimately in this? Is there another way?

 

There's a great saying: “Relax. Nothing's under control.” This suggests a paradigm shift. And this is what I want to write about today.

 

How liberating! Many women when I ask them in Mama Baba Yoga, when they come back to yoga after the birth, about what their journey of becoming a mother has revealed or taught them so far, say a similar thing: becoming a mother is showing me that I am not in control. And imagine! Almost all women say that this understanding comes as a relief, a source of relaxation and pleasure.

 

So while you can have a great deal of influence on the outer circumstances of the birth – where it is , with whom, under which conditions and in which atmosphere – you will never be able to control it completely. The person you were counting on to be there can't be there. Something comes up during the birth that means an intervention becomes necessary, you are held up in traffic, someone in the room is in a bad mood.. Uncountable factors subject to variation. What is the ONLY thing you can control?

 

Your mind.

 

Do you have control of your mind?

 

If the answer to this question is anything but an emphatic yes you belong to the vast majority of humanity. Your mind is the fastest thing on earth. Yogis say a thousand impulses are released from your mind per second, some of which become thoughts. Your mind is super active, a measuring, analysing, comparing, assessing tool, without which we couldn't exist in this world. But are you your mind? Are you these thoughts? Or are you something beyond your mind, bigger than these thoughts, or a context for these thoughts? Thoughts are constantly changing and moving. Is there anything that is still?

 

In yoga we say the mind is there to SERVE the soul, so we cultivate mastery of the mind and recognise its limitations. We practice quietening the mind so that in the stillness the truth that is always there beneath the movements of the thoughts can be revealed. Thoughts produce a lot of turbulence, like choppy water, stirring up sand or mud, making the water cloudy. It is then not possible to see through to the bottom of the water. By stilling the mind the waves subside, the water becomes still, and the treasures always lying there on the bed of the sea, waiting to be discovered, reveal themselves. So in meditation, having done the work of quieting your mind, what may well reveal itself is a quiet inner joy. How amazing. Under all the commotion, a quiet inner joy. A spaciousness that you crave.

 

This is what is meant by happiness that is not dependant on outer circumstances. And cultivating your access to this inner calm and contentment is in my opinion the BEST THING YOU CAN DO to prepare for the birth, but also to prepare for the challenges and joys of being a parent.

 

How? Let me highlight a contrast in 2 ways of being. In one way of being it is rather a way of doing. Our nervous systems are in a constant process of balance and adjustment. The sympathetic nervous system reacts to stress. Stress in itself is a non-emotional, neutral things. There are stressors in life – things that call for a response on our part. In ancient times the stressors were threats to our existence – wild animals, enemy tribes, threatening imbalances in the elements. These days they are traffic, job stress, unrealistic expectations, financial issues, overstimulation etc etc. Our stressors are further removed from the basics of survival. They are mostly not existential threats. And yet, we get very stressed. How is that?

 

This is not the place for a deep look at modern life, but the mechanism and message is the same: it is not the stressors themselves that matter, it is our REACTION to them that matters. And those reactions happen in our minds. Is it traffic that is stressful? Or is it the thoughts that follow that create the stress? Here I am wasting my time! How many years of my life will I spend sitting at red lights? I'm going to be late. What will happen when I'm late? I've been late 3 times this week! Maybe I'll lose my job if I keep being late! Etc etc etc. And what is happening in your body while these thoughts are coursing through your mind? A tightening in your chest? A closing in your throat? A hunching in your shoulders? Your heart beats faster, your blood pressure rises. You feel stressed, like there's not enough time or space and the pressure is mounting.

 

In short, your sympathetic nervous system, the fight or flight response, leaps into action, to get ready to attack or defend. And yet, where is the enemy? Your mind has created this reaction out of the situation and is engaged in shadow boxing. It may or may not be true that your being late will have consequences, but certainly the WAY you RESPOND if this happens will be influenced by how stressed or not stressed you are about it. In other words, your experience of reality is totally subject to your reactions to it. Others also respond to us by taking in the state we are in and in turn reacting, so it creates a chain of events which then take on a certain reality in appearance.

 

In default drive, the sympathetic nervous system kicks in. We get stressed. We know this. At least if it's not pleasant, it's known to us, and in this way, paradoxically, somehow a “safe” situation. What is less known to most of us is the alternative.

 

What IS the alternative to letting the mind react and run riot, creating a physiological reaction of stress and even fear? The alternative is to RESPOND. Respond is very different to react. The main ingredient that makes the difference is....... AWARENESS.

 

This is what all yoga is about. Awareness. Slowing things down so that we have a CHOICE. We can't control outer events, but we CAN choose our RESPONSE to them. When we respond rather than react, we create an opening in our EXPERIENCE of the rush of events, a pause, and then... we have a choice.

How to get to this more spacious space, where there is choice? The easiest way, the common way as a golden thread through all practices, whether ancient, spiritual, modern, scientific: the breath.

 

The breath.

 

On the inhale when you are aware of inhaling you balance your sympathetic nervous system.

On the exhale when you are conscious of exhaling you balance your parasympathetic nervous system.

In stead of fighting events and the stress that reaction in default drive, the absence of awareness, brings, we simply BE WITH what is happening. And we stay with what is happening, in awareness, by staying with the breath. Consciously inhaling, consciously exhaling.

 

This, friends, is the most direct way to influence your mind. Use the breath, slow it down, make it conscious and deep, and within seconds the chop caused by turbulent thoughts in the ocean of self begins to calm. After a few minutes, miracle of miracles, you may even find that underneath the chop and turbulence was always a feeling of calm and okayness. From this perspective, in this psycho-physiological state, things look very different. Much more manageable. New and creative solutions may even rise up out of the depths. Solutions the mind could never arrive at with its thinking. Which happens first: the mind slowing which then creates more balance in the nervous system, or the nervous system balancing, which creates more calm in the mind? Who knows? Does it matter if it works?

 

These days this practice of BEING rather than DOING, of slowing down and being aware of your breath, of noticing all the sensations of your body and seeing thoughts arise and letting them pass away without attaching to them or feeding them, is called Mindfulness. However, humans have always had minds and this is really just a packaging of truths that are eternal, not specific to any one time or space. In essence, instead of running and chasing and doing and trying to solve, you STOP, BREATHE, FEEL and BE. That's meditation. And meditative mind is by nature intuitive.

 

This brings us to the how of being with birth. Being with birth.

Birth is a process which we can't control. Birth happens not in the modern neo-cortex of the brain, but in the limbic part of the brain, which is much older. It is emotional and instinctive, not rational and logical. You don't DO birth. In birth, all you have to do is stay connected to that older part of your brain. Everything will happen then. And you do this through your breath.

 

No doubt, birth involves very strong sensations. Intense contracting and expanding of uterus and cervix in a wave like pattern. The best analogy for birth I have found is that it is like surfing. Each surge or rush comes (aka contraction) and it is your choice as to whether you will ride the waves, fight them or try to get away from them. I can tell you, as you instantly know yourself, that the first option is the only one that really works!

 

So how? One thing is, and this is a thing you can practice to great effect all through pregnancy, to learn to not fight the sensations. What you resist persists is the eternal truth to look at here. As I said above, our minds tell us we should avoid all discomfort if possible, and yet the more we fight against things we don't like, the stronger they seem to become. We turn our experiences into the enemy and then we fight. This is just an assessment of the mind. How could sensations that are part of getting your baby out into the world be the enemy? They are the friend!! Just turning your perception around in this way will make a HUGE difference to how you EXPERIENCE them. YOU CAN CHOOSE.

 

So this is why in pregnancy class we practice the birth preparation exercise. It is a challenging arm exercise in which strong physical sensations come up and you learn how to BE with these sensations, without avoiding them. What you are invited to learn, is that when you open yourself to and accept ALL the sensations – and feelings – that you have, they can be revealed as not the enemy at all. A sensation that you welcome, allow and embrace will transform. Consciousness, then, your conscious choosing of your RESPONSE, creates transformation. By staying open and curious (states which the hormone responsible for the rushes, oxytocin, naturally brings about), the sensations can be integrated into your overall experience in a whole new way. You RESPOND with awareness to your experience, you BE with it, just as it is. More than REACTING to or trying to DO something to get away from the sensations of birth, experiencing yourself as being reluctantly dragged through it, you become an active, willing participant.

Luckily, you have a load of help for this, coming from your own internal hormone cocktail. I have written other posts about this cocktail. Oxytocin is the hormone of love and connection. It makes you open, curious and empathetic. You can be empathetic with your self! Kind and compassionate with yourself. The more kindness and compassion you can bring the more beautifully you will sail through it. Kindness and compassion create an oozing of oxytocin, therefore stronger, more effective surges of waves. Oxytocin is also combined with vasopressin in the birth, which makes you courageous. You will need courage to rise up to meet the strong sensations of birth and not run away, to stay breathing and present throughout. BUT IT WILL BE WORTH IT.

 

Added to this you have during birth endorphins – nature's pain killer. Each rush comes like a wave (a SIMULTANEOUS contraction of the uterus and expansion in the cervix) AND BETWEEN THE RUSHES ARE PERIODS OF REST! Capitals because we normally emphasise the rushes, whereas you spend MUCH more time during birth between waves than actually riding them. MUCH more. Anyone who has really surfed knows this. And so what is happening then? Well, in reactive, fight/flight, fear mode, in between you will be suffering from the last wave, anticipating the next painful one, contracting in your mind and body rather than opening and expanding, feeling overwhelmed and stressed, even panicking and trying to get away from the experience. Is the next rush going to feel more or less painful? Right, more. Alot more.

OR, you are resting. Recovering. Opening. And enjoying! Yes, enjoying. It is a high, a good, happy feeling, with those endorphins and that oxytocin running through you. So you can relax and savour it. Enjoy the peace. Really drop into the peace. Be with your breath, your true friend and golden thread throughout. Consciously inhaling and exhaling, balancing your nervous system, calming your mind, bringing loving kindness to every cell and to your baby's every cell. Maybe even going to sleep for a few minutes, later in the birth when you may be tiring. And when the first signs of the next rush come, welcoming them, allowing them, saying yes to them. Breathing consciously to stay present, riding to the peak of the wave and then gently surfing back down the other side. The actual peak will only last a few seconds. Most of it is building and subsiding. And then resting at the bottom of the wave, basking in the peace until the next one.

 

That's all you have to do. Sounds easy right? Actually, if you stay in the moment it may not be easy exactly, but it certainly is a challenge you are up to. Certainly. The problems only come when you start listening to your mind and fearful or resistant thoughts, which creates an imbalance in the sympathetic nervous system and a physiological state of fear in reaction to danger.

 

So while nothing is under control, THIS IS TOTALLY UNDER YOUR CONTROL. It's the only thing that is under your control, but it is also the most significant thing in determining HOW you will experience the birth subjectively. Wow. That's pretty cool.

 

Big news: This is also a NO MATTER WHAT scenario. It is not true only under certain conditions, but UNDER ALL CONDITIONS. So if something should happen before or during the birth that you hadn't planned for and thought you didn't want even, you can STILL choose what happens next on an internal level. Will you react, letting your mind add all sorts of layers to the facts of reality, jumping fearfully into what ifs in the future or replaying unhappy scenarios from the past to prove its point, or will you simply stay present? If you can stay present in this present moment and breathe consciously, I promise you your perspective will change. There may well still be emotions of disappointment, fear, anger, sadness, and they are all welcome and have their place. So allow them to be there, be kind and compassionate to all that arises, breathe, create an opening in the rush of events.. and from here take your time to respond. You will never regret a response, because in responding you are really giving yourself a chance to draw on all your inner and outer resources accessible in that particular moment to respond to the situation. In reacting you are not giving yourself time to consider deeply. Your deeper resources are not available – your creativity, true intelligence, wisdom, compassion and strength – and nor are you likely to investigate and possibilities and consult about alternatives on the outer level and so you make a choice that is not really a choice. THAT, you may later regret.

 

So this is in no way suggesting there is a perfect birth to aim for and anything else is a failure. Not at all. This idea is, when you think about it, also a construct of the mind that wants to control things, which as we have seen is a flawed premise for living. We say in Kundalini Yoga humanology that the soul of the baby chooses you, in full beyond time and space knowledge of all that you are, so from this perspective there is a level that is entirely out of our control and even comprehension and yet perfect just as it is. Reactive mind cannot understand this, but responsive awareness can certainly apprehend and touch it, and FEEL a sense of understanding and acceptance. Which brings peace. Even leaving soul out of it, the choice as to how to respond is still always there.

 

So let all this encourage you deeply. You will be getting the sense that developing a conscious habit that breaks the habit of default drive could bring a great deal of richness to not only birth but also to the life you already live, and to the life that lies before you as a parent. For what do our children need from us more than anything, more than any special pram, carrier, bed or toy? US. Our presence. Our awareness. Our loving, open attention and kindness. Pregnancy and birth are the training ground – a blessing and an opportunity, NO MATTER WHAT.

The Process of Choosing a Health Care Provider

Jai Ram Kaur Hergo - Friday, July 11, 2014

 

Very likely you are reading this because you are pregnant. And perhaps you are thinking of joining pregnancy yoga classes with me. Have you already thought about who will be your care providers for your pregnancy and birth? Or are they already chosen?

 

In this post I would like to share some things with you that may help you a.) in choosing where and with whom you would like to give birth or b.) in building a relationship of trust with the care providers you have already chosen.

 

But first, why is this important? If this is your first pregnancy, where everything is new and you have no measure from past experience, even the context that gives rise to this question might not be clear. So here I will try to help you into a place from where you are more aware of what is informing your choices and how you may be able to influence outer circumstances to make them most conducive to what you want, which is a healthy, happy baby and a healthy, happy you.

 

Many of you reading this will I suppose also be intending to have a birth with minimum to no medical intervention, so I would like to support you in this. There is much that can be done from WITHIN yourself, to help create the context where this becomes more possible, and this is what we practice in my pregnancy yoga classes. Ultimately, so much is OUT of our control, so the best thing you can do is to prepare for the unexpected and develop attitudes and skills that will help you, NO MATTER WHAT. AND there is also a lot that can be done on an external level to help create an environment where a birth in which you are aware and present and peaceful becomes simply more likely.

 

By the time women come to my classes they have most often already chosen a health care provider and where they will birth (waiting lists are often long and you have to move fast!). So hopefully here I will catch some women who have not yet chosen.. as well as, as I said before, giving some tips as to how to maximise the good in the relationships if there are no other alternatives.

 

For many women, birth will happen in a hospital. It's a good idea to visit the hospital and take the tour. Get a feeling for the place and the staff. You can then ask your questions. In general, hospitals are systems which operate according to procedures and schedules. This by nature puts the hospital as institution at cross purposes with the process of birth. In her great book, Mindful Birthing – Training the Mind, Body and Heart for Childbirth and Beyond, Nancy Bardacke highlights the difference between Institutional Time, which hospitals follow, and Horticultural Time, the time inhabited by a pregnant woman and her baby. Horticultural Time has its own inner logic. It is nature-driven. A seed is planted and if the ground is fertile and the conditions are right it will grow. 9 months that seed is nourished into a plant in your womb. Nature ripens in its own time and eventually when the fruit is ready it will drop from the tree. This is not a process that can be manipulated or pushed, any more than nature can be pushed. We are learning on a global level what happens when nature is pushed.

 

In the process of pregnancy and birth we are asked to approach the experience in a certain way – to be patient, humble and allowing. Each fruit (baby) has its own time, a result of a multitude of visible and invisible factors. (In this analogy the sunshine comes from the love from your heart and the other hearts that shine on this baby.. a topic for another day!).

 

The hospital system will try to influence nature with various interventions. This is not to say that medically trained people do not have the well being of you and your baby at heart. They do. But just as we are likely to go into auto pilot mode and do things just because we haven't considered alternatives or whether that thing is really the right thing at the time, so do they tend to go on auto pilot. An intervention applied just because it is procedure can have negative effects on the process. Just as an intervention applied as a result of a mindful and considered choice, that is applied with wisdom, has the potential to very positively influence the process. It is never the case of one thing is good and another bad. There is no substitute for mindfulness in each moment, as each moment has never happened before. This is what systems and institutions by their nature do not have programmed into them.

 

So when you go on your hospital tour, you will want to find out how much you can influence the process.

 

  • For example, asking what the caesarian rate is in the hospital is important. The World Health Organisation says 15% of births as caesarian is reasonable. In many hospitals in Australia, one third and sometimes higher is more likely.

 

  • Ask about induction and when the policy is to induce. These days women are increasingly being induced before term. Studies clearly show that babies born when they are ready to do so suffer from many less problems, particularly respiratory, during and after birth. Also, induced labours are twice as likely to end in caesarian.

  • Also ask about the use of sintocinon, the synthetic oxytocin used to “speed up” labour.
  • I have written another post on the relationship between sintocinon and epidural and the natural hormone cocktail in birth. Some hospitals use sintocinon as a procedure. Used wisely, it can help speed up a stuck or slow labour. It can also cause stress for mother and baby, bringing sharper contractions and therefore increasing the likelihood of the need for epidural. So it is good to ask how the hospital views the use of it.

  • Also ask about foetal monitoring. If you are permanently hooked up to a machine this will limit your mobility, and in labour being upright and able to move is working with gravity and ensures a rich blood and oxytocin supply to your baby and womb. It can also be distressing to feel stuck. Can you be monitored intermittently, using a Doppler? This is a hand held device for hearing a baby's heartbeat as it responds to contractions or rushes or surges.

  • How about vaginal examinations? Having someone roughly investigate how dilated you are can actually cause your cervix to contract as a reaction, so enquire how often they are deemed necessary. Experienced midwives can tell how dilated a woman is by other signs. If the hospital will not err from policy on this, you (your partner or assistant) can ask the examiner during the birth to be very gentle and breathe expanding breaths during the exam, visualising an opening and softening happening at the same time.

  • What is the policy on eating and drinking in labour? Sometimes a hospital will forbid it, so that you will have an empty stomach in case you need to have a caesarian. However, being able to eat if you're hungry – something light and easy to digest like fruit or light soup – will keep your strength up. And drinking liquids is also very important. Having fluids through a drip will also limit your mobility.

  • How about after the birth? These days it is more widely understood, as it was in the further back past, that waiting for the cord to stop pulsating before cutting it delivers precious blood, nutrients and antibodies to the baby. What is the policy on this and if it differs to your own view, is there flexibility? How about skin to skin contact? The sense of touch being the first language of a baby, how precious it is for your baby to feel on its skin your skin, feel your warmth, hear your familiar heartbeat. Putting your baby to the breast for the first time within the hour after birth significantly increases the chances of you having no problems with breastfeeding and is a strong factor in that first bonding between you. Is the hospital prepared to wait before doing tests, giving injections etc. Also, find out what exactly the procedure is here, so you can research what these things are, in order to ask yourself if they are really necessary or if there are alternatives.

It must seem like a lot! And a lot of work. It is certainly possible to have a wonderful birth with minimum to no intervention in a hospital, with good relationships with staff, but to look at it very honestly: this is work you will need to do, energy you will need to expend, to make it possible. There are many factors and evidence to strongly suggest that it will not happen by default. That's just the reality. This is nobody's fault, and no need to get angry or upset about it. We are all humans in this together, each on our own particular journey. AND there is also no need to give over the power of choice. There are other possibilities.

 

You may as a result of a visit to the hospital (or conversation with your obstetrician) find that there is too much of a mismatch for your satisfaction. Pay attention to your feelings during these conversations. If you feel comfortable in asking the questions, if you feel heard and welcome, this is a good sign for you. If you feel concerned or anxious that your views will not have a place in this setting, or that there may be no room for negotiation, go home and take time to consider whether there are alternatives. There is no right or wrong. Only by listening to yourself will you find the right way FOR YOU.

 

If you do feel that there is too much of a mismatch between you and the hospital, there are alternatives. There is in Perth the Family Birthing Centre, which provides midwife led care. If you are not in Perth find out if there are birthing centres in your area. In general the midwifery model of care is more Horticultural. It sees the woman in the centre of the process and is THERE for her, in her process. It emphasises the BEING over DOING way. BEING there for the process and giving it the TIME it needs, rather than thinking what needs to be DONE to move it along to fit into the procedural framework.

Here in Perth there is also Community Midwifery Centre, which provides midwife support for home birth and also a Domino programme, where your midwife accompanies you to the hospital.

 

Or there is the option of having a Doula – a trained birth assistant (not medically trained as a midwife, but aux fait with hospital procedures). She will be with you all through the birth and serve as an advocate for you in interface with medical staff, so you don't have to worry about this. She can also keep a close eye on you so that if an intervention might be wisely applied at any given time, she is in a position to recognise this and pose it to you so that you can decide together. In a hospital you will likely not have this kind of continuous care, as shift midwives will come and go. Evidence shows that women who have one person continuously there to support them (aside from the partner, who is mostly not trained) are much more likely to come through the birth without intervention.

 

A Doula can also be there for you after the birth, visiting you in hospital and at home and supporting you with breastfeeding. Simply knowing someone is at your side can be immensely helpful. She is definitely someone who follows the Horticultural Time way of thinking and is probably a strong advocate for this, since she has chosen this path for herself.

 

On a last note, my wish is that all this empowers you. I have come to see the whole process of preparing for birth as a kind of a modern rite of passage. Collectively, historically, we humans have come away from the view and experience of womanhood and motherhood as something natural, wholesome, divine and powerful. We women have contributed to this too. So going through this process CONSCIOUSLY and choosing consciously can for some women be a kind of reawakening to their own sensitivity, intuition, inner strength and capability to influence events. Not control events, but influence them. In fact, a huge lesson seems to be to learn that we are not in control. So much can happen in birth that is out of our control. So it is about creating as much of a conducive environment as possible, without it needing to be perfect.. and then letting go.

 

And this is where your own inner experience comes in. This is perhaps THE most valuable lesson of all: when you learn that no matter what, you can choose where and how to focus, when you learn that through your breath you influence your body and your mind, that you can find peace and calm in the midst of a storm, that happiness is your natural condition, no matter what... you have conquered your mind. And when you conquer your mind, you conquer the world. Not in a dominating way, but in the way of mastery. And this, dear women, is the highest skill you can take into life in general, and into parenting in particular, where emotions will run high, things WILL get irrational, and you will be challenged. To be able to breathe, find your centre, be strong and at the same time let go. In this way, birth is a training for life.


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