The Waiting Game

39 Weeks

It's my due date today... yahoo! 

In the midst of a million emails and text messages asking, "Is it here yet! Is it here yet!" I would like to confirm that only 5% of women give birth on or before their due date. Using my very basic mathematical prowess, that's only 5 out of 100 women. 

What's up with that? 

If most women don't have their babies until they're overdue (past 40 weeks) and women are more likely to be overdue than anything else, it invites an obvious question: are they really 'overdue'?

The concept of a 40-week pregnancy was popularized nearly 200 years ago by Franz Naegele, director of a maternity hospital in Germany and author of a textbook for midwives. In a method called "Naegele's Rule", he calculated the date of birth by adding 280 days to the date of last menstrual period.

 Naegele borrowed this idea of a 280-day gestation from the 18th-century Dutch physician and botanist Herman Boerhaave who created the modern teaching hospital. Boerhaave based his estimate of a 280-day gestation on evidence from the Bible that pregnancy lasts 10 lunar months.

There is one glaring flaw in Naegele's rule. Strictly speaking, a lunar (or synodic - from new moon to new moon) month is actually 29.53 days, which makes 10 lunar months roughly 295 days, a full 15 days longer than the 280 days gestation we've been lead to believe is average!

I'd like to add that Naegele’s Rule assumes that women are having regular periods and ovulating on day 14 of her cycle. Of course for many women, including myself, this isn't the case. 

There is also the assumption that the routine pregnancy is 280 days based on our current calendar system, yet many months contain 30 days or 31 days. And what happens in a leap year, or if you're pregnant over the shorter month of February?

So here's what I'm thinking, Naegele’s Rule seems a bit archaic and inefficient; especially if we are using this dating method to determine the necessity of medical interventions. So what do we “do” with the “due?” date? 

One of the most vital pieces of information to keep in mind when your phone starts buzzing, or you doctor starts at you with a pitocin drip, comes from the the ACOG (American College of Obstetricians and Gynecologists)itself. The ACOG does not recommend interfering with a normal pregnancy before 42 completed weeks. In fact, the ACOG says the following:


“Waiting for the birth of a child is an exciting and anxious time. Most women give birth between 38 and 42 weeks of pregnancy. But very few babies are born on their due dates. It is normal to give birth as much as 3 weeks before or 2 weeks after your due date... The average length of pregnancy is 280 days, or 40 weeks from the first day of a woman’s last menstrual period." 

Did everyone get that? Let me write it again. A postterm pregnancy or a post date mama is once she passes 42 weeks. Not 40 weeks, not 41 weeks 2 days, but 42 weeks is considered post date.

 

This information can help mama and baby avoid unnecessary trauma throughout the labor and delivery. Remember, babies can't read calendars; medical issues aside, most come on their own time and almost always without complication when left alone to be born when they are truly ready.

For more on what ACOG says about due dates, moms can read their Education Pamphlet.

So with this in mind, there are plenty of non invasive natural ways to help to encourage labour and pass the time if a mama is feeling antsy. As far as I know none of these methods have been medically researched or proven, but I've heard they worked for some moms and when you're 40 weeks pregnant and have no-so-much to do except wait for baby to bust out of your vagina... anything helps:

1. Keep Busy.** A watched pot never boils! Wax your snatch. Clean the shit out of everything. Organize the shit out of everything. Read books that have absolutely nothing to do with babies. Pick the crusty stuff off your nipples. Rub oil all over your body. Bake five different kinds of cookies. Talk on the phone like a teenager. Cry into your baby's new soft plush bunny toy for no reason in particular. When strangers ask when you're due, tell them you're not pregnant: you're just fat. 

**I may or may not have done all of these things.

2. Sex, Sperm and Orgasms. If you feel up for sex, it's a great way to help bring on labour. Sex could trigger the release of oxytocin, the hormone that causes contractions. The sperm help soften and dilate the cervix. Orgasms cause contractions by stimulating your uterus. It's fun, safe, and a game the whole family can enjoy! Just don't do 'it' once your waters have broken, OK?

3. Acupuncture. I've talked to tons of moms who said acupuncture brought on labour when they were at risk of getting medically induced. I plan to visit Acumamas here in Vancouver if I hit 42 weeks and baby hasn't arrived yet. 

4. Evening Primrose Oil (EPO). As recommended by my midwife, stick 8 500mg capsules up your nether region to help ripen the cervix. Won't induce labour, but helps soften it and get everything down there ripe and ready to roll.

5. Castor Oil. I don't know too much about taking castor oil personally, but it's supposed you give you the shits and the subsequent bowel movements induce labour. I have one acquaintance that took too much, went into labour within 24 hours, and spent the whole time spraying her medical professionals with poop. 

I think I might shit, I mean sit, this one out if that's OK with you? 

6. Eat Dates! This one has a recent study behind it:

“We set out to investigate the effect of date fruit (phoenix dactylifera) consumption on labour parameters and delivery outcomes… 69 women consumed six date fruits per day for 4 weeks prior to their estimated date of delivery, compared with 45 women who consumed none. The women who consumed date fruit:

    • Had significantly higher mean cervical dilatation upon admission compared with the non-date fruit consumers (3.52 cm vs 2.02 cm, p < 0.0005)

    • Had a significantly higher proportion of intact membranes (83% vs 60%, p = 0.007).

    • Spontaneous labour occurred in 96% of those who consumed dates, compared with 79% women in the non-date fruit consumers (p = 0.024).

    • Use of prostin/oxytocin (for inducing/augmenting labour) was significantly lower in women who consumed dates (28%), compared with the non-date fruit consumers (47%) (p = 0.036).

    • The mean latent phase of the first stage of labour was shorter in women who consumed date fruit compared with the non-date fruit consumers (510 min vs 906 min, p = 0.044).

It is concluded that the consumption of date fruit in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labour, and produced a more favourable, but non-significant, delivery outcome. The results warrant a randomized controlled trial."

Get 'em in ya! 

7. Galloping. Many women claim that imitating a horse can help start labor. Make sure you wave when you see me trotting down Main Street!

(Camel-toe optional)

8. Pineapple. Best taken fresh and raw. Statistically speaking, the chemicals pineapple contains, which are said to start labour, aren't very high. So that means about 7 pineapples should put you into labour. 

Ya, good luck with that.

I'd rather gallop around in tight white pants.

YEEHAW. 

Snip It

Week 38

Nothing (and I mean nothing) evokes more vitriol and controversy on mom-to-be internet sites than the topic of circumcision– the most commonly performed surgical procedure in the world. 

It's a crazy and confusing thing. 

On one hand you have Moms (primarily from North America) citing scary statistics about penile cancer and genital infection rates in uncircumcised boys and men. On the other hand you have Moms accusing parents who circumcise their kids of child cruelty and genital mutilation. So either you mutilate and harm your child, putting him at a small risk as a baby to save the potential of a small risk in the future OR you leave your kid as-is, saving him pain in the present but risking possible complications later in life. 

Heavy stuff, whichever way you slice it...

The funny thing is that until very recently I didn't think circumcision was a big deal. Almost every guy I've ever been with (and trust me there are MANY-- just kidding Mom!) has been circumcised. In my generation around 50% had the procedure done fully covered by the Canadian medical system. Of those I know who have been circumcised, no-one has admitted suffering unduly. Of those who haven't, I have at least one older family member who had to undergo the operation at the age of five due to infection. It was unpleasant, but not life destroying.

These days around 32% of boys in Canada are circumcised. Since 1996 the official position of The Canadian Pediatric Society opposed the routine circumcision of newborns. This year, the Society (after dealing with much of the aforementioned vitriol no doubt) issued a more 'neutral' statement that captured the risks and the benefits of circumcision while respecting personal preferences, religious issues and many other things that dictate this very personal decision. The bottom line is that according to our country's medical professionals: it's OK if you don't, and it's OK if you do. It's pretty much up to you.

To complicate the issue further, the positions of the world's major medical organizations range from considering neonatal circumcision as having a modest health benefit that outweighs small risks, to viewing it as having no benefit and significant risks. No major medical organization recommends either universal circumcision for all infant males or banning the procedure altogether.

So what's a Mom to do?

The reality is that parents opt for circumcision of their baby boys for a host of reasons: religion, culture, tradition (the “I want him to look like Dad and all the other boys in class” argument). What I find interesting is that most of the indisputable benefits of circumcision (aside from an oh-so-slightly lower rate of easily treatable UTIs in the first year of life) are conferred on sexually active adults.

For example, in the U.S. circumcised men have about a 15 per cent lower lifetime risk of contracting HIV. They have a lower risk of contracting syphilis as well as genital herpes, but there is no protective effect for gonorrhea. These differences, apparently, are really only significant in sub-populations that have high rates of infection, such as men who have sex with men and/ or sex trade workers.

It has long been believed that circumcised men have lower rates of penile cancer. Again, this is common knowledge these days, to which I'd like to add a couple of lesser-known important provisos:

1) penile cancer is very rare and;
2) the risk is apparently exclusive to uncircumcised men with phimosis (a condition in which the foreskin does not fully retract).

There is no evidence that penile sensitivity, sexual satisfaction or sexual function varies between circumcised and uncircumcised men.

So taking all this into account, if circumcision really only affects men later in life, why not let adolescent boys and young men make the decision to be circumcised once they are old enough and wise enough to make an informed decision? Is the procedure really so much more traumatic once a man is older?

Apparently not. Excising the foreskin of a man is no more complicated than doing so to a newborn (this argument was made quite forcefully in the Canadian Medical Association Journal) and in fact poses less of a risk for adult males because adolescents/ adults can take better care of themselves and also communicate more effectively than newborns. The main difference of course is that an adult will remember any pain and discomfort, where as a newborn will forget.

At the end of the day I can only say for sure that I agree with The Canadian Pediatric Society on this one. In the words of this cynical mom-to-be: 

You're damned if you do and you're damned if you don't. 

Do whatever feels best for you. Trust your intuition because chances are your baby will be just fine either way. Teach him to be grateful for the gift of life, and celebrate the fact that people are different, that everyone and every body is unique. In the end that's what will make the most positive impact on your kid's life... not what the hell his penis looks like. 

Placenta Pâté

Week 35

The placenta is an extraordinary thing. 

Seriously.  

It's the only organ in our body that is 'transient', meaning it grows and dies for a short period of time. It acts as the baby’s lungs, kidneys, liver, digestive and immune systems while also producing hormones that send messages advocating the baby's needs to the mother's body to maintain a healthy, happy pregnancy. It's also the only organ that's genetically two people- it contains both fetal and maternal cells, which I liken to having half of someone else's kidney growing inside of your own.

I can barely wrap my head around how this is even possible. The simple fact that my body doesn't reject this weighty thing (it's technically 50% foreign genetic material) is crazy enough. Somehow the placenta also 'knows' to protect the baby from damaging substances like alcohol, tobacco, drugs and toxins. The placenta of a smoking mother, for example, will have hard clarifications in it from trying to stop the tobacco from passing through to the fetus. Amazing, right? It's like a guardian angel and an iron lung all at the same time!

So learning all this amazing stuff about my placenta, I have to admit I've grown a little attached to the thing. In Western culture (if you can even call it a culture), we mostly leave the placenta behind at the hospital to be tossed with the garbage or burned as medical waste. Other cultures treat the placenta quite differently. Many ancient cultures believed that the placenta was a separate soul, and treated it accordingly with a ritual burial honoring it's short but productive life. In Iceland, it's held that the child’s guardian spirit resides in the placenta, leading them to name it “fylgia”, which means “guardian angel”. Hardly something you'd chuck out with the trash.

My Doula asked me and my husband if we wanted to eat our placenta. This is something I'd heard about, but not given much thought to mainly because I'm a vegetarian and would rather tuck into a kale smoothy than a hearty dose of organ meat. However, not wanting to throw away this special part of me and my baby with yesterday's extra thick nighttime Kotex,  I dug a little deeper and found out that 'placental encapsulation' is an increasingly common post-natal practice. Essentially, you pay someone to dehydrate and encapsulate your placenta, and then you eat it, one vegan gelcap at a time. NBD.

Those who advocate eating the 'fruits of their labour'  say the placenta contains iron and vitamin B12 and that eating it increases energy and helps with milk production as well as staving off the baby blues. Those that don't advocate placentophagy just say that it's a total waste of time, although with no empirical studies this is as likely as saying placentophagy is beneficial in my opinion.

Here are 6 reasons why I personally will be eating my placenta:

1) I totally want to be that chick who can say I ate my placenta. I am not getting any younger and the list of weird shit I can do in my life will only be getting smaller.

2) All the other animals are doing it. All mammals except giraffes, whales and seals eat their placenta. If it's good enough for Lassie, it's good enough for me.

3)People have been eating placentas for centuries. The placenta has a number of uses in Traditional Chinese Medicine (TCM). It's used to treat fatigue and/or insufficient lactation, but more generally it's used by herbalists as a strong tonic to treat weakness and restore energy and blood. So it's not just for postpartum use; it might also be used for someone who's been ill for a long time and has gotten very weak.
4) It’s real, and it’s whole. Which is more than I can say for half the crap most people eat everyday. I’d eat 3 placentas before I’d eat a McDonald's Happy Meal.

5) Beats the hell out of Zoloft. No one bats an eye when a women starts taking Zoloft to combat postpartum depression. It’s a man made pharmaceutical. Completely unnatural. Sure there are studies that say it’s safe and effective. But you know why there are no studies like that about placentas? Because there’s no money to be made in your special meaty afterbirth.

5)Because I want to. Enough said.

Just Eat It

British celebrity chef Hugh Fearnly-Whittingstall, known for his series of River Cottage programs, notoriously cooked and ate a woman's placenta on one of his episodes. My husband's a chef, and while we've discussed the possibility of cooking up something nice for the family after my long, hard labour, we decided that it would be more convenient to go with placental encapsulation instead. After all, everyone says you don't feel like cooking once the baby arrives! 

Should you wish to cook up your afterbirth though, and trust me some people do, here is a delicious recipe and a handy 'how to' video courtesy of the aforementioned Mr Fearnly-Whittingstall. Enjoy!

Ingredients:

 8 oz (225 g) placenta, rinsed and trimmed

 2 tablespoons Cognac

 8 oz (225 g) butter

 2 level teaspoons mustard powder

 ¼ level teaspoon ground mace

 1 level teaspoon chopped fresh thyme, plus 6 small sprigs to garnish

 2 cloves garlic, crushed

 salt and freshly milled black pepper

For the red-onion salad:

 3 medium red onions, peeled and cut into 8 wedges through the root

 3 tablespoons olive oil

 1 heaped teaspoon light soft brown sugar

 3 tablespoons red wine vinegar

 ¾ level tablespoon wholegrain mustard

 salt and freshly milled black pepper

 

Method:

To make the pâté, take a medium-sized, heavy-based frying pan, melt about 1 oz (25 g) of the butter in it and fry the placenta over a medium heat for about 5 minutes. Keep the placenta pieces on the move, turning them over quite frequently.

Remove the placenta from the pan using a draining spoon and transfer it to a blender or food processor. Now, in the same pan, gently melt 5 oz (150 g) of the remaining butter and add this to the blender or food processor. Then pour the brandy on to the juices left in the frying pan (to capture all the lovely flavours), and pour that over the livers. Now add the mustard, mace, thyme and garlic, season well with salt and freshly milled black pepper, and blend until you have a smooth, velvety purée.

Next, divide the between the ramekins (or pots). Then melt the remaining 2 oz (50 g) of butter, pour a little over each one to seal, press in a sprig of thyme, and leave them to get quite cold. Cover with clingfilm and leave them in the fridge till needed.

To make the red-onion salad, all you do is heat the oil in a medium-sized saucepan, add the onions, turn the heat down to low and let them cook gently for 5 minutes, stirring now and then. Next, add the sugar and 3 tablespoons water, stir well, then pop a lid on and let it continue cooking gently for another 10 minutes. After that, add the vinegar, mustard and some salt and freshly milled black pepper, and give everything another really good stir.

Then spoon the onions into a serving bowl and cool until needed. Don’t forget to remove the placenta pâtés from the fridge about an hour before serving, as both the pâté and the salad need to be served at room temperature.

To Doula or Not to Doula

Week 32

Hubby and I have been on and off the doula train since we found out I was preggers. For those not in the know, a doula is a birth attendant/ labour coach separate from a mother's medical caregiver. A doula offers emotional and physical support to a woman and her partner before, during and after childbirth. DONA (Doulas of North America) explains it like this:

“Women have complex needs during childbirth. In addition to the safety of modern obstetrical care, and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences. The role of the birth doula encompasses the non-clinical aspects of care during childbirth.”

Doula support generally includes:

• Birth education and preparation
• Birth planning (including creating a written birth plan/birth preferences document)
• De-briefing previous births
• Massage and other comfort measures
• Optimal fetal positioning
• Suggesting positions and changes to help ease pain and facilitate a smoother, more effective labour
• Providing reassurance and encouragement
• Talking through emotional blockages which may come up in labour
• Maintaining Ambiance – aromatherapy, music, candles etc
• Assisting with negotiating with medical staff if what the mother and the hospital wants differs
• Photography and/or vide0

The etymology of the word, awkwardly enough, originates from the Greek term δούλη meaning 'female slave'. It was first used in a 1969 anthropological study documenting birthing traditions around the word. Historically, in most societies a cadre of women supported mothers through labor and birth. This was a role usually occupied by female family members or friends. Over time, as our birthing process (in North America at least) became more institutionalized and less community focused, our networks of women with significant birthing experience dwindled to the point where if we want skilled help now, we have to pay for it.

Part of me thinks that's kind of fucked up.

I mean, what happened? Did life get so busy that we forgot how to give birth? Why would I spend $800 - $1200 dollars hiring someone to speak up for me, rub my back, and give my husband a break when I'm off my tits on adrenalin during transition? Isn't that what family and friends are for? Surely we can light our own candles, create our own 'unique' experience, and not have to pay somebody to do it for us.

Theoretically, yes. My husband, family and friends are more than capable of doing all these things and more. However, labour can be-- and most often is-- an intense and personal experience, especially if we don't know what the hell's going on, which most women (especially with their first babies) don't.

Add to that the fact that the average labour lasts eight hours, and that a doula is there for support the entire time. Is it fair to expect my family and friends will reliably do the same, at any time of day or night, with little or no birthing experience, busy jobs, and busy lives? Will they happily rub my feet as I projectile vomit across the room during contractions?

To be honest, as much as my friends and family are happy to help (thanks guys!) I'd feel bad puking on their shoes, and I'd personally feel more at peace having someone else around with specialized birth experience to normalize the whole intimidating process both for me and my husband.

There is also a growing body of evidence that confirms concrete medical benefits to doula care. Studies (and reviews of the studies) demonstrate that working with a doula through birth and labour ends in significantly fewer caesarean sections, fewer incidences of forceps and/or vacuum assisted births, and fewer stitches in one's vagina (hurrah!), in addition to higher self-esteem and less anxiety and depression for the mother at 6 weeks post-partum. These benefits are significant enough for me to believe that a doula would be a worthy investment.

The bottom line is that I know my husband and I could survive the birth of our baby, but this isn't a process I simply want to 'survive'. It's an experience I want to enjoy and cherish as much as humanly possible.

We met with a doula yesterday who has a plethora of experience as a labour coach. She lived in Kathmandu Nepal for fifteen years and gave birth to her two sons in a small clinic there, where she also volunteered her labour services to friends and family. She has deep, beautiful smile lines and laughed freely with us about the fact that my cat attacked the last doula we interviewed, who neither my husband nor I connected with so much. She has experience in everything from emergency caesarians, to water births, to home births, to straight up old-fashioned hospital labour. She was very clear that her role in no way takes away from the father's role, or any other friends/ family that attend. Rather, as someone experienced in the ups and downs of childbirth, she can guide and reassure when needed - especially during the most intense times - so everyone can simply be present and make the most of the experience.

I liked her a lot, and would be happy to pay her very reasonable fee which includes pre and postpartum in-person visits, unlimited phone and email consultation, and in-person care through my entire labour.

She also works for this amazing program in Vancouver: 

http://scbp.ca/ 

The South Community Birth Program (SCBP) was established in 2003 to pilot a unique maternity care system in the under serviced South Community area of Vancouver. Family physicians, midwives, community health nurses, and doulas work together cooperatively (all covered by MSP!) in a community-based, culturally-appropriate, and woman-centered manner during pregnancy, birth and the newborn period.

It's the first 'shared care' program of its kind in Canada, and I hope it catches on. I've saved my pennies and am lucky enough to be able to afford a doula this time around, but I'd argue that most women can't. Should women suffer limited care and an increased risk of serious intervention during childbirth because they can't afford a doula?

I think not. Bring on the doulas I say.

Assume the Position

30 Weeks

I suck at meditating. It's the hardest thing in the world for me. I'd rather run a marathon in a shitstorm than sit for any length of time without moving. It's taken a lot of research, patience, and perseverance to cultivate a regular meditation practice over the years and I still suck at it. 

I always thought it was my mind that was the problem. My brain is like the fucking Swamp of Sadness. My thoughts wander into a bottomless sandpit of doom and literally suck me into oblivion. I’ve battled depression since the ripe old age of fifteen, at times seriously enough to be medicated. Physically moving around, running or practicing yoga asana for example, can help to calm me down. Sitting still with no distractions often makes things worse.  

My dear friend Craig, who I've written about before, was a practicing Buddhist and Zen meditation teacher. He gave me this book and clued me into the fact that it wasn't my brain that was the issue. We often think of meditation (and depression for that matter) as an activity involving our minds, but in truth meditation, and I believe depression to some extent, is initiated by assuming a specific gesture with our bodies. If any one element is out of whack, it's practically impossible for the mind to achieve stillness and clarity. 

What we need to do- first and foremost- is turn our bodies into a cathedral and create space for our minds to follow. Instead of carved stone, the building blocks of the human body are the feet, lower legs, upper legs, the pelvis, the abdomen and lower back, the chest and upper back, the shoulders and arms, and finally the head. If these segments can be stacked on top of one another, the body will be able to sit (or stand) in an elegant and balanced way.

Like so:

A balanced posture requires very little energy to sustain and also allows the body’s major muscles to relax. Subsequently it’s much easier for the mind to relax as well.

I remember the first time this 'clicked' for me. Craig sat me down on his meditation pillow and added additional support under my knees. He adjusted my chin (apparently I have writers neck from leering forward at a computer screen all day) and also tucked in my lower ribs. Once I relaxed into this gesture, I felt like I'd just popped an Ativan: a quiet, dull calm settled into my bones. My body sighed and my mind (finally!) let go. 

That feeling of mental and physical ease lasted all of thirty seconds, but since then it's been easier to 'click' into that space where my whole being can mindfully rest, if only for a short amount of time. 

So here's what I'm thinking… 

If posture can have such a significant affect on our body and mind's ability to relax, why not apply the same principles to childbirth? Surely squeezing something the size of a small watermelon out of my vagina could be made slightly more bearable by assuming the optimal position, no?

Unfortunately mainstream medicine doesn't feel the same way.

More than half of women who gave birth vaginally in hospital in Canada reported that they lay on their backs in labour. Slightly more than one-third indicated they gave birth in a propped up (semi-sitting) position. Is it any wonder that interventions such as episiotomies, forceps and suction births are so much more likely in hospitals?

There are a number of reasons why lying on your back with one's feet in stirrups is not even remotely helpful in opening the hips and pelvis. 

First of all, stirrups are for cowboys. 

Secondly, lying on your back actually decreases the size of the pelvic outlet; it forces the woman to put direct pressure on her sacrum (tailbone) which flexes it upward, forcing it into a curved position which can inhibit the baby's descent. The birth canal is effectively placed in an "uphill" orientation, forcing the mother to push upward against gravity to expel the baby. 

Thirdly, what about gravity? Sitting or standing upright makes sense because of the simple fact that the weight of the baby will naturally pull it down, in, and out of the pelvis.

Optimal birthing positions use a combination of gravity and physiology to relax the muscles, allow the mother's sacrum and coccyx the freedom to rotate backward and consequently create a perfectly stacked 'cathedral' for the baby to pass through.

*insert sounds of heralding angels here*

There are five main types of labor and birth positions that facilitate heavenly pelvic opening. While some are definitely not glamorous, they each offer unique benefits to mother and baby.

1.Quadruped childbirth positions (on hands and knees) are beneficial for back labor, turning a posterior baby, and are often the best birth positions for birthing a large baby.

2. Sitting positions combine the helpful force of gravity with relaxation. A birth ball, rocking, or toilet sitting can be utilized to rest while gravity helps labor progress. 

3.Squatting positions are helpful in opening the pelvis to allow a baby to find the optimal position for birth. Squatting can be performed through use of a birth companion or a tool such as a squatting bar.

 

 

4. Side-lying positions are beneficial for resting during a long labour, promoting body-wide relaxation, and minimizing extra muscular effort. They are best used in the latter stages of labor since gravity isn't able to speed the process.

5. Upright positions for childbirth use gravity to the mother's advantage. They help the baby drop into the pelvis and prevent pressure from being concentrated in a particular spot. They represent the most under-used birth positions. 

 

These positions have been documented historically in cultures around the world. So the lingering question for me is this: if studies confirm that a mother needs to explore her own optimal birthing positions based on her unique physiology and the position of the baby, why the hell are most of us still stuck on our backs with our feet in the air?

The story, true or not, is that Louis XVI wanted to see the birth of his son (something men were not permitted to do at the time, but he was King so he could do what the hell he wanted) and asked the obstetrician if he could place Marie Antoinette on her back with her legs extended to facilitate his wishes. 

The obstetrician realized that this position made things much easier for him - he didn't have to stoop down and look up at the woman, which was not only difficult physically but socially demeaning. So he continued to use this position for delivering babies, and other obstetricians picked up the practice quickly. 

I don't think there was actually a law concerning this, but I could be wrong. In any case, this position has continued to be favoured by obstetricians and used in many hospitals. Midwives continue to favour letting women assume whatever position works best for her.

I can only conclude then, for lack of other evidence, that laboring on one's back is mostly for the convenience of the doctors rather than for ease of passage for unborn child and mother. 

One could argue that maternal death rates have dropped since Louis and Mary Antoinette’s time (though they are actually on the rise in America) so we must be doing something right. I credit this to advancements in infection management and also surgical interventions when necessary, more than ‘advancement’ in birthing positions. 

Just because historic rates of maternal death were much higher in the past they are today does not mean we should not consider historical practices and birthing positions when thinking about labour. 

Our bodies are cathedrals, beautiful works of art. Let's not make this the status quo:

Additional Resources:

While writing this post I came across a book entitled Labor Among Primitive Peoples  by George Julius Engelmann MD that includes some amazing diagrams of traditional birthing positions. It is available in it’s entirety thanks to the power of Google Books! 

TheBusiness of Being Born

SpinningBabies

Givin' It Up...

28 weeks

"There is no worse sickness for the soul, o you who are proud, than this pretense of perfection."

                 - Jalāl ad-Dīn Muhammad Rūmī

 
I like to think I'm  pretty easy going. Life's thrown me a few curve balls and I've managed to stay flexible in the figurative sense by not clinging to things that were never meant for me, and in the physical sense by accepting my body and all it's beautiful limitations.

My ongoing battle- and it's a tough one- has been to try to not define myself (and self-worth) by what I have accomplished. I am not what I do... but who I am as I do it. This involves cultivating a huge amount of self-acceptance, acknowledging that I'm not perfect and loving the shit out of myself anyway.

Having said all that, I realized recently that I'm a bit of a tight ass. I like things just so. I'm a slave to routine. I drink a mug of lemon water every morning without fail, and if I don't practice yoga at least four times a week and partake in some form of writing every day I literally lose my mind. I can't write, relax or socialize unless the room I'm sitting in is clutter free and smells nice. I can't stand it when people are late, nor can I stand it when people don't respond to messages or phone calls in a timely fashion. I check my email about twenty million times a day.

Also as you may remember in my initial blog post, one of the few persistent irritations in my pregnancy so far has been a constant and sometimes debilitating pain in my ass that radiates through my hip and down my left thigh and iliotibial band. I visited my massage therapist twice in 5 days, and both times she commented that my glute and hip muscles were gripping to my pelvis and femur for dear life. Her words exactly:

It's like they don't want to let go.

Hmm. Interesting.

A few weeks ago one of my favourite Vancouver yoginis Shivani Wells gave a very poignant and timely yoga class on the lesson of svāhā, or "surrender". Literally translated from the Rigveda (an ancient Indian collection of Vedic Sanskrit hymns) svaha means "oblation", an offering, or tossing of doubt into the flames to truly let go of whatever ails us.

Shivani let go of a lot recently. She suffered a brain injury while teaching a meditation class. She spoke very candidly about the decisions she's made, giving up teaching for long periods of time and dropping out of school to give her body a chance to heal. These are brave and difficult choices and I was overwhelmed with gratitude that she chose to share her struggles with us so openly. 

As I breathed my way through Shivani's class that day, I couldn't help but notice the the pain in my behind. I'd been taking it easy, modifying my regular yoga practice more than I knew was necessary. And yet there my butt was, literally screaming for attention every day. In the safe space of my worn out old yoga mat, inspired by Shivani's bravery, I finally started listening. My ass had something to say.

I need to let go. I thought I was embracing my pregnancy, but I'm not. Not completely. 

For example... what if at some point in my pre or post pregnancy I needed to give up yoga? Would I be willing to surrender, or would I grip even more tightly to the person I wanted to be, fighting to practice asana gracefully through labour and beyond. Would I hate myself if all I did was sit in bed for three months and stuff my face with Betty Crocker Super Moist Yellow sponge cake and canned chocolate icing? I probably would. So what does that say about my philosophy of self-acceptance?

Not so bendy flexy now are you Christina.   

And it's not just about yoga. I decided to take a year off school, forget about my M.F.A and focus on being a new Mom. I made the decision knowing I could still work on other projects and turn my attention towards my degree next year. But what if I couldn't? I've picked up a project already, collaborating on a new film festival screenplay, which if successful would have us attending workshops a few weeks before the baby is due. We'd start filming in January. I figured I could do this no problemo, but what if it doesn't work out? I have no idea what my labour and post pregnancy will bring. I could be an exhausted mess, struggling to get through the day with my eyes open never mind creating a worthwhile cinematic collaboration.

And so in the silence of savasana I realized my biggest fear of all. What if in the end I accomplish nothing more significant in life than being a mother. In all honesty how would I feel about myself then?

In all honesty I'd feel really shitty. I don't want to only be a mother. I want to be a writer, yoga teacher, and PHD student. I want to make movies and fly to LA to pitch my first TV pilot. I want to publish my first novel. All these dreams may not, at least initially, fit with my experience of motherhood. It's not that I'm not excited to be a Mom. I'm just maybe not as OK with myself as I thought I was. My self-worth definitely still hinges on my own perception of success over experience.

 
So this lesson of surrender is an important one, at least for me as a new Mom. Surrender does not mean giving up, it means letting go of whatever expectations you may have of an experience so you can truly appreciate the experience itself. Maybe my yogic and creative journeys won't take the path I thought they would take, but that's life. If my path changes, it will be because there's something better out there for me. I'm not giving up my dreams, I'm just surrendering to a future I never imagined was possible.

And you know what's kind of cool? Even though I'm still anxious about what the next year will bring (whether it be as a writer or a yogi or a Mom) since I've been embracing this idea of surrender, the pain in my ass is gone. It's been replaced by a warm fluidity, a calm and quiet acceptance that I am much more than my accomplishments. Even if I struggle as a parent, don't write anything but a few shitty Haikus for a year, forgo my healthy plant-based ways and eat nothing but processed box cakes, I'm still a good person. I'll still be OK.

Svāhā xo