Saturday, May 10, 2008

Intervention and support in difficult childbirth

More thoughts on how we give support in a long or difficult labor.

Too often, birthing families are pressed between the policy and the clock. Care providers are concerned with how a labor looks on paper, in the chart. How will this labor look in court? Their concerns overshadow the relationship they have with the mother and the mother is forced to submit to their comfort in their career. Suddenly we hear Dr.s, nurses and midwives yelling or cheerleading.

This very action pushes them further from the mother. They separate themselves from the mother by their perspective of what can she do for them, rather than what can they do for her. Can she hurry? Can she agree to intervention? What will I say at the desk? How will I chart this or write my report?

How can the busy hospital nurse, doctor or midwife support the birthing woman who is experiencing a long and/or difficult labor? It may be that they have to "act as if." They show a calm and trusting face to the woman. They sit down across the room from her and enter in to the rhythm of breathing. They smile, that half smile of contentment with what is occuring.

Of course, I am talking about when labor may be long, but there is no emergency. If you are reading this with strain and thinking, "but what if?" I would invite you to take a deep slow breath and let go of the adrenaline through which you filter birth. Breath in the endorphine state that gets babies out. Adrenaline holds babies in. Why would an entire culture of birth surround itself around the substance known for labor dystocia?



On the other hand, too much help can be distracting, too. The mother surrounded by too many caring people has to filter their words, actions and sometimes, chatter. They prop her up with morale building effort.

There are times in a long labor that a mother may have to go within herself to reflect. So support in a long labor can be required to ebb and flow. Rest is necessary, mentally as well as physically. The support person or people must be able to observe the needs of the mother, before she does, and adjust themselves accordingly.

The father may be present or not, depending on the situation, this discussion doesn't exclude him. The mate, both calm and attentive without asking too many questions, can be the determining factor in whether a woman feels safe to continue a long, challenging labor.

One constant person is often required. If so she needs to be in that midbrain state of the rhythm of labor. The mate may need her presence to model his. He observes and absorbes her calm. He falls into the rhythm of breathing, at least, when reminded.

Sometimes rhythm is missing from the labor, as sometimes happens when there is an asynclitic presentation, even in a calm, trusting laboring woman. Then that calm, mature woman becomes the rhythm. She holds the concept of peace and birth within her eye. Her breath reveals the rhythm, as does her movements and her half closed eyes that gaze beyond the woman.

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Changing the Earth by supporting Birth

Mothers bring forth life; medical corporations do not. Birth can be simple, powerful and loving. Fetal positioning, natural birthing and practical help for normal birth.