I think you can guess from this blog that I’m a bit of an analyser. I enjoy thinking things through, sometimes I chew things over long after they are fully dissected, and I get great satisfaction from finding a thread in the great big messy spaghetti of life and unravelling it. And I’m not the only one. One of the downsides (and upsides) of the modern age is that we have access to more information than ever. When it comes to birth, we can read a million stories, watch endless YouTube clips of birthing and even see how a baby emerges through the birth canal.
But having an elaborate birth plan, a ticked-off checklist on top of your packed hospital bag, and a list of reminder questions to ask health professionals does not an easy birth make. In fact, paradoxically, the more research you do, the more plans you make and the more prepared you feel – the more difficult you might make things for yourself.
For women who are used to being (or appearing to be) the self-sufficient, efficient, competent, unflappable creatures we are expected to be nowadays, the sheer physicality of birth can feel like a complete unknown. But birth is one time in your life when trying to plan, control and order can hold you back* – both physically and psychologically. In fact, the best preparation you can do is learning how to quiet that 21st century planner and get back in touch with your hunter-gatherer self. Less princess, more lioness.
All that information about pain relief, the process of labour, birth positions – of course it’s all good to know. But all you really need to remember is that your uterus (yes, yours) is 100%, totally, completely, fantastically amazing.
What is a uterus anyway? Up until now, it’s just sort of lain there, building up tissue and shedding it again every month, sitting quietly by, waiting for an opportunity to shine. Then, since you became pregnant, it’s gradually stretched and grown into a globe, with muscles criss-crossing around, up and down to support your growing baby. Towards the end of your pregnancy, these muscles start to gather up towards the top of the uterus, forming an upside-down pear shape. As your uterus contracts and retracts (the only muscle in your whole body which can do both of these things at once!), this thins out the cervix, enabling your baby’s head to eventually pass through.
I’ve been trying to think of an analogy for this. Thumping the bottom of a ketchup bottle. A cork exploding out of champagne. But nope, nothing quite describes the incredible way your uterus – without any intervention, and without any help from you – can gather its strength and push your baby out into the world.
The ‘without any help from you’ is important. Because, while you can give it a helping hand by remaining upright and active, and pushing when the urge takes you, your uterus is designed to help that baby out. Your baby plays a part in this too, rotating around and tucking in chin-to-chest to ease their passage, with their head knocking on the door of your cervix to encourage it to thin further. The best thing you can do then, is leave them to it. Even women in comas have given birth.
Like breathing, birth is a process which is predominantly controlled by the more primitive parts of the brain. As labour starts, we are flooded with oxytocin, the ‘feel good’ hormone that is involved in just about everything to do with your baby – from the first romantic feelings you had towards your partner to the initial bond you have with your newborn. This not only helps the uterus contract, it also crosses to the fetus to prepare for delivery by triggering a change in the brain to offer protection from oxygen-deprivation.
The trouble is, it’s difficult for us to quiet the developed parts in the frontal lobes of our brains, responsible for reasoning, planning and organisation. While the old brain is saying ‘come on uterus, get on with it’, the new brain is wringing its hands together, saying ‘is this ok?’, ‘what should I be doing now?’, ‘am I doing this right??!’ Our inherent skill at multifaceted analysis can lead to every twinge leading to a waterfall of questions, doubts and worries. Add to this the overload of information you’ve read/heard/seen up to this point, the fear of what is happening to your body and your impending motherhood – and it’s suddenly become pretty scary.
And here enters another old evolutionary friend – the fight or flight response. The very useful reflex we have to pump our bodies full of adrenalin when faced with a big bear. Adrenalin which cuts through good old oxytocin, shouting ‘STOP!!!’ to your uterus so you can go and find a nice cool cave to birth in. And when your uterus obediently stops, that taut muscle may feel a little more painful, especially with a big baby bonce knocking up against it wanting to get out. And a lovely midwife, trying to help and move things along, might notice that your contractions have slowed down and start talking about intervening. Which might make you a bit more anxious. At which point your uterus might say ‘I think that big bear is still out there, I’m just going to wait here a bit longer’.
So what’s the solution?
Well, one solution is to learn how to really, truly reeeeelax. Listen to hypnobirthing CDs, go to those antenatal yoga classes, learn how to breathe through your anxiety. We know that relaxing works. It gets your oxytocin flowing again (by the way, so does nipple and clitoral stimulation. Just sayin’). Adrenalin eases away, your uterus gets the message that the bear has moved on and you can focus on safely birthing your baby.
But sometimes telling yourself to relax doesn’t cut the mustard, and the trouble with this solution is that the onus is firmly on you. It can feel hard to relax when you’re in a hospital room with strangers walking in and out, bright lights on and your body doing things it’s never done before. Those frontal lobes muttering ‘You’re not relaxed! You should be relaxed! Relax, goddammit!’ won’t help. Not being relaxed enough can also become a stick to beat yourself with afterwards if your birth wasn’t as straightforward as you’d hoped – ‘if only I’d practiced my relaxation I wouldn’t have needed the drip/forceps/C-section’.
If we’re talking about the primal process of birth, and the survival process of fight or flight, it makes sense that we perhaps should turn to a more primal solution too. Paramount is feeling safe. What do you need to bring that nice cool cave to life? What you need may be totally different from the relaxation kits you can buy for a tenner – Led Zeppelin full volume is another woman’s aromatherapy candle. Think about how you usually handle stressful situations. Do you need to retreat off and be alone or do you want support? Do you get flustered and jittery or angry and irritable? Think about what you have done in the past which helped you deal with difficulty – but also what you have done which made things harder for you. Did you lose your rag then feel embarrassed? Did you worry what others thought and denied your own needs? You can use this information to give you a clue about how you might respond to your labour starting, and think about how you want to handle this. For example, if you can see yourself screaming obscenities at the midwife, talk to your birth partner about what they can do to help you if you start to see red. If you can imagine apologising to the midwife for your mismatched undies, talk about what your wishes and needs are so that your birth partner can be an advocate for you.
Thinking about who you want to be at the birth is an important step in creating your cave. Childbirth, in the very fact that you haven’t done it before, is scary and can feel lonely – but less so with someone there to support you through it. Research has shown that having continuous support during labour has a number of positive outcomes including reduced need for pain relief and greater satisfaction. It’s worth noting that the support of other mothers – whether your own, or a professional – is particularly helpful, even over that of your partner. Perhaps because they can calmly tell you ‘it’s normal’, and not freak out at that mooing noise you just made. However, there may also be times that you want to be completely alone and that’s fine too. This is one time you should feel able to ask for as much support or privacy as you wish. The aim is to spot those bears and do what you can to send them on their way – in whatever way feels right for you.
There may be times that you and your uterus do need some help. There are many factors that can complicate the normal birth process. But using what you can to help you feel safe and relaxed can ensure that you feel calm throughout and feel that you’ve had a good outcome whatever happens. (I’m not talking about the baby here – we know that will be a great outcome. But it’s important to acknowledge that the birth is itself an important rite of passage and to be allowed to focus on this as you feel necessary both before and after.)
With that cave prepared, those bears vanquished and that baby on its way – its time to put those frontal lobes to rest and just get on with it. No more worries about pregnancy. No time to worry about motherhood. Just focus on birthing that baby.
*Actually planning, ordering and controlling can quite frequently hold you back but that’s a whole other story!