A Male Midwife's Story of
Birth.
Dear Jackie while this article is not specifically about VBAC the
ideas discussed may help prevent unecessary C's from having to be
undergone. Best wishes, Rayner and Sachi Garner
FAILURE TO PROGRESS
When we conceived a daughter in 1980 we both wanted to have as natural
birth as possible. We had read Childbirth Without Fear by Dr. Grantly
Dick-Read and much of what he wrote seemed very sound to us. So we
prepared as thoroughly as we could.
Sachi's grandmother had delivered two children by herself while working
on a sugar plantation in Hawaii, so we had a precedent, and we read
whatever we could find, particularly on other cultures practices and
attitudes to birth. So we felt confident that we would be unlikely
to need specialised intervention and care. We also spent a great deal
of time throughout the pregnancy, ventilating our concerns and anxieties
about birth and our relationship.
As this was Sachi's first birth we decided to have a midwife although
we were tempted to go it alone. We found a very competent, kind and
attentive midwife and we were set. When Sachis's waters broke her
contractions came in very strong and powerful and we both felt that
it was only a short time before she would give birth. To our surprise
as soon as the midwife and two friends who were going to give support
arrived, everything stopped! Sachi's contractions ceased, and she
had lost her serene look and had become agitated and restless. When
I looked at her closely I could see that she was breathing rapidly,
had dilated pupils, and was starting to shiver. (Some of the classic
symptoms of the flight or fight syndrome).
So I sent our friends and the midwife out of the room to make tea,
and told them some issues had come up which we needed to deal with.
Not to worry about any noise that may be made. Then I encouraged Sachi
to get angry and she began to beat on pillows, kicked out with her
legs and screamed with rage. As soon as she stopped, as if on cue
her contractions restarted, and we called the midwife and friends
back in.
(As flight is not an option, the mother will need to discharge the
Adrenaline with physical exertion. One of the best ways to trigger
rage is to get the birthing mother to crouch on the bed or floor on
her hands and knees, and start to roar like a lion from a deep a place
in her belly as she can. For some reason this seems to release hidden
rage. Then if she is encouraged to beat on pillows or a mattress this
will discharge the adrenaline, and contractions will then resume without
extreme pain.)
It was the most amazing, and moving experience of my life to be
there, kneeling on the bed with cupped hands ready to receive Fonda.
Sachi was squatting with our friends behind her partly supporting
her, relaxed and in control, when Fonda's head emerged. Fonda opened
her eyes, (our only light source were candles,) and I became totally
lost in those deep brown eyes that seemed to be so full of old wisdom
and love. Then with a slight wiggle the rest of her emerged and I
placed her lovingly on Sachi's breast.
After the birth was over we got to thinking, why was the flight
or fight reaction stimulated? Then we realised that although the midwife
was very warm and loving we didn't really know her. Unconsciously
Sachi may have felt a threat to her survival and reacted accordingly.
That in spite of her preparations, classes in prenatal yoga, relaxation
classes and her conscious knowledge of how kind and loving her midwife
was, her primitive self had automatically reacted and closed down.
All species are equipped with this flight or fight mechanism in order
to get away or fight off any predator that interrupts, or invades
the birthing environment. We obviously posses this same primitive
response judging by the number of births which I have attended where
this same phenomenon occurred, the reports that I have read, or heard
about since our birth; of failure to progress, or a birthing mother
arriving at a hospital only to find her contractions stopped and her
cervix ceasing to dilate. On being sent home, contractions will often
restart and sometimes birth will take place in the car or ambulance
on the way back to the hospital.
I think that the power of this unconscious mechanism has been underestimated.
Many parents that I have talked to have been disappointed and sometimes
felt wanting, that in spite of all their preparations, Bradley and
Lamaze classes, etc., their birth was very painful and distressing.
That in many cases medical intervention became necessary because of
the threat of foetal distress.
There are cultures that only employ midwives who have been lived
in close proximity with the birthing mother all her life or close
relatives who will not arouse that unconscious reaction. In such cultures
labour often takes minutes once the water bag has broken, and discomfort
is minimal. (I suspect that if there are unexpressed antagonisms,
and hostilities present between caregiver and birthing mother this
may still create tension, and delay birth no matter how accustomed
to each other they may be.)
Dr. Grantly Dick-Read writes: Fear is the natural protective emotion
without which few of us would remain alive for many days. Its intensity
varies from precaution and doubt to uncontrollable terror. Even mild
anxiety can make a woman tense, thus causing the circular muscles
to resist the expulsive muscles of the uterus. A tense woman has a
tense outlet to the uterus, giving rise to the saying "Tense woman
- tense cervix." A tense cervix means a long and painful labour in
the majority of cases, for the mother is closing the door against
the progress of her baby from the uterus.
For some time now I have been suggesting to physicians, midwives,
and doulas, that greater awareness is directed at diagnosing the arousal
syndrome and taking steps to help the birthing mother to discharge
the adrenaline which is in her bloodstream, before using pharmaceuticals
to mask the pain.
An alternative would be for private birthing rooms to be equipped
with a video camera, and a two way wireless, and the birth monitored
by health professionals in an adjoining room or central viewing station.
Part of the prenatal caring would be to instruct the mother to be
and her companion in the simple practice of an uncomplicated birth.
Without comparative strangers present the flight or fight reaction
may not be stimulated. If complications arise, qualified help is immediately
on hand, and the safety and comfort of the two most important people,
the mother and child, would be assured. Rayner Garner
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