This Pink Kit Story's last response

14 February, 2007

This is the last part of my response to this woman's initial birth story. She has since continued our correspondence and sent photos. Meanwhile we've also gotten a lovely Pink Kit Story from a woman who used The Pink Kit to have her 6th baby. I'll also put that one up on the blog.

CONTINUED FROM LAST BLOG '

I've been recently compiling some insights from the three midwives whose clients teach themselves The Pink Kit skills. This is something all of these midwives said (and is absolutely true) ... the women who stay open, relaxed internally and get into positions their baby likes early in labour are less likely to have long labours or hit non progressive plateaus.

This is one of those very subtle concepts that is extremely difficult to get across, particularly to first time mothers or people who have been told to 'just get into any position they like'. You can go back over the 5 Phases of contractions and Bell shape curve in New Focus which is where we address this concept. The very good news is that next time, this is something you'll have an increased awareness of. Our job as labouring women is to follow the progress of our cervix to open and our baby to descend into our birth canal and out our body.

Women without skills are reacting to the sensations they have rather than reading those sensations in terms of what their baby is doing and what they need to do to assist their baby's efforts.

Often the stories I hear from women who have previously used the PK skills, is that they have such an amazing ability to read their baby's effort by what the contractions are like and how to adjust themselves in order to create the most effective contraction. As one woman said: 'I didn't waste one contraction.'

Also, had you or your husband checked you every time your contractions really upped a notch then you would have realized how quickly you were progressing which would have increased your self knowledge and confidence to another level. The good news is that you are more likely to do this next time.

It's obvious during the period you spent at home you really incorporated your positive breathing patterns and internal relaxation. Bravo.

Your first disappointment that threw you off your flow was the birth pool. Yup, shit happens. The next time, use the shower and if that's not possible then just take a moment to reassess your surroundings then claim your space with what you have. Getting lost in internal space ('I was required to lie down when I didn't want' or 'I was so tired I lay down and couldn't cope') in labour really throws a wrench into the works. This is something that our willpower must take charge of. What you get is what you have and what you have is what you have to work with. This is the challenge women in labour are faced with and often given as the reason for shame, blame or guilt. This changes once we realize all there is is only the NOW in birth so get on with it.

When I was giving birth to my son, I was being quickly wheeled down the hall to theatre squatting on a cart as he was beginning to come down into my birth canal. I felt I was surfing. Because I was in charge of my birth, I had to readjust to reality. I certainly would not have chosen this scenerio, but I was giving birth at 32 weeks so there were lots of adjustments I had to make. Once in theatre they then wanted to know how I wanted the birthing table to be? I thought ... shit they want me to decorate too! However, I was in charge every single nano second because I knew I wasn't going to do this again and I didn't want to miss one moment by giving up my ability to birth myself.

Back to your story. There are two reasons why your contractions became overwhelming at this point. First your disappointment about the birth pool blocked your conscious involvement and application of your skills. Second, 8-full dilation is when labour just gets so full on. Combine those two realities it's easy to throw up your hands and just roll with the pain.

But the fact that you got 'stuck' at 9 cm tells me that you probably just had been pulled off track by your disappointment. The desire to have something or do something in labour (particularly if we think it will relief our pain) is very strong and if we don't get that thing then we sort of give up. That's why next time you'll just adjust faster to the unexpected. Instead you'll actually laugh a bit about Murphy's Law. That's certainly what I did with my son's birth. Everything was Murphy's Law so I dealt with my reality not my imagined birth.

Consider a woman in Baghdad going into labour with bombs all around ... really she would just have to adjust! So we can do it with our little disappoints that we perceive are big ones.

This period of 'not being able to push' is very complex. There are several things that go through my mind. First, I don't know anything about your body so I can't really comment on some things because I don't know your body. Second, given that you had a failed ventoose with an epidural tells me that your baby's head was either slightly not flexed, a wee bit (what they call asynclytic .. spelling ... off to one side ... ) or your baby had his hand up by his face. Do you know if any of those things are true. Also where do you think your baby got stuck? What do you know about your body that could give you a clue? Investigating those things are very exciting.

Then there's the issue of medical assessments, beliefs and practices about 'don't push because you're not fully dilated'. Within the 'system' (even midwifery care) there is a belief that if you're not fully dilated that you shouldn't push. Sometimes that's true. If a woman shouldn't push (meaning that her baby can't come through the cervix and into her birth canal) then when she pushes, there will be no progression of the baby into and through her birth canal. However, there are many women who get a strong urge to push at 9cm and do and the baby just opens the cervix and barrels down the chute.

Please remember I have no medical training and I'm not a midwife. Everything I talk about comes directly from stories women and men have told me, so I try to pass on those stories. I pass on the stories so that other women can look inside their own experience and make decisions based on what they are truly experiencing rather than what others are telling them or what they believe they 'should' do. That's why having and using skills helps us feel confident with what we are personally experiencing without having to explain it to others. For example, when I went into labour, my water had been leaking for 10 days. I knew my son was fine so I didn't tell the doctors. They would have behaved differently. Because I had only gained 8 pounds, they all thought I was going to give birth to a 1 1/2 baby but I could feel where his head was inside me, his butt and feet. I knew he was a good size. He was 5 pounds. I also knew he was healthy after birth and took him home the next day fully against 'doctor or hospital advise' but I just asked them what they needed me to do (bring him in every day) and I agreed. Hope that makes sense.

However, a very common story by women who have had quick births like yours is that if you hold off pushing when they have a strong urge even if they are not yet fully dilated is that the urge to push then becomes compromised and things just get weird. Some women lose the urge entirely, some have contractions that suddenly really space out or have pains in unusual places.

This occurs because the term 'don't push' means that a woman has to tense up inside to prevent what is occurring in her body and that is counterproductive to giving birth. What you can for yourself at this point is to replay this part of your birth in your mind as though you were entirely on your own with no one telling you anything. How would you go back and use your skills to resolve this period for yourself. You will eventually gain a body aware insight which is probably accurate.

Then with that new found skill, continue through the birth applying your skills mentally until your baby is re-born.

And you're probably right that doing the hip lift and sacral stuff, even Kate's Cat might have helped you to focus on each contraction, or unstuck your baby, or realigned his head if that was the problem and probably what you needed to do. The movement of the baby through the hole in the bones into the birth canal requires that the baby's head pass through that place inside you where the tissue of the cervix meets the inside of the bones. There are many sensations associated with this place. If you do Kate's Cat now and pay attention to the area from which the sacrum see-saws, this is that place. You can draw a line from this area to where the leg bones meet the pelvis (an area of your hips). Inside our body at this spot also is where the biggest part of your baby's head meets the narrowest part of the hole in your pelvis. Therefore, it's not uncommon that there can be a plateau period in labour when the baby has to come through this narrower space.

Were you informed how high your baby's head was (could you see it on the perineum) when they tried the ventoose? that will tell you where your baby got stuck. How long did they have you push before the epidural? Did they rupture your membranes or did they rupture spontaneously?

Since you did the internal work, were you aware of what the shape of your sacrum was from feeling inside? Were you aware of the muscles and tissue high up on the walls of your pelvis or in the back toward your sacrum that might be tight? Even now, think about those minnie mouse muscles and ask yourself were they tight during this confusing period of labour?

As we gain more internal insights we understand more. It's fascinating and helps us comprehend.

Although they say epidurals don't effect babies they do. The first one I ever saw used, the baby's heart stopped. The doctor stuck her fingers up the woman's vagina touching the baby's head and shook the baby saying 'come on baby, come on baby'. Finally the baby's heart beat resumed. An infrequent but real ... not often discussed.

It's amazing they chose an epidural with you being fully dilated instead of another type of pain relief that they could have given you.

You will probably have a very fast 2nd stage next time.

Having that spasm in your rectum would be entirely unexpected and is not too common. It does indicate that the baby's head was not quite flexed or a hand was up by the face but I don't really know for certain.

Now on to your opinions about the resources. Glad you like the matter-of-fact approach to learning skills. The book was the first resource written in 1990. The video was done in 1996 (no money, sort of dorky and certainly not sophisticated). Women have two responses to the video ... 'it's so boooooring' or 'oh my god, I learned so much about my body don't change a thing!'

The fact that it's a bit of a chore to get through the sections in the video does tell us how detached we are from something we live in all the time ... our body. Great to hear how you used MS and CG. You mentioned Kate's Cat as a 'practice' but did you remember to use it in labour?

Go over Language and Touch again and see how these skills might have been utilized. Also discuss this with your partner. Ask him in hindsight if a greater tool kit of skills would have helped him more to help you? Having skills associated with childbirth is so unfamiliar to most people for the simple reason no one has taught us that we should have them. Your husband really didn't know how important it was for him to teach himself these skills. What both of you know now is there is no one else to really help you contraction after contraction. Birth is such a big experience and so dynamic one would think it would have skills coming left, right and center.

Ask your husband to help me if he would encourage fathers to take more time to practice these skills before birth and ask him how we can get more fathers involved. Many dads are actually more involved in practicing then women so it's not actually a gender thing but sometimes perceived of as a gender perception ... 'birth is woman's business' or 'the doctor will take care of her'.

Yup and nope to your thoughts that the PK works best when your partner is 100% there. In reality we're the only one doing the labour so in reality we have to incorporate the skills for ourselves because no one else really knows what is going on inside our body. You've discovered that there's a fine line between I CAN and I CAN'T but really what so many of us discovered is that the I CAN'T was, at the time, more I WON"T. Without blame, shame or guilt and in 20/20 hindsight we usually see that we actually made choices to stop figuring things out for ourselves or stopped applying our skills. We actually expected others to do something just like you hoped to get into the birth pool. The pool was going to do something for you.

And what you say about your husband's emotional involvement in birth rather than skills-based participation speaks volumes about what happens to us as women when 'they don't' help us. What hundreds upon hundreds of other women taught me is that we have an expectation that 'they' will help us. And once we wrap our heads around the fact that 'we' have to help ourselves, then we exhalt in giving birth. It's challenging, requiring lots of will power but absolutely mandatory. That's why next time you'll follow the process more accurately even down to the ability to take your husband's hands and show him what you want him to do. Words aren't sometimes possible during the very strong part of labour.

It's a bit of a societal habit that men believe we actually know what we're doing because 'women have always had babies'. Sometimes men also feel that what is happening to us is exactly what 'birth is about' so there's nothing they need to do (remember neither of you have been at births so what happened to you is the 'norm' because it's not relative to any other experience). Another feeling men have is ... if the woman doesn't know what to do then how could she expect me to know what to do. Then finally men can feel ... if the woman's in too much pain 'won't someone come and put her out of her misery please'.

And you're right as soon as 'too emotional' is the reaction to your pain then the skills just get put aside. This is where women taught me how very determined we had to be in dealing with our absolute reality as it was happening right now. All our illusions of being saved by 'them' just had to be set aside. All our illusions that 'birth shouldn't be like this' had to go out the window. As one woman said: 'I realized I had the rest of my life to sort out all the problems. I just had to get on with it.'

I'd love to continue a correspondence for a while as you continue to put your pieces together. Hope this has helped you'.

Hopefully, there are some people out there who will benefit from these correspondences.

Pink Kit Story's response continued part 2

11 February 2007

CONTINUED FROM LAST ENTRY:

'All memories of pain disappear over time whether they are birth ones or not. That's parr for the course. Who remembers any sickness other than 'I was so sick' or 'it hurt so much'. Unless we are sick or in pain, we aren't. We remember we were but we can't create the intensity at will.

Births never go as 'planned' that's why Birth Plans should never be seen of as choosing items from a menu or a wish list. What the PK skills do is permit us to adjust to reality as it unfolds.

You said it so well that you 'want things differently next time and have learnt greatly from the experience'. Given that we give birth so infrequently in Life, it's quite amazing how fast we learn what we could have done differently were we able to replay it. That's what our mind does for months and sometimes years after each birth. If we don't have birth skills to add to the 'replay' then we just often 'wish' it were different and believe a different birth plan will change the experience. This often fails. As you know the 'outcome' is very significant BUT it's our own process of 'doing labour' that we learn from.

After 35 years of listening to birth stories, I can actually tell you that there are certain types of births. Thankfully there are not an infinite variety. Yes, every birth is different and unique however, in its simplest form labour is a series of contractions that arrive one after another spread out over 'time' and with levels of intensity ranging from 'don't feel anything' to 'I feel a tightening', to 'yup it's a bit painful', to 'yup it's quite painful but manageable' to 'wow this is intense' to 'I'm not getting on top of this pain'. Many women go through the whole gamut as labour progresses. You can hear that in your own story.

What is unique to each birth, is how fast we move through those stages. The quicker we move through them, the faster our labour is progressing.

All births progress by contractions becoming longer, stronger and closer together, so when you say that from the start you had strong but bearable contractions and in 6 hours you were 7-8cms this should tell you (in hindsight) that your body's ability to labour effectively and quickly is part of who you are. Which means next time, you might have a shorter birth with contractions coming close together, although next time they might not be as 'strong' at first. Some second time mothers who have had similar births as you have a vaguer early labour and then suddenly full on for a very short time. Because they confuse the early part as 'non progressing' they can end up suddenly finding themselves pushing.

You're the type of woman who needs to think next time about not being able to get to the hospital. However, if you want to birth in hospital then you need to really learn to 'check' yourself so you can feel how quickly your cervix is dilating. You'll also know by how fast the intensity changes. If you have questions about this or anything I say, please feel free to ask.

One thing you mentioned is that you changed position 'not really thinking about what was keeping you open but just doing what made me feel better'. May I ask a question here? Were you told in childbirth class or read that you should get into any position that makes you feel comfortable?' TO BE CONTINUED

Next entry I'll add more of my comments. We've just received another story, so you'll get that one as well.