27 Oct 2007
Where to start? In the past 35 years I have listened to tens of thousands of birth stories from all over the world ... and in many countries where modern medicine is not available. Those stories are very different because there is no where to go if there are problems. So, I'm going to leave those stories aside for now. I'm going to start at the beginning ... early 1970s.
To understand 'what about ...' we always have to put the individual family's experience in context. Here is the context first. In 1970s birth practices in the US were positively changing. Families today take for granted many of those positive changes and believe birth was always like this. But it wasn't. I know I had my daugher just as many of those changes were occurring. But this isn't my story.
Here are some of the changes that were not available to families in the US prior to 1970. Take a look at what has been accomplished.
- Birthing in the same room as where you labour.
- Not being strapped down with feet in stirrups.
- Not being shaved or given an enema.
- Fathers with us to help as well as other support people.
- Being able to move around.
- Being able to deliver in various positions.
- Use of water to ease pain. Birth pools, showers, baths.
- More attractive rooms. Birth stools, birth balls.
- Being able to eat and drink.
- Bringing in music and other personal belongings.
- Moving furniture around in the room.
- No mandatory episiotomies.
- Vaginal births after cesareans.
- Not being knocked out for the birth.
- Delayed cutting of the cord.
- Baby on belly after birth.
- Baby staying with parents instead of being whisked away.
- Being able to breast feed after birth.
- No formula or sugar water given routinely.
- Rooming in.
- Family staying rather than just 'visiting hours'.
- No routine circumcision.
- Early discharge.
- Birth Centers
- Midwifery training.
- Legalization of midwives and home birth options.
And there are probably more. What an incredible change from just a few years earlier! And from my mother's generation after WWII and throughout the 1950/60s.
However in the 1970s as today there is a great deal of variations on these themes. Here's the first story and how The Pink Kit skills worked.
This particular woman had a history of terrible menstrual periods. She would be in bed for a week of each month with pain, fainting and heavy bleeding. She was terrified of giving birth. She loved being pregnant because she didn't have periods!
She wanted two people to be with her to support her. Her doctor was fine with that but the hospital had a policy .. one person.
Yes, she was faced with a political issue about policy. This is not uncommon in many of the
'What about ...' stories. Recently I've been corresponding with a woman who is pregnant with twins and is not only seeking a natural birth but one at home. So she has lots of questions that start with 'what about ...'
The woman in this story actually got pro-active. There was a second hospital. There it was ok to have two people if the labour wasn't long and they had to stay in the room at all times and didn't hang out in the corridors. That's the reality. You have what you have.
What about ... the Pink Kit skills (they weren't called that then)? Well, the couple was learning them at home and enjoying doing that. Her husband, like so many fathers-to-be, absolutely loved there would be very specific and practical skills he could use to help her when she was in pain.
Because of her history, her doctor was concerned and wanted her monitored and using pain relief. This is all political. '
What about ... ' what she wanted?
She and her husband learned the Pink Kit skills not just in the last few months but throughout her pregnancy because she was so terrified. Then her husband had a back injury that laid him up for weeks and then had a spinal fusion at the end of her 8th month. '
What about ...' Life that goes on even when you're pregnant? That's what you have.
She didn't want to do the Internal Work starting at 32 weeks. Although her husband was very gentle she won't have it, but she would let her other friend do it on her with her husband present because she believed it was important. It was uncomfortable for weeks and stimulated her fear of pain and caused her to tense up 'down there.'
So,
'what about... ' her ability to relax down there. It was a struggle but she also used the Internal Work as 'practice' to relax. Boy she had to work hard
When labour started about 9:00pm, he tried to sleep but wasn't very successful. Her mind was racing and she had a lot of fears of what would happen.
What about ... all her skills? Good question! In hindsight she said that she didn't use them at all and regrets that on looking back. Her husband tried to get her to use her Directed Breathing, the 'what do you want to do now?' technique, relaxing around the pelvic clock, deep touch relaxation ... anything. But she said that she just absolutely got stubborn and refused to even try. She realized after the birth that she had a habit of giving in and giving up. So she had a miserable night and so did her exhausted husband.
He eventually went to sleep feeling guilty about leaving her alone and she was resentful that he did. Which in hindsight after the birth she said was another of her habits .... to make it so hard for anyone to help her that they finally got tired and then she'd feel resentful. Birth is amazing at bringing out all our habits. And that's what we have to deal with. So,
what about.... the PK skills? She says that her biggest mistake was not using them right away. A mistake she did not repeat at her next birth 3 years later.
Her husband was 5 weeks post-operative from major back surgery and he was concerned.
'What about ... ' his ability to really help her if she needed to lean on someone? 'What about ....' all the skills they had practiced as three people and she wasn't willing to even try? After the birth, he realized that women have to want to use them and then do so. He couldn't make her no matter how hard it tried.
By next afternoon not much had changed but she wanted to go to hospital and be checked. She was in a miserable mood and he was nervous. She called the hospital and they told her to come in and be checked. '
What about ...' that experience?
After the birth she said everything about her hospital visit was made worse by the fact that she was not using any of her Pink Kit skills. She had a rough internal done by a midwife. It made her cry. She was only just beginning to soften in her cervix and wasn't dilated at all. She believed that she had been in labour since the night before and she was pissed off.
The midwife called her doctor. Her doctor told her to go home! She was angry with everything and everyone! She only lived a few blocks from the hospital so she and her husband walked home. She was absolutely miserable.
On the way home they talked. '
What about ...?' Well, they talked about the fact that labour wasn't progressing, that she was tired and he was exhausted by trying to help her without much success. And afterward, she said they talked about reality. This was what was happening and could they do anything about it? Her husband always believed they could ... just use the skills or at least try them!
She said that reluctantly she was willing to work with one of The Pink Kit skills ... 'What do I want to do now?' A great skill to use when labour isn't yet progressing. At first she said: 'I don't know'. And that was after her husband made a number of suggestions! '
What about ....' that?
Well, one of the greatest skills is to make a decision. It doesn't matter what you do because even if you refuse to make a decision you are still going to do something. So why not choose? And then consciously do? That's the first step to using your Pink Kit skills.
'What about ... ' the next few hours of their experience? Well, first she chose to take a walk rather than go home. She said afterward that inside she was hoping the labour would just get going but nothing changed. After the walk her husband asked the same question: 'What do you want to do now?'
For the rest of the afternoon and evening, he asked that question and begrudgingly she made a decision. After the birth she said that doing this turned out to be the most transformative aspect of birth. She realized that she had lived a large part of her life letting things happen and the question was forcing her to take responsibility. Her husband, after the birth, said that during the afternoon and evening she went through every single 'I can't, don't know, why bother' that tended to her response when things got tough in her life.
He knew this was hard but he also knew that she had to do something, anything so why not use the skills they had taught themselves?
'What about ... ' the rest of the afternoon and evening? Surprise, she got so good at deciding what to do next, she had a list made and they went through it. They laughed alot. She relaxed. She began to use some of the other skills between and with the contractions. Afterward she said that they were a bit annoying but nothing like what they had been like the night before when she was just stressed, tired and anxious.
After a warm bubble bath, they both had a good night's sleep. She said she'd sort of wake up a bit with each contraction but she used her Directed Breathing and Pelvic Clock and went back to sleep. Afterward she said that doing things for herself was really calming and empowering.
In the morning the contractions had changed a little bit. They were deeper, lower, longer and a bit stronger.
'What about ...' that morning? Well, they used their skills. She even went into the bathroom and checked herself. She said she could feel the baby's head and the tissue over it but couldn't really tell. But for her this was a major achievement.
She had her list of what she wanted to do and they just went about their day doing those things. Afterwards both of them said that this was an incredibly beautiful time together.
By afternoon the contractions were definitely getting stronger and more intense. She often had to stop during a contraction. Her husband watched her face and listened to her breathing and if he heard or saw any tension he immediately breathed with her or told her different parts of her body (inside) where to relax. But he knew this wasn't really strong labour. However, he was really impressed by how she was coping.
Normally, at this amount of pain with her period she would be writhing around on the floor, white as a ghost.
Late in the afternoon she decided she wanted to go back to the hospital and be checked. She was certain labour was now progressing. 'What about ...' this experience? Well, she arrived and asked the midwife to call her doctor. She decided she didn't want to be checked except by her doctor. The midwife objected strongly and argued with her but she really insisted. The midwife called her doctor who said she'd come in.
The woman sat on the bed with her husband and worked through each contraction. Her doctor arrived and did a very gentle internal. She was barely 1 cm dilated and 50% softened!
'What about ...' her response? Well, she said that at first she was absolutely livid! She said 'What have I been doing all this time?'
Her husband said that he was a bit surprised but not anything like she was! The doctor told her this was not uncommon for a first baby and she could go home again. The doctor left her and her husband alone to make a decision about what they wanted to do.
After the birth they said that this was another turning point for them. They said it was all about '
what about....' This was how it was. She had now been 'in labour' (from her view point) for almost 2 days. Her doctor told her it was 'false labour'. She could have spit tacks at that term. But she had more experienced with using her skills and she had a husband who loved using them.
It is all about reality. This is what it is so all you have is what you can do. The more you work with what you have and the less with what you want, the better the experience.
Funnily she said, she relaxed and was just getting up to get dressed when the contractions really changed. Just like that from one contraction to the next. At this point it was early evening.
They told the doctor they would like to stay. The doctor was fine with that. So,
'what about ...' the rest of the evening?
Well, her labour picked right up. In fact within 20 minutes her contractions were 3 minutes apart and one minute long. Afterward she and her husband said that they had now such a good habit of using their Pink Kit skills that it was very easy to just work more closely and at every opportunity which was every moment.
After another hour she felt sick and went into the toilet. Meanwhile they hadn't told anyone that labour was changing. They didn't think about it and no one had come into the room to check them. When she went into the toilet to get sick, she also got scared. Afterward she said that the nausea triggered old feelings about her menstrual problems.
She said her husband was amazing and she could actually
compliment herself on letting him help her. Great progress really.
But you want to get on with her story!
Which brings us back to
'what about ... ' what happened next? The midwife happened to come in to see how they were doing and found the woman sitting on the toilet and her husband kneeling on the floor between her legs really helping the woman to stay calm. The midwife could hear from the sounds she was making ... 'grunting' that she must be close to delivery.
The midwife rushed out to get the doctor who was just leaving the hospital. Meanwhile in the bathroom ... Afterwards the woman said that she was absolutely faced with a moment to moment decision dig deep and use her Pink Kit skills to overcome her fears and all the intense sensations. She said her head was so clear and her inner dialogue so caught between her 'negative voice' (which she had been taught to recognize in The Pink Kit) and her management voice (another valuable Pink Kit skills). She said these two parts of her were at war. She could choose either.
While this was going on in her head through each intense contration and very short space between,
what about ... her husband?
He'd never been to another birth. All he knew was that for 2 days she had been having these sort of mild contractions and in one and a half hours she was doing this! Afterward he said that the change was SO quick and so dramatic that the only thing he focused on was keeping her in 'management mode' rather than freaking out.
He said, he didn't feel afraid at all ... not even of her pain but he knew she WAS in lots of pain and his job was to keep her coping and managing at all costs. He figured he'd let the professionals do what they did and when the midwife came in she didn't have any concerns about what was happening but also didn't help. But did tell them before she went out to get the doctor 'You're doing so well!'
He said his wife was really tensing up her hands and he made her look in him the eyes and said to her: 'You can't do that right now. You must get rid of your tension.' She said: 'I CAN'T.' Then he said an inspiration struck him and he told her 'Just throw the tension out your hands!' With that she started to flick her fingers and shake her hands and as she did that, she started to cope better with her breathing. (See ... knowing a set of skills inspires you to find others at the time!)
'What about .... ' the time frame? Maybe 15 minutes had passed!
The doctor came in as the woman started to push. Keep in mind this was a first birth but the woman had done the internal work although reluctantly.
The doctor suggested she get up on the bed. After the next contraction the woman managed with the help of her husband. Given the last two internals she was thinking 'Oh my god, what if I'm only 1cm still'.
Instead the head was showing! She had another 'pushing' contactions and the baby's head almost crowned.
The doctor said: 'Your baby is almost here'. The woman had that wonderful space between 'pushing contractions' where you can chat etc. She looked at her husband then reached down and touched her baby's head then looked up at both the doctor and husband and said: 'Is this all there is to giving birth?'
Everyone laughed and within two more contractions she had given birth to her son.
'What about ...' how she and her husband felt afterwards? First, the doctor and midwife complemented them on such a wonderful job. The woman told her husband she couldn't have done it without him. He told her how proud he was of everything she had done. She complimented herself and then told everyone what she would have done better next time (this is a very natural Pink Kit response. It's not self criticism, it is actually self learning and needs to be honored, respected and investigated later ... even over the next year this self learning grows)
From the time the couple decided to stay in hospital to the baby out was a little under 2 hours. This woman is one of 30% of women who dilate right at the end of labour instead of 1cms/hour.
I'm another one of those women. My births were different. Five hours + and very progressive but with little dilation until the end and then pop open and baby is out in a few pushes. This is one of the things we've learned over the years and why it is so very important to just keep working with your baby's efforts.
'What about ...' after the birth? Well, since this couple was one of the early families to fully incorporate learning, preparing and utilizing their skills they experienced what so many of us have since ... a total transformation of our lives.
This couple said that once they started to use their skills and work with what they had then they became conscious. Once they were conscious then they could adjust to what was happening. Sure they had moments when they were a bit confused but they defaulted to skills and sorting it out rather than defaulting to feeling out of control and overwhelmed.
This spun off into early parenting and into their personal relationship. They were always able to step back and sort things out.
Their second Pink Kit baby was born 3 years later with so much more confidence and joy and still the same amount of preparation (including the internal work) but this time with both of them working from the same page!
