Beyond Biology: The Holistic Stages of Labor
The
Holistic Stages of Labor
Written by Whapio Diane Bartlett
Embarkation
(Pre-labor and Latent Labor)
Labor is a Journey. The preparation has often been elaborate,
conscious and consuming. There is usually an all-important ritual of
Arrangement preceding the actual event. We call it nesting and Mother
has moved about in a final flurry of activity, taking care of all last
details…clothes are washed, food fills the freezer, house is
ship-shape…all is in order.
Nesting is part of Embarkation. Mother senses that labor is soon.
Perhaps contractions and the loss of a bit of the cervical mucus has
offered a hint that the journey is about to commence.
Then it does begin and Embarkation is also the time when a woman
realizes that labor is truly here. Mother is excited, maybe a bit
nervous, concerned for the welfare of her loved ones having made sure
that they will be well taken care of while she is gone. As the Journey
is launched she may call all her family to her to bid them goodbye or,
depending on her custom and constitution, she may silently take leave
with her partner and companions. Usually, at this time she alerts her
chosen caretaker. If she is birthing at home, she notifies her midwife
who may or may not arrive immediately depending on the mother’s
preference. If she is planning to give birth in a hospital or birthing
center, she may notify her chosen caregivers and remain at home until
other changes occur. Often, moms wish to spend time acclimatizing to the
sensations the body offers before they actually connect with their
birth attendants. Most moms are aware that labor is still in early
phases and are excited and managing their energy very well.
During this time the Mother often feels like talking and sharing
impressions as she is pulled away from ordinary reality. She may be
chatty and relate information about each contraction or each sensation.
She usually stays centered as she is stretched and molded; her
sensations become stronger, more intense, powerful. Most Moms experience
this as varying degrees of pain. The waves of contractions repeat with
increasing intensity and frequency and the Mother is swept toward the
Unknown.
In modern parlance this time would be considered pre-labor and the
latent stage of the First Stage of Labor. Physically, the cervix is
beginning to efface and dilate and this stage lasts until the Mother
reaches 4 to 5 cm dilation. Contractions are usually 30 to 45 seconds
long and 5 to 10 minutes apart. As Mother comes closer to the chasm that
separates her from ordinary reality, contractions build in intensity
and become coordinated and rhythmic. It becomes apparent that the Mother
is being called away – she is less and less present in ordinary reality
with each successive contraction. Her chatty persona disappears,
replaced with a growing seriousness.
As she feels herself pulled toward the Veil she will probably want to
connect with her caregivers. She may feel the need for the presence of
the midwife or doctor because she understands that she will be leaving
ordinary reality, taking a definitive step into the unknown, and she
wants her caregivers to be aware and ready to witness.
Entering
the Veil
(First Stage, Active Labor)
The Mother reaches a point in her traveling where it is time for her
to go alone. The endorphins released by her body during her embarking
have begun to change her consciousness and she enters, more deeply, the
realm of the altered state. She travels to the edge of her normal
reality, parts the Veil and goes beyond. The Veil is my nomenclature for
the curtain that separates ordinary reality from the deep altered
state. Brain wave patterns have begun to slow down and change from Beta
(ordinary reality) to Alpha (the bridge into the subconscious) in the
Embarkation phase. Now, in the next stage of labor, brain wave patterns
slow down even more and mother has access deep into Theta (the
subconscious). The aloneness reflects the fact that women move into a
place of self-direction that seems to emanate from a grounded yet
altered place in them. The Veil is that stage of labor that heralds the
change to this new place. This doesn’t mean that a mother wishes to be
alone and that others are not relevant. Rather, it signals the shift
into a more self-directed realm.
Mothers may approach the Veil several times before deciding to move
through. Circumstances may also prevent the mother from moving through.
Constant questioning, especially about mundane affairs, and
interruptions in mother’s rhythm serve to bring mother back to ordinary
reality.
At the Veil, Mom no longer feels chatty and often the experience of
something more serious and profound presents itself. She begins the
process of separation and while the mom is aware of details and
specifics occurring in the room, she becomes less interested in them.
There is often a palpable smell in the air or a subtle but
perceptible color change in the room that marks the presence of the
mother at the Veil. Many caregivers can calculate the flow of labor by
these signposts, making yoni exams redundant at this point. I have
experienced color changes and find this to be very reliable and helpful
for me as I witness a mother’s journey.
In conventional terms, the Mother has achieved 4 or 5 cm dilation and
the character of the labor changes. Contractions begin to be about 60
seconds long and about 5 minutes apart. Mother may seem to act a bit
more spacey and unfocused to caregivers in the beta mindset.
Between
the Worlds
(First Stage, Active Labor)
During this time the Mother craves privacy, silence, warmth and the
intimacy of the dark. She looks to her Guardian to know that she is safe
and that no one will breach the sacredness of her travels by
distracting her or leveling any expectations on her. But most
importantly, she looks to her Partner to see if he* is with her. She
reaches for him to bring him into the vortex and together they speak a
silent language as the sensations between them become more powerful and
intense. No one may disturb them; they are Between the Worlds. They
become tuned to rhythm of this process and perhaps to the spirit and
soul of their child. They may have visions, see colors, hear the voice
of their child. Whatever their experience, it is unique and relevant to
them as partners, parents and family.
This place Between the Worlds is the trance-like altered state where
the opportunity exists to access the mystical state of transformation.
Profound realizations may occur; new truths may become evident. Non
ordinary reality may bring forth new information and new perspectives
that forever alter the consciousness of the individual and the family.
Mother is no longer in Beta, way past Alpha and moving through the
deepest states of consciousness…Theta and Delta (beyond the subconscious
to unconscious). It is important not to interfere with the birthing
couple and it is seldom necessary.
Mother stays upright, moving with her labor, moving with her
contractions. They become longer and stronger – from 60 seconds to 75
seconds, almost to 90 seconds. At this time her dilation moves from 5 cm
to 8 or 9 cm. Labor is considered hard now and often painful…at the
least, strong and intense. Mother has coping strategies. She is not
lost. She has what it takes to find her way. She doesn’t usually need
words…simple reassurance in the form of present companions who give her
privacy and offer safety, although sometimes quiet murmurings of respect
and affirmation may afford the mom an understanding that you are there
if needed. Sometimes humming or soft singing, from another room, may
provide the mom with any needed reassurance. Mother may wish touch, eye
contact, the healing powers of water…or none of the above. I’ve learned
to make no assumptions. Now, I follow the mother and the journey. Again,
the Art of Midwifery is inherent in being able to provide for the needs
of any women, whether she wishes company or aloneness, eye contact or
someone in the next room. The Art is being able to individualize your
presence to the preferences of each woman. I often take a position in
the corner, quietly witnessing, though not observing or intruding on the
birthing couple‘s privacy. After all, what could possibly be wrong if
the caregiver is knitting in the corner.
Mother climbs higher as she plunges deeper.
The
Summoning
(End of First Stage — Transition)
Mother becomes aware that she is nearing the peak. She is deep in a
vortex, past anything she has ever known.. She has been continuously
opening to wisdom, opening to revelation and now she comes face to face
with the apex of her labor. This is what she has come for – accessing
the new spirit, the new person that is her child and her Partner’s
child, and bringing this soul to Earth. She hears the Summons, she
summons her child and together they make their way back. This is often
the most precarious part of the journey. Mother must summon all her
reserves and she may want to know that her Partner is totally present
and supportive. She assumes her caregiver is following their course and
holding everything steady on the other side of the storm. Mother is
braver and more courageous than ever before in her life.
Transition is considered the most intense time for Mother.
Contractions are long and hard – 90 seconds plus and coming 3 or 4
minutes apart. She is reaching toward 100% dilation or 10 cm. This is as
open as a woman can be. Of course things may seem hectic and often the
Mother flounders briefly during this supreme openness. She may say that
she cannot go on or that she wants to go home. She may have a wild-eyed
look and seek the presence of others. She may ask for help but I have
noticed this is not the authentic need for someone to do something,
rather it is the calling out to be witnessed in this hardest phase yet.
Sometimes the presence of another person, especially one she loves and
trusts, will restore calmness. And sometimes, the presence of another
will allow her to feel safe and she will then rage to the end of the
universe. Her personal tempest may take her far from ordinary reality.
She will become the storm, become wild and incredibly powerful.
Caregivers and partners may be amazed, even intimidated. Mother will
find her way however it takes.
It’s important to note that birth does not look any particular way.
Some moms are calm, some are wild. Some labors are fraught with pain,
some are totally bearable, some are even orgasmic. I am not suggesting
that any style of birth is better or more conscious than another. What I
am saying is that when the mom is in her authentic power, no matter how
that may appear, her birth is normal, natural and perfect for her. I am
also saying that when a mom is imprinted by cultural or caregiver mores
or prevented from accessing her instinctual wisdom, her experience of
birth may be unbearable, agonizing, out of control, humiliating and
shameful.
At this time, a woman often needs to find her own way. She needs to
hear the Summons in her own language and on her own terms. When she
does, the journey toward home can be initiated. Any distraction at this
time can be confusing and dangerous but I have witnessed women be
flexible and powerful and rise above danger and distraction with
astounding regularity. During this time of openness, women find their
way, find themselves, find their power and their will and commune with
forces greater than they have ever experienced.
Again, the art is to witness yet not to disturb the process.
The
Quiescence
(The Resting Phase)
This is the period of great stillness and peace that occurs after
transition. All becomes calm and quiet and the Mother knows that IT has
happened. She knows she has found what she is looking for…her still
place in the tempest and access to the soul of her baby. Both mother and
baby are tranquil and serene, drifting toward the shores of home. She
may choose to rest in the arms of her Partner or create a still place to
recoup her energy. She is not finished with her travels – she must
manage the breakers ahead – but right now she is in peace.
This is one of the most important parts of labor.
For many years there was no acknowledgment of this stage of labor in
our culture. Once a Mother achieves complete dilation she is usually
encouraged to begin to push out her baby. But in the holistic paradigm,
this stage, which usually lasts about 20 to 30 minutes (but can be as
short as 5 minutes or can last hours), is Mother’s time to regroup and
collect her energies for delivery. Labor seems to stop; contractions
literally stop or slow down and the Mother may fall asleep or fall into a
quiet, meditative trance. Everyone waits in the hush until contractions
resume.
What happens during the Quiescence is more than resting or
regrouping. When you have climbed the highest mountain and finally
reached the Summit what do you do…run right back down the other side. Of
course not. Would you simply rest up for the journey down. Of course
not. You may open your eyes and look! You would see what you have come
this far to envision. You would possibly have a sacred and holy moment,
set apart from all other moments in your life. You may receive.
This may be the pinnacle of the altered state. Brainwaves may shift
to Delta, the slowest and deepest of our known patterns, which allows us
access to the realms of the unconscious…the realms of profound knowing,
meditative understanding and peak experiences. This is the realm of
transformation.
In this case, mother receives understanding and knowing pertinent to
this new human being that she is birthing. She receives wisdom that is
easily accessible at this great altitude and in this momentous altered
state. We lament that we are not accorded the blueprint with which to
raise our children but that is not entirely true. There can be a
veritable download of information about her child…the blueprint. This is
a key part of the journey and mothers wish to be respected and afforded
solitude to experience this phase of labor.
This stage is different for each woman and for each labor but in a
labor where the Mother is not required to perform to any expectations or
has any strong programming about exactly how labor should unfold, I
have noticed that this interval lasts about 20 to 30 minutes. At the end
of this period, contractions begin and the Mom is often startled into
wakefulness. She is now ready to head down the mountain, carrying
precious information. She is heading to shore on the incoming tide.
The
Tides
(First Stage of Second Stage)
Mother puts her feet on the ground again. However, the resumption of
contractions does not mean the mother is planning or ready to push out
her baby at this time. During the time of the Birthing Tides the mother
is alive with wonder and she is aware that her body is bringing her baby
down the birth canal. She feels the sensations of baby moving, she
feels a quickening and an alertness that allows her to shuttle back and
forth through unconscious, subconscious and ordinary reality. She knows
something is different, she knows birth is imminent but she’s not in a
hurry. She is coming down the mountain with a steady step…revitalized,
reflecting, remembering what she has seen.
Her contractions may become strong and intense and her uterus is
doing something very different than when she was ascending to the top.
Her cervix is completely open and her contractions begin moving the baby
through the birth canal and closer to her perineum. She may have small
urges to push with each contraction but more often than not she will
just let the contractions sweep the baby down without pushing with them.
She may feel the intimation of pressure and pushing but the momentous
urge to fiercely bear down is usually not present yet. In her wisdom she
understands that she does not need to push hard at this time. Rather
she needs to wait until her baby is there. Mother is focused, receptive,
alive and alert. She is still Between the Worlds, but she is a new
woman. Alive and active, mother says to all – “Stand back. I’m about to
have a baby.” She finds her own position, her own rhythm. Her eyes are
trained on the shore; she is coming back, bearing a great gift.
The time of the Birthing Tides generally feels good to women. No
matter how tiring or exhausting her journey, the Mother experiences a
second wind, a new spurt of energy and excitement. The birth now becomes
more of an active event – the receptive state of Between the Worlds
gives way to the active state of the Birthing Tides. Most Moms are
galvanized into a place of intense power. Sensations are considered
strong and powerful rather than painful. A Mother who is alert, erect
and under her own authority will instinctively know what to do. She will
find the appropriate place, position and rhythm for the work she is
doing. She will absolutely know how to birth her baby.
Mothers generally tend to vocalize during labor. In the early parts –
Embarkation – the Mom is often chatty and responsive to the
environment. As labor progresses and Mom reaches the Veil (active labor –
5cm) she becomes quiet and responds to her own inner environment. Her
vocalization may change to sighing, humming, ohming or ahhhing. As she
moves Between the Worlds these sounds escalate in their depth (not
pitch) and in their intensity. The Mother may begin to sway and moan and
give herself completely to the primordial quality of this powerful
experience. During the Summoning she may call out loudly to the
Universe, to her partner or to the soul of her child – usually remaining
deep and grounded but occasionally reaching out to share the intensity
of this journey with her companions. Sometimes the Mom may ask for
reassurance during this time, sometimes she goes even deeper into her
own realms. During Quiescence a hush prevails. Then as the Mother begins
to navigate the Breakers her sounds change. Louder and deeper still,
the sounds that emanate from the birthing Mother are the sounds of opening; a channel is being
cleared and everything moves out of the way.
It is also relevant to note that some women go from their Quiescence
directly into the next stage, The Breakers. In some births I have
noticed that women, usually moms having their second or third+ children,
wake from the Quiescence already with the baby on the perineum and
ready to begin pushing.
The
Breakers
(Second stage of Second stage — Pushing)
At this point the baby’s head reaches the perineum. It can be felt by
the mother, it may be visible to her partner if her position makes that
available. Mother knows her baby is right there. The sensation of the
baby on the perineum will bring on pushing contractions from the mother
if necessary. Usually mothers seem to be at one with the power of the
waves and push with them but I have witnessed a few women who never
actively push during their labors. The uterus does everything. Mothers
articulate with these birthing contractions and the birthing song that
began in early labor crescendos into magnificent aria. The mother’s
voice may actually guide the baby to the end of the tunnel. These
universal sounds may spur the baby on through his or her journey and
create the natural excitement and tension that comes with reaching a
goal. At this point, close to Crowning, the Mother experiences a rush of
adrenaline. With the speed of light she is in two worlds. Her oxytocin
birth trance is still palpable and she is cognizant of her earthly
reality. She is back and is ready to bring her baby to dry land.
I have noticed that almost all women engage the same position for
birth. Women who are left alone and not told what to do…universally and
naturally seem to do this…
KNEEL on one knee.
During their time Between the Worlds, most women are upright and
flowing with labor. Many women sway with contractions and will lean
forward during the majority of the contraction. This is natural wisdom.
In labor, the uterus moves upward and forward and women naturally move
with the uterus, facilitating the process. Some women will even hold
their uterus up and forward with contractions…never having been guided
or encouraged to do this. During Quiescence, women seem to relax. They
may float in the tub or sit back. They may even lie down on the side.
When contractions resume full-on during the time of the Birthing Tides,
women are usually upright again…walking, swaying, leaning. As this time
becomes more intense and melds into the actual Breakers a woman
instinctively knows her baby is near and will begin to hunch down and
get closer to the floor. Finally, when the breakers are in full swing,
women invariably bring down one knee and take a kneeling position with
one knee on the floor, the other bent. A mother will never drop her baby
out on the ground. She will crouch on the floor, one knee down, one
bent and facilitate the birth of her child. Her partner usually crouches
in front and above her, like the Archangel, protecting and witnessing,
claiming his family. The caregiver is nearby…waiting to be called closer
if needed. Most mothers birth their babies solo. Babies generally don’t
come barreling out of the uterus when the mother is present and
instinctually engaged in her birth, so no one needs to catch. Mother’s
hands know what to do…as always…and assistance is seldom needed. Baby
comes through mother’s hands and she places her baby gently on the birth
mat prepared for the baby on the floor.
A note about other positions…
Women will sometimes go from a kneeling position during the Breakers
to a hands and knees position. This is popular position because the
laboring mom can get the weight of the baby off her back and has her
arms to support her as she leans over. A mother will only do this if a
caregiver or partner is facilitating the actual delivery because a mom
instinctively knows that her baby is now behind her and she cannot
receive her baby herself. Often moms confide after the birth that the
hands and knees position made sense in the moment but that they were
sorry to have missed the birth of their child. Someone else ended up
catching the baby and many moms I have known will not choose this
position again.
Women seem to dislike a supported squat. They are totally dependent
on someone else to hold them up during birth, usually the partner, and
then the partner does not easily see his child born. Also it often puts
the mom in an awkward state…needing to depend on someone to hold them
during birth when they instinctively understand that this is not really
necessary. I realize that supported squat is a caregivers position for a
mom rather than a position that she would naturally choose. Also, in a
supported squat, I have seen women have difficulty arching their back
for the fetal ejection reflex that Michel Odent speaks about.
Semi-sitting, the most culturally popular position for childbirth, is
the most difficult position in which to birth a baby. It’s a matter of
sacred geometry. When a women is sitting on her coccyx, which is exactly
where she is sitting when leaning back, she is occluding the birth
canal. In labor, the coccyx will naturally roll out of the way so the
baby can fit through. When mom is sitting on it, great force may be
required to move the baby over the coccyx. That translates as hard and
heavy managed pushing with the legs to the ears and often a lot of
yelling and coaching. Even though it is psychologically preferred to
lying on the back or in stirrups I have never seen a mother choose this
position, or need to. Actually, from the physiological stance, lying on
the back is an easier position for labor because the coccyx can move out
of the way with less effort than when the mom is sitting on it. Moms do
not like lying on their backs in labor because intuitively they know
it’s not natural and it creates more work for the uterus which moves
forward and upward.
Women opting for a water birth may sometimes remain in the
semi-sitting position. This works in water because as the baby is
borning, mother can easily raise herself up and let the coccyx move and
the baby come to crowning.
Lying on the left side is chosen by moms who are wanting to be in
their beds or are confined to bed for some reason. It seems to work very
smoothly as it equalizes pressure on mom’s bottom but women report that
there’s something very awkward about needing to have your leg held up
during your birth.
What I learned from birthing women is that they will instinctively
find the position that works best for their labor….usually the kneeling
position. Whatever position a woman chooses…semi-sitting or hands and
knees or kneeling…it is the natural position in the moment. There is no
one correct position for birth. It is as individual as each woman and
each labor. My experiences have been that women most often choose a
kneeling position when not culturally imprinted.
The distinction between the
two stages of Second Stage of Labor:
In clinical practice, we have acknowledged only one aspect of second
stage. In this holistic model we notice that mothers don’t usually push
until the head is on the perineum and we have delineated two stages of
labor. The first stage of second stage, The Tides, occurs after
transition and includes the time between full dilation and the arrival
of the head on the perineum. This stage encompasses the time that the
uterus naturally brings the baby through the birth canal. The other
stage, The Breakers, characterizes the time when the baby is visible and
the mother has a compelling and involuntary urge to push. Sometimes she
will feel her uterus pushing gently during the Birthing Tides. She does
not push with it…it’s not necessary. In fact, encouraging or managing a
mom to push during this time before the head is on the perineum may
cause undue damage to her vaginal tissues, pop capillaries and disorient
the mom who instinctively knows her baby will come down with privacy,
time and the ability to find the appropriate position. During The
Breakers she will use her own effort with that of the uterus to birth
her baby. I have been taught by women that it is not necessary tell a
mother to begin pushing or to guide or manage a mother in pushing. This
overrides her instincts and unless something is terribly wrong, her
instincts will always be her best guide. Pushing before the head is
visible… known as managed pushing…is a dubious achievement at best. It
can be humiliating to position a woman on her back or bring her legs up
to her ears and exhort her to push her baby down and out. It is
instinctively incorrect, it seems overbearing and generally, from my
experience, unnecessary.
(Certain variations, such as moms with babies in a posterior
position, often do need assistance with pain relief and with pushing
techniques…more on that later.)
Emergence
(Birth)
At the time of Crowning the largest part of the baby’s head has now
passed through the Birth Gate. Mother is often ecstatic and totally
energized.
She may cry out as if to announce her return. An adrenalin response
occurs in the mother and she rises up slightly from her kneeling
position and arches her back. This has been called the fetal ejection
reflex by Michel Odent and this rising up allows her to facilitate
crowning and the baby moving through the last part of the birth canal.
This adrenalin surge, that co-exists with the flow of oxytocin, is
responsible for the alertness of the mother and baby during this time. A
mom may feel somewhat overwhelmed as she transports from one dimension
to another but she is never at a loss for what to do. She simply births
her baby. As she kneels to birth, her partner may be facing her, ready
to catch his child. Perhaps another pair of hands, those of the midwife
or caregiver, are ready to assist, and then again, perhaps not.
Assistance is normally not necessary. Mother is not out of control,
birth is not chaotic, there is no hysteria or confusion. Birth is
accessible and a woman does what is natural.
It is an absolute fact that a woman does not particularly need anyone
to catch her baby. She may desire another pair of hands in her field or
she may desire someone to catch her child but women do not particularly
NEED anyone to catch their babies. The myth that someone must check for
the cord or perform head traction to free the baby is simply not true.
Cords seem to resolve themselves…in fact one third of all babies I have
seen born have had the cord around the neck and generally nothing was
needed to be done. Head traction or assisting the baby is usually not
necessary either and may, in fact, cause a problem or delay.
The
Return
(Immediate Postpartum)
Baby slides into a new world. A transformation has occurred. Both
mother and child experience a period of re-integration and
re-organization. This stage may take about 5 to 10 minutes and is
similar to the Quiescence in it’s calmness and quietude. Mother and baby
are stabilizing – reorganizing molecular structure – and neither may do
anything that is visibly apparent for a few moments. Baby is changing
from fetal circulation to neonatal circulation, initiating respirations,
smelling the environment, feeling air for the first time, listening,
seeing, and experiencing his or her first impressions of this planet.
Mother is seeing this planet through new eyes. She will usually sit
quietly for a few moments allowing herself to return. She then reaches
out to touch her baby. Usually the partner sits by, watching, with tears
of awe.
This is the moment of earthly bonding. Oxytocin, the hormone of love,
runs high…higher than at any other time in labor and the family falls
into love with each other. Mother recognizes her child, partner claims
his family. The bonding occurs first on psychic and spiritual level,
then the mother reaches to pick up her baby.
Mothers have taught me that it is not appropriate to interfere with
this important stage of birth. This is an incredibly high and holy
moment and if we truly understood birth and the ramifications of
returning from an altered state…the re-integration…we would protect the
privacy of the mother and baby at this time more than any other. I have
noticed that mothers are often not ready to hold their babies
immediately after delivery. They need a moment, or two, or five. They
need to experience their baby in an authentic and instinctive manner. We
need not hand a baby to a mother and please, never remove a baby from
the mothers field.
Acquaintance
At this time Mother has picked up her baby and begun to become
acquainted. Mother and Father are in awe; in awe of their baby, of each
other, of the amazing realms through which they have just traveled. With
a sense of wonder and reverence they approach their baby. Initially
they may be crying and speechless, still wrapped in the mystical cocoon
of the Vortex. This may soon give way to expressions of delight as
parents caress and speak to their baby and each other. The period of
Return and of Acquaintance are times when distractions should be kept to
a minimum in order to respect the initial bonding between parents and
baby. Stethoscopes, flashing cameras, suctioning devices, hands and
voices other than the mother and father can be disruptive and
inappropriate during these vital first few minutes, especially if the
parents want the sanctity of the bonding process honored.
As the Acquaintance comes to an end (usually after about ten minutes)
and mother and father have explored their new child, the mother may
feel the placenta descend and feel that it may be ready to be birthed.
If so, she will signal for the bowl and perhaps wish the caregiver to
come closer. However most women I have worked with have not desired to
birth their placentas until after the next stage.
From the Tao…‘The midwife does her work by doing nothing.’
From close by, without interrupting or being in the mother‘s field,
the midwife or caregiver can assess the newborn, assess mom’s placental
separation and bleeding, assess and meet the immediate needs of anyone
in the room, stabilize the environment and be the silent witness during
these first minutes and stages after the birth.
Communion
This is the point at which the parents choose to share their new baby
with others in the room. Children, grandparents, friends, attendants
are invited to come closer and greet the newborn. At this invitation,
the caregiver may move into the space of the Mother and family. Momma
and baby are alert and receptive. Father is processing the experience
and claiming his family. Baby may show interest in nursing.
Congratulations are offered and a quiet celebration ensues. The Return,
Acquaintance and Communion together last about 20 to 30 minutes and
comprise the immediate postpartum. While they are short in duration they
are very different stages of birth, each with a unique and important
experience that impacts the development and well-being of the family.
Completion
(Immediate postpartum, Delivery of the
Placenta)
About 30 minutes after the birth, the mother will often turn her
attention to her placenta. At this time, the placenta is out of the
uterus and sitting in the yoni. It is easily birthed at this time with
very little fuss and concern. The midwife may hold the bowl and assist
the mother in positioning herself to release the placenta.
The mother has had her bonding time and has had initial communication
with her loved ones and she now settles herself down to nurse and
fortify herself with something to eat and drink. The family is stable
and safe. Perhaps the midwife has finished that baby hat by now and may
offer it to the parents before she withdraws.
Babies tend to be alert for the first hour or so after their birth.
Then they generally drift deeply into sleep, having nursed and fallen in
love. Mother has birthed her placenta and received nourishment and
witnessing from her loved ones. This is now the time, after about an
hour, while her baby sleeps, for the caregiver to return to the scene
and assist the mother in accessing her body and her bleeding. Mother may
wish to shower and assess her bottom, the birthing room is tidied,
phone calls are made. Perhaps mother calls for more food and wishes to
talk, perhaps she wishes to rest. As this finishing winds down over the
next while, mother and partner draw together and prepare to enfold their
baby, and each other, in sleep.
The midwife enfolds all as she writes her notes or closes her eyes in
silent vigil.
Weaving
the Story
(Postpartum)
During the next days and weeks the vortex remains open.
Mamatoto…motherbaby…are establishing their relationship and rhythm. The
altered state is still apparent but beginning to close. How quickly it
closes depends on how soon the mother returns to her ordinary reality.
During this time, family and caregiver revisit the events of the birth.
This is a crucial time of witnessing and articulating the journey to
each other. Mother has an opportunity to review her altered state with
her companions and formulate her wisdom. Partner is incorporated into
the experiences and the parents share their insights.
The Weaving goes on forever. Families and caregivers form a special
bond and as time progresses and children grow often the birth wisdom
continues to be revealed and understood. Being present with families in
the postpartum is as relevant as being present in pregnancy and birth.
Also, this is the stage when parents let me know what worked for them
and what didn’t. This is time of open and candid communication as
parents taught me how to better midwife them.
As I continued to facilitate women and families in birth, more was
revealed. As I gave up my preconceived ideas about birth, and witnessed
what actually happened, women were free and delighted to share a new
paradigm with me. And while I realized that this account of birthing
does not represent the mainstream in birth today, it is my experience and the
experience of many of the women I have attended. As a constant student
of birth, I offer thanks to them.
*While I use the pronoun ‘he’ to refer to a partner, in no way do I
wish to marginalize same-sex couples. Nor do I wish to minimize single
moms who have done more for liberating women than any group I can think
of. My practice has been mostly with non-same-sex, married couples so I
use what I am most familiar with.
Resources for this
article:
Women Giving Birth by
Astrid Limberg and Beatrice Smulders
The Scientification of Love
by Michel Odent
Birth Reborn by
Michel Odent
A Plea for the Reform of
Second Stage of Labor by Constance Benyon.