When working with a pregnant mum it is incredibly important to understand the psychological impact you have on her and ultimately her birth. Regardless of whether you are a trainee midwife attending your first birth, an experienced birth professional of many years or even one of a multitude of other care providers who come into contact with pregnant mums, if you are involved in her journey then you can have an impact the birth outcome. By creating consistent positive messages for mum, between us we can help her to relax and trust in herself, her body and her baby. A positive birth experience does not necessarily mean a natural birth or home birth, it simply means that mum recognises that her birth experience was a positive one.
"There is power that comes to women when they give birth. They don't ask for it, it simply invades them. Accumulates like clouds on the horizon and passes through, carrying the child with it." Sheryl Feldman
Factor 1 - Generating and maintaining a trance state
When women are experiencing a calm and relaxed labour they find themselves going into a trance state, this is a completely natural state and is key to the outcome of the birth. The complete unfaltering focus of attention that mum has on what is happening inside her body needs to be maintained and protected in order for her to work with her body and baby successfully. In a similar way to the telephone ringing when you're reading a good book, an interruption to this trance state will distract mum and cause her to need to refocus her attention. Achieving and maintaining trance states during labour can be quite difficult when in an unfamiliar environment (eg hospital), where comings and goings are assumed to be out of the control of mum and birth companion, however it is key that either a birth professional or birth companion recognises the importance of the trance state and removes or reduces opportunities for this to be impacted. This can include:
- Enhancing how relaxed mum is by focusing on all of her sense e.g. favourite scent, soft blanket, relaxing sounds, favourite picture to focus on, visualisations incorporating all of her senses
- Reducing volume of people present and controlling who is able to enter the room
- Removing clocks (time distortion happens during a trance and recognition of how long you have been in labour can break a trance state)
- Reducing examinations as much as possible
- Reducing medical noises in the room which may increase anxiety
- Reduce monitoring as much as possible - listening to a machine means she's not listening to her body
- Allow mum to stay in her own comfortable clothes
- Birthing pool can be particularly good, not only for how relaxed they make mum feel, but also they act as a barrier to people entering her "zone"
If any external activities do impact mums trance state, then it's important to recognise the signs of this and to understand the impact of anxiety creeping in. To gain an understanding of this for yourself, please check out my video on Fight or Flight.
Factor 2 - Resolving key emotional issues
Harbouring emotional issues can cause labour to slow down or to stop and often conversations arise during labour which have been outstanding for some time, get resolved and then labour continues. For mum to be completely at ease and for her mind and body to recognise that it is a safe time and place to give birth, resolution of these issues should happen prior to labour. One technique I have found particularly useful is to talk through the key basic needs which give us good balance in our life, this is based on a Human Givens approach. In summary, the Human Givens include;
- Sense of security - This can be both in mind and body. Think for a moment about your home, work, or where you spend a lot of your time, does this feel like a physically safe environment? From a mind perspective, how safe and secure are you in your relationships, whether these are personal or work related.
- Sense of status - It may be that you do get a sense of status from a particular role you play at work, however this can be also achieved in the home, in relationships and when taking part in outside interests.
- Connected to something bigger than oneself - This can be anything from being part of a local club or collection of friends, to joining with others with similar beliefs, to a simple interest in the world and people around you.
- Goals and Purpose - It is important to have an element of purpose within your life and by recognising what that purpose is, it becomes easier to achieve and life becomes more satisfying.
- Mind and Body Connection - This is where you have an understanding of the impact of mind over body and vice versa. This can include understanding how certain foods can make you feel differently, how a lack of sleep can make you less able to deal with the day in the short term and in the long term can start to impact your health seriously, through experiencing not only physical health issues but also depression*.
- Novelty and Stimulation - Whether you are a sudoku whizz, a football fan or a trashy novel reader, we all need something which keeps our minds active.
- Sense of control - This can be control over your job, a particular role you have, control over people around you and really any general change happening in your life.
- Giving and Receiving Attention - Whether this be through contacting old friends, meeting up with your family, joining local interest groups or even doing volunteer work or even doing volunteer work. You can also see a truly positive impact in this area when people build that unique bond with a pet.
- Feeling Understood - Feeling understood will mean that you have been listened to and your thoughts, views, values, life style or choices you have made have been appreciated (not necessarily agreed with!).
*If the mum is suffering from depression, it is key to ensure she is receiving the appropriate professional help, particularly as there will be significant changes in her life which she may need support in dealing with.
Factor 3 - Being in Control of the Birth
Regardless of the birth outcome a key factor in a mum defining her birth as positive is the amount of control she felt throughout the experience. Birth is often an unpredictable journey, so maintaining a sense of control for mum can be quite challenging for birth professionals but it is key nonetheless. In particular, here are the main areas which can really make a difference:
- Making sure mum has walked through her birth experience and considered all possible decision points
- Should unpredictable eventualities occur during labour allowing time for the Birth Companion and mum to consider all of the options
- Removing obstacles so mum can have the birth environment she wants - e.g birth pool, music, duvet/sheets/pillows from home, dimmed lighting etc
- Having people there who mum wants to be there
- To have considered the above and documented it, revisited it a few times and walked it through with the birth professionals who will be involved on the day
The key to a lot of this working is that mum should have a strong Birth Companion - whether this be her partner, a doula, friend or other birth professional. It should be someone who she can trust to help make sure that the decision she made are represented in the labour room.
Factor 4 - Believing that birth can be positive
This isn't just mums belief system, this is yours too. In order to help mum truly believe that birth can be positive, you too need to be consistent with that thinking. People (and especially pregnant mums) are both consciously and subconsciously aware of differences between what someone says they believe and what they actually believe. So the first task is to manage your own belief system by reframing your own view of birth. Re-read Ina May Gaskin, watch Birth Day, check out some of the positive posts on this blog and get yourself into the right space for creating a positive impact. Once you feel comfortable with this, then here are some ways helping mums belief system;
- Making sure mum knows how her body helps her during labour
- Making sure mum knows how her baby helps her during labour
- Build good rapport with mum and her birth companion so they trust that what you are saying
- Provide real life stories and footage of great births
- Help mum control the negative influences e.g. well-meaning but unhelpful comments from friends, limiting dramatised TV programmes which cover birth, baby magazines with sensationalised stories
- Helping mum maintain her belief system by helping her with positive affirmations
“The euphoria that follows an unmedicated labor is a very special time for anyone who is privileged to witness it. It's even better for those who get to experience it” Ina May Gaskin
However you are involved in the amazing journey of birth, I hope the above gives you extra ideas and thoughts on how to continue to positively impact birth from for mums, birth companions and of course baby too.
If you are pregnant and looking for more information as to how you can help enable a positive birth experience, or if you are a birth professional interested in more resources then please check out The Psychology of Giving Birth Programme which contains more information on all of the above topics as well as practical exercises, examples and hypnosis downloads.
Yours for calmer births, more often,
Photo credit: teddylambec