Imagination before Dilation…

  1. […] Cervix checks – I will not be agreeing to any cervix checks at any time during my pregnancy and possibly during labor. What your cervix is doing during pregnancy and labor is only a very small factor of how you are progressing, and it usually sets women up to feel as though their bodies are not performing the way they should be. Here’s a good link explaining why they aren’t necessary. […]

  2. melanie good September 20, 2012 at 5:19 am
    I totally buy there being a mind-body connection and have given 3 natural births–one at home unassisted with no one to tell me when was time to push , and that was the fastest of all my labors (my second-born, too, so it wasn’t simply a matter of birth order).

    Melanie wrote: “Saying things that are blatantly untrue to those trained in science is part of why many obstetricians and other scientist do not support the natural birth movement. They find our reasoning, logic, and evidence to be lacking and when you misapply scientific principles like this, you are adding to that perception in a justified way.”
    Melanie I agree with you in a way, but my main gripe with obstetricians is that they think the only science is randomised controlled trials which can only look at ‘treatments’ and that their understanding of basic birth anatomy and physiology is so poor, I think they misuse science far more than the natural birth movement does, all their talk of science is a con trick to make women do what they want and much is hot air

  3. ilona says:

    This is great. Another point I’d like to make is that internal examinations can be very stressful for some women especially those who have been raped or sexually abused. An internal may be perceived by the woman as a violation or even an abusive act and then labour may shut down out of fear. If the woman can understand the rationale for the examination and dilation check and knows that it isn’t just a part of hospital protocol, (and it is only does sparingly when it is needed) then distress can be reduced and hence labour progress would be less compromised.

  4. Sarah says:

    I couldn’t agree with you more. I just had my sixth drug-free childbirth and because I knew this would most likely be my last time to experience childbirth (I am 43), I was SO committed to really really being in the moment, letting my fears go, maintaining control and enjoying every moment my getting myself into deep relaxation. Once I got settled in bed (I was in a hospital) I felt like I put myself into complete relaxation mode-I was controlling my mind and feeling my body almost disconnected…it was awesome and I was using visualization, breathing, counting, etc. I had no idea who was in the room and what was going on anywhere but in my body. It was going exactly the way I wanted it to. But when my dr. insisted on checking me (I asked her if we could skip this and she said no) I was thrown off a little…and then she told me I was about 8 and had a little while to go. I didn’t WANT to know and had to work hard to get back to my zen-like state right during the hardest part of labor…she broke that flow by checking me. But what was funny is she walked away with the intention of not coming back for awhile…and I knew because of every contraction I was FEELING, not FEARING, like I had for my previous births, that the baby was going to be born any minute. I told her quickly that the baby was going to be born in one more contraction and she brushed it off. And the next contraction? I pushed out my baby’s head and the doctor had to come running back.

  5. Katrina says:

    I was a birth support at a VBAC home birth some years back and at a point in labour my friend became quite fearful and concerned that her scar was going to rupture (as she had been fed a lot of fear from medical people when she said she wanted both VBAC and home birth if possible). I looked in deeply and felt in my own body that her uterus was fine and what was happening was that she had reached the point of dilation that she had got stuck at in her previous birth (no VEs were being done at that point by the way) . But I also knew that it was not for me to tell her this, it was her journey to allow that fear and find her own place of empowerment within it. The midwife attending seemed to be doing the same, asking Helen what she saw, and what she felt was needed. Well within a few contractions Helen was just getting on with it and she moved beyond her fear and proceeded to full dilation shortly after. It showed me so much about the birthing field and how even unspoken fear could have the potential to disturb it. And how subtle the disempowerment could be as well with well meaning friends or attendants telling the woman rather than letting her find the strength and power herself. In the end this woman needed a C/S due to a very short umbilical cord. But she knew at the crucial points herself that she needed to go to hospital, and when she got there an epidural was what she wanted and proceed to C/S rather than rupture membranes and endeavor to give birth vaginally. She did not know what she knew, but she knew and when the baby was born , they discovered a short cord that would not have allowed a vaginal birth. I learned so much at this birth.

  6. Donna says:

    Brilliant – makes so much sense!

  7. melanie good says:

    I totally buy there being a mind-body connection and have given 3 natural births–one at home unassisted with no one to tell me when was time to push ;), and that was the fastest of all my labors (my second-born, too, so it wasn’t simply a matter of birth order).

    BUT as a physicist I must must ask that you PLEASE DON’T INVOKE QUANTUM PHYSICS to explain this. It DOES NOT APPLY to the macroscopic world of which our cervix is a part. Saying things that are blatantly untrue to those trained in science is part of why many obstetricians and other scientist do not support the natural birth movement. They find our reasoning, logic, and evidence to be lacking and when you misapply scientific principles like this, you are adding to that perception in a justified way.

  8. […] This again relates to the huge role stress plays in inhibiting and slowing down birth. For example, one of my first hospital births turned quickly into a medical procedure when mom was given artificial oxytocin to bring on pressure waves after hers stopped completely. Why did they stop? Because after a cervical exam, the midwife sighed and said “It’s been two hours, and you’ve only progressed another half centimeter”.  Mom became scared she was going to be given artificial oxytocin, and through her prenatal education had learned how much more intense pressure waves are with that intervention. Her pressure waves stopped instantly because she became stressed and discouraged. It was amazing. Nothing highlights the truth about mind-body one-ness like birth. I really liked a recent article that explores this, called How Cervical Dilation Checks Undermine the Imaginal Power of Birthing Women. […]

  9. krista says:

    @Kaurina: So true!!!

    @Rumyana: “They were really nice women but didn’t know what my soul needed to get through this journey.” Most midwives (and OBs for that matter) are really wonderful people, just unacquainted with the paradigm of soulful “care.” We can’t blame anyone. Just call for what we know is true. It’s a revolution of sorts and there is a groundswell of women wanting something different.

    I am happy to hear that your dreams are guiding you…. Perhaps a solution will emerge for you from the dreamworld??? Keep me posted!

    @Feminist Breeeder: Here is a great article from Midwife Thinking about why cervical lips are not a problem “until they are detected” (because of the way the cervix dilates the anterior portion is always the last to go. ie all women have cervical lips at the tail end of dilation):

    That said, a previous birth trauma is likely to present itself in subsequent births and I have the utmost compassion for this. (I myself have experienced it) I wonder, what might have been different if you knew that cervical lips were “normal?” and had worked to resolve that previous trauma ahead of time? (I have no idea, maybe you did work on it. Would love to hear about it!)

    In the end, I am not sure I am completely against EVER using physical touch to connect with oneself, one’s baby, or one’s “progress.” I am just calling into question our reliance on them as essential and important protocol in midwifery care. Some women do have an authentic internally generated impulse to feel for their baby. However, from my research and experience this is actually pretty rare. Most women are soaring in the stratosphere and not all that interested in particulars. They often ask questions, but if we wait…. the answer usually emerges in the birth space, like a koan being broken open.

    I am also talking about an ideal here, which is important, but also trickier in practice. You make a very good point about the epidural case, but I wasn’t thinking of applying this to a hospital setting. In the hospital I think management does become important. If you intervene in birth you must start “managing emergent complications.”

    I am more interested here in how we can avoid complications to begin with.
    Best to you!

  10. krista says:

    @Tabitha: I wonder too…. about those checks. Most often they are not reassuring to mothers (though this is not always the case). Many many women actually report wishing their midwives/OBs had lied to them! I think this is a sign of the fact that women need to imagine themselves further along than they actually are in order to progress, or live into their own vision.

    About your question:
    “I want to train as a midwife at some point in my life, and i wonder how to broach this with a preceptor or future clients. Do your clients accept your rationale, or do they “NEED” the numbers?”

    This is SUCH a GREAT question and one that I have personally struggled with as well. You might consider looking at prospective preceptors and see where they studied and apprenticed. The Matrona and Ancient Art Midwifery Institute are good examples. Also, find out who they apprenticed with and investigate. In general unlicensed midwives are less bound by mandatory protocol. Ask. You are hiring them as much as they are hiring you so do your research.

    In the early days women who wanted to birth at home just started attending each other’s births. I completely support this option even today, though it’s not very popular or supported. Contact me (anyone reading this) and I will send you an essay about one culture’s “dreamtime” midwifery apprenticeship. I am also working on a larger article about the topic of apprenticeship so check back for it.

    I have a huge respect and compassion for women who really aren’t ready for something as radical as undisturbed or unassisted birth. That said, I am also a believer in unassisted and undisturbed birth as an ideal. It is my position that, like birth, “traditional midwifery” also belongs to mothers themselves and that motherhood is the truest “midwifery training” around.

    As far as working with clients goes. I work exclusively with women who want to claim this level personal power. This doesn’t even mean I think it’s right for everyone. And yet, for those who it’s right for it can be hard to find support. So, I just work with these families and it makes me very very happy. I have found that understanding how to help oneself and others in the birth space “settle” and contact their instinctual selves provides access to the very best reassurance available.

  11. krista says:

    Dearest Kai: Our observational field (as I am calling it) can be shifted with our intention. While I was in Peter Levine’s Somatic Experiencing Trauma Resolution training we did a lot of work with this. Especially powerful when an audience can bring their awareness into themselves and leave the stage open and free. I think there is an expectation for “therapists” to be completely focused on and engaged with their clients which can actually inhibit release. I use it all the time now and it’s quite amazing. In being with women in birth it can mean knitting in the corner…. I think though that this doesn’t happen often enough during “pushing” and immediate postpartum. What if our observation interrupts women’s return, bliss and bonding…. Perhaps this observation (even when it’s of ourselves) is at the root of most postpartum bleeding and breastfeeding issues.

  12. krista says:

    @Amy: Wow, that imagery is so poignant and compelling and beautiful…. I am breathless and awakened reading your words. My deepest gratitude for your sharing here! I would love to include your story in a larger write-up (you know in that book I will someday write. smile). Stay in touch!

  13. krista says:

    @Crystal, Laura, Erin, Jen & Amy. Thank you for your sisterhood in this mission! It is my pleasure to welcome you here!
    @ Elizabeth. Yes, many will not understand or appreciate the “pseudo-science” here and that’s ok. I am speaking to all those who DO get it because there just aren’t very many voices speaking to this powerful and often silenced few. I think Einstein would get it though. he he he…..

  14. I agree, cervical checks can be utterly useless. All we really need to know is if the baby is out, and well, we can see that! It’s like people who look up the weather instead of walking outside to see how it feels.

    I have seen, however, times when it can really help a woman’s confidence. When I was pushing during my home water birth, I got to a place where I was terrified to push anymore because I thought I felt an anterior lip (which I’d had in my previous labor.) When the midwife reached in and said “Nope! Fully dilated, baby’s at +2!” it was exactly what I needed to hear to let go and get the baby out. That wasn’t based on a fear of birth – but a fear of repeating a previous experience. I’ve also seen a mom who wanted drugs say “Oh, I’m at 9! Okay, let’s do this!” instead of accepting the epidural. Of course, that can have the opposite effect if she’s only at 2, but I’ve developed a very certain ability to tell how far a woman is dilated by just being WITH her so I really try to have moms avoid checks when I’m certain the answer will be disappointing to them.

    It would be so great if we could all let go and not check the weather.

  15. krista says:

    What amazing company I have here!
    Sisters, you make me weep with your words of power, encouragement and wisdom.
    I have a full day with clients, but I will return with more considered responses!

  16. Rumyana Kudeva says:

    You are magical! Your words were speaking directly to my soul and made such waves within me. I have experienced main stream overmedicated and technologized hospital birth ended up in c-section. Tried for HBAC next time and ended up with the same – not so medicated, but still sectioned me because I never got the support I needed in my home from the midwives. They were really nice women but didn’t know what my soul needed to get through this journey. Now I know that my soul needed this second “failure” to heal itself from the initial trauma that was carved into my heart and body from the first csection. I keep having dreams and imageries about me birthing alone, undisturbed and in peace and I now know I need to listen to my heart and soul. This next pregnancy will be my last one and I want to give myself what I deserve not what others offer me or expect from me. My husband is against homebirth period, but he cannot understand the true meaning of birth for a woman who has been through so much grief and pain. Thank you so much for speaking the words and bringing more light in my heart!

  17. Kaurina Danu says:

    Totally agree with this article!
    For my third child, I went out of my way to find a midwife who was ok with my request for no internal exams at all.
    I would like to suggest my experience in response to the idea of “labor stalls when a woman is observed in labor.”
    I have found that the mental and emotional state of the observer affects the birthing woman, so labour can be positively or negatively affected by what’s going on in the observers mind. If the observer is bringing a belief of trust in the woman and the process, that enhances the labour, but if the observer is looking at the woman and feeling sorry for her, or looking with the unconscious intention of finding something wrong in the process, well, you know how it goes.

  18. Tabitha says:

    I love this, and have first hand experience with the negative effects of cervical checks. With my third daughter( second pregnancy, i had a twin homebirth with my first pregnancy) i was checked and found to be at a stretchy 9 cm. I became terrified, Pushing my first had been a horribe experience, directed pupe pushing by a midwife, teing me i couldn’t rest, i was at 10 so i needed to push, so when i was told i was again near pushing i oanicked. when i was checked again an hour later, i had reversed my dilation to a 4. So i had to relabor. I often wonder that if i had never been checked with my first or second births, would i have experienced any of that.i personally don’t find early labor that much easier tha ate labor, so a 3/4 feels as intense to me as a 10, and the numbers just discourage me.

    I have a question though. I want to train as a midwife at some point in my life, and i wonder how to broach this with a preceptor or future clients. Do your clients accept your rationale, or do they “NEED” the numbers?

  19. Kai says:

    So inspiration, Sister! Thanks for putting it out there and weaving the threads so eloquently .. . . you are a true craftswoman of your Art! I would love to learn more from you about what you describe as “your observer field” . .. I feel like this is something we don’t learn at school and can be crucial to not standing in the way of the Unfolding. I recognize too that I want to dedicate more time to my prayer practice and connection with Spirit, for that Knowing is a Greater Guide than all the knowledge gained in school. Looking forward to continuing to go Deep with you throughout this journey of learning to Be with Women. xxx

  20. Amy Frank says:

    This is such an excellent concept, beautifully and accurately described despite its inherent abstractness. My first and only birth thus far was unassisted, with only my husband in attendance, and this really resonated with me, even though I had no managed. medicalized birth experience to compare it to as so many other UCers (sadly) have. When I came to the section on imaginal psychology, I was immediately brought back to vivid memories of my birth experience. One thing that has always stood out to me is all the imagery going through my mind during my birth. As I was reading this section of the post I couldn’t stop thinking about this one part of my birth: as my body started to transition from dilation to fetal ejection, I became distraught and irrational for a time. My husband was encouraging me as I sat on hands and knees in the tub, telling him I didn’t think I could do it and suddenly, I sat upright on my knees, put my hands up on the wall and felt my baby move downward with the most scrumptious pushing sensation I have ever experienced (I’m sure this was my Rhombus of Michaelis opening). I knew something was shifting and changing and in my mind I saw an image of a white horse in a wintery night scene; the horse had been running for some time, it was panting and snorting and there was condensation rising from its nose. It reared up and whinnied loudly just as I placed my hands on the wall and felt my baby begin to move through my cervix. I have always known this was my soul’s voice but you put that thought to words better than I ever could have. Thank you for this post!!!

  21. Amy says:

    I found that when I was scheduled for an induction with my daughter, I went into labor the night before. We had everything ready and our minds were ready. My mind and my body came together and we had a lttle baby girl at 2 am!

  22. Jen says:

    This is great! I was never checked with my 2nd and she came 10 days “early” 😉

  23. Erin says:

    Great Article. Should be read by all involved with pregnancy and especially birth.

  24. Elizabeth says:

    I agree. This is friggin’ incredible. I love that it delves into science, but it’s a realm of science that becomes so abstract that so many who consider themselves logical will unfortunately not be open to it.

  25. Wonderful, Krista!!

  26. LOVE THIS! Thank you for sharing your thoughts! 🙂

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