July 26, 2013

Pushing Past My Comfort Zone: Childbirth Educator Workshop in Huntsville, AL

By Shandus Parish

I attended the BirthWorks Childbirth Educator workshop on February 1-3, 2013, in Huntsville, AL, with facilitator Sally Healey. Although the weekend was packed with challenging exercises and conversation, I had a wonderful experience engaging in self-reflection, learning a great deal about myself, and forging deeper relationships with a group of women I previously knew mostly as acquaintances. I expected to learn the nuts and bolts of facilitating discussion, become educated on a variety of birthing topics, and generally learn about leading a class. I was pleasantly surprised to discover that this workshop involved something much more complex – nitty-gritty, emotional, soul-searching.

I was inspired many times that weekend, particularly in response to the visualization exercises. I’ve always struggled with this kind of exercise because I find it difficult to stay focused on something that felt forced and, frankly, a bit hokey. However, the exercises we used in the workshop did not feel forced, I think because they were structured in a way that required full participation from our inner consciousness. I was astonished by my responses to some of them, coming up with answers that I didn’t even know were in my head. For example, during one visualization we were instructed to imagine a maypole with many colorful ribbons attached to it. In our mind, we were to visualize grabbing hold of one ribbon and to reflect on how that ribbon symbolized ourselves. I expected to see a strong, thick, sturdy ribbon, but instead I immediately imagined a crinkly, fragile-looking ribbon. Despite my best efforts, I couldn’t get that ribbon to morph into anything else. It revealed to me a deep sense of fragility that I didn’t realize I still had.

Another inspiring activity involved writing about our own birth story from our mother’s perspective and then to analyze any negative assumptions that were revealed in that story. I expected this to be an easy, fairly objective exercise, but as I wrote and then shared with the group, I sobbed uncontrollably as I sympathized with the deep embarrassment, hurt, and abandonment my mother felt at the time of my birth, due to actions of my father. I grieved for my mother and the experience she had, and developed a strong sense of gratitude and understanding of the strength she must have had to mother me so well, despite her circumstances.

In general, I was inspired by how powerfully the births of our own children (even our own births) influence our personalities, emotional responses, and ways of interacting with the world. Conversely, the culmination of how we were raised, the experiences we had as children and young adults, and the relationships we’ve had with significant others and friends can have a tremendous influence on our birth experiences. To ensure the highest likelihood of a positive, empowering birth, expectant mothers should intentionally explore and process through those experiences so that they can begin to own them and transform negative circumstances into empowering memories.

For my own life, the workshop reminded me to trust my instincts more often, not just when giving birth, but in every moment of my daily life. Our inner consciousness knows far more than we can ever realize! I was reminded how important authenticity is in my life and relationships, and to embrace my true self, regardless of how others may receive it. Additionally, it taught me to be more aware of how others’ experiences have shaped their behaviors and how they respond to the world. That is, I should be gentle with everyone, because I may never know what struggles they have to work through.

The workshop will influence my teaching in several ways. For one, I will research and practice ways of responding to my students’ answers so that I can be prepared for any response. I have facilitated many group discussions in the past, and I know how easy it is for a discussion to end too quickly when a facilitator isn’t skilled at helping individuals process difficult emotions and at drawing out responses from those who tend to be quiet and non-participatory. I will also make myself engage in activities that may seem silly or uncomfortable to me, because at the workshop I found that when I was faced with an exercise that made me feel uncomfortable, I had a great deal to learn about myself and about why that discomfort was there. Pushing past my comfort zone was always rewarding. Because of that, I will embrace those uncomfortable, challenging moments in my classes, knowing that if we can all push through that wall, we may discover something momentous.

July 19, 2013

Oxytocin: The Hormone of Love

Kerstin Unvas-Moberg

This is Part Two of BWI President Cathy Daub's report on the Mid-Pacific Womb Ecology Conference, held in Honolulu, HI in October of 2012.

From a lecture by Kerstin Uvnas-Moberg MD, PhD

Kerstin Uvnas-Moberg began her lecture by describing oxytocin as a highly charged protein that does not pass membranes easily. Thus, it cannot be measured well in saliva or mucous. It is also a neurotransmitter in the brain. The Paraventricular Nucleus (PVN) is a very important oytocin producing site. From the PVN, neurons pass down to the pituitary but also to many other areas of the brain. Thus oxytocin may have psychological effects as well as physical effects like breastfeeding. The important thing is that oxytocin releases in the brain and circulation at the same time.

What triggers oxytocin release? Labor activates nerves from the cervix to the spinal cord and to the brain. Mammary sensory nerves send impulses to the brain for oxytocin release. Skin nerves release oxytocin so touch is very important. The effects cannot be obtained by looking, but rather by touching and being held. In fact more oxytocin is produced when a baby’s hand massages her mother’s breast than by nipple stimulation. This massaging creates a positive cycle where the mother is more interested in her baby and more oxytocin is produced. Babies have an inborn capacity to suckle within one hour of birth. There is a higher rise of oxytocin when the baby is on her mother’s skin right after birth.

Oxytocin is also released from neurons in the brain and leaks out and reaches lots of areas in the brain without even needing nerves so it is acting in many ways. More oxytocin is released in a new mother just by seeing and hearing her baby. Finally, it is interesting that oxytocin triggers its own release, which further triggers other releases.

The mother’s temperature pulses with skin-to-skin contact with her baby. She becomes warm and this helps the babies to relax and open their blood vessels. These babies have better self-regulation one hour later and this becomes a learned response.

Kerstin explained that children who have not had skin-to-skin contact with their mothers at birth and through breastfeeding, exhibit behaviors that are not as closely connected to their mothers as those who have had skin-to-skin contact and this remained true at one year of age. Children were filmed during play interaction one year after birth. Those with mother/baby skin-to-skin contact were more sensitive and interactive as compared to those without mother/baby skin-to-skin contact. In addition, the babies’ ability to handle stress was better than those babies without mother/baby skin-to-skin contact, showing there is a long-term effect.

In the HPA (Hypothalamic Pituitary Axis), oxytocin makes the mother calmer in the amgydala (limbic or emotional brain). Oxytocin neurons pass down to the pituitary to enhance production of prolactin and other substances for breastfeeding. Dr. Moberg also related that the half-life or duration of the substance is stated in the literature as being three minutes but that this is not true. In actuality, oxytocin has a much longer half-life of about 20-30 minutes. Dr. Moberg mentioned that if there is no mother/baby skin-to-skin contact in the first hour after birth – a biological window – later, there would be a need to repeat things more often to get the same effect. Early interaction influences the long term – it is more difficult for mothers and babies to come back to this positive interaction later on.

Obstetrical anesthetics interrupt the natural flow of hormones and have behavioral consequences. Dr. Moberg said that mothers who didn’t have oxytocin release were the mothers whose children didn’t touch their mothers – they received blocks. The mother and baby interacted less efficiently. You could actually calculate if mothers had received blocks – babies had to press twice on mother’s breasts and still less oxytocin was released so the whole system has become less sensitive. In other words, there is a blocking of the whole oxytocin system. This is important because this early interaction influences the long term. We have lost this positive influence to the brain and it leaves mother and baby where stress will have a much greater impact.

Mothers with normal birth have more social babies and both mother and baby are more relaxed. With a cesarean section, there may be no oxytocin release. If a scheduled cesarean, there is no labor to stimulate the release of oxytocin compared to normal vaginal delivery. Four days after birth, a woman normally has oxytocin pulsing releases at 90 second intervals and each time there is a milk ejection release. With a cesarean these nice pulsing releases are absent. So there is a disturbance in oxtytocin release in cesareans. This may be due to lack of skin-to-skin contact. There are no peaks in prolactin levels in cesarean mothers four days after birth so a lack of oxytocin has made prolactin release affected so breastfeeding in cesarean mothers is difficult.

An epidural blocks transmission of nerve impulses in the spinal cord so there is a decrease in oxytocin production during labor. In addition, with an epidural, there is an inhibition in the rise of skin temperature in the infant. When a mother holds her baby, the baby’s skin temperature increases which is a sign of relaxation. You normally see nice skin rising temperature in the first couple days after normal birth, but you don’t see this a couple days later in cesarean mothers. Mothers with decreased oxytocin secretion had higher blood pressure and cortisol levels i.e. increase in stress hormones with decreased ability to relax.

In summary, Dr. Moberg expressed her concern:

In labor, something happens in the regulatory system when there is interference in the natural process and this is especially true if it happens during a sensitive period. There are long-term effects. When you give exogenous oxytocin (Pitocin) to rats, it lowers their blood pressure – and it remains lower for life. Problems with breastfeeding are consistent with the effects of a sensitive period and it is likely that this can have an influences in a negative way for a long time. Low oxytocin levels lead to low breastfeeding and long-term impact.

Dr. Moberg’s new book “The Hormone of Love” will be published in March 2013.

July 12, 2013

Looking into the Future: Visioning Birth in 4012

This is Part 1 of Cathy Daub's report on the Mid-Pacific Womb Ecology Conference, held in Honolulu, HI in October 2012.

By Cathy Daub, BWI President

In October of 2012, I had the pleasure of attending the Mid-Pacific Womb Ecology Conference in Honolulu, HI.

The concept of Womb Ecology, which is promoted by Michel Odent, MD in his newsletters and books, is gaining acceptance and having a global impact. I was honored to be asked to present a workshop with midwife Elizabeth Davis entitled “Transcendent Emotional States in Birth.”

At the conference I was also pleased to speak several members of our BirthWorks Board of Advisors, including Michel Odent MD, Kirsten Uvnas Moberg, MD PhD, Elizabeth Davis, Jan Tritten, Suzanne Arms, and Heloissa Lessa, a midwife from Brazil who helped Michel Odent organize the conference.

The conference brought together representatives from 52 countries. As I gazed across the audience, I realized I was in the midst of more than 600 people who would be spreading the concept of Primal Health and Womb ecology to all corners of the globe. In a day and age when birth has become an industry, and technology, and obstetrical drugs are dominating the birth scene, I realized the magnitude of what was about to happen. We would be hearing speakers who would talk about the interaction between art, science, and techniques, and engaging meaningfully with the idea that interfering unnecessarily with the environment around the womb is fraught with dangers that can influence our health as adults.

One of the most interesting parts of the conference was a panel inviting speakers to share their vision of what birth will be like 2000 years from now, in the year 4012. Here are some highlights:

Vision for 4012 birth: Panel

Michel Odent asked a panel of experts what their vision was for birth in 4012.

Peggy O’Mara said we would be moving towards total trust of the body towards normal birth. There will be more midwives and fewer specialists.

Robbie Davis Floyd said we’ll be giving birth in 0-gravity space. There will be sophisticated technology and private enterprises such as hotels on Mars. Birth centers will orbit the earth and moon. She noted that birth on Star Trek were normal, natural birth. There will be an entire industry for orbital birth. Her fears included, “Will we be choosing the gender of our babies? Will we be ordering babies from a catalogue someday – breeding for color of hair, etc.?” Yet she does envision normal physiologic birth in 4012 believing that, “Mothers have the power to give birth and babies have the power to be born.”

Sarah Buckley envisioned a future where a loud noise lasting 11 minutes would cause the cessation of all electric fetal monitoring equipment, ultrasounds, and the clock. She asked what birth without monitoring would look like. There would be no more epidurals, inductions, and cesareans that were necessary would be short and efficient. She said Jan from Midwifery Today would train a new generation of midwives who know how to trust labor without technology. Love and connectedness would in our cells and generations of babies would be born that would lose the imprinting of fear in childbirth. Once physiologic birth is in place, we would have a generation of people who would treat the earth gently. There would be few obstetricians and attendants would be good at knitting.

Jackie Chang of Korea said that we will not argue about how we’re going to give birth anymore but will focus on maternal instinct and being ourselves. We will learn to be wise again and listen to each other. We will be dancing and singing together giving birth. Rapid changes are taking place in birth in Korea and not just in lifestyle – also in philosophy. Maybe some women need cesareans for their own survival and others need to be natural. Right now, cesarean mothers have an enormous guilty feeling after cesarean section. We must find out how we can be together so there is no judgment. Please don’t let one mother feel guilty.

Michael Stark MD said, “I’m afraid we don’t have good news for the future and in 4012 it will not be what we are expecting it to be.” He went on to say that 4,000 years ago in Egypt, there were midwives and midwifery schools. In 4012, he believes we will have produced artificial ways to conceive and give birth - the artificial woman.

Odent to Stark: You’ve made the cesarean so simple today – has this done more harm than good?”

Stark: “There are currently high rates of cesarean section. It was never my intention to make delivery easier for the woman through cesarean section.” He went on to describe what the future might be with a civilization born by cesarean section. “Just 150 years ago, people tended to be smaller. In one to two generations, we have become taller. If we continue with this direction of more cesareans, we won’t need a wide pelvis and the pelvis may evolve to become smaller. Babies may have smaller necks and the head may become larger and pregnancy may take longer. If we don’t need to deliver by nine months, we might have more mature children with bigger heads.”

My hope is that small things can happen to change history. “Michel, I believe you are one of these people. In 4012 perhaps all the world will have Odent delivery rooms. Less is more. There is so much love in this hall, maybe it is like oxytocin spray.” Both of Dr. Stark’s grandchildren were born normally.

Odent: “In Rio de Janeiro, they use spray of oxytocin in the shop. It can reach brain receptors and in subtle ways make people feel comfortable and want to come back.”

Jan Tritten of Midwifery Today emphasized that we all have a responsibility to make decisions that will benefit future generations. We have a planet, food supply, and mothers to take care of. People in China and around the world want to change current birth practices. Oceans are going to rush in. So let’s take care of the planet and our mothers and babies. Two thousand years from now is only 80 generations.

Laura Uplinger, interpreter for the conference being fluent in four languages, spoke about how we can reach the golden age in 4012. Babies will be given better conditions and optimal biochemistry will be flowing in the mother’s blood. The importance of the Primal Period will be better understood. Every pregnant woman needs to eat well, feel joy, and be inspired by birthing. There will be more resources for mothers such as birthing centers built in gorgeous parks where pregnant mothers walk together enjoying joyful synergy. Hospitals will have closed their doors to birth. Breastfeeding will be a universal practice. Children will live longer and enjoy good health.

The panel ended with Michel Odent saying, “We have no concensus of childbirth in 4012. We need other conferences. Technology is going fast. We need to organize our next conference outside the planet earth – somewhere over the rainbow and at our next conference our dreams will come true.

We ended the panel by singing “Somewhere Over the Rainbow.”