40 weeks + 6 days, and a few million thoughts

This blog is an opportunity to round up the many, and I imagine typical, thoughts going around about my imminent birth. Including birth plans, particularly my intentions to have my little girl stay at home  (see Being Around), and the valued reading I've been doing, namely, of pregnancy and birth affirmations that have helped me clear up my plans for these post due date weeks, and of yoga breathing techniques for use in labour. Altogether, these thoughts all point to how it all comes back to instincts (again). I am incapable of succinct blogs, unlike my superb guest bloggers, so please bear with me!

1. Turn around on childcare plans

NB: Not Abbie's luggage, but she'd love it (Nemo mad)!

Last weekend, I had a stomach bug. Yes, we both got excited - are these pre-labour signs? Oh.... maybe baby! But after three days of feeling funny, stomach and back aches and general fatigue (I slept ALOT), it all went away and I was back to definitely not being in labour by Tuesday. Ah well.

It did allow me to have a dress rehearsal. The main effect was that I could test out the impact of Abbie being present, and I found it quite distracting and stressful at times, that heart rate rising. Particularly the normal toddler antics, when she was playing up either to me or when I could hear it going on in the house. The sound of your children goes straight to the heart and while I was trying to stay calm and relaxed in preparation for the potential coming labour, it just wasn't possible with Abbie around. For example, we went for a walk and Abbie decided she didn't want to go home or walk anywhere and we were at a stalemate, I found the challenge of negotiating with her (something I'm doing on and off all day usually!), even though B was there helping too, really exhausting, I even went a bit light headed (part of bug probably), but it was too much and B had to take over. My friends (who were going to stay over and be available if Abbie woke in the night if it was an overnight delivery), also said that they weren't sure how they'd manage it if she was distressed on waking and wanted to go downstairs to see Mummy or Daddy. I think her age (2 years 7 months) makes it probably not the right time for us all to be in the house for the homebirth. If she were much younger, or older and more able to understand what was going on, it'd probably be different. So plans have changed again and we've packed up with Abbie a bag so that she knows she'll be staying at her friend's house now.

2. Winded by latest midwife appointment, boosted back by affirmations

I saw my midwife about a fortnight ago. Everything was fine, heartbeat, blood pressure, tummy size etc. The one thing that threw me was her immediate discussion of booking me in for a cervical sweep (first step to being induced) at my next appointment (this coming Tuesday). Although I doubt she intended for it to, it made me feel like I'd already been written off, that they were already having to make plans to help me along to start labour as couldn't rely on me or my baby to manage it naturally. Furthermore, that the date my body/baby went into labour (whenever that might be) wasn't good enough, that it couldn't be left to start of its own accord. I went into a spin, which didn't put me in the right state of mind for these last pre-newbaby days/weeks. On top of this, I had a really informative update on my friend's labour, which made it even more important to me that I chilled out and came to a decision about what I wanted to do re the sweep and, potentially, the induction process.

My wise friend had her first baby at home about three weeks ago. She was completely clear on what she wanted and, although wasn't going to refuse medical assistance if it came to it, was confident in her ability to labour and for her baby to find his own way out. And she did it, delivering a 9lb baby on a couple of paracetamol and visualising the contractions as waves pushing a boat along in the ocean. She doesn't have freakishly wide hips, she wasn't 'lucky', and she wasn't trying to crusade against medical intervention, she just trusted her body and got on with it. The main point that she made to me was the importance of Not Thinking. Getting stressed about her labour not progressing enough due to his head position early on, was what nearly stopped things for her. It was only by getting her thoughts together in the shower and settling into focusing on nothing but her breathing through the contractions that everything calmed down and a baby born three hours later.

I contacted her in panic, should I agree to the sweep? I had a sweep last time, and was still induced last time, something I want to avoid this time around. What did she think? She gently suggested that I read some affirmations to help me to decide whether or not to agree to the sweep (it's optional). After reading them and speaking to B (who'd also read them, and reminded me that I knew what I wanted to do inside, I just needed to do it), it was clear. I am going to decline the sweep . I have now printed the affirmations out and read them every so often, keeping myself centred (see Buddhist saying from my prenatal yoga sessions).

Here are a few as an example (the full list is available here):

My baby is strong and healthy.
I trust my body.
I am a strong and capable woman.
I have patience.
I am at peace with the world.
There is no need for us to hurry.
Birth is a wonderful, safe experience.
My body knows exactly what to do.
Untapped sources of strength are available to me.
My baby is free to choose his own destiny in the world.
I am a link in the endless chain of birthing women.
My baby will be born at the perfect moment.

An interesting link is to the Association of Radical Midwives, where a discussion is held about cervical sweeps being carried out weekly from 38 weeks in order to push things along for all pregnant women on a consultant's books (see here). In particular, reading the impression of an experienced midwife on the process, confirmed my decision further:

"I originally wrote in response "I think it is simply unethical for health professionals to put their fingers in women's vaginas on the off chance that it might precipitate labour. If women request this and have full information it's a different matter. This may seem extreme but I think there are a number of issues.
1) the consultant's motivation and the assumption that on what is essentially a whim he can determine other health professionals actions.
2) the acceptance that pregnancy should be shortened for no apparent reason.
3) the disregard with which the female genitalia are held.
I'm on one of my hobbyhorses -- that any interference with normal physiology needs to be justified in ethical terms."
Since then I've read the various abstracts which people have posted and I'm not sure that it really undermines the substance of what I wrote. There was an unthinking assumption that a shorter pregnancy is better and according to my reading of the original mail the consultant didn't justify or rationalise this instruction. And even if it doesn't cause infection and regardless of the degree of discomfort it seems wrong to me to subject women routinely to this. It seems to suggest that pregnant women's genitals should be generally available to any old health professional. It is common for women to say after they've had a baby that they have lost all modesty -- and I don't think it should be like this. This kind of routine treatment is a way of inducting women into a submissive role.
Yours,
MT (retired midwife, probably with a rather strange sense of proportions)"

3. Faith in ourselves, even when it comes to breathing

I finally ordered Mother's Breath, by Uma Dinsmore-Tuli, PhD, the source of some of the breathing techniques that I learned in prenatal yoga. I started reading it this weekend and it reflected back alot of themes already covered in this blog, about finding and following our instincts, believing in, and taking responsibility for ourselves and our children.

Here are some quite long snippets:

    "It is a universal axiom that a woman's body, breath and mental state are the material from which her baby is created. Thus the transformation of all women is the crucial factor for creating peace and harmony in the world." (p viii)

    "There is a natural physiological link between breathing and heart rate, known as respiratory sinus arrhythmia (RSA*). The arrhythmia is due to variation in firing rate of impulses along the vagus nerve to the heart's natural pacemaker. This firing rate is controlled by respiratory centres in the brainstem and causes the heart "to beat more slowly during exhalation than it does in inhalation" (Coulter 2001:91). it is this natural effect of the exhalation which many pranayama techniques... harness to create a quietening and calming effect. It is as fundamentally simple as this: if you take longer to exhale than to inhale, especially when you are relaxing, the slowing down effect of exhalation will predominate... thus reducing the heart rate, decreasing the amount of air remaining in the lungs after exhalation, and as a result, reducing fear and anxiety." (p x)  *Interestingly, in my previous postdoctoral psychology research into maternal sensitivity and contingency and the impact of stress and reduced self efficacy, there was a link in the literature between these concepts and objective, biological measures of sensitivity that included RSA and the vagal nerve... not just a load of hippy nonsense here!

    "So what does this mean then, to 'learn how to breathe'?... Not everybody is convinced that anybody needs to learn how to breathe... I once made the mistake of mentioning that breath awareness practices might have a role in the management of anxiety and the experience of pain in labour [at an Active Birth workshop for midwives when sole yoga teacher]... "Teaching women to breathe?... didn't I think they had been doing it all their lives with no help?". I got her point. The distrust of any 'interference'  with the natural capacity of women to find their own ways to cope with labour and birth is an understandable attitude shared by many midwives and childbirth educators, who have seen women struggling with the various fads and edicts about how to breathe in labour... Whole institutions, training methods and, more recently, marketing franchises have grown up around these kinds of techniques.  More often than not, the 'training' that they provide functions at a cognitive level, and causes nothing but worry and anxiety for women trying to remember to follow what they have learnt as they go into labour.... Labour is a somatic experience - whereas trying to remember stuff you learnt with your head requires cognitive focus and clarity. The two things just don't go together.... The yoga approach to breath presented in Mother's Breath is... based on the heightened awareness of the natural and instinctive flow of breath." (p 4-5)

    "Whilst it's helpful to have external encouragement from those around us, it is more powerful to have that silent inner voice than any of our outer voices." (p ?).

In reading this book, along with the affirmations earlier, flags again with me the potential we all have inside us, if we were able to connect with our instincts and listen to our inner voices. This isn't me going away with the fairies: the mind, so our nervous system, impacts on body, e.g., the story earlier about the homebirth labour being slowed by worry, but brought back by composure. If we all had more faith in ourselves and were able to listen and follow our instincts, perhaps we would be less dependent on medical intervention in, and be more able to take responsibility for, childbirth altogether. This is perhaps applicable to something highlighted in the news today, apparently women are labouring for longer than previous generations, e.g., Telegraph article.

This is one example of dependence too, it extends to all aspects of our lives: decisions we make in who we want to be, what we're doing at work, in any dilemmas or crossroads - big or small. We have perhaps leant too heavily on external advice, consciously or subconsciously, e.g., supernannies, life coaches, dieting groups, news headlines, product advertisements.

We know what to do for ourselves, we just need to allow ourselves to listen.

...Maybe you already know this and do this. I'm basing this on my own experiences and what I've seen in other's confidence wobbles, especially in the massive life changing time that is having and bringing up children, so well done those who already have faith and apologies for boring you with something you know already!

Image left: A chicken following her instincts.