Hidden Tigers

When we were expecting the Boodge, we took a fantastic "Birthing From Within" prenatal class through Dancing Star Birth in Vancouver. The class was based on the book Birthing from Within by Pam England and Rob Horowitz, which I highly recommend to anyone expecting a baby. It's a holistic guide to childbirth, taking into account that it is not just a physical journey but also a psychological and spiritual one. It offers women and their helpers many tools to confront the fears and misconceptions that may hinder birthing, and achieve a birth where they feel in control of an important rite of passage in their lives.

In one class, our facilitator, Sarah, pulled out a little statue of a cave-woman and another one of a tiger. "This woman is labouring in the woods, and she smells and hears this tiger coming. What do you think will happen to her labour?" Sarah explained that fear would stop the woman's labour, giving her time to get to a place of safety. As Birthing From Within explains:

Fear activates the nervous system to produce adrenalin, which fuels the 'fight or flight' response. This increases heart and respiratory rates and shunts bloods away from the internal organs (including the uterus) to the large muscles. Increased levels of adrenalin also neutralize the effect of oxytocin (the hormone responsible for stimulating uterine contractions).

This didn't come as a surprise to me. As a student of psychology, I generally believe that the body is affected strongly by the mind. But as Birthing From Within also explains, the nervous system does not know the difference between real or imagined "tigers". "That is why it's important to bring your images, beliefs, and fears to conscious awareness, where you can tame, eliminate, or even harness them."

My belief in the power of the mind, and my view of birthing as a rite of passage, was also why I chose midwifery care rather than the medical model. I couldn't imagine treating my pregnancy like I would treat a medical condition, with regular 15 minute check-ups that addressed only the physical. My midwife gave me an hour of her time each time I went, answering any questions I had, checking in about my emotions, my support system, my relationship with my husband, my stress level at work. She asked questions about the messages I had received about birthing so that she could understand any misconceptions I may have. She also went over all the physical aspects of birthing and the possible medical interventions in a way that educated me and offered me the ability to choose what I wanted.

But much as I prepared myself psychologically through our class, with my midwife, and on my own, I didn't anticipate what my "tigers" would be during labour. In hindsight, if seems obvious. I've always had the problem of being a "pleaser", trying to accommodate other people in spite of what I may prefer. This came into play even prior to the birth, as the women in my life expressed their desire to witness the event.

My mother, a trained Doula, wanted to be my support person. She was understanding when I told her that I may not feel comfortable having someone so close to me, who would likely be bothered by my pain and anxious in any complications, be the person I leaned on. Instead, I suggested she witness the birth. My mother-in-law and cousin wanted to be present at the birth too. Though I was comfortable with my cousin being there, I was less at ease with my mother-in-law watching, so in the end I turned them both down so that my mother-in-law wouldn't feel singled out. But, wanting to please, I told them that they, too, could be at my apartment during the labour so that they could come in as soon as the baby was born.

I was beginning to feel like my labour was going to be a spectator sport, and joking that I should sell tickets. But I ignored my uneasiness, as well as the warnings I had read in Birthing from Within that birthing was as private as making love or going to the bathroom. I thought I could overcome my discomfort. So there I was during labour in a small 2 bedroom apartment with my husband, my doula, my mother, mother-in-law, and cousin.

Before everyone came around noon, I was making great progress just relaxing in the tub and the bed. My midwife checked me and I was 4 cm, and she was very pleased. But as the afternoon wore on, my tigers began creeping up on me. My doula urged me to walk the stairs of our building and the sidewalk outside to get things moving. We had just moved, and I was afraid of running into our stodgy building manager or meeting a new neighbour while in labour--but I agreed, not wanting to offend. My mother was in the kitchen cooking up a nervous storm, and with my heightened senses I cringed every time I heard the knife crunching through the celery. When a contraction came and I started moaning, I would notice her come out of the kitchen and stand in the doorway watching me until it passed.

Meanwhile, the other "ladies in waiting" were in the adjoining office, trying to be unobtrusive. But I noticed that they had nowhere comfortable to sit, and they were whispering. About what? How long was this going to take, I wondered, and should I move to the bedroom so they could use the living room? Overall, I felt annoyed, conspicuous and on display. And then somewhere in all this, my Dad called.

I hadn't told my Dad I considering a home birth, because I knew that like most doctors, he would be against the idea. I didn't want that fear put into me, so difficult as it was not to share with him, I decided to just tell him about my birth once it was over. But he called during the labour, and Sean told him I was in labour, so felt like I needed to call him back. When I did, he figured out I was having a home birth and expressed his disapproval right then and there.

My contractions had started around 2:30am, and it was now 6pm. My doula had called the midwife over to check me, as things had been moving along well. But I had only dilated 2 more centimeters, and by the time she finished setting up for the birth, my intense contractions had stopped and I was alert and talking just like in early labour. I had stalled. She and the doula conferred and sent my waiting ladies out to get dinner. While they were gone, my midwife asked me if I really wanted all these people in my apartment. "Oh, it's OK." I replied.

"Is it really OK? Or are you just letting them be here to be nice?" I admitted that I felt pressure to get on with the show, not to keep them waiting any longer. She suggested that I send them home and call them when I started pushing. After she and the doula communicated this to them, she went home herself and instructed me to just do whatever felt right. So I lay down in bed with Sean and just relaxed. I didn't try to do anything to get labour moving. And within an hour, it picked up again and I was on my way. At 12:30 am that night, I finally delivered my baby.

Now, preparing for my second birth, I'm trying to anticipate my tigers. I know the one about feeling watched, and having too many people around. And I anticipate that if I feel like the Boodge isn't OK, I may not be able to relax. For this reason I feel like I won't go into labour until my mom arrives on the 13th of October, because she is the person (aside from my husband) that I trust most fully with Boodge. I've also told my doula that much as I want to labour at home for as long as possible, if I find myself too distracted by how my son is doing, I may have to go to the hospital earlier than anticipated.

The hospital, because there is a tiger in having a home birth again. I loved my home birth, and I would defend any woman's right to have one. Research indicates that they are just as safe as hospital births in normal, healthy pregnancies and labours assisted by a regulated midwife. But as I've mentioned before, Boodge was born with "wet lung" and we had to go to the hospital right away, where he spent his first 30 hours in an incubator. Though he was getting enough air and it was not a dire emergency, it was scary. Since the hospital is 1/2 an hour away this time, I don't want to take any risks. Labour and pushing was fine for me, and I feel confident that I can handle the pain (assuming that it will be somewhat similar to last time). But I don't want to be worrying about what will happen when the baby comes out, and I think that will be easier in the hospital.

On the other hand, I have reservations about the hospital. There will be people involved in my care that I've never met before, and I've heard that the wrong nurse can really have an impact on labour. Also, though we'll have access to emergency care if necessary, I don't want to feel pressured into getting any care that isn't necessary. If Boodge had been born in a hospital, I might have been told I was "failing to progress" when I stalled, instead of someone understanding that psychological factors were involved. Also, he likely would have been taken from me immediately after birth. As it was, I at least got about 45 minutes at home to hold him, sing to him, and try to nurse him. Those 45 minutes meant the world to me and consoled me when I felt, for myself and him, the horrible emptiness of being suddenly separated from the one who had been in my womb for so long. For this birth, I long to have that experience so many women talk about, where your baby is just put in your arms, perfectly healthy, and you nurse and cuddle and feel the bliss of new love.

We have been to the hospital though, and the birthing unit seems excellent and geared towards empowering women to make their own choices, and staying out of the way of her caregivers. Having a midwife as my caregiver also helps me feel comfortable that at least my preferences have been asked about and will be honored if at all possible. So I'm going to just try to be assertive if I need to be, and focus on my job of birthing my baby rather than the millions of possibilities of what can go wrong when it comes out.

Overall, I feel pretty confident in my ability to birth this baby and deal with whatever comes up in the process. But labour is such a wild card, and the stakes are so high. I wonder if there are any hidden tigers this time, and if I'll be better at sniffing them out than I was in my first labour. I'm interested in hearing about the tigers that affected you out there, reading this. How did fear, or discomfort, affect your labour? And how did you sniff it out and get to a place of safety?

Birthing the Mama

On TV today, a (male) doctor was talking about why it wasn’t right to force men into the delivery room if they were uncomfortable with the idea. Maybe there was a reason that birth was only women’s domain for so long, he surmised, and then he referred to birth as a traumatic experience.


I guess it was the terminology that irritated me. Birth is not a trauma, it’s amazing, surreal, painful, indescribably intense—but trauma? Then I thought about the definition, in the DSM-IV, of post-traumatic stress; in order to be diagnosed with PTSD, a person has to have experienced an event that involves “actual or threatened death or serious injury, or a threat to the physical integrity of self or others” and responded to that experience with feelings of intense fear, helplessness, or horror.


I suppose if that is how you define a trauma, it is possible that some men, and women too, feel that birth is a trauma. Still, as a counsellor, I’ve worked with survivors of trauma, and I can’t equate birth with the unspeakable violations and losses they’ve been exposed to.


Still, giving birth (vaginally or by caesarean) does bring us up next to death. Not to suggest that birthing is inherently dangerous—I’d never want any woman to feel anything but empowered and confident in her body’s ability to complete such a natural process. But it’s a bloody affair, (I was surprised how bloody!) and it is powerful, and I can see, especially for the partner watching, how it may be traumatic to see your beloved become an animal version of herself, to know your child is struggling towards this world, and to be helpless to do anything.


I remember my aunt Libby, after my first nephew was born, saying that she believes every woman, at some point during pregnancy or labour, must acknowledge the (remote) possibility of her own death. Most of us, I think, are more concerned about the possible death of our baby. Dear friends and family have had births in which the baby was stuck and had to have his collarbone broken, or have an emergency cesarean birth.


My son’s delivery, no doubt, was traumatic for everyone that was at our home birth, including myself. He had had “wet lung”—when he hit the bed, the midwives started arguing about why he wasn’t breathing. He needed oxygen, and luckily, they had some there, but we had to go to the hospital immediately.


It wasn’t a dire emergency—they delivered the placenta while I held him, the oxygen tube under his nose while he cried rapidly, sucking in air. But then I was on my feet, directing people where to find the things I needed to take to the hospital, getting dressed. “Sit down,” my midwife said, “You could faint. You’ve just had a baby.”


I needed reminding—because that was the last thing on my mind. My baby needed to go to the hospital, the ambulance was on its way, and I was not going to be the one to hold it up. Later, my cousin Natasha told me she had said to Debbie, my doula (also dear sister-friend) “Did you see that, how she just got up and started going, just after giving BIRTH.” And Debbie replied “That’s her Mama kicking in.”


Traumatic, I suppose. I did feel, as I locked eyes with my silent, wet, naked son, still attached at to the placenta inside me, Death standing just off to the side, watching. But I prefer to think of the experience as transformative, not traumatic. My Mama kicked in.


When I rose up from that bed it was with that new part of me that grew along with my son during the pregnancy, and was birthed along with him that day. That person can survive on less sleep than I ever imagined, can find new stores of patience when she thought she was at her end, can carry and rock a feverish baby all day and barely notice the aches of her body. And every mother goes through that transformation, whether through birth or through the sleep deprived, overwhelmed days of first looking after a baby.


Trauma, like birthing, does often show the survivor just how strong she is, and help her ultimately find deeper compassion and wisdom. In birthing, those gifts come in abundance, along with a new being that brings more love and joy than you knew were possible. It transforms the maiden into the mother, marks her body and her spirit forever, not to harm, but to forge.


Maybe this is why we want our partners to be in the room with us, because we know that we will come out of that room changed, and we want them to be changed too. I saw my husband at the hospital, holding the oxygen mask over our baby’s face, making sure he was with him in everything that happened to him next, arguing and advocating with all the staff, his face tense with worry, his mouth set in determination. His Papa had kicked in. I’m glad we crossed that threshold together.