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Psychophysiological Integration

By Gayle Peterson, Ph.D.

Excerpt from Chapter 6 of Birthing Normally

Available for purchase online at Amazon.com

Labor and birth are taught as a continuously unfolding process that grows out of pregnancy. Stages of labor are referred to only if women have questions about them from various books. Phases of labor is a more appropriate term and may be used in lieu of "stages," as "phases" imply a "traveling through" rather than something that is set or "staged," and static. An association may also be made for a woman with performance anxiety about birth, as a "stage" is also a place for theatrical performance. However, it is questionable whether either of these terms is needed for description of labor, as both tend to artificially divide a whole into parts.

In classes, women are introduced to labor as a phenomenon which begins with early labor, which may go on for days or weeks. Early labor is generally considered as 1-4 cms. dilation for a first baby and 1- 5 or 6 for a subsequent baby. Women are encouraged to go about their daily lives, with some adjustment or relaxation, but to do all their normal activities in between contractions, letting the contractions come and go, centering attention on the contraction as it comes and returning to daily activity as it wanes.

Labor gradually grows more and more painful, creating an increasingly intense focus. When a woman can no longer go about her daily activities in between contractions, she is considered to be in hard labor, focusing all of her energy between and during contractions on her body giving birth. It is during this later phase of labor that women are encouraged to vocalize as needed or desired.

The phenomenon of "transition" is not described in classes, as it has not been my experience that such a phenomenon exists. If women are not taught to expect a period of panic, nausea, and unexpected changes in perception which are labeled "transition", they ordinarily do not experience it. As a woman expects her labor to increase in intensity until the baby is born, she normally travels through the said "transition" period, in a continuous manner to her initial style of coping. Description of transition is an artificially divided piece of labor as described in childbirth literature.

One of the greatest dangers of the myth of "transition" (Transition is described as a "panicky" time, one in which the woman will experience confusion, nausea and loss of control) is the proclamation by well-meaning childbirth teachers that it is the hardest time, and from there on it is easy. Women of first babies are led to believe that it will not hurt to push (second phase) and that it will even feel good and be easy.

Many a first mother is mentally ready to quit when she finds it is not true for her, since she had not prepared herself for pain or hard labor beyond this point. This delusion has caused many arrests in this part of labor, and is not realistic preparation.

Pushing during labor is taught as something which may or may not happen without conscious effort. A woman may feel as if her uterus is doing all the work, while she rides through the contraction. Or she may experience a need to consciously exert the effort of pushing deliberately in order to birth her baby. An outgrowth of vocalization is often a natural bearing down, or pushing sound, which can help to expand the diaphragm, creating a pressure on the top of the uterus, helping to push the baby out.

To help stimulate a lack of inhibition about sound and to simulate the effect of the pressure of a contraction and the releasing energy of sound, the following exercise is done in class.

Sound Release

Class members are instructed to take a deep breath and to hold the breath and begin to bear down, (pushing as if going to the bathroom). Holding the breath and pushing simulates the pressure of a contraction building.

When there is a sign of increased pressure, and class members are working hard, instructions are given to very suddenly open the throat, to release constriction of the throat completely. If the exercise is done correctly, the person doing the exercise will spontaneously emit a very open sound. The greater the inner build of pressure, the greater and longer the sound. This exercise usually needs to be done several times before a person will permit themselves the lack of inhibition necessary to experience it.

Women are also encouraged to use the natural body function of moving their bowels in order to experience the difference in quality between holding their breath and pushing feces out, and opening their throat and using sound to help to push.

During a contraction, the pressure is many times the intensity of such an exercise and is readily apparent, so that the open throat can be an immediate response. As a woman emits sound, her pushing will come from the diaphragm, pushing down on the uterus (i.e. effective pushing as opposed to ineffectively pushing with the stomach or thighs). It is this combination of letting go, while pushing, that can create the easiest and least resistant passageway for the baby's descent.

The baby's descent (or second phase of labor) is referred to as a period in which a change in quality of experience will evolve as the baby moves out of the womb and into the vagina. Women are prepared to expect it to be a very "active" time, as opposed to the more "passive" yielding state that can take place during first phase of labor. Pushing the baby out is a period of active yielding, and needs to be respected as such.

The energy of birth is an aggressive force. It takes enormous energy to create and move a human body from the plane of nonphysical existence (prior to conception) to emerge into the plane of physical experience (birth). It is important that a woman not be afraid of aggression in this context, as it is a healthy aggression like the turbulence of rainstorms, the barreling of thunder clouds as they clap together. Again, the belief in a "gentle" birth cannot preclude this aggressive thrust of life, without the possible side effects of psychophysiological dissonance in labor.

With the terrible beauty of the thunderstorm comes the quiet, the gentle, the stillness of fresh wet grass under opened sky. The gentleness in nature is a response to the aggressive beauty and yielding of the earth.

As a woman learns to weave aggression into her natural and culturally conditioned gentleness, she releases herself from the restrictive role of the feminine in our society. She liberates herself to the strength and power found in tenderness. Giving birth can be one way for a woman to reveal to herself her individual tapestry. It is not the only way. It is simply one of nature's gifts of self-discovery.

At birth, self-discovery has just begun, and the workings of the maternal-infant relationship trace the deserts, forest floors and rivers of a woman's heart. If she has begun the journey in a positive manner, she has that much fortune of a good beginning.

Copyright 1995 by Gayle Peterson. All rights reserved under international copyright conventions. This excerpt has been reprinted with permission from Shadow and Light Publishers. This article may be printed out for personal use but may not be reproduced in any manner, including electronic, without prior written permission from the publisher.

Gayle Peterson, MSSW, LCSW, PhD is a family therapist specializing in prenatal and family development. She trains professionals in her prenatal counseling model and is the author of An Easier Childbirth, Birthing Normally and her latest book, Making Healthy Families. Her articles on family relationships appear in professional journals and she is an oft-quoted expert in popular magazines such as Woman's Day, Mothering and Parenting. . She also serves on the advisory board for Fit Pregnancy Magazine.

Dr. Gayle Peterson has written family columns for ParentsPlace.com, igrandparents.com, the Bay Area's Parents Press newspaper and the Sierra Foothill's Family Post. She has also hosted a live radio show, "Ask Dr. Gayle" on www.ivillage.com, answering questions on family relationships and parenting. Dr. Peterson has appeared on numerous radio and television interviews including Canadian broadcast as a family and communications expert in the twelve part documentary "Baby's Best Chance". She is former clinical director of the Holistic Health Program at John F. Kennedy University in Northern California and adjunct faculty at the California Institute for Integral Studies in San Francisco. A national public speaker on women's issues and family development, Gayle Peterson practices psychotherapy in Oakland, California and Nevada City, California. She also offers an online certification training program in Prenatal Counseling and Birth Hypnosis. Gayle and is a wife, mother of two adult children and a proud grandmother of three lively boys and one sparkling granddaughter.

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