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Managing Labor Wtihout Drugs

Anxiety as well as excitement about the unknown is common, especially for first-time mothers. Though we all know that millions upon billions of women have given birth before, we do not know what it will be like for each of us. The experience of birth is universal yet it remains a mystery. Like love, labor is difficult to describe in words. Still, it is the work of each pregnant woman to seek a personal understanding of and commitment to the process of childbirth.

To meet the stronger contractions of active labor, we must develop our own coping styles that are naturally activated to cope through the pain, rather than merely relax!

Discovering Your Natural Coping Style

We process information based upon the three sensory cortices of the brain: auditory, visual, and kinesthetic. From the time of birth, people develop unique patterns for processing and organizing information. John Grinder and Richard Bandler in their two volumes of The Structure of Magic, have analyzed patterns by which people process experience. They describe these models as "representational systems" and believe that a person will lead with one and favor one or possibly two cortices for incorporating new information.

Some people process information using the internal or secondary visual cortex which is used in dreaming and visualization. Others will rely on the secondary auditory cortex to repeat phrases in order to comprehend the meaning of a concept. People who utilize their secondary auditory cortex in this way will be likely to use auditory metaphors like "It rings true." And still others will need a hunch or to "feel it in the gut" in order to understand. These people utilize the internal kinesthetic cortex for their primary system in processing new information.

It is also possible, even desirable, to develop all three cortices for information processing, which will yield greater creativity and lend a richness to our everyday experience. However the first cortex we use for initial processing will be the system we lead with and therefore our predominant style for integrating new information in a manageable manner.

When we can identify our primary lead system, we can enhance our natural coping style for dealing with pain in labor. Some women suppress their natural style of coping because they have been taught relaxation and breathing techniques which do not take into account their unique manner of processing the labor experience.

Women have many different ways of dealing with pain in labor. When left to uninhibited expression, a large percentage will moan or make some use of sound during labor. These women use an auditory means of expression for dealing with their pain. Other women may squeeze a pillow or a friend's hand or even want to move around as a way of meeting the contractions. These women are kinesthetic in their coping style. Still others prefer to use internal or externalized visual images for traveling through contractions. These women use primarily a visual means of coping with pain.

Some methods of childbirth preparation inhibit vocalization or movement because these expressions do not fit the concepts of what relaxation is supposed to "look" or "sound" like. Methods which discourage sound and squeezing in favor of relaxation which renders a woman quiet and still, often inhibit the woman's natural and predominant coping style. However because of the intensity of the labor experience most women need to express and release through a contraction using auditory or kinesthetic techniques in addition to visual methods.

The following exercises will help you to understand and identify your own natural coping style, as well as increase your ability to develop your other sensory pathways for dealing with pain during contractions.

Lie down comfortably, perhaps on your side with a pillow between your legs to accommodate the growing space between your hips, now that you are very pregnant. This exercise is best to do when you are approximately seven months pregnant. At this time you are eager to prepare for birth, and learning comes quickly.

Arrange for your partner or a friend to pinch you in the area of the fleshy part of your leg behind your knee. In this way you will experience pain and will have to accommodate to it in some way. Instruct your partner to gradually -- over the course of 60 seconds -- to build pain, until he or she is pinching you very hard. The pinch simulates a contraction in that it causes you to do something, either internally or externally, to adjust to it. If it does not challenge you, then your partner is being too gentle. You should feel a need to respond in some way to allow the pain to be present and then pass.

Give yourself sixty seconds to rest and relax before the next simulated contraction. Releasing between contractions is a very important part of the exercise.

Partner's instructions: Pinch under the knee, building from a gentle squeeze to a hard pinch in thirty seconds. Talk her through the simulated contraction, telling her that you are about to begin to squeeze before you do, then telling her when it is peaking and when it is beginning to fade. When you reach the maximum pinch at thirty seconds, hold it for approximately ten seconds, telling her it is peaking, then gradually loosening your hold, diminishing the squeeze, while telling her it is fading. The gradual fading should take twenty seconds. You should observe your partner exerting some effort to deal with the pain when it is peaking.

How did you respond to the pain? Did you hold your breath? Did you breathe harder, listening to your breath and your partner's voice? (auditory) Did you speak to yourself internally? (auditory) Did you tighten your hands into a fist? (kinesthetic) Did you use movement of any kind, such as hitting your hand on the couch? (kinesthetic) Did you want a cold or a hot compress? (kinesthetic) Did you use images to help you? perhaps nature scenes? (visual) Or sounds such as rushing water? (auditory) or faces of those you love? (visual)... If necessary, do the exercise again paying particular attention to your responses. If you found that you instinctively held your breath, do the exercise again, being certain to maintain your breathing continuously while observing what other ways you respond.

You may have identified already whether you favor an auditory, visual or kinesthetic response. The following exercises will help you to clarify which modalities will work best for you in labor. I encourage you to try all three, as well as combinations of auditory-kinesthetic, and auditory-visual-kinesthetic to see what works best for you.

NOTE: If there are any medical contraindications to this exercise, such as varicose veins, consult your doctor regarding a safe place to pinch.

Auditory Coping

The only negative way of coping is holding your breath. Sometimes you won't notice you are doing so because it is instinctive if you have been taught to hold in your feelings and not express yourself. It is important to continue breathing through contractions. One way for your partner to know for sure you are breathing is if he can hear it.

Usually women stifle their breathing due to a conditioned response to hide pain or because they do not want to cause others distress. Remember this is your labor. Do what works for you and let others take care of themselves. Work towards expression and release if your tendency is to hold back. By doing so, you will be getting ready for labor.

Do the simulated contraction exercise again, this time purposely giving some sound to your breath. Hissing is good because it engages the diaphragm, even though in labor you would use a moan instead of hissing, because the internal pressure of the contraction would be present. A low hum or hiss is best for this exercise.

When the pinch begins to peak, use the sound of your breathing to carry you through it. Increase the hiss to a very loud sound. Put all the pain into the sound of your breath, making it louder the more pain you feel. Let the sound diminish as the pain ebbs away and you don't need the sound to help you.

Kinesthetic Coping

Some women need to use movement or to meet the pain by squeezing a pillow or even their partner's hand, if he is willing. As long as you are breathing it is a useful technique for traveling through contractions. However when women squeeze and hold their breath, they are really squeezing inside instead of externally, tightening the respiratory and other internal body pathways.

It is entirely possible to squeeze or tighten your fist without tensing the internal organs as the voluntary and involuntary nervous systems work in opposition most of the time. Therefore it is not the case that if you are furrowing your brow, unfurrowing it will be better for labor. In fact it is unrealistic for women to expect they will totally relax all muscles during a contraction. Women who cope kinesthetically usually need to express their pain physically. By squeezing a pillow with your hand, you can express this tension externally thereby lessening the likelihood of inner tension. As long as you continue to breathe, your physical expression will help you through the contraction.

Repeat the simulated contraction with your partner, this time using the squeezing to express and release pain at the peak of the contraction. You may also want to do both the auditory and the kinesthetic together, particularly if you are inclined to hold your breath.

Visual Coping

When using visual imagery for coping with contractions, it is important that the image change or transform in some way to match the changing intensity of the simulated contraction. If you are using the image of a flower opening, say, you should visualize the flower opening larger, or its color deepening, as the contraction peaks. This allows the secondary visual cortex to accommodate the increased sensation of the simulated contraction.

Repeat the simulated contraction exercise this time using an internal image which changes as the contraction peaks. Be sure you are simultaneously breathing through it as well.

None of these techniques will work if you hold your breath. That is why it is often a good idea to incorporate an auditory response of hearing your breath during contractions no matter what other modalities you use or favor.

Try the exercise again. This time, listen to the sound of your breathing, imagine your baby's head coming down as your cervix opens, and hold tight to your partner's hand. This allows you to experience all three coping strategies. Of these, which comes most naturally to you? Which helps most with the pain? Can you use each of them or all three together?

By doing the above exercises just one time thoroughly, you have trained your body to adjust and adapt by using pain to help you through labor. Your body will automatically respond to what worked for you in these hands-on, body-centered exercises.

Remember that release in between contractions is where you are headed as you travel through labor. During a contraction, encourage yourself to meet the peak of the contraction with the active coping strategies that work best for you. By encouraging yourself to follow through the peak of the contraction with whatever coping strategies you have identified in this chapter, you will find yourself adjusting to your own inner tempo. Welcome the deep rest possible in between contractions. It is within these valleys of deep release that you can encourage yourself to completely rest, relax and replenish yourself. Some women even report falling asleep in between contractions.

From: Chapter 7 of "An Easier Childbirth" by Gayle Peterson, PhD Shadow and Light Publications

Copyright 1993 by Shadow and Light Publications. Reprinted with permission from the author and publisher. This excerpt may not be reproduced in any manner, including electronic, without prior written consent 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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