Monday, June 20, 2005

Mindful Words

Picture a birthing room. A woman is leaning over beside a bed, and the voices around her are saying...
“You look so tired!”
“That baby isn’t very happy.”
”It can’t possibly be time for you to push yet.”

She drops her head, and cries...

The language that we use in the birthing room touches a woman deeply. When in active labour, a woman is so open to suggestion that any negative word can sap her energy and make her want to give up completely. Her negative emotions can then slow down the labour, or cause complications that would never have happened if those words had never been spoken.

Picture that same birthing room. The woman is leaning over the bed, and the voices around her are saying...
“You’re so powerful...I know it must be hard, but you can do this!”
“Your baby’s head must be coming down for the heart rate to drop then recover so quickly. That’s a good sign!”
“Trust your will tell you when it’s time to push.”

The woman lifts up her head, and smiles...

Smiles in a birthing room? You must be joking! Well, there can be smiles and laughter, and incredible joy. But you don’t hear about that side of birth. People want to tell stories of blood and pain, exhaustion and tears, doctors’ golf games, needles, and drugs.
No one dares mention that there can be joy during labour. You might laugh at them!

Studies have shown that women never forget their birth experiences. They often recount stories of their births using the exact words spoken by caregivers. One eighty year old women recalls the head matron standing in the doorway with her Great Dane, saying, “You can’t possibly be ready to give birth. Stay in bed. I’m far too busy. The dog will stand guard.” Another woman questioned her obstetrician about the need for a cesarean, so he asked, “Do you want to have your child taken to school in a Funny Bus?” When I found out I was pregnant with my second child, and questioned the need for a vacuum-assisted delivery at my first birth, my physician said, “Well, what did you want...a dead baby?” The start of my path towards empowerment came with that doctor’s question. I stood up, left the room, and slammed the door. I hired midwives for my second birth, wrote a letter of complaint to the doctor, and worked to surround myself with positive words. The language that people use can hurt us, but it can also heal us.

Most of the language used in hospital birthing rooms is medical, masculine, and certainly not positive. “Incompetent cervix”, “elderly primip”, and “trial of labour” are a few phrases which make women feel less than capable. Women don’t “give birth”, they are “delivered by the doctor”. In the hospital setting, women find themselves using prison-terms to describe their stay: “I was released” or “They let me out”. Falling into the role of patient, the labouring woman starts to ask permission to go to the bathroom, to move, to make noise, undermining her own body’s natural inclinations. When I was in labour with my daughter, I automatically got into the hands and knees position. My body knew that this was the best position to help my daughter turn and fit well into the cradle of my pelvis. I started to rock and sway and hum. I was coping well. Then a new nurse walked into the room and said, “Well, that’s a weird position to get into!”, and shook her head. Being vulnerable and open to suggestion, I turned over, sat down, and lost my ability to listen to my body. The body speaks to us in labour. If everyone else was quiet, maybe we could hear the body better, and perhaps there would be less medical intervention.

Perhaps the most wonderful example of this came at a birth I attended many years ago. The labouring woman was deaf. She didn’t use sign language, and would generally read lips. However, during her labour, she closed her eyes, finding comfort in an internal focus. She said she loved to hear her body talking to her in the labour. Her husband and I communicated with her by using our hands - to touch, to stroke, to hold, to hug. She laboured beautifully, accepting the wisdom of her body, and gaining strength through the calmness of our hands. Ah, but the nurse kept trying to tell the woman what to do from behind - always forgetting that her words would go unheard.

During labour, a woman goes deep into herself. One father described this basic instinctual process, “Getting in touch with her reptile brain”. As support people, we should do whatever we can to nurture that process, but quietly, and one at a time. The “reptile brain” can’t deal with many voices, many demands. Quiet, confident messages whispered into her ear can really help. “You are strong”, “You are safe”, “Your baby is strong”, “You can do this”. Encouragement from many voices may seem helpful to the supporters, but to the labouring woman it can seem demanding. It can reinforce the feelings of self-doubt - “Am I doing okay?” “They’re all calling to me because they know something I don’t know”. Quiet presence is more strengthening. One woman who had her baby last week, said that it became very confusing at the end, because a number of new people entered the room and started telling her what to do. Then she felt my hand reach for hers and heard my voice, quiet and calm, in her ear, saying, “Just block out the voices and breathe out your baby. Open your eyes and see your baby.” So, instead of being confused, she said she gained clarity, and time stood still. She opened her eyes, and breathed her baby out - watching the whole thing. She was also so fully present that later described being able to feel the baby’s head, shoulders, arms, hand, and hips, as they came through her and out into the world. What joy!

By being mindful and gentle with our words, we can help women give birth with joy. This doesn’t mean that there won’t be a struggle, or pain, or moments when she will doubt her ability to continue. This just means that we won’t be making her journey more difficult by using words which add to her struggle. Rather than demanding, “PUSH!”, we can empower a woman by saying, “Let your body open...breathe the baby are are safe...” The long-term effects of those words are immeasurable.

- Jacquie Munro, Vancouver Doula

No comments: