Sunday, November 2, 2008

Breathing Down vs Pushing

There was a recent discussion on the HypnoBirthing practitioners webgroup about "pushing" & why some medical care providers don't think HypnoBirthing works during the "pushing" phase since we use Birth Breathing to "gently breathe the baby down". Jennifer Elliott, a HypnoBirthing practitioner, has written the following letter to midwifery groups to explain Birth Breathing & has given me permission to share it on my blog. Thank you, Jennifer! It's a great explanation. Here is her post:

I sent the following letter to some midwifery groups here and received a very open minded response and now have more support than ever. I am privileged to have attended a birth of a most committed first time mother, fully supported by nurse and doctor, who had a perfect HB birth and brilliantly breathed her baby down. So I not only believe but also see.

Here's my letter:


An Explanation of the HypnoBirthing Approach

There has been confusion surrounding the approach of HypnoBirthing toward second stage. Some of your clients may have told you that they will not be "pushing" their babies out. HypnoBirthing does have a particular approach to second stage. First, HypnoBirthing, the book, advises against "forced pushing,´ purple pushing and the valsalva manouever. It uses the term `pushing´ to refer to all of these that are generally caregiver coached and directed and often against a woman´s natural instincts and desires. In addition to reducing oxygen to the baby, valsalva pushing, associated with a tense jaw, tends to cause women to tighten their vaginas, like a pelvic floor exercise, causing the baby´s head to meet more resistance as it is pushed down.

In an article contrasting Active Management of Labour with physiologic birth, Marie Mongan, author of HypnoBirthing and developer of the program, says, "When using forced pushing, she is closing the sphincters of the vaginal outlet ahead of the baby. This kind of pushing reduces the flow of oxygen to the baby, and his heart rate may decline. If this happens, there will be talk of the need to get "that" baby out."

Midwife Ina May Gaskin believes a relaxed mouth and jaw are directly correlated with the ability of the cervix and vagina to open fully (The Sphincter Law).

HypnoBirthing replaces the word `pushing´ that refers to more spontaneous bearing down with `birth breathing´, `breathing down´ and `nudging the baby down´. It may be only the language that is different from how a midwife might encourage her client. One difference is that the HypnoBirthing woman has learned to relax her body completely and is working to maintain that relaxation in most of her body, even in second stage. (She may be in a more upright position in second stage, requiring more of her muscles). By relaxing her vagina it unfolds more easily and the baby moves more gently into the world. Practice for breathing down is done on the toilet during a bowel movement. Women are encouraged to notice how their vagina and anus open and how they bear down on the exhale, sending the energy down their body.

When birth breathing is working well, women may appreciate only quiet, gentle encouragement. They take several breaths with each surge (contraction) , usually in and out through their nose. HypnoBirthing encourages women to begin breathing their baby down when they feel the urge, which may be some time after they are fully dilated. Mongan argues that we wait for women with epidurals to allow their bodies to bring their babies down and we should be prepared to do the same for all women.

Jennifer Elliott, BEd, HBCE, CH, CD(DONA)


www.lifesjourney. ca

No comments: