Untucking the Tail for Birth.

The forgotten art of untucking the tail.

This post was originally published on 7 Nov 2015 at www.yogawithivana.com

A tiny detail we’ve lost since the hunter-gatherer times and how to fix it

Illustration by Jillian Nicol at www.livealigned.ca

I’ve been spending most of my time lately learning about biomechanics, healthy alignment and how movement affects our bodies in relation to gravity. The research from the last few years shows that the way we move affect us not only mechanically, as it was previously thought, but also causing biochemical changes on cellular level, changing us from inside out. This process of the body adapting to and being shaped by movement is called mechanotransduction.

We seem to be living in the world that encourages sitting with the tail tucked under.

The furniture we use sitting all day is optimised for comfort and convenience, but usually not ergonomically adapted for pelvic floor health. Who would even think about that?

There is a well spread myth in our society that pelvic floor issues are a normal consequence of pregnancy and birth, or ageing for men. But we would rarely think of looking for a cause a bit deeper, in the way we have been living and moving before that.

Did you know that the anatomic function of our remnant of a tail is, amongst others, to control opening and closing of the pelvic outlet. If you look at a dog, or a another tailed animal, you can see that they keep their tail up, happily wagging when they are in a good mood. And this is the default. When you see a dog wearing his tail down between his back legs, it is usually a sign that the dog is on the fight of flight mode and his pelvic floor is tense as a part of his whole body reacting to danger.

Even though we now have only the beginning of what was once a real mammalian tail, it behaves the same. Untucking the tailbone opens the pelvic outlet, tucking it closes it — tightening the pelvic floor. The dog with his tail down between his legs is an equivalent of you sitting on your sacrum, the back supported by a chair or a couch. If you spend multiple hours a day in this position, your pelvic floor doesn’t really have a chance to release and allow the muscle fibres to regain their natural length at resting state. So gradually it shortens.

In his book Pelvic Power, Eric Franklin compares natural movement of the pelvic floor to a kite. As you stand up the pelvic floor slightly lifts and narrows similarly to a kite picking the wind and taking off. Reversely, as you sit down (with untucked tail, using your sitbones) the pelvic floor widens and releases to its full length, like a kite descending down, opening and landing. But what if we never allow it to release?

Tight muscle does NOT equal a strong muscle.

Biomechanicist Katy Bowman compares an optimally functioning pelvic floor to a trampoline. It supports the weight of all our pelvic organs and allows any extra load to just bounce off its healthy, elastic fibres, tensing and releasing naturally. Keeping the muscles short all the time doesn’t let them perform their function optimally. And further on, as our bodies naturally adapt to the way we use them, we gradually end up with shortened muscles.

This is further exacerbated by using pelvic floor exercises (‘Kegels’) on ‘the more the better’ basis — Bowman explains. Doing more and more repetitions of contractions of the muscle isolated from the rest of the body without allowing it to ever fully release, you get a muscle that is tight and locked short. Tight muscle does NOT equal a strong muscle. A strong muscle is able to both fully contract and fully release.

So why I am telling you all this now? Reading Katy Bowman’s last book — Move Your DNA, I’ve started to incorporate more movement into my life other than and independently from exercising. And especially, I’ve started to squat more, when playing with my toddler, picking things off the floor and even going to the toilet.

Learning to untuck my tail has made me finally realise why I still had to push my baby out and not bear it gently down, letting the gravity do the job, in spite of all the birth preparations and beautiful relaxation techniques I mastered beforehand.

To “breathe the baby out” you have to first untuck your tail.

Anatomically, in order for the baby to come out the pelvic floor has to release, but you can’t possibly release the pelvic floor with the tailbone tucked under. You can only use the strength of your muscles (transverse abdominals and diaphragm as they instruct you to hold your breath and “puuuuussssh!”) against your pelvic floor. And that’s a sure way to end up with a nice tear and possibly a pelvic floor disfunction. I was lucky that the athletic challenge, how my birth experience felt to be honest, ended without any serious damage. My body just took over at the last moment and following a very primal instinct jumped on a dining chair opening the pelvic outlet fully. The squats and kneeling with rounded back would have probably taken me to an assisted delivery.

“Modern birthing science has placed a large burden on secreted hormones (like relaxin) to prepare the body for needed mobility.” Katy Bowman says. Yes, hormon relaxine is useful in letting the body open up for the birth, but it’s not enough, unless we have strong muscles that can fully contract, but also fully release. But then, strong isolated muscles are not enough either. In order to have smooth births we ned to have a whole-body endurance. A great way to develop endurance is to walk as much as you can. “The woman who wants to go about a birthing process naturally can follow the lead other “natural” processes women have been doing for millennia — walking 5–6 total miles per day, and squatting to bathroom multiple times daily.” — she adds.

So, the bottom line is: get off your tail and sit on your sit bones instead, walk more, squat more, move more. It’s all about really using the body. Reintroducing a variety of movement we can strengthen the muscles of the pelvic girdle and release our tail once again, allowing it to respond freely to the demands of natural movement. And this can make a big difference for our pelvic floor health and the general level of our wellbeing.

Even more reason to keep off the bed during labour and birth? Not sure about "squatting to bathroom" though, sounds messy.

Your first labour does not have to be long and hard.

Women need to find their own way of coping in labour. For some it will be to use relaxation techniques like hypnobirting, bake a batch of cup cakes, or for one lovely young lady I know it was walking round and round in a circle! 12 February 20:00 "Hi Ann! Thank you very much! I can't believe how quick it all was! I woke up at 1.45 in the morn Srom'd (her waters went)  started getting tightenings at 2. They were every 2 mins from the word go so I went downstairs and thought I'll start timing them. I was just walking around in a circle focusing on going round and round! By 3 I thought these are pretty strong now, woke hubby up. Needed to wash my hair thought I cant go into hospital without doing that so managed to have a shower between the contractions! By half 3 I rang MAU (Midwifery Assessment Unit) and said I think I'm going to have to come in. Got into hospital for just after 4 (put the hypnobirthing music on in the car on the way!) Was examined and said I was fully dilated! I said are you sure can u recheck?! I was shocked despite the pressure I had with every contraction i still thought no way could I come in fully dilated with my first baby! Went to the birth centre got in the pool had some gas & air just to use as the contraction built up before I pushed then had him at 5.56 in the pool! It was amazing my perfect labour I couldn't have asked for anything more!" Your first labour does not have to be long and hard. Distraction techniques like walking have been used for centuries to take women's minds off their labour. When women center totally on their contractions they start to panic and then adrenalin, released due to any kind of anxiety,  'sticks' to the cervix and makes it harder to open. Whatever coping technique you choose be confident in your ability to birth your baby, we are women, we are built to give birth and when we take charge during our labours we can have the birth of our dreams.

Increasing breastfeeding worldwide could prevent over 800,000 child deaths and 20,000 deaths from breast cancer every year.

Date:

January 29, 2016

Source:

The Lancet

Summary:

Just 1 in 5 children in high-income countries are breastfed to 12 months, whilst only 1 in 3 children in low and middle-income countries are exclusively breastfed for the first 6 months. As a result, millions of children are failing to receive the full benefits provided by breastfeeding. The findings come from the largest and most detailed analysis to quantify levels, trends, and benefits of breastfeeding around the world. 

Then why are women still not getting the message?

 Although breastfeeding is one of the most effective preventive health measures for children and mothers regardless of where they live, it has been overlooked as a critical need for the health of the population.

"There is a widespread misconception that the benefits of breastfeeding only relate to poor countries. Nothing could be further from the truth," says Series author Professor Cesar Victora from the Federal University of Pelotas in Brazil. "Our work for this Series clearly shows that breastfeeding saves lives and money in all countries, rich and poor alike. Therefore, the importance of tackling the issue globally is greater than ever."

Breastfeeding not only has multiple health benefits for children and mothers, but it also has dramatic effects on life expectancy. For example, in high-income countries breastfeeding reduces the risk of sudden infant deaths by more than a third, while in low-and middle-income countries about half of all diarrhoea episodes and a third of respiratory infections could be avoided by breastfeeding. It also increases intelligence, and might protect against obesity and diabetes in later life. For mothers, longer-duration breastfeeding reduces the risks of breast cancer and ovarian cancer.

Furthermore, the authors calculate that boosting breastfeeding rates for infants below 6 months of age to 45% in the UK would cut treatment costs of common childhood illnesses (eg,  pneumonia, diarrhoea, and asthma) and save health care systems at least 29.5 million in the UK.

Yet, worldwide rates of breastfeeding are low, particularly in high-income countries. For example, the UK (<1%), Ireland (2%), and Denmark (3%) have some of the lowest rates of breastfeeding at 12 months in the world. "Breastfeeding is one of the few positive health behaviours that is more common in poor than richer countries, and within poor countries, is more frequent among poor mothers. The stark reality is that in the absence of breastfeeding, the rich-poor gap in child survival would be even wider. Our findings should reassure policymakers that a rapid return on investment is realistic and feasible, and won't need a generation to be realised."

Persistent underinvestment in protecting, promoting and supporting breastfeeding by governments and international funders has exacerbated the issue. Social media do not portray breastfeeding women in a positive light. It was banned on FB to show a BF woman as you could see some of her breast! OMG.

Powerful political commitment and financial investment is needed to protect, promote, and support breastfeeding at all levels -- family, community, workplace, and government, say the authors. Additionally, more needs to be done to regulate the multi-billion dollar breastmilk-substitute industry which undermines breastfeeding as the best feeding practice in early life. The authors point out that the International Code of Marketing of Breastmilk Substitutes could be an effective mechanism if adequate investment is made to ensure its implementation and accountability across all countries.

Global sales of milk formula (including infant formula and follow-on milks) have increased from a value of about US$2 billion in 1987 to about US$40 billion in 2014...Political commitment, investment, and effective international, national, and local leadership are needed to end promotion of products that compete with breastfeeding."

Ask your Community Midwife for help and advice about breastfeeding your baby before you decide. There is lots of help and support out there when you have had your baby, just ask.

"No way am I trying this natural!" How Hypnobirthing can make your birth beautiful.

I went into this pregnancy not knowing how I wanted to give birth. At first, I said, “No way am I trying this natural! Why would I do that?” Then after doing lots of research and learning about all of the benefits I decided it was the only way to go. Moving forward I had heard about Hypnobirthing. “Whaaaaaaaaat? That’s weird, right?”

I was referred by a friend to Julie Byers and her 6 week Hypnobabies class. I also went into this class not knowing what to really expect. I already love to meditate and thought it may be the same thing. It was the BEST decision I ever made! I began the class very unsure and insecure about pregnancy and birthing period. It was the most informative, educational, supportive, and uplifting class that gave me confidence and my own voice about MY birth! The techniques I’ve learned through this class made me realize, I can do this! I wanted an all natural waterbirth.

My guess date was September 7th. On September 1st I thought maybe I would try this “midwives cocktail” out that I had heard about from a friend who said that she drank it and was in full blown labor within 3 hours. (1 cup apricot juice, 1 cup champagne, 2 tbsp almond butter, 2 tbsp caster oil). I was teeter tottering with the idea but actually decided I would wait because this baby knows when to be born. At 11:30pm that night, I lie down to go to sleep and *POP* I hear, and feel, what felt like a tiny water balloon in the top right side of my uterus. “Was that what I think it was???” Sure enough, a few seconds later, I felt the small gush. It was definitely my bags of water. “Now what?!” Do I call the midwives? Do I call my doula? I did both. They both told me to chill out, get some rest and just wait because I would need the energy for when my pressure waves begin.

I slept maybe 4 hours that night. I woke up in the morning and still no pressure waves. I went to work. YES, I WENT TO WORK! Just for a few hours…. Around 2:00 pm I called the midwife on call and she said to go ahead and drink the “midwife cocktail” to try and induce, otherwise, I would have to come in and start a pitocin drip which was the opposite of my birthing plan! After drinking the midwife cocktail, I sit and wait… around 4:30pm I get a call from the midwife and she says to come in so they can confirm that my water had actually broken and see how much amniotic fluid I was losing.

As soon as I get in the car, I feel my first pressure wave! “Yay!!” At this point, I know it’s GO TIME! I get to the hospital, get admitted. At this point, if I was not dilating, they were going to start the pitocin. At 5:00pm Susan, the midwife checks me. I am dilated at 2cm and changed to 4cm literally in her hand. The pressure waves were coming longer, stronger and closer together! I called my doula and had her come to meet me! It was time to use my Hypnobabies techniques. I turned the lights down, tried to relax and hum my way through each one. I used the birthing ball, many different positions, walking, and a hot shower (my favorite) to labor. It was peaceful.

Around 10:00 pm, during a pressure wave, I felt the urge to throw up! To me, I’m thinking, “okay, power and purge, this is normal right?” As soon as that happens, my doula runs and grabs Susan and we get my beautiful wife on video chat! (She is overseas for work) Apparently this means I’m going into the transition period of labor! Susan comes in and checks me again and I’m 9cm! Time to grab the water birthing tub and fill it up!

Once the tub is filled, I hop in quick! Oh it felt sooooooo amazing! It relieved most of the pressure I was feeling! I began pushing and about 5 minutes later I could feel her head with my hands. It was the most beautiful experience I have ever been through. I only pushed for about 10 minutes and my baby girl, Venice Aliana Marie was born at 11:53pm on September 2nd. She was 7lbs, and 19.5 inches long. Just perfect!

I had an amazing pregnancy the entire time and my birth was even better! I am all about putting out the positive things you want in life and not listening to anyone’s negativity! I hope that my birth story can inspire at least one person!

Lovely. Not sure why she did not get in the pool sooner and labour in there. Have seen it aid the relaxation techniques used in Hypnobirthing loads of times. 

Fear for a VBAC

A post by the wonderful villagemidwife that I wanted to share.

Posted by Villagemidwife 08 Dec 2015 10:12 PM PST

A young mother whose second pregnancy is at about 30 weeks phoned me, and we chatted for a while.   As I listened to her story, I felt enormous sympathy for her in her search for confidence. 

I have pondered the predicament of this young woman, who I will call Bea, and others in similar situations many times. Bea is booked to have her baby in a hospital, under the care of a team of doctors and midwives.  Bea is hoping to find someone who will palpate her abdomen and tell her how her baby is growing, and whether she will be suitable for VBAC (vaginal birth after Caesarean).

Bea experienced an emergency Caesarean birth after a long and painful labour for her first child.  She felt traumatised, disappointed, confused, depressed; at times blaming herself and at times numb towards herself, her child, the child's father, and the world.

In preparing herself for this next birth, and in an effort to come to terms with her memories, Bea has had counselling.  One of the outcomes of that counselling is that Bea recognises a lack of confidence in the (nameless) people who will provide care for her in labour and birth.  Midwives, doctors, others: all with a role in the system that produces babies, yet Bea has no confidence in that system.

Bea is an intelligent woman who is used to researching every aspect of life, from the energy efficiency of white goods in her home, to the source of the food she buys.   She wants to know about pregnancy and birth specifically as it relates to her.  She reads posts from other mothers on social media.

Bea is particularly concerned about the size of her baby; whether he or she will 'fit'.  Bea would like me to palpate her abdomen and (hopefully) tell her that her baby will fit through her birth canal. I can't tell if the baby will 'fit'! Many times I have attended little women who have big babies.  Many of them have given birth spontaneously and quickly.  I have never tried to be a prophet, predicting events in the future.   The decision making processes in midwifery require the midwife to understand and work in harmony with the natural physiological processes, and only interfere if there is a valid reason to do so. 

Bea told me she has at least three birth plans: a vaginal birth; a caesarean after labouring; and an elective caesarean.

You need to take ownership of your own natural processes which are essential if natural birth is to progress well. ...to make the best decision you can at any point when a choice or decision needs to be made.  Here are a few examples:

• The doctor tells you at 38 weeks that he assesses the baby to be large and advises an elective caesarean (without labour) at 40 weeks.  Do you think the best decision at this point is to say yes, to say no, or to make a decision closer to 40 weeks?
• It's a few days before (or after) that magical 40 weeks.  You think you are coming into labour - it's midnight and you woke up with a contraction, and felt baby make a few big moves.  Waters have not broken.   Do you get all excited and ring your support team, and ring the hospital, and wake your husband?  Or do you tell that baby to go back to sleep - you have a big day ahead if labour does begin, so you need to get some shut-eye!
• Later ... You think you are really in labour now.  Memories flood back each time your womb contracts, and you remember the early part of your first labour.  You remember using the labour ap on your phone to track the contractions.  You know you need to get organised - little Johnny will go to his granny after breakfast, DH will stay home from work, and the birth support friends will need to make arrangements for their families and work.  Contractions are coming every 10 minutes, and feel good.  You need to walk and rock through them.   Do you ask your team to come now, or to wait for another call?  Do you call the hospital now?

These 'decision points' might seem insignificant, but I say they are some of the most important decisions you will make.  Each decision is a fork in the road.  If you take one, you cannot take the other.  There is no turning back.  Can you feel confident about these decisions?  If you have that confidence, and you establish labour without any outside (medical or psychological) assistance, I know that you are well on the way to successful and healthy VBAC.  

 Hospital care can cause women to lose faith in themselves, Bea had a traumatic time and is now fearful of her next birth. This is true of many women today.

After a very traumatic first birth I researched why the first stage of labour hurts and why it was never designed to. I found out abour relaxation (see post: Progressive Muscle Relaxation) and staying upright on a comfy chair or birth ball. My second was wonderful. Fear and anxiety are the worse emotions to have when going into labour. Practicing progressive muscle relaxation from 34/40 gestation will ensure that when labour day comes you will NOT PANIC. But sit down and run through the relaxing. Eat and drink small regular amounts and do not go to the hospital too early. When at the hospital, they will want to put you on a monitor, remember to stay upright and NOT LIE DOWN. You can be on a monitor and still be mobilising or relaxing on a comfy hospital chair till it is time to push! Do not let them break your waters or the contractions may cause you some pain. The waters are there to cushion the baby's head on her journey down the birth canal. Keep it normal and natural if you can for a VBAC so the contractions do not become too strong putting pressure on your scar (see post: VBAC at home?).

Good luck Bea, you really deserve better than you got. xx

 

ORGASMIC BIRTH

What It's Really Like to Have an Orgasmic Birth

Cosmopolitan.com spoke with women who have had orgasmic births to find out what it's really like to orgasm your child into this world. 

Woman A: I didn't really study up on it but I had read a book called Orgasmic Birth, which is more so about the fact that birthing is a sexual and sensual process that should be treated as such, but it's not a how-to guide to having orgasms during your birth.
Woman B: Oh, yes. I read tons of books.

Did you tell anyone you were going to have an orgasmic birth while you were still pregnant? What did your friends and family think about the idea?​
Woman A: I just knew it was a possibility but didn't view it as a goal to achieve.
Woman B: I only shared the idea with my husband.

What did your partner think about the idea?​
Woman A: He thought it was lovely.
Woman B: He thought it was a great idea.

Where did you give birth? ​
Woman A: At home.
Woman B: I gave birth at home in a water-filled tub.

Did you use any pain medication at all?
Woman A: No.
Woman B: None.

What is the process? Do you start with foreplay? ​
Woman A: I didn't try to have an orgasm. As I approached the transition [birth], I did feel slightly aroused and remember thinking, 'I wish my midwives weren't there so that I could masturbate or be intimate with my husband.' But my orgasm was spontaneous.
Woman B: ​He touched me lightly, caressing, kissing, nipple stimulation, and there was also clitoral stimulation. ​

Did you masturbate, or was your partner or anyone else involved in turning you on?
Woman A: The main way that I experienced orgasmic birth was by looking in my partner's eyes as I had each contraction and saying, "I love you, I love you, I love you," with each wave. In my opinion, this produced large amounts of oxytocin that helped the labor progress, and kept me relaxed and connected rather than stressed and in pain, and all that contributed to the orgasm. ​
Woman B: My husband was involved in the process, using digital clitoral stimulation.

Is there a certain point after which you can't have penetrative sex because the baby is too far down?
Woman A: I don't know, but I only had penetrative sex in the days and weeks leading right up to labor.​
Woman B: Yes, definitely, but I did not have intercourse during labor.

At what point in your labor did you begin orgasming?
Woman A: ​My labor was very fast and intense and I had waves of orgasmic pleasure the whole time.​
Woman B: I was experiencing a spontaneous full-body orgasm throughout the transition [birth].

How many orgasms did you end up having throughout the birth? Did they feel different than regular orgasms?​
Woman A: I just had one, but yes it was very different than my usual orgasms. It was more of a very deep, full-body orgasm. I've also had a ton of those since the birth!
Woman B: I had four separate orgasms.

Was it weird having an orgasm in front of medical professionals?​
Woman A: Because I was at home and the only people present were my husband and two midwives, I felt very comfortable. I orgasmed mostly silently and told them that I did afterward. It felt very comfortable. I am convinced I would have never been able to have that level of relaxation to allow for an orgasm had I been in a hospital.
Woman B: I was at home, so that wasn't a problem.

Did you have trouble finding medical professionals who were experienced in orgasmic birth? 
Woman A: No, both my midwives were familiar with the concept.
Woman B: I was planning a home water birth with an RN who was very familiar with the methods.

Did you tell people you'd had an orgasmic birth when it happened? What were their responses?
Woman A: I told a few close friends, who all thought it was wonderful.
Woman B: I only told intimate friends whom I knew would consider my experiences sacred. It's nothing to brag about, it's just such an incredible experience.

What do you think the biggest misconceptions are about orgasmic birth?​
Woman A: Having sex during labor or masturbating to orgasm during labor isn't the same thing as the birthing process itself bringing pleasure and an orgasm.
Woman B: That they are not real orgasms, when in fact they can be so much better than an orgasm.

What advice would you give to other women who are considering orgasmic birth?
Woman A: Check out OrgasmicBirth.com, they have a film and some books. Also, the more private your situation is, the more you can use the hormones of sexuality to help you in labor. ​
Woman B: Give birth at home in the most comfortable and relaxed environment possible, with as few people around as possible. Be open to all possibilities and try to make it feel as natural as possible. Intimacy with oneself is amazing.

Wow, wish I had read this when I was having my babies!
To help with an orgasmic birth read posts in this blog on Why Labour Hurts and Hazards to a Pain Free Labour.
Pain Free Labour Books now available from Amazon, cheap as chips.

 

Research into hypnobirthing methods to reduce labour pain.

Downe S. et al (2014) set out to discover if teaching women hypnobirthing relaxation techniques could lead to less use of epidurals. Their findings are available in full from the Wiley Online Library. 

At last, I thought, evidence that labour does not have to be the trauma seen every day by hospital midwives world wide. How disappointed I was.

I read it with a sinking feeling. It was as a whole a very well thought out study with randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal.

I could not find anywhere in the study where positions in labour were even considered when every midwife worth her salt knows that keeping women off the bed leads to less pain relief needed. The primary outcome was if a woman had epidural analgesia or not with secondary outcomes of how women measured their fear levels looking back on their labour.

Margaret Jowitt (2014) has written an entire book on how positions in labour can influence the success rate of normal births. “Women were not designed by evolution to labour and give birth propped up semi-sitting or lying on their backs. The hospital bed can turn a healthy active woman who is quite capable of trusting her body to give birth by itself to a passive patient hooked up to machines which immobilise her and increase her pain.” If the women in the intervention group were not advised to keep mobile or upright on comfy chairs or birth balls during their first stage of labour then no wonder the same amount of them needed epidurals as in the usual care group.

There was no mention of how many of the women in either group went into labour spontaneously or had to be induced. Does relaxation/hypnobirthing make a difference in delaying labour if fear is a factor? Also a massive 75% delivered in an obstetric unit where the main object that you see when entering a room is the bed. I often have to stand in front of the bed when a woman enters a delivery room and guide her towards some of our comfy chairs much to her surprise. She has watched One Born Every Minute and is convinced that labouring women are ill and should be tucked up in bed like a patient with doctors on hand to heal them.

This piece of research was a lost opportunity to turn the tide against the ever rising amount of women who see birth as a terrible ordeal to be got through with as many drugs and interventions as possible. The conclusions of the study were that the hypnobirthing teaching sessions and CDs were no better at avoiding epidurals than usual ante natal care. If the women in the intervention group had also been given the advice not to lie down in labour, as many seem to want to, then the outcome may have been very different.

Downe S et al (2014) Self-hypnosis for intrapartum pain management (SHIP) in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness. BJOG available on line at Wiley Online Library.