As a Hypnobirthing practitioner encouraging women to ‘breathe their baby down’, I find that it is often a very challenging concept for them to embrace. The portrayal of the second stage of birth in the media has mainly been of the mother being coached in an urgent and intense tone of voice, generally by a doctor, to hold her breath, count to ten and then bear down as forcefully as she can. This technique, known as the Valsa maneuvre, or variations of it, has tended to be the standard practice in most hospitals in the UK and US.
I always had an interest in history. A window in the past can lead to better understand of the present. According to the Doula guide to Birth, the Valsa maneuvre was originally developed to test pressure in the ears, and later used to test heart function. “The technique of forceful pushing was developed without research showing it was beneficial; even so, it has been used on and off since at least the 1930’s and currently predominates in maternity care. As of 2008, twelve studies have found no medical benefit to this style of pushing(1).” The authors even claim that “Heavy straining may cause the front wall of the vagina to be pushed down ahead of the baby. In this situation, the vaginal tissues may become “bunched up” and actually block or slow the descent of the baby, as well as damage the area where the vagina attaches to the bladder.” “It also causes your baby to experience emotional and physical trauma, as she is pressed against the walls of a resistant passage that is not yet receptive to her journey”(2).
Altogether not a greatly inviting option for mums or babies! So what is the alternative?
“Mother-directed” breathing down is one alternative put forward by Marie Mongan, the founder of hypnoBithing, now a popular way of giving birth with the benefits of hypnosis. Using hypnoBirthing, the mother would allow nature to function as nature intended and follow the waves in her body with her breath to nudge her baby down the birth path, without added force. “There actually is pushing involved with this approach, however the mother does not intentionally add to the bearing-down efforts her body makes on his own, nor does she hold back.(1)
Carole Thorpe a hypnobabies practitioner describes what breathing baby down means to her: “By “breathing baby down”, we mean that moms are breathing, “aaaahhhhhh” to open their throats, because we know that if their throats are open and relaxed so are their bottoms. Through a process called peristalsis, our ‘gut’ which is one continuous tube, ‘communicates’ from one end (the mouth) all the way down through the digestive tract to the other end (the rectum). Whatever is going on in mom’s face, is being mimicked by her bottom. So, when mom is ‘breathing her baby down’, she is relaxing her jaw, her throat is open, and she is relaxing and allowing her birthing muscles to bring her baby down through the birth canal slowly, and gradually. This is so the birth canal can unfold accordion-style, and open gently, and so that baby’s head can also mould to fit the pelvis slowly and gently. Baby is propelled by the force of the pressure waves (contractions), down a little, down a little more, and even a little more each pressure wave, and then baby slips back a bit when the pressure wave ends, in a gradual, “two-steps down, and one-step back fashion”. Mom breathes and relaxes and allows her body and her baby to do all the pushing in the beginning. She allows her body to do what it already knows how to do, inhaling relaxation, and then exhaling and saying “peace” while powerful anesthesia automatically flows down and out ahead of her baby to exactly where she needs it in her bottom. This is similar to what women who have epidurals experience, and the hospital staff calls it ‘labouring down’. Those moms typically don’t push at all until baby is on the perineum. Then, when baby’s head is so deep in the pelvis that it is pressing on the nerve endings in mom’s rectum, it will trigger a powerful, automatic bearing-down response. When this urge to push becomes strong enough that mom just HAS TO PUSH, her body will involuntarily push… POWERFULLY. And, she’ll begin to want to help that process by bearing down just a little at the peaks of some of the pressure waves. Then gradually that urge to push becomes longer and stronger until mom has an overwhelming urge to push throughout the entire pressure wave, each and every time. And, she will push because her body is guiding her to do so.”
Both anecdotal findings and several studies support this more natural way of birthing.
A study conducted in 1957 showed that “when women were allowed to push without straining, better progress and greater ease [that] has to be witnessed to be believed” and less damage to the vagina. A study from the University of Texas South Western Medical Center was reported to have come to the same conclusion in 2006.
It can indeed take seeing it to believe it and watching mothers birthing their baby on the HypnoBirthing DVD can really open women to a possibility they may never have considered previously. Here is a link to a hypnobirthing video on you tube which shows the way one woman birthed her baby without straining.
In the next newsletter I will be delving more into the in and out of pushing including explaining more of the physiology and ways a mother and birthing partner can support or hinder the process.
Olivia Seck June 2010
Olivia is a holistic birth practitioner, a doula and trainer and the founder of Birthing Wisdom. She also facilitates Holistic Hypnobirthing retreats in a beautiful setting in Devon.
- The Doula Guide to birth: Ananda Lowe & Rachel Zimmerman
- HypnoBirthing: Mary Mongan