The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Turning Fear and Pain into Relaxed Focus for Birthing

When my wife became pregnant with out first daughter, we did a lot of research into my wife's family birthing experiences and other cultures. We found that her grandmother gave birth in a Hawaiian sugar plantation by herself. Two children were born to her in this manner. There was no pain or distress. Labor was a matter of minutes once her waters had broken, she took a day off work, and resumed work the next day with her baby strapped to her back.

To her such an outcome was unremarkable. A later birth in the local hospital was another matter. She reported that as very painful and the labor took 10 hours. She found the whole experience very unpleasant, and demeaning in how she was treated.

We found several cultures where birthing is gentle, quiet, relatively painfree, and labor is measured in minutes once the water bag has broken. (This is not to say that conditions are ideal in many other areas in these cultures. They are not.)

We decided after comparing home birth with hospital birth to have our baby at home. We found a very supportive and kind midwife and ignored the warnings of disaster and threats of prosecution for manslaughter if anything happened to either mother or child!

When her waters broke her contractions were strong and regular and birth seemed imminent. Then as soon as the midwife and two friends arrived everything stopped. My wife was displaying symptoms of fight or flight. So I sent everyone out of the room to make tea, and as flight was impossible I got her very angry and for quite a while she pounded the pillows and mattress and shrieked her rage as loud as she could.

Once she had discharged her rage her contractions restarted and her cervix dilated, and she had a very easy birth. This experience gave me a new perspective on birth and how the birth process can be effected. From then on whenever I was called upon to attend a birth I began to suggest and apply some techniques that I had developed for mitigating or resolving chronic pain.

For a while I was quite puzzled as to why so many birthing mothers went into fight or flight when midwives, Doulas family or friends arrived or they went to a hospital. Particularly as so many these days have undergone extensive preparation for the birth with relaxation classes. Then I realised that the adrenalin rush is a primitive response designed for survival and we have probably underestimated it's power, and while conscious training will help under some conditions, if a birthing mother unconsciously senses danger, birthing will cease until either the threat has left or the adrenalin has been discharged with violent exercise, and no amount of training will inhibit it.

We are almost certainly the only species that allows relative strangers into the birthing environment. The cultures that appear to have benign births are those where the birthing mother is attended by people who she has known all her life, or she is encouraged to give birth by herself. Even then, if the wise woman or midwife of the tribe senses a family member present who stimulates tension for the birthing mother she is asked to leave. Which brings me to a very important aspect which can have disastrous consequences for the neonate. It is to do with that we are also the only species which allows strangers into the nurturing environment before maturity. I will post that separately, and some of the methods I use to mitigate pain and discomfort, as this post is quite long already.

As I mentioned in an earlier post at least 60% of my chronic pain patients had through regressive analysis traced their pain back to a traumatic experience at birth. Forceps or manually assisted delivery often imparts chronic neck or shoulder pain. Sometimes lower back pain as well although I have found most lower back pain to be a result of other causes which I will describe. Many phobic symptoms and symptoms such as asthma, anxiety and depression can also be traced to birth.

If when the neonate is born and it's mother is under stress or recovering from an anaesthetic, and is not fully available to it physically or emotionally, it may well bond with someone in it's immediate vicinity who is appearing to be a dominant survivor. Depending on the intensity and duration of the stress it may bond/ imprint "whole cloth" as it were. Not only the positive qualities which are the motive for identifying, but also any pathology that the person that they have bonded with is demonstrating.

When we look at how so many neonates were treated in the past: drugged with their mother's anaesthetic, slapped into wakefulness, cord cut prematurely, medicated, sugar watered, washed, weighed, and separated from their mother for varying lengths of time; surrounded by a cacophony of sound and harsh lights, and handled by a variety of caregivers, who are usually anxious and highly stressed it is little wonder that adults today are bonded/addicted to the many distractions of this modern world, and are often incapable of intimacy with a significant partner.

What I have found is that a large proportion of symptoms of pain and dissonance are traced directly back to identifying with someone else in the neonates or older child's vicinity while they were undergoing trauma or extreme stress. This is why so many of my patients pain could not be traced to any organic cause. It was of the order of the phantom pain in an amputee's missing leg. That lower back ache that started later in life, plagued them on and off for years, and resisted treatment was the pain in the physician, midwife's or birth attendants back, or a relative or friend present when the neonate or child was undergoing separation or other trauma.

I developed a simple technique to discover if a patient's pain was "his" or not. I would get the patient to relax and press on the painful area, and at the same time ask him to describe the pain. Was it sharp or dull, is the area tense or relaxed? Then I would ask, what kind of person would have this pain if it wasn't you? An image would invariably form in their mind. If it was someone other than them, I would ask what do you want to do with that image? If they responded, "let it go," and they did, the pain would cease or whatever symptom they were displaying would cease.

If it wasn't someone else but them I would ask them to go back to the first time they felt that pain and they would regress back to the time of the incident. We would run it through rather like a movie taking place in one's mind, discharge any emotions surrounding the incident, and recover any significant decision made at the time.

The same phenomenon is present before maturity I have found. If an older child is also subjected to extreme stress it will also identify in the manner which I have described. Dealing with that is simpler I have found. If the child displays a personality change or sudden symptoms of dissonance it is usually enough to ask: who are your being?... to obtain a halt in their dissonant activity, a slow smile and....Oh, I am being....... Usually a dominant playmate.

Again we are the only species which permits the intrusion of strangers into the nurturing environment before maturity. I think that there are very sound biological reasons why most species will either fight off intruders or flee before allowing them to be in contact with immature offspring. If a species doesn't protect it's young in this manner it is in danger of forming a rogue species with disastrous results for it's species future survival.

In my experience addictive behavior is the exposure of an immature child while under stress to negative behaviours or substances. This is why trying to cure addiction is very difficult, if not impossible. Nature did not anticipate that a species would not guard it's immature young from potential harm.

(Of course I was not working with a representative sample of patients. I was usually the practitioner of last resource. Most of my patients had spent years seeking help from a variety of sources to no avail or only temporary relief.)

In my next post I will describe the specific sequence of techniques that I suggest a birth attendant can demonstrate to a birthing mother.

I think that it is important to reiterate that pain that accompanies any normal growth process is an indication that something is awry. A signal from the organism that attention should be paid and adverse conditions need to be attended to. If pain accompanies birth or menses there is pathology present.

I am aware that very often midwives do not have the power to create ideal birthing situations particularly in a hospital environment. My hope is that the public may become educated enough to understand that normal birth need not be painful, and demand better conditions and that midwives are recognised by the medical establishment for the care and attention that they give to birthing mothers.

I would like to see mandatory education on childbirth given in schools with midwives being in charge of developing the curriculum. It is vital that we counter the litany of horror stories with accounts of birth that are benign and normal.

I was fortunate in being able to work under ideal circumstances. The births that I attended were all at home and with mothers who had been working with me on other issues. A small proportion of mothers were referred to me with specific problems who had not previously seen me.

The main technique that I used to help the mother to change pain into pleasure, was by stimulating her to fight. Invariably I had noticed that when I or other birthing attendants arrived once labor had started, the fight or flight syndrome was stimulated, and labor slowed or halted. (If we arrived before labor had started sometimes the delay would be so long, that we would either leave or go into another part of the house to rest. Very often as soon as the mother was alone, her waters would break and labor would commence.)

I would then suggest that as flight was inappropriate, that the mother tap into her anger. A midwife on this list has pointed out to me that not all mothers would so easily be able to access and discharge their anger. I have found with the mothers that I worked with, that one of easiest ways for mothers to access suppressed anger is for them to get on their hands and knees and bellow like a bull from as deep down in their gut as they can. I usually demonstrate this first as sometimes people are embarrassed to do this, particularly with making such a strange noise. I also encourage a husband or partner to join me which also helps enormously.

Once the rage is triggered I encourage the mother to furiously fight a large pillow or the mattress until the adrenalin is discharged and labor resumes. I also encourage them not to consciously push, but allow themselves to "be pushed by". This of course only applies to a normal birth. Unless strenuous muscular activity takes place and adrenalin discharged, the conflict will remain and the muscles of the uterus will oppose each other and prolonged labor accompanied by severe pain and distress will usually occur.

If I have the opportunity to work with a mother in the early stages of pregnancy, I use a couple of methods to bring up any suppressed feelings: doubts, uncertainties, anxieties etc., which I find is really helpful if they can be ventilated. I teach Jacobsen's relaxation method. Using phrases such as "deeper and deeper your your body is relaxing, your muscles are getting warm and heavy," most people can achieve deep states of physical and mental relaxation over time. I spend at least an hour in preparation, giving attention to each group of muscles.

Then I suggest that they visualize giving birth. An ideal birth. If there is any latent anxiety, fears etc., this will stimulate them into consciousness, and all the horror stories or memories of past births will arise. I encourage some venting, and then suggest that they resume a relaxed state. Whenever negative feelings occur I encourage them to just recognise them and concentrate on their body relaxing. It is impossible for negative emotions to occupy the same space in the mind as the relaxation signals coming from the body. Continuing to relax while visualising will de-condition these memories. If the negative emotions continue to overwhelm there ability to relax, I will then carry out the De-Identification Process mentioned in an earlier post. Usually chronic anxiety that resists clearing is due to an earlier identification with someone else.

Many mothers I find while pregnant, during birth and postnatal, are being their mothers. Not surprising of course. Not many young women see births on a regular basis, let alone positive birthing experiences.

Many women have been sexually abused and this can present added difficulty and stress. Not all mothers are aware of early abuse but a number of midwives that I have talked to often have a intuitive sense that this may be a problem. Often this is confirmed during prenatal exams or labor.

Usually if there has been abuse memories will surface while undergoing the relaxation/visualization process. Most of the women who I have attended who suffer from chronic pelvic pain discover that the source of their pain is either an identification with their mother while she was giving birth to them, or trauma from sex abuse.

I use the same method for accessing and ventilating feelings from memories of abuse described earlier. I have found that it helps immeasurably for a woman to have the opportunity to voice her pain and anguish. Again I always encourage physical action to accompany the emotional discharge.

Some will be more comfortable referring a client to a sex therapist if they are comfortable with that and the client can afford it. I usually check that before I suggest a referral.

I also instruct the future mother on how to birth herself, and if there is a partner involved how they can support the mother in having an enjoyable experience. I also recommend that both mother and partner read Spiritual Midwifery, particularly with reference to sexual pleasuring. Either self pleasuring or with a partner. I am sure most midwives are familiar with the physiology of sexual pleasure in reducing anxiety and pain. I suspect that birth could be the most orgasmic experience that a woman could have. Unlikely at the moment I know, but I do hear from mothers who claim to have had multiple orgasms throughout the birth.

In my next post I will recount how a narrow pelvis can sometimes be opened, and how to reduce or eliminate chronic pain during menses.

I hope that what I am writing is clear and of interest. So much unnecessary misery could be forestalled if the understanding was gained that we are primed to give birth in privacy or with only those who represent no unconscious threat to us present. If that is impossible to arrange a strategy such as I have described can still transform birth from pain to pleasure. This information is not new, it has all been described in detail by earlier workers in the natural childbirth movement.

Pain during menses

Usually the birth is a painful and problematic. Much anxiety is associated with the birth, and the feeling that their life could be in danger is present, and felt to be overwhelming. If the subject can disassociate from the identification, the usual pain, cramping and nausea is absent when their menses next occurs.

One of the grave disadvantages of this bonding with inappropriate people while under stress, is the lack of a primal identity with it's accompanying feelings of unauthenticity. There is also the complications that can arise from identification with the opposite sex with regards to sexual identity, and orientation.

When I was teaching these methods in London some years ago, I had the opportunity to use young ballet students as models for demonstration purposes.  One of my regular patients was a ballet dancer who I had treated for chronic pain, and she referred a number of dancers who had difficulty in turning out. This is a particular position (1st.) where the dancer has to evert [turn out] their feet by rotating the head of the femur in the pelvis.

These dancers had a number of similarities. They had a narrow pelvis, and had not started their menses. Their figures were boyish and most were homosexual or bisexual. If they were sexually active they tended to fall into extreme categories.

Several had a hearty appetite and ate well so compulsive dieting or bulimia was not solely responsible for their lack of development.

When they underwent the De-Identification Process, combined with a form of bodywork that I had studied, it was found that they had identified with a male figure while very young. Sometimes as a result of being abused a child will identify with their abuser, or an even more dominant figure in their environment. If their abuser is of the opposite sex to them, they are then sexually attracted to their own sex. One finds very often that many survivors will flip between being their abuser or the little child that they were at the time of the abuse.

When these young women shed their identifications a startling hormonal change took place. During a session devoted to releasing and loosening muscular and emotional tension located in the pelvis, some were able to allow their pelvis to assume a more appropriate configuration for their sex. Their bodies softened, menses started, and their sexual orientation changed. They also gave up ballet. Which was a disaster for me as far as public relations with the ballet school was concerned!

I have found it is very common once their primal identity has been uncovered under the layers of assumed identities, that most people undergo a drastic transformation, and pursue a different career and lifestyle. How much better it would be if we could protect our young from the stress and pain which causes such transformations, and assist them to retain their true identity, and the high self worth and capacity for pleasure that accompanies this.

I will be happy to answer any questions or clarify some of the observations that I have made. I would encourage the use of the De-Identification Process, and will be happy to post the sequence of commands for anyone to use. The method is very easily replicated, and just requires some patience and a willingness to listen, qualities which all midwives that I have met have in abundance.

Happy birthing and nurturing.
Rayner Garner <rayner@intuit.org.uk>
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