Instructions:
Childbirth educator, author, and nursing professor Judith Lothian uses the phrase “the simple story of birth” to describe the physiology of childbirth. Sharing this “story” with your students helps them to understand how the mother’s body is perfectly designed for labor and birth.
"During the last weeks of pregnancy, the mother’s body prepares for birth by releasing hormones which soften, thin, and begin to open the cervix. About two weeks before the baby’s birthday for first-time mothers (closer to the baby’s birth date for second and subsequent babies), the baby “drops” down into the mother’s pelvis. When the baby’s lungs are fully mature, the baby releases a protein that signals the mother‘s body to begin labor. Labor contractions are regulated by the hormone oxytocin, also known as the “love hormone” because of its role in orgasm, birth, and breastfeeding. Oxytocin production is stimulated by the pressure of the baby’s head against the mother’s cervix, and later by the baby’s head against the pelvic floor. As contractions build in intensity, the mother’s body produces endorphins to help her deal with the pain. Endorphins are similar in chemical composition to morphine, and are the same hormones responsible for the “runners’ high” experienced by long distance runners and others involved in strenuous physical activities. If adrenalin, the fight-or-flight hormone, is produced during the first stage of labor due to high levels of stress, oxytocin production, and thus labor contractions, will slow or even stop. However, during the second stage, small amounts of adrenalin (catecholamines) give tired mothers a burst of energy that helps them to push effectively. The adrenalin that enters the baby’s system causes the baby to be wide-eyed and alert to greet his parents immediately after birth. Oxytocin, which peaks in the mother during second stage, promotes breastfeeding and mothering behavior after birth. The interplay of oxytocin, endorphins, and adrenalin regulates the events of labor and birth and prepares both the mother and the newborn for the baby’s transition to the outside world."
STORYTELLING: One of the best ways to get across the point that labor has so many variations is to tell birth stories you have heard or experienced. Rather than giving a lecture that a long prodromal labor is normal, it is far more effective to tell a story about a woman and her labor partner who coped effectively with several days of pre-labor contractions. Instead of making transition in labor a long list of “discomforts,” tell stories of coping with transition. Students enjoy hearing how others have handled situations dealt to them. Even more impressive is to invite former students to share stories of their births with a pregnant class. Allow time for processing the stories told after the new families have left. Always ask permission to share a story, and/or change names, times, locations, etc. to protect identity.
Talking Points:
Think about possible stories of your own where you overcame a challenge that you might want to share with your childbirth class. Childbirth educators who have experienced natural childbirth or those who have completed a difficult physical challenge such as a marathon, lengthy bike ride, hike, or mountain climb often find amazing similarities between the two experiences. In both cases, preparation and support are vital. In both cases, the participant usually starts out with enthusiasm and excitement. Soon, she falls into a good rhythm, with her body working just the way it is supposed to work. Pacing, breathing, rhythm, and support are all important. After a number of hours, muscles begin to strain. Lactic acid begins to build and pain increases. Eventually the pain increases so much that the participant doesn’t feel that she can go on. She wonders why she ever wanted to do such a thing. She has to dig deep inside to find the strength to continue. Sometimes words of support can make the difference. When she does finally complete the task, overwhelming feelings of exhilaration and pride overcome her. “I did it, I did it, I really did it,” she thinks to herself. Whatever the task, whether natural childbirth or completing a strenuous event, later in life when she faces other challenges the participant often remembers the increased self-esteem and feeling of accomplishment she felt at the time. The educator may choose to describe the running of a marathon or similar experience to groups without specifying exactly what challenge she was facing. After she completes her story, she asks the group “What experience do you think I am describing?” Sometimes they will come up with the actual event, but more often the group will say, “natural childbirth.”
In either case, she may bring up the fact that during an athletic event, everyone cheers the participants and no one encourages them to quit; whereas, during childbirth, sometimes support people are quick to recommend medication to a woman desiring a natural birth rather than to encourage her when the going gets tough. Clearly, a laboring woman always has the right to choose medication whenever she wants, and this comparison is not appealing or even appropriate for all groups. However, it can help students to look at labor pain with a different eye if they think about other situations when people choose to work with and overcome pain for a purpose or goal.
Modifications:
In response to a controversial column in the Boston Globe, Judith Lothian shares the delightful story of a walk in rural Ireland and compares the challenges of the walk to the challenges of labor.