Holistic Stages of Birth
The Holistic Stages of Birth in A Quantum Paradigm
In my early years of practice I found myself called to attend women who were building large families. My third client family was welcoming their ninth child, my next mom was having her seventh. I realized very quickly that my personal experience of birthing two children and my three years of midwifery study paled in comparison to the knowledge of these birthing women. I understood, that as their midwife, I would sit at their feet and learn from them.
Here are some of the things I learned.
After a women has her first baby, SHE UNDERSTANDS. She understands instinctively how her body works, how childbirth feels, what she likes and doesn’t like. She is aware of what she wants and doesn't want the next time she gives birth. She knows what her partner is capable of, what she wants in a
caregiver and how capable she is to figure things out. She also knows that she can’t be fooled. She doesn’t want to be abandoned yet she doesn’t want to be observed. And she also wants a caregiver who KNOWS...a caregiver who understands that she knows these things.
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The women I worked with taught me how to be a midwife...they trained me to KNOW. Actually, they trained me to remember what I already knew and to engage with them using my instincts. They wanted a midwife with skills -- the skills to be in harmony with them. They wanted me to be practical and offer information and advice when appropriate. They wanted my years of study and experience to be available to them, but in a way that was harmonious with their needs and desires. They wanted a midwife who could instinctively open an arena of participatory care with them and I quickly realized that co-creating care would look differently with every woman and every family.
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Pregnant women are incredibly insightful and naturally wise. During prenatal care, as we developed our relationship, they instructed me on these realms of wisdom and insight. We would talk and tell stories, we would share a meal and share our feelings about birth and then we would check the baby together. We exchanged knowledge and information as women and sisters and equals. More and more, I remembered the knowledge of birth inside me, so I shelved my textbooks and let the voices of my illustrious midwife teachers grow silent for a bit so I could listen to the women I served and to myself.
Most women needed little or no testing, counseling, dietary guidance or other managerial therapies that seem to be the stock and trade of many midwives and midwifery practices. Although everyone's prenatal care evolved differently, most women, regardless of their backgrounds, educations, resources or spiritual beliefs, wanted a very similar thing. They all wanted to birth their babies their own way. They really didn't want or need a trained midwife telling them how to do it. They wanted a wise person, standing by. They wanted someone they loved and trusted in attendance to witness how amazing they were as they unfolded the birth that was authentic to them.
Here’s another crucial thing I learned. Women in pregnancy and especially women in labor have access to realms of non-ordinary reality.
Pregnancy and birth have easily accessible altered states of consciousness and women have the option of attaining information that is not apparent in our normal reality. What this ultimately means is that pregnant and laboring women are quite adept at handling any concerns that arise at any time. The altered state, complete with endorphins and access to these broader realms of information, qualifies the pregnant mother as the most suitable person to make any decisions about her process.
Mothers understood that they will birth this child only once and because this child is so important, it was paramount that they make the decisions from the place of their innate wisdom, not someone else’s. Parents understood that birth is sacred, a 'set apart' experience in their lives that emanates from the realms of spirit and soul as well as physics and biology. Parents chose what was instinctive and authentic to their beliefs and traditions.
When I speak of altered states I am not speaking specifically of religious beliefs although various
spiritual beliefs may enhance the altered state. I am speaking of the natural shift in brainwave patterns that occurs during parts of pregnancy and peaks during birth. The patterns have been identified as Beta, Alpha, Theta and Delta and each progressive pattern accompanies a deeper altered state.
I became more and more comfortable being where the mom and family wished me to be rather than having any preconceived ideas about where I felt I should be. This became the Art of Midwifery to me...understanding that a woman knows instinctively how to have her baby and not disturbing her or her family during this process, being available to watch and wait and come forth when called, respecting that a woman will call when necessary, finding my place at each birth with the natural rhythm of unfolding, not presuming anything, carrying no fear, bringing no routines or procedures, welcoming all that is transformative, witnessing the creation of life on earth...all this is the true Art of Midwifery for me.
I recognize that each woman gives birth individually yet, over time, I noticed a specific overarching pattern emerge that was perceptible in each labor. I call this pattern the Holistic Stages of Birth and I would like to share my experience of how I have seen birth flow. The language I have chosen to describe these stages befits a journey, a rite of passage or a sacred event rather than a medical process. It is symbolic and poetic rather than clinical although this does not imply that the process I have witnessed is a metaphor for labor.
Embarkation
(Pre-labor and Latent Labor)
Labor is a Journey. The preparation has often been elaborate, conscious and consuming. There is usually an all-important ritual of Arrangement preceding the actual event. We call it nesting and Mother has moved about in a final flurry of activity, taking care of all last details...clothes are washed, food fills the freezer, house is ship-shape...all is in order. Nesting is part of Embarkation. Mother senses that labor is soon. Perhaps contractions and the loss of a bit of the cervical mucus has offered a hint that the journey is about to commence.
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Then it does begin and Embarkation is also the time when a woman realizes that labor is truly here.
Mother is excited, maybe a bit nervous, concerned for the welfare of her loved ones having made sure that they will be well taken care of while she is gone. As the Journey is launched she may call all her family to her to bid them goodbye or, depending on her custom and constitution, she may silently take leave with her partner and companions. Usually, at this time she alerts her chosen caretaker. If she is birthing at home, she notifies her midwife who may or may not arrive immediately depending on the mother's preference. If she is planning to give birth in a hospital or birthing center, she may notify her chosen caregivers and remain at home until other changes occur. Often, moms wish to spend time acclimatizing to the sensations the body offers before they actually connect with their birth attendants. Most moms are aware that labor is still in early phases and are excited and managing their energy very well.
During this time the Mother often feels like talking and sharing impressions as she is pulled away from ordinary reality. She may be chatty and relate information about each contraction or each sensation. She usually stays centered as she is stretched and molded; her sensations become stronger, more intense, powerful. Most Moms experience this as varying degrees of pain. The waves of contractions repeat with increasing intensity and frequency and the Mother is swept toward the Unknown.
In modern parlance this time would be considered pre-labor and the latent stage of the First Stage of Labor. Physically, the cervix is beginning to efface and dilate and this stage lasts until the Mother reaches 4 to 5 cm dilation. Contractions are usually 30 to 45 seconds long and 5 to 10 minutes apart. As Mother comes closer to the chasm that separates her from ordinary reality, contractions build in intensity and become coordinated and rhythmic. It becomes apparent that the Mother is being called away – she is less and less present in ordinary reality with each successive contraction. Her chatty persona disappears, replaced with a growing seriousness.
As she feels herself pulled toward the Veil she will probably want to connect with her caregivers. Shemay feel the need for the presence of the midwife or doctor because she understands that she will be
leaving ordinary reality, taking a definitive step into the unknown, and she wants her caregivers to be
aware and ready to witness.
Entering The Veil
(First Stage - Active Labor)
The Mother reaches a point in her traveling where it is time for her to go alone. The endorphins released by her body during her embarking have begun to change her consciousness and she enters, more deeply, the realm of the altered state. She travels to the edge of her normal reality, parts the Veil and goes beyond. The Veil is my nomenclature for the curtain that separates ordinary reality from the deep altered state.
Brain wave patterns have begun to slow down and change from Beta (ordinary reality) to Alpha (the bridge into the subconscious) in the Embarkation phase. Now, in the next stage of labor, brain wave patterns slow down even more and mother has access deep into Theta (the subconscious). The aloneness reflects the fact that women move into a place of self-direction that seems to emanate from a grounded yet altered place in them.
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The Veil is that stage of labor that heralds the change to this new place. This doesn’t mean that a mother wishes to be alone and that others are not relevant. Rather, it signals the shift into a more self-directed realm. Mothers may approach the Veil several times before deciding to move through. Circumstances may also prevent the mother from moving through. Constant questioning, especially about mundane affairs, and interruptions in mother’s rhythm serve to bring mother back to ordinary reality.
At the Veil, Mom no longer feels chatty and often the experience of something more serious and profound presents itself. She begins the process of separation and while the mom is aware of details and specifics occurring in the room, she becomes less interested in them.
There is often a palpable smell in the air or a subtle but perceptible color change in the room that marks the presence of the mother at the Veil. Many caregivers can calculate the flow of labor by these signposts, making yoni exams redundant at this point. I have experienced color changes and find this to be very reliable and helpful for me as I witness a mother’s journey.
In conventional terms, the Mother has achieved 4 or 5 cm dilation and the character of the labor changes. Contractions begin to be about 60 seconds long and about 5 minutes apart. Mother may seem to act a bit more spacey and unfocused to caregivers in the beta mindset.
On the Mountain
(First Stage ~Active Labor)
During this time the Mother craves privacy, silence, warmth and the intimacy of the dark. She looks to her Guardian to know that she is safe and that no one will breach the sacredness of her travels by distracting her or leveling any expectations on her. But most importantly, she looks to her Partner to see if he* is with her. She reaches for him to bring him into the vortex and together they speak a silent language as the sensations between them become more powerful and intense. No one may disturb them; they are Between the Worlds. They become tuned to rhythm of this process and perhaps to the spirit and soul of their child. They may have visions, see colors, hear the voice of their child. Whatever their experience, it is unique and relevant to them as partners, parents and family.This place Between the Worlds is the trance-like altered state where the opportunity exists to access the mystical state of transformation. Profound realizations may occur; new truths may become evident. Non ordinary reality may bring forth new information and new perspectives that forever alter the consciousness of the individual and the family.
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Mother is no longer in Beta, way past Alpha and moving through the deepest states of consciousness…Theta and Delta (beyond the subconscious to unconscious). It is important not to interfere with the birthing couple and it is seldom necessary.Mother stays upright, moving with her labor, moving with her contractions. They become longer and stronger – from 60 seconds to 75 seconds, almost to 90 seconds. At this time her dilation moves from 5 cm to 8 or 9 cm. Labor is considered hard now and often painful…at the least, strong and intense. Mother has coping strategies. She is not lost. She has what it takes to find her way. She doesn’t usually need words…simple reassurance in the form of present companions who give her privacy and offer safety, although sometimes quiet murmurings of respect and affirmation may afford the mom an understanding that you are there if needed. Sometimes humming or soft singing, from another room, may provide the mom with any needed reassurance. Mother may wish touch, eye contact, the healing powers of water…or none of the above. I’ve learned to make no assumptions. Now, I follow the mother and the journey. Again, the Art of Midwifery is inherent in being able to provide for the needs of any women, whether she wishes company or aloneness, eye contact or someone in the next room. The Art is being able to individualize your presence to the preferences of each woman. I often take a position in the corner, quietly witnessing, though not observing or intruding on the birthing couple‘s privacy. After all, what could possibly be wrong if the caregiver is knitting in the corner.
The Summoning
(End of First Stage ~ Transition)
Mother becomes aware that she is nearing the peak. She is deep in a vortex, past anything she has ever known.. She has been continuously opening to wisdom, opening to revelation and now she comes face to face with the apex of her labor. This is what she has come for – accessing the new spirit, the new person that is her child and her Partner’s child, and bringing this soul to Earth. She hears the Summons, she summons her child and together they make their way back.
This is often the most precarious part of the journey. Mother must summon all her reserves and she may want to know that her Partner is totally present and supportive. She assumes her caregiver is following their course and holding everything steady on the other side of the storm. Mother is braver and more courageous than ever before in her life.
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Transition is considered the most intense time for Mother. Contractions are long and hard – 90 seconds plus and coming 3 or 4 minutes apart. She is reaching toward 100% dilation or 10 cm. This is as open as a woman can be. Of course things may seem hectic and often the Mother flounders briefly during this supreme openness. She may say that she cannot go on or that she wants to go home. She may have a wild-eyed look and seek the presence of others. She may ask for help but I have noticed this is not the authentic need for someone to do something, rather it is the calling out to be witnessed in this hardest phase yet. Sometimes the presence of another person, especially one she loves and trusts, will restore calmness. And sometimes, the presence of another will allow her to feel safe and she will then rage to the end of the universe. Her personal tempest may take her far from ordinary reality. She will become the storm, become wild and incredibly powerful. Caregivers and partners may be amazed, even intimidated. Mother will find her way however it takes.
It’s important to note that birth does not look any particular way. Some moms are calm, some are wild. Some labors are fraught with pain, some are totally bearable, some are even orgasmic. I am not suggesting that any style of birth is better or more conscious than another. What I am saying is that when the mom is in her authentic power, no matter how that may appear, her birth is normal, natural and perfect for her. I am also saying that when a mom is imprinted by cultural or caregiver mores or prevented from accessing her instinctual wisdom, her experience of birth may be unbearable, agonizing, out of control, humiliating and shameful.
At this time, a woman often needs to find her own way. She needs to hear the Summons in her own language and on her own terms. When she does, the journey toward home can be initiated. Any distraction at this time can be confusing and dangerous but I have witnessed women be flexible and powerful and rise above danger and distraction with astounding regularity. During this time of openness, women find their way, find themselves, find their power and their will and commune with forces greater than they have ever experienced.
The Quietude
(The Resting Phase)
This is the period of great stillness and peace that occurs after transition. All becomes calm and quiet and the Mother knows that IT has happened. She knows she has found what she is looking for…her still place in the tempest and access to the soul of her baby. Both mother and baby are tranquil and serene, drifting toward the shores of home. She may choose to rest in the arms of her Partner or create a still place to recoup her energy. She is not finished with her travels – she must manage the breakers ahead – but right now she is in peace. This is one of the most important parts of labor.
For many years there was no acknowledgment of this stage of labor in our culture. Once a Mother achieves complete dilation she is usually encouraged to begin to push out her baby. But in the holistic paradigm, this stage, which usually lasts about 20 to 30 minutes (but can be as short as 5 minutes or can last hours), is Mother’s time to regroup and collect her energies for delivery. Labor seems to stop; contractions literally stop or slow down and the Mother may fall asleep or fall into a quiet, meditative trance. Everyone waits in the hush until contractions resume.
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What happens during the Quiescence is more than resting or regrouping. When you have climbed the highest mountain and finally reached the Summit what do you do…run right back down the other side. Of course not. Would you simply rest up for the journey down. Of course not. You may open your eyes and look! You would see what you have come this far to envision. You would possibly have a sacred and holy moment, set apart from all other moments in your life. You may receive.
This may be the pinnacle of the altered state. Brainwaves may shift to Delta, the slowest and deepest of our known patterns, which allows us access to the realms of the unconscious…the realms of profound knowing, meditative understanding and peak experiences. This is the realm of transformation.
In this case, mother receives understanding and knowing pertinent to this new human being that she is birthing. She receives wisdom that is easily accessible at this great altitude and in this momentous altered state. We lament that we are not accorded the blueprint with which to raise our children but that is not entirely true. There can be a veritable download of information about her child…the blueprint. This is a key part of the journey and mothers wish to be respected and afforded solitude to experience this phase of labor.
This stage is different for each woman and for each labor but in a labor where the Mother is not required to perform to any expectations or has any strong programming about exactly how labor should unfold, I have noticed that this interval lasts about 20 to 30 minutes. At the end of this period, contractions begin and the Mom is often startled into wakefulness. She is now ready to head down the mountain, carrying precious information. She is heading to shore on the incoming tide.
The Breakers
(Second stage of Second stage ~ Pushing)
At this point the baby’s head reaches the perineum. It can be felt by the mother, it may be visible to her partner if her position makes that available. Mother knows her baby is right there. The sensation of the baby on the perineum will bring on pushing contractions from the mother if necessary.
Usually mothers seem to be at one with the power of the waves and push with them but I have witnessed a few women who never actively push during their labors. The uterus does everything. Mothers articulate with these birthing contractions and the birthing song that began in early labor crescendos into magnificent aria. The mother’s voice may actually guide the baby to the end of the tunnel. These universal sounds may spur the baby on through his or her journey and create the natural excitement and tension that comes with reaching a goal.
At this point, close to Crowning, the Mother experiences a rush of adrenaline. With the speed of light she is in two worlds. Her oxytocin birth trance is still palpable and she is cognizant of her earthly reality. She is back and is ready to bring her baby to dry land.
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I have noticed that almost all women engage the same position for birth. Women who are left alone and not told what to do…universally and naturally seem to do this…
KNEEL on one knee.
During their time Between the Worlds, most women are upright and flowing with labor. Many women sway with contractions and will lean forward during the majority of the contraction. This is natural wisdom. In labor, the uterus moves upward and forward and women naturally move with the uterus, facilitating the process. Some women will even hold their uterus up and forward with contractions…never having been guided or encouraged to do this. During Quiescence, women seem to relax. They may float in the tub or sit back. They may even lie down on the side. When contractions resume full-on during the time of the Birthing Tides, women are usually upright again…walking, swaying, leaning. As this time becomes more intense and melds into the actual Breakers a woman instinctively knows her baby is near and will begin to hunch down and get closer to the floor. Finally, when the breakers are in full swing, women invariably bring down one knee and take a kneeling position with one knee on the floor, the other bent. A mother will never drop her baby out on the ground. She will crouch on the floor, one knee down, one bent and facilitate the birth of her child. Her partner usually crouches in front and above her, like the Archangel, protecting and witnessing, claiming his family. The caregiver is nearby…waiting to be called closer if needed. Most mothers birth their babies solo. Babies generally don’t come barreling out of the uterus when the mother is present and instinctually engaged in her birth, so no one needs to catch. Mother’s hands know what to do…as always…and assistance is seldom needed. Baby comes through mother’s hands and she places her baby gently on the birth mat prepared for the baby on the floor.
A note about other positions…
Women will sometimes go from a kneeling position during the Breakers to a hands and knees position. This is popular position because the laboring mom can get the weight of the baby off her back and has her arms to support her as she leans over. A mother will only do this if a caregiver or partner is facilitating the actual delivery because a mom instinctively knows that her baby is now behind her and she cannot receive her baby herself. Often moms confide after the birth that the hands and knees position made sense in the moment but that they were sorry to have missed the birth of their child. Someone else ended up catching the baby and many moms I have known will not choose this position again.
Women seem to dislike a supported squat. They are totally dependent on someone else to hold them up during birth, usually the partner, and then the partner does not easily see his child born. Also it often puts the mom in an awkward state…needing to depend on someone to hold them during birth when they instinctively understand that this is not really necessary. I realize that supported squat is a caregivers position for a mom rather than a position that she would naturally choose. Also, in a supported squat, I have seen women have difficulty arching their back for the fetal ejection reflex that Michel Odent speaks about.
Semi-sitting, the most culturally popular position for childbirth, is the most difficult position in which to birth a baby. It’s a matter of sacred geometry. When a women is sitting on her coccyx, which is exactly where she is sitting when leaning back, she is occluding the birth canal. In labor, the coccyx will naturally roll out of the way so the baby can fit through. When mom is sitting on it, great force may be required to move the baby over the coccyx. That translates as hard and heavy managed pushing with the legs to the ears and often a lot of yelling and coaching. Even though it is psychologically preferred to lying on the back or in stirrups I have never seen a mother choose this position, or need to. Actually, from the physiological stance, lying on the back is an easier position for labor because the coccyx can move out of the way with less effort than when the mom is sitting on it. Moms do not like lying on their backs in labor because intuitively they know it’s not natural and it creates more work for the uterus which moves forward and upward.
Women opting for a water birth may sometimes remain in the semi-sitting position. This works in water because as the baby is borning, mother can easily raise herself up and let the coccyx move and the baby come to crowning.
Lying on the left side is chosen by moms who are wanting to be in their beds or are confined to bed for some reason. It seems to work very smoothly as it equalizes pressure on mom’s bottom but women report that there’s something very awkward about needing to have your leg held up during your birth.
What I learned from birthing women is that they will instinctively find the position that works best for their labor….usually the kneeling position. Whatever position a woman chooses…semi-sitting or hands and knees or kneeling…it is the natural position in the moment. There is no one correct position for birth. It is as individual as each woman and each labor. My experiences have been that women most often choose a kneeling position when not culturally imprinted.
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​DEEP LEARNING ENGINEER
San Francisco, CA
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