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Birth Pauses

We don't talk enough about the PAUSES in birth. Just like moments of silence in communication are super important to get a message across, so are pauses within the physiological birth continuum.

In a society where progress is measured, calculated and perceived as linear, birth is yet another reminder of how different the energy of the feminine works. It moves in spirals, it is NOT linear. And so is the energetics and nature of birth.

Some people even say that before someone dies or has a near death experience, time stands still and there is a PAUSE where "life flashes before their eyes" or something like that.

Sometimes the mother's body or the baby's body needs some time to PAUSE, regroup and get ready for the next phase. Let us consider the process of labor. As soon as it is ignited - probably by stress hormones produced by the baby and released into the mother's blood stream signaling the baby is ready to be born (which is basically speculation and a subject of its own) - the perfect hormonal cocktail starts being released, thus initiating the blueprint for the birth process that we carry in our female bodies at a cellular level.

We know that mother's and baby's bodies work together during their labor & birth process. As the mother's cocktail of hormones flows, the baby shifts positions inside the womb so as to navigate the pelvis until they descend into the birth canal, ready to emerge. Depending on various factors, known and unknown, there will be a series of uterine movements of contraction and expansion and the TIME that this will take is unpredictable.

That's when the first PAUSES start to make an appearance. If a woman starts experiencing uterine contractions that feel rhythmic, that does not mean that she's necessarily going into labor. Maybe she will still be able to get a full night's sleep and barely be bothered. Often, during the full moon, women who are at the end of their pregnancy will feel like they are really in labor, only to discover the next morning that the surges have completely disappeared and that their babies will make an appearance only two weeks from that on!

Other times, women will be internally begging for a PAUSE, as their process gives them no break, and contractions feel like they are coming "back to back". Depending on how long the process goes for, sometimes a few days or nights, women are able to go into deep sleep in between contractions, which is the PAUSE their body is looking for so it can sustain the process.

A very common PAUSE and not nearly discussed enough, actually the motivation for this post, is the pause that we see once dilation is complete and right before women start pushing their baby out. Mind you, cervical examinations are not necessary to know a woman has reached this point in her labor - that too deserves its own separate post. I am a firm believer that cervical examinations are distracting, can be painful, even perceived as traumatic by the woman, and useless for predicting when a baby is coming, not to mention dangerous in matters of introducing infection. If you are not convinced (and I am not here to convince you of anything), go read Dr Rachel Reed and ALL she has to say about them. But I digress…

When I witness birth undisturbed where women are in their full power, the shift in energy is palpable before the process of baby's emergence (often referred to as "second stage" - I don't believe in stages of labor, so I refrain from using this language). There's often a PAUSE. Sometimes a few minutes, where the woman seems to be more aware of what's going on. This is easily perceived once they go past "transition", which many times is the hardest mental phase in the whole process, usually that point where we commonly hear women asking for help, saying they want to give up, that they will die, etc.

The point is that this PAUSE can last from minutes to hours. And that's not usually understood. Years ago, when I didn't know much about birth physiology and was having my babies, one of my midwives told me a story. It was a birth she had attended with an elder midwife. The woman had reached this point of PAUSE and it seemed her labor had "stalled out". A vaginal examination was carried out and so it was indeed "verified" the woman had dilated to completion. The midwife suggested that she rest and spend some time with her husband, privately, in their bedroom. A couple of hours later, her contractions came back and she went on to have her baby at home as she had wanted.

Other stories that involve a similar PAUSE have come to my attention. One of them was a known breech presentation at term, and the provider thought that because the mother had reached full dilation and that her contractions had "stalled", the best thing to do was a transfer to the hospital, where she was not able to birth vaginally as she had initially intended at home. A similar story was shared with me where a mother who wanted a freebirth was laboring at home with her birthkeeper and partner. When her contractions stopped, they believed her baby had died. This mother was trying to rest and going through a mental struggle, believing her baby was dead in the womb. After a few minutes, as they were preparing to leave for the hospital, her contractions came back and her baby emerged in a breech presentation, alive and kicking - a total surprise!

If we put on our physiological lens to look at this kind of PAUSE, we understand that for whatever reason, this mother's body or her baby's body needed a break from the intense labor contractions in order to make the cervix be pulled up towards the fundus of the uterus and "get out of the way" of the baby's presenting part be it the head or the butt. In the medicalized birth culture, this PAUSE is not usually welcome. It is seen as a nuisance and a "waste of time", thus women birthing in the system (hospital and even many times at home) will be encouraged to "push" just because they are "fully dilated"

This lack of understanding of birth physiology coupled with impatience and other people's agendas bring stress to the birthing mother. Babies' births are hastened without need which can cause psychological trauma for the mother and physical trauma to her vaginal canal and perineum, not to mention unnecessary stress for the new baby navigating so many shifts before and right after birth.

There are other important physiological PAUSES in the birth process. As soon as the baby is born, the contractions will go away. When a woman is birthing by herself on land, she will usually choose a position close to the ground. The baby simply slips out and rests on the ground until the mother has had a few seconds, sometimes a minute or two to catch her breath and even feel grounded enough to pick her baby up. This is called the "birth PAUSE". Slowly, she will reach out and discover her baby, by touching their body first, then picking them up and bringing them close to their face, so they can smell them, lick or even kiss them.

When there are birth attendants in the room that understand about these PAUSES, and maybe they have even received the baby at the mother's request, they may simply wait while the mother gathers her senses. When she's ready, they should simply pass her her baby, sort of "mimicking" the birth PAUSE in the wild.

If the mother feels intuitively that their baby needs help to initiate breathing, she may suck at their nostrils and mouth to get any gunk out and give the baby a few puffs of breath. And that's yet another normal physiological PAUSE in the birth process: many babies do not initiate breathing right away. They may need a moment, or a minute, sometimes several minutes to get that started. Again, this is a subject of its own and I do not intend to go into detail here.

Another PAUSE is before the birth of the placenta. One of the first motos I learned years ago when I started birth work as a doula was "the birth is not complete until the placenta is out". It's one of the first teachings from beautiful midwife Ibu Robin Lim. There is no need to hasten this process either. For sure, this also deserves a discussion of its own. But the point here is to talk about pauses in the physiological process of birth. So yes, there will be one between the birth of the baby and the birth of the placenta. Sometimes it takes only a few minutes, a half hour, an hour, and occasionally a few hours. If there's no concern of excessive blood loss, mother and baby are bonding, most of the time, the placenta is just sitting at her perineum. With some encouragement, a change in positions, sometimes a beautiful herbal ally can come in to facilitate the completion of the birth.

All in all, just like in life, birth requires PAUSES. And we must understand and know what they are so we can show up with more integrity and in service to women who want to be witnessed by a wise presence there. And for the birthing mother, please know these are normal physiological and necessary PAUSES if they are happening. Most times we don't know why they're happening. Maybe these pauses are happening because you need to figure something out, something emotional, maybe a fear is coming up and you need to look at that. Or, more often than not, the PAUSE is just a physiological need and things will pick back up when your body is ready. So I'd encourage you to welcome the PAUSES when they manifest, embrace them and take this opportunity to rest, catch your breath, and go deeper in the surrender into your labyrinth.


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