Sunday, February 3, 2013

Diane Wolkstein, the passing of a great storyteller

Dear Birth Peeps,
As you know, of all the stories I love to tell pregnant women, I love the stories of Inanna best. Many of you know the story of Inanna's Descent (and all the stories of Inanna) written over four thousand years ago in Sumer. We would not know this story were it not for the archeologists who found the clay tablets on which the poems were written, and for the people who painstakingly deciphered the cuneiform--the first written language. 

Samuel Noah Kramer, a renown Sumerologist, was one of the original translators of the epic poems about Inanna. But his work was a direct and scholarly translation; the poems were not in language modern people could relate to. So, Diane Wolkstein, a famous storyteller, spent hours with Kramer, searching for "other words" she could use to re-write the epic poems so we could understand them.

Diane Wolkstein died, suddenly, just a few days ago (January 31, 2013). When the news came to me I had just finished writing the chapter, "Inanna's Descent Into Laborland," for my new book, Birth as a Hero's Journey. I had been thinking about Diane's work all day. Had she not made that beautiful translation available in her book, Inanna: Queen of Heaven and Earth, I would not have known Inanna. I would not have the internal map of the hero's journey. My life, my births and birth stories, and my work all would be void of this most powerful influence. In fact, I cannot imagine my life without the story of Inanna.

Now the woman who loved Inanna, who brought Inanna to us, has left us. And I want to say thank you to this great storyteller who has touched all of us. Visit Diane's website to learn more about her and her work.

Pam 


Tuesday, January 8, 2013

Change #36 A Tribute to Family Practice at UNM and the Changing Attitudes of Doctors

Hi Birth Peeps,

Happy New Year. 
I didn't make too many new year resolutions. Of the three I made, number one is to finish the book, Birth as a Hero's Journey. But I did make another: to blog once a week. Maybe we'll get to the 50th way to change birth in our culture this year. I was kind of hesitating to put too many eggs in that basket just in case the Mayan calendar was right. So here we go.

On December 7, I was invited by Drs. Larry Leeman and Jen Phillips to give a little talk about birthing from within and birth as a hero's journey at Family Practice Grand Rounds at the University of New Mexico Hospital. The room was packed with young docs who I think were just beginning their OB rotation. Larry and Jen had prepared a wonderful power point presentation orienting the new docs to the philosophy of care that they are cultivating at UNM Hospital labor and delivery.  

Wow!

Larry and Jen took turns describing the importance of mothers being up, walking about, delayed cord cutting, and doulas... among other things we know matter. The last comment was that women remember the day they give birth, this day matters. The message was to do their best to make the birth experience memorable.

I sat there and said to myself, "This is really amazing. This is not a conversation or orientation new doctors would have had a decade or more ago!" A room full of new doctors were being oriented to mother-centered, midwifery-tinged care... in addition to their medical ob training which still prevails and should in a hospital. (I want to add there are nurse-midwives at this hospital, too, so the midwifery model is also practiced there.)  

And yet, under the supervision and modeling from Larry, Jen, Mary and other experienced Family Practice docs and midwives, these new doctors are going to see a different kind of birth management than docs see elsewhere or would have seen anywhere a decade ago.
During this rotation, these new docs are going to have different kind of conversations about cases; they are going to learn to listen to parents and learn how to support them emotionally as well as providing safe birth care. (I recently witnessed the a warm, midwifery-home birth-like hospital birth attended by great nurses and Dr. Leeman... so I know he walks his talk, and this message is one they sincerely want to make happen.)

When these docs graduate and leave UNM and scatter in towns across the country, they will take this philosophical seed of care with them. 

And this... the changing attitudes and practice of doctors... is changing birth in our culture.
Hats off to Drs. Larry Leeman, Jen Phillips and all the docs and midwives at UNM.


Pam

 

Friday, December 28, 2012

DOULA FROM WITHIN JANUARY 12

I am offering three one-day 
DOULA FROM WITHIN workshops 
in Albuquerque:
I January 12, II February 9, and III March 9 (10 am to 5 pm)

Here's the exciting learning agenda for DFW I:
  • Doula Work as Your Hero's Journey
  • How You Can Help Parents Experience Any Birth as a Hero's Journey
  • The Integrated Doula
  • Time to Heal Your Birth Story: When/if you have attended a birth where you didn't know what to do, or what you did didn't seem to work, and you want resolution: bring your story
  • An introduction to Solution-Focused Dialogue. A demonstration showing you how SFD creates amazing results in minutes! (This training will continue in DFW II and III).
This  workshop is for everyone who supports women/couples in labor: nurses, midwives, and doulas (new, experienced, regardless of where you received training or certification).

Register Now: Early Bird Registration only $95 for the day. Late Registration is $125.
Sign up for all three and get 10% off the Early Bird price, only $265 for all three.

Details and info: http://www.birthingfromwithin.com/doula_from_within
Register here: http://www.birthingfromwithin.com/store/show_by_tags/Pam%27s+Events


5.5 contact hours will be awarded by California Board of Nursing.

Hope to see you soon,

Pam

Sunday, September 2, 2012

Response to Daniell about the Birth Huntress


 Dear Danielle and Birth Peeps,
The study of the archetypal patterns of our lives, our behaviors, and of the world adds depth and new dimension to how we experience our lives, birth--and how we share the meaning of birth with others. One of our readers is really taking up the study, thinking about the Birth Huntress. Danielle wrote, and I promised her a response on the blog because I think my answer will speak to others, too. 

It is very easy to confuse the Huntress archetype with the Gatherer, the part of us that gathers up bits of information and opinions and birth plans.... the Gatherer has an external perspective, her attention is turned outward, and she gathers from others exclusively. In this model, the Birth Huntress turns her attention inward, she is not hunting for what she wants in the world "out there," rather she is stalking her own mind, her beliefs, her patterns. There is no "killing" involved; hunger is sated when we "know ourselves."


Danielle wrote:
"As with a Huntress (perhaps this is just my own notion of what it i to Hunt) you have to be prepared for the beast you are chasing down to turn on you. And, as wild as it sounds, does Birth not often turn on us and become the very thing we are running from? Does the next step, the next surrender, the next question-to-be-answered not terrify enough that it feels as if it will grab us by our necks and we will indeed die from it"

Just as in the animal world a predator can easily become prey, in the psychic-spiritual world of personal growth, we too are both predator or prey depending on how we have learned to perceive and respond to life circumstances. Sometimes when we are caught by surprise, we don’t have time to make a conscious “choice” and we respond unconsciously, from instinct or habit, which means we may behave either as prey, or as predator. When it feels like someone or something "out there" has "grabbed us by the neck and we may die from it," we are in the Victim, helpless Child part of us, and it is this urgency to "wake up" that awakens the Huntress to seek power, awareness, patience, truth, and new ways of being.

To the degree we are developing our Huntress awareness skills daily, during ordinary times, that is non-threatening times, we are more able to draw on those skills under duress. Under threat is not really the time to cultivate our Huntress and awareness skills; under threat we will do whatever we have already learned or been conditioned by, and act without thinking it through.

". . .you have to be prepared for the beast you are chasing down to turn on you. And, as wild as it sounds, does Birth not often turn on us and become the very thing we are running from?"

In your present thinking, Danielle and perhaps other readers, you may be thinking of the predator being exclusively “out there.” In the archetypal model I am presenting to you, the Huntress (predator) turns her attention inward to stalk her habit-mind, the inner-predator and prey of negative and limiting beliefs, defined by what she is telling herself about herself, about life, and about what the situation means about her. This archetypal inner-Huntress is not going to be hunted by “birth” but she might be “taken down” by what she is telling herself about herself, the moment, the circumstances.

Danielle, and readers… in this model, in your own life, prenatal preparation or postpartum inquiry, the seeker must ask herself,  "From What am I running? How do I know to run, rather than stalk, study, fight, pounce?"

“Birth” is a word that contains many meanings, both literal and metaphorical. In one dream “birth” might be a beast, it could be symbolized by a force of nature, for example a weather pattern, or a physiological process. In our work we strive to be very specific about what exactly it is that we are drawn to, and why; what exactly it is we are trying to avoid, and why; and what exactly we might be inclined to run from, and why?

“…birth turning on us…” In my way of thinking, birth is. Life is. It arises in us and we in it—without separation.  When we do fall into subject-object thinking and perceiving, we then perceive “birth” “out there” –but how we see it is still a mirror of how we “see” and what we believe--within. So when we think of “birthing turn on us,” we create a split, a subject-object, victim-perpetrator, hunted-hunter split… which activates primarily victim-prey-Child energies within us in which we try to outrun something bigger than us, something that is coming after us. In this state of mind, we are no longer co-creators, we are not participants in the creation and the solution.

In labor, and in the daily process of life, death, and rebirth, we cannot run from “birth” but we can try to avoid a certain, particular thing that, if it happened, we would feel we failed, or we were weak, or we were not a good mother… or whatever negative self-belief our habit-mind comes up with (btw, none of these beliefs are true). “Birth” as an experience, no matter how grizzly, does not take us down. What takes us down the downward spiral is our own mind, our own stories about ourselves, what we should have done, what others should have done—or not done, how this event/outcome should not have happened if only this, if that. We confuse planning to avoid it in the future with the Huntress, but in fact this is the scared Child trying to control her future.


Danielle wrote: "If we set out on our Hunt with the deepest respect for the thing we wish to consume, our own Birth, and realize it will lead us where we are meant to go, when it turns on us, we may be able to adjust in a different way.. To release our control to it and allow it to, instead, devour us. Radiantly and on the hallowed ground of our own path."

So now you see the Huntress is not an informed health consumer (that is the Gatherer archetype). Information, planning, and deep beliefs or respect do not “lead us where we are meant to go.” Maybe we are not "meant" to be anywhere in particular, maybe we can’t know how or why we wind up in a particular spot at a particular moment. This is one of the Great Mysteries. It seems we have some say in it, at least some of the time, but then there is this unexplainable force that leads us, stalls us, detours our intention… and then the unexpected happens.

The Huntress is awake, a master of awareness. Even so, being human, we are limited in how far we can see, hear, smell, and feel. Nonetheless, she neither “releases control,” nor is she “in control” of the situation or outcome…. Danielle observed, “When we realize that the Huntress. . . never knows the outcome of her Hunt, not on the veld or Discovery shows of wild animals, and not in birth or in life. Rather, she is ever-practicing sensing, awareness, responsiveness or deliberate patience.

The Huntress is not “devoured.” (That might be Victim… I’ll have to think on this.) However, when we are one with our environment and hunger, when subject and object merge in those rare moments of human bliss and clarity, the Hunter as a separate ego dissolves and becomes the activity of the hunt.  She so becomes the prey she hunts she anticipates the prey’s next move. Do you see and feel the difference?
  
Hunting is deliberate, quiet, patient. I cannot say to you, lightly, "Happy Hunting," because true hunting stills and calms the emotional waves within, and yet there is no stagnation. True hunting or stalking of habit mind is utterly dynamic. It can be done on a meditation pillow or in a busy airport.  I sincerely wish for each and everyone of you the call of the Huntress that you will become a Master of Awareness.

Pam

Wednesday, August 29, 2012

First Living From Within (TM)

Hi Birth Peeps,
For two days I have been  in Santa Fe, New Mexico.... overlooking beautiful vistas with two lovely and bright  yoga teachers who are eager  to learn the Birthing From Within model Beyond Birth--and to learn about LIFE as a Hero's Journey! As those of you who have taken our workshops and are in our program already know.... Birth and Life as a Hero"s Journey is a multi-layered, rich, uplifting, healing, forward-moving model that guides your participation in, and your understanding of, your life (both your past and future). This model also helps us to understand how systems (work and family) and culture works, and how we can help in a small way towards building cohesive relationships and personal freedom with this model.

Over the years many people have told us we should take Birthing From Within into the world as Living From Within(TM)--so non-birth people could benefit from the philosophy and practices. Thanks to this invitation, and the exceptionally committed attention of DeAnna Alvarez and Peter Goodman, who will take this message into their lives and work, BFW has added another rung to her spiral of influence.


Love,
Pam






Saturday, August 18, 2012

#35 What We Can Do . . .

 Dear Birth Peeps,

Last week, I shared how chronic stress in the first trimester of pregnancy is associated with preterm labor and low birth weight babies. This week I continued to think about the problem of stress during pregnancy— and about practical solutions for decreasing stress for pregnant women living, working, driving in and being driven by— our culture. 

If we are going to motivate parents, employers, family members, and business owners for change and present a strong argument, we need to understand the autonomic nervous system and its role in health and in stress. If you are interested in reading an excellent paper presented by Roz Carroll in 2001, a registered body psychotherapist and trainer in London, explaining the autonomic nervous system, its function, how its imbalance affects health, and how body work can help, go to: http://www.thinkbody.co.uk/papers/autonomic-nervous-system.htm

Briefly, I’ll explain the autonomic nervous system (ANS). There are two parts: the sympathetic (drive) and parasympathetic ("brake"/rest).
   The sympathetic nervous system (SNS) kicks in when you need to be focused, analytical, goal-oriented, fight/flight. When SNS is in play, the heart and respiratory rate and blood pressure increase, increased muscle tension, constriction of circulation, thoughts, feelings, breath, you are extroverted; body organs lack tone.
  When the parasympathetic nervous system (PNS) is in play, you are receptive, introspective, speak slower, “process-oriented and solution-focused. Everything flows better in the body: breath, thoughts, blood, and digestive juices. You can rest, recover, rejuvenate.

Here are some practical things to do, and to encourage parents in their childbearing year to do, to re-balance their ANS:

1.   Everyday, “stop and smell the flowers.” Brief rest periods or mini-meditations throughout the day help to re-balance the sympathetic and parasympathetic nervous system. Meditate on a favorite phrase, quote, or poem. Listen to an uplifting song. Discover a new relaxing hobby, such as handwork (knit a baby hat), paint or draw, learn to play a musical instrument, plant a tree or start a small herb garden and tend it daily.

2.  Yoga, walking, swimming, dancing, Qi Gong, massage and other body-work are all physical ways to get out of our "head" and into our bodies-- this can re-set our nervous system.

3.  Think positively. Be solution-focused, not problem-focused. Practice and express gratitude.

4.  Starting your day in peace and calm is a little seed for the day. Soon the seeds will accumulate and you may be waking and living in a garden of a calmer mindset. 

5.  Practice forgiveness, compassion, and patience with yourself and other humans. 

6.  Don’t compare yourself (or your pregnancy or birth) with others. Your experience is uniquely yours. Don't strive to "get it right", instead, do the best you can and embrace your imperfections.

7.  Eat well. Take your vitamins. Eat whole foods. Decrease processed junk food. Sit down at a table to eat; light a candle. Eat slowly, mindfully; taste your food. Perhaps eat breakfast in silence with your baby (no TV, radio, conversation, or reading).

7.  Organize your day to drive less, and leave five minutes earlier to decrease stress from fear of being late.

8.   Make a ritual out of bedtime so you can wind down before going to sleep. Have a warm cup of tea or milk and honey. Listen to music or white noise (rain/river sounds).  Light a candle, meditate, consciously release tension from head to toe. Sleep is essential for rejuvenating the body and rebalancing the nervous system.

9.  Decrease electromagnetic stress. Turn off computers, television; schedule quiet time each day where you turn off digital stress. Make sure you don’t have electric clocks, radios, computers near your head when you sleep.*

*Many of these ideas came from another excellent article on stress, health, and hair analysis: http://drlwilson.com/Articles/NERVOUS%20SYSTEM.htm 

Here are some cultural hurdles to consider, because these "realities" will interfere with making this radical change a reality:

   Women in their first trimester are often "couch potatoes"--our bodies are telling us  we need naps and more sleep to nourish the parasympathetic nervous system and prenatal/fetal health... And yet there are no social mores to allow the exhausted new mother to do this without penalty in pay, hours being saved up for the baby postpartum, or losing a "grade" in school. 

   Our culture at large has not been informed or entrained to treat women in the first trimester (or at any time in pregnancy) more kindly. Because pregnancy is a healthy physiological even, she is expected to keep up with work, school, errands, social events... even when her body is telling her to rest.  

   When a partner/family can’t even tell she is pregnant yet, it’s easy for a partner, friend, boss, there may not be motivation to pick up the slack to ensure the groceries or household tasks got done, or the older kid(s) get picked up from school. So, the partner, family, and again everyone, needs to be educated to change our collective attitudes.

Let's be careful not to lay the burden on the mother, or to blame her if she can't make changes to reduce her stress. When new mothers learn about the importance of first trimester rest, meditation, and stress reduction they tell me they cannot really do what it would take to reduce their stress because they need to keep their job (or two jobs!), and they know or doubt their employer would give them a day off in the middle of the week and let them work on Saturday, or take a longer lunch break to rest. In addition, the U.S. does not give generous maternity/paternity leave; therefore, pregnant mothers hoard every hour of their sick time and vacation time to use after their baby is born. Even if they are stressed or sick, they often can’t afford to take a break during pregnancy.

Prenatal clinics are often over-booked; by the time a woman can get her first appointment, she may be at the end of, or even past, her first trimester. So even if a birth peep has this new information and could teach a mom a meditation technique, scheduling might not allow it.

When talking this over with Virginia Bobro, she pointed out that many women do not share with others or their employers that they are pregnant—in the first trimester. This means that even if we wanted to share the importance of this new research with our sisters, or an employer might have been open to supporting her, the opportunity might be lost.

As part of my recovery, and understanding the role stress played in my illness, I have taken up a daily practice of meditation and visualization to re-balance my ANS. It has made a tremendous difference in my well-being and my ability to concentrate and be creative. I highly recommend taking up even one small change every day. 

To a more balanced life and more compassion for pregnant women and babies,

Pam


References:
 http://website.lineone.net/~thinkbody/biography/index.html
http://drlwilson.com/Articles/NERVOUS%20SYSTEM.htm

Thursday, August 9, 2012

Radical Change #35: Shift Focus of Early Prenatal Care: Teach Mothers to Reduce Stress to Reduce Preterm Labor and other problems


Hello Birth Peeps,
  
A growing number of studies are confirming there is truth in an old wives’ tale that says pregnant women should be protected from stress or a sudden shock to avoid premature labor (Ahhh, high fives to the power of observation by the old ones who did know!). 
     Most of us think we should help mothers reduce their stress and rest more in the third trimester, or after she develops symptoms such as early contractions or hypertension. But research is showing an ounce of prevention in the first trimester is worth pounds of cure in the third. 

 Recent research is showing a correlation between stress in the first trimester and early miscarriage, pre-term labor, low birth weight, and influences on the baby’s temperament.1 One in ten babies is born prematurely in the U.S., as we know, and have sympathy for these little babies who struggle with many health problems. If you could do something to reduce this suffering, you probably would… read on!

After the Northridge Earthquake in California, it was observed that women who were in their first trimester when it happened had shorter gestations than women who were in second or third trimester. Why would stress in the first trimester increase preterm labor and low birth weight?:   
        
When a pregnant woman perceives a stressor, her brain releases a hormone called CRH (corticotrophin-releasing hormone)—a hormone that signals the body to release other stress hormones (e.g. adrenalin and cortisol, among many others) needed to generate the complex fight-flight-freeze response. When the threat or stressor is resolved, the stress hormones return to baseline, and all is well.

Stress hormones cannot return to baseline whenever pressure and tension is unrelenting; when she is in a constant state of anxiety and worry because she doesn’t know what to do, or she believes there is “no back door,” no way out. Her stress might be related to work, or not having a job, not having enough money, racial discrimination, a pregnancy-related concern, among other stressors.

Persistently high levels of maternal stress hormones signal the baby’s placenta to increase production of CRH (as much as twenty times normal level), which cross the placental barrier and circulate in the mother’s blood. The developing baby is also stressed and begins producing its own stress hormones. 

Did you know that elevated CRH levels measured in the mother’s blood between 16 and 20 weeks gestation can predict whether she is likely to deliver prematurely (the risk is three times higher).2 Thus, CHR levels have been referred to as the “placenta clock.” 

Here's where it starts to get interesting because there is something we can do:
In addition to external stressors, the mother’s coping style also influences her level of CHR and stress hormones. It makes sense that when the mother reduces her stress by taking action toward solving the problem, stress hormones can return to baseline. 

   On the other hand, when she does not or cannot make a decision or take action on her behalf, the problem or "threat" (whether real or imagined) continues to loom over her. If her coping style is to disengage, to try to ignore the problem, or hope that someone or something “out there” will intervene on her behalf, she will probably have higher levels of CHR and stress hormones.3

RADICAL CHANGE BEGINS HERE!!
We can’t hold this information or responsibility solely over mothers’ heads as another thing she “should” do (unless we want to risk increasing her stress and guilt). We know it is not possible for mothers in the first trimester, in this socially obtuse birth culture, to make this radical change on their own--independent of the support of their families, work place, birth attendants (who may "order" rest), and culture as a whole.

This important change, Change #35, will be realized when birth attendants collectively and radically shift their focus—from enrolling pregnant women in their first trimester in prenatal care primarily to gather a medical history, estimate the due date, and take lab tests—to using early prenatal visits to teach each mother how to assess and reduce stress, and how to rest. Again, we must stop thinking that there is nothing we can really do in the first trimester and call for "Early Prenatal Education" classes.

     How the Huntress Warrior Lowers Stress:  

Track your daily rhythm and level of stress.
Pay attention to what is happening around you and in you.
Ask yourself, “What needs to happen next?”
Dare to act deliberately and decisively.
Do what needs to be done, but nothing extra.
Don’t look back, second guess, or judge yourself;
just reassess the new moment
and do what needs to be done next—
without an attachment to outcome.

Stalk early signs of tension, dread, or stress,
notice when you start to feel pressured by daily hassles—
do something different—and lower stress early.

Eat well, eat mindfully, avoid fast food.
Organize your week to do fewer errands, less driving.
Greet the sun with a poem, a dance, or a meditation.
See the humor in life, laugh, watch funny movies.
Practice guided imagery, following your bliss,
yoga, tai chi, and take long walks in nature.
(excerpted from upcoming book, Birth as a Hero’s Journey copyright 2012 Pam England)
  

In-Love,
    Pam

P.S.  Are you still wondering why stress in the second and third trimester is less problematic? Here’s another mini-physiology lesson:
CRH levels normally increase in the second trimester, and increase even more in the third, even when pregnancy is not particularly stressful. Ordinarily, this surge of CRH would stimulate an overproduction of stress hormones in the mother, but this does not happen because simultaneously her body begins producing large quantities of a CRH-binding protein that prevents CRH from being recognized or utilized by her body.4



 Citations and Resources:
1  Retrieved July 2012 from: stresscourse.tripod.com/id11.html, “Stress Management for Health Course: The Fight or Flight Response.” <<Johntel, no author given anywhere. Since these are facts and not creative material, let’s not spend a lot of time on permissions>>
2   http://www.medicinenet.com/script/main/art.asp?articlekey=51730&page=26 

3  Latendress, Gwen, Ruiz, Roberta J.  (2010). “Maternal Coping Style and Perceived Adequacy of Income Predict CRH Levels at 14–20 Weeks of Gestation”
http://brn.sagepub.com/content/early/2010/06/30/1099800410377111.abstractAbstract
4  Dewar, Gwen Pregnancy stress hormones: How a natural rise in hormone levels may benefit baby…and re-program mom’s brain Copyright © 2008 by Gwen Dewar
retrieved July 2012: www. parentingscience.com/Stress-hormones-during-pregnancy.html
.

Hobel, Calvin, Goldstein, A. and Barrett, Emily S. “Psychosocial Stress and Pregnancy Outcome”
Clinical Obstetrics and Gynecology. Volume 51, Number 2, 333–348 r 2008, Lippincott Williams & Wilkins