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