The Life Patterns of Birth Dolly Lefever     Raising the consciousness of parents and healthcare providers is necessary to heal our birthing experiences.   Birth experiences form life long patterns.  Every birth creates an impression, an imprint.  If we accept that babies are actually having experiences pre-natally and in birth and these experiences affect their perceptions of life and set patterns of behavior, how would we as parents and health care providers change our own beliefs about birthing and prenatal care?  What different choices would we make?  What do babies want?   In 1929, Dr Otto Rank wrote a book entitled The Trauma of Birth.  His belief, based on his experience in psychoanalysis, was not accepted by mainstream medicine, which believed that babies’ brains were too primitive at birth to be affected by birth.  After all, what adult in everyday reality actually remembered birth!  Up until 1985, surgery was done on newborns without anesthesia as it was believed their nervous system was immature and that newborns would not remember the surgery. Without conscious recall, how could the surgery affect the newborn?    Over the past century, many adults in therapy were regressed back to birth (and even pre-birth) to find the source of the emotional/behavioral patterns that affected their adult lives. This often happened spontaneously during psychoanalysis, hypnosis, breath work, meditative states and other altered states of consciousness.  Research over the past 30 years has brought awareness to the lifelong patterns that are connected to one’s birth experience.  All types of birth create imprints and/or traumas.    Currently in the United States (and in a number of other countries as well), there is a rising Cesarean birth rate.  In 2004, 4% of U.S. parents were choosing non-labor Cesarean birth mainly due to fear of labor.  Cesarean birth rate climbed as more parents chose inductions and active management of labor. The United States is 39th in the world for morbidity and mortality rates, and we have the highest health care cost for pregnancy and delivery care.  In many places, women are no longer allowed to do VBAC’s (vaginal delivery after Cesarean section). This means that a larger portion of babies will be born by Cesarean birth over the next years.    What is known about Cesarean birth behavioral patterns and worldview?    Jane English has spent 20 years of her life exploring what it means to be Cesarean born.  Her work started initially as a way to help herself deal with personal limitations and interpersonal relationships.  It is through her inner journey from a child’s point of view that we have gained a deeper understanding of the dynamics of a different way to be birthed.   Jane English lists four major differences she has found in her experience and in the information she has gathered from other non-labor Cesarean people.   1. Space and time are different. Vaginal birth takes time and has an ebb and flow, while Cesarean section takes only 2 to 4 minutes.  For some Cesarean people, this gets translated into rapid and full action when one decides to do a project.  There is total involvement with no breaks and a sense that the project needs to be finished ‘now’.  This can be an asset in getting projects finished, but can also create issues around planning, assessing and/or anticipating problem areas.  For other Cesarean-born there is a hanging back, a sense that others must help, that the project cannot be done alone or that help is necessary.  When this is the dominant characteristic, the Cesarean child needs to learn how to push through, while spontaneous vaginal born children learn this during birthing. It’s interesting that assisted vaginal delivered babies (i.e., a forceps delivery) experience similar frustrations and need to learn to push through to complete projects.    2. With the rapid delivery, the Cesarean birth person experiences the ability to transition from point A to point B quickly. This can be seen as not having goals or not working toward a goal.  Vaginally born tend to take transitions slower by looking at all the reasons something can or cannot be done; they are comfortable with longer term planning and then working towards that goal.   3. The Cesarean person has less perception of boundaries physically, emotionally and psychologically.  Boundaries need to be learned in order to function socially.  Without boundaries, a person lets too much in.  This is positive in that one feels connected to others, but it is also overwhelming emotionally. Relationship patterns can be abrupt and intense, with an expectation that the relationship does not need to be nourished or that it doesn’t even exist.  There can be continual testing of boundaries and limitations.   4. Cesareans view the world differently.  The ability to communicate one’s perspective of life with a vaginally born person can be frustrating. Jane English describes this like fitting a square into a circle. Often, the words of communication are the same but the meanings are different.  It seems that our language leans to the vaginal perspective. It takes deep listening to hear from a different perspective.   The Cesarean Experience  Psychologist Dr. William Emerson is one of the world’s leading authorities on shock/trauma in the Cesarean birth.  After 20 years of clinical and behavioral observation of Cesarean-born children, he knows Cesarean birth causes considerable trauma to babies. These traumas are expressed in excessive crying, feeding problems, sleeping difficulties, colic and tactile defensiveness.   Tactile defensiveness is expressed as babies pulling away when held or becoming fussy when touched, and opening up to love only after becoming exhausted.  This often causes the parents to feel inadequate—and this tension reinforces the touch tension. This can later lead to bonding issues.   Body tension patterns are held in the neck from being pulled out by the head and neck.  This tactile defensiveness continues into adult life.  Hugging can make the Cesarean adult withdraw and feel uncomfortable   Dr. Emerson also believes that long-term psychological issues occur in rescue complexes, inferiority complexes, poor self-esteem, and other relationship difficulties. Jane English similarly reports her deep sense of wanting to be rescued, of wanting others to help her, yet cites her own inability to ask for help.  She also discusses her intense “murderous” anger at any rescuer who tried to meet the impossible need to be rescued.    Dr. Odent, a French obstetrician best know for introducing water birth into Western culture, has looked at the hormonal connections between mother and baby in different types of birth.  Studies conducted in Scandinavian countries tested levels of oxytocin in both Cesarean and vaginal delivery.  There is a decreased release of oxytocin in Cesarean births, which affects both the ability to breastfeed and the length of breastfeeding.  This may change the bonding between mother and child and set life patterns of behavior.  Dr. Odent also believes that the mixture of hormones within the baby and mother that arise in vaginal birth are important in creating love relationships.  If this is scientifically proven to be true, how will Cesarean sections affect loving relationships?   Birth Trauma Release: A Brief Comment   Dr Emerson has developed cathartic and empowering techniques to use with babies.  His research with control groups and long-term follow-up provides knowledge on how we can work with the behavior patterns related to Cesarean birth traumas. As the awareness and acceptance of birth trauma increases, there will be more exploration and therapy offered not only to prevent this trauma, but also to soften and heal birth trauma early in life.   As Emerson addresses the presenting behavioral problems seen in babies with methods to resolve/heal the traumas early in life, Jane English brings a retrospective view of the struggles she had in healing the personal-interpersonal issues limiting her life. As such, both bring perspectives on healing Cesarean birth trauma and working with these traumas at different levels.      As more people experience Cesarean birth, our worldview will change.  If the shadow patterns are expressed, there is a possibility that violence will increase. I truly believe that raising the consciousness of parents and healthcare providers is necessary to heal our birthing experiences.      For more information, see: Chamberlain, David,(1998). The Mind of Your Newborn Baby. California , NorthAtlantic Books. English, Jane,(1994). Being Born Caesarean: Physical, Psychological and Metaphysical Aspects,  The International Journal of Prenatal and Perinatal Psychology and Medicine, Vol 6, #3, September. Grof, Stanislav,(2000). Psychology of the Future, New York , State University of New York , Albany . Verny, Thomas with John Kelly,(1981).  The Secret Life of the Unborn Child, New York , Dell Publishing, New York .     Dolly Lefever, a nurse midwife and clinical hypnotist, has spent much of her 37-year medical career finding ways to blend cultural views, nature, and science into healing modalities. For HypnoBirthing classes, call 223-9927.

 

Jaundice in Babies Kirsten Gerrish   Jaundice, a common condition in newborns, is caused by the accumulation of bilirubin in the body.   The preceding article is the result of a stressful year.  My daughter was born last summer.  It was a wonderful, peaceful, easy birth.  She was a pink, alert baby who nursed like a champ.  We had no cause for concern until her normal newborn jaundice didn’t go away.    Her case was rare.  She was born with biliary atresia.  Biliary atresia is the congenital absence or closure of the ducts that drain bile from the liver.  Unless an operation is performed in the first months after birth, babies with biliary atresia will nearly always require a liver transplant.    My little girl got a liver transplant and is now thriving.  It was an incredible journey—scary and triumphant!  In order to give back a bit to the world, I would like to help more parents know about jaundice.    Jaundice is a common condition in newborns. It is caused by the accumulation of bilirubin in the body. Normally, bilirubin is produced from the breakdown of red blood cells and then excreted by the liver. Infants are born with an abundance of red blood cells.  More red blood cells means a baby can survive without oxygen longer during birth.  After birth, the excess red blood cells are no longer needed.  A newborn's liver is still immature; this can cause the yellow pigment in bilirubin to amass and deposit in baby's skin and eyes. As a result, baby's skin and eyes can appear yellow.   It is not unusual for newborns to be slightly yellow; this is considered normal physiologic jaundice. Normal physiologic jaundice will peak around 3 to 5 days and then decrease.  Increasing nursing will usually be all that is needed.  The fluids encourage baby to have bowel movements, which carry the bilirubin out with the stools.  Parents can also help flush out the bilirubin by putting baby in the sunlight. If the weather is cloudy or cold, a blue incandescent light or "grow light" may be used.     Here are a few simple rules when dealing with jaundice: Place baby (in diaper only) on a blanket next to a closed window in direct sunlight. "Sunbathe" for approximately 15 minutes, three times a day. Take care so that baby does not become chilled from drafts, or overheated or sun burnt. Cover baby's eyes.   If a baby is extremely jaundiced or jaundiced very shortly after birth, it is important to have your care provider test the level and type of bilirubin.  Bilirubin can be evaluated with a simple blood test.  Pay attention that the jaundiced baby is active and nursing well.  A baby that is not nursing well may become lethargic and dehydrated.  This will allow the level of bilirubin to increase.   Kernicterus is the most serious consequence of severe jaundice. It develops when bilirubin binds to specific areas of the brain, such as the basal ganglia.  It may be fatal or cause severe movement disorders (choreothetosis), mental retardation and deafness.  This is extremely rare as bilirubin is normally tightly bound to albumin that will not cross over to brain tissue.  Certain drugs can enable this to occur. Also, premature babies are more susceptible. If a baby’s urine is dark-colored or bowel movements are nearly white, it is imperative that the child be seen by a doctor.   There are many reasons why a baby may become jaundiced but, fortunately, all but physiologic jaundice are extremely rare.  There are some metabolic disorders that can cause jaundice.  These should be ruled out by the metabolic disorders tests (commonly known as a PKU) that will be done shortly after a baby is born.  Special care should be taken in watching premature babies, babies of diabetic mothers and those babies who have traumatic births.  Birth injury can cause jaundice as the bruising gives baby an extra load of red blood cells to process.  Arnica and frequent nursing can be used for these babies to help turn their color back from yellow to pink.   Jaundice may make a baby look anywhere from mildly yellow to pumpkin orange to strangely green.  Just looking at a baby will not tell you the level of bilirubin they have in their blood.  In the vast majority of healthy full-term babies, mild jaundice is normal and harmless. Breastfeeding babies have a tendency to get more jaundiced than formula fed babies because of the time it may take to get breastfeeding established.    Some research has concluded that a slight elevation in bilirubin may actually be helpful in preventing bacterial infections in newborns. Bilirubin also has the ability to function as an antioxidant in the brain. According to Dr. Sylvain Dore of Johns Hopkins School of Medicine, "When women breastfeed, the babies have higher levels of bilirubin and are healthier. Babies with higher bilirubin levels are more disease-resistant. Bilirubin also protects against retinopathy in premature babies."   In order to decrease a baby’s chances of getting severely jaundiced, parents can start working early.  Take care of yourself by eating well, taking vitamins and getting prenatal care.  Having a healthy full-term pregnancy enables your baby to deal most easily with anything that may not be optimal.  Premature babies are more likely to get jaundiced and be more injured by it.  Work towards having a peaceful birth.  Birth trauma can, among other things, cause bruising and jaundice.  Also, try to avoid being induced with Pitocin as this has been implicated in increased rates of jaundice.   If your baby does get jaundice, rest assured you are in good company and your baby is probably just fine.  Talk to your favorite care provider and start your journey as a parent with a success: a healthy pink baby!   Kirsten Gerrish, CDM, is a licensed Midwife at Pioneer Midwifery. She is also a Happiest Baby instructor. For more information, visit www.midwife.net  or email kirsten@midwife.net.

 

What Do Babies Want? Dolly Lefever     Perhaps if we look at what babies want, we would find compassionate ways to be with our children long before we hold them in our arms. To ask this question, one must first challenge the belief that the fetus and newborns have no experience until 2 to 3 years of age.  After all, most of us do not remember our lives before age 3 or 4.    When parents are asked, “What is most important to you at the birth of your child?” the answer will usually contain words like physically safe and alive or no malformation or (physical) damage to the baby.   But what about the psychological health of babies?  Generally, psychological trauma experienced prenatally and/or at birth is not perceived as an issue.   Although our awareness of the body/mind connection is growing in the adult health arena, we are lagging behind in accepting this in our prenatal and birthing rituals. However, there is an increasing scientific body of information that demonstrates prenatal events and birthing leave lifelong behavior patterns within each of us. Perhaps if we look at what babies want and understand both prenatal and birthing experiences from the baby’s viewpoint, we would find compassionate ways to be with our children long before we hold them in our arms.    It is still unclear exactly how memory happens and the various types of memory we hold.  We all recognize cognitive recall, emotional recall to past experience, and the five senses that bring up memories of experience.  However, there is now recognized a cellular memory that can be experienced without the typical recall.   Science has long held that an immature brain structure could not be learning or have memory. Therefore, newborns or fetuses could not be having experiences or memories or be learning.  But studies indicate that that newborns do listen to stories that parents read to them before birth.  If one story is read repeatedly during pregnancy, babies after birth will pick that story out among others and demonstrate attention to the familiar story.  Babies learn through their senses long before they are born.    For example, the sense of touch starts early.  By 8 weeks, just shortly after most parents realize they are pregnant, a hair brushed across a fetus’s head will cause the fetus to withdraw or respond. By the 17th   week, touch is fully developed. Most mothers become aware of the baby responding to certain stimulus through their pregnancy. What we have not fully realized is that experiences in utero and during birth have left a perceptual awareness, have been recorded within the brain of the baby, and are further interpreted into ways of viewing their world.    And yet, our birthing rituals continue to ignore what babies are experiencing.  We have loud, cold, brightly-lit rooms.  We vigorously rub down the baby with rough cloth and strokes.  We often remove the baby to a mechanical warmer instead of utilizing the natural warmth of the mother’s body and the security of the one person this child has know for 10 months.  We see crying as a sign of health, not as an expression of distress. We fail to see that the baby has just experienced a struggle for life through the birth process and is in the process of adjusting to many system changes.  Consider how you would want to be met after a major struggle to arrive in such a strange place!   Newborns are extraordinary communicators. It is adults who need to learn the communication.  Eye-to-eye contact with the parents sets off many brain patterns.  Newborns will look directly at a voice that is known: mom and dad.  Babies grimace, coo, cry, clench their fist in frustration or open them when relaxed.  This is a universal body language recognized by humans.    Babies grimace inside the uterus in response to sour or bitter flavors when these tastes are introduced to the amniotic fluid.  Parents soon learn to recognize sounds, facial expressions, and body movements connecting them to their baby’s needs.  When these early communications are not recognized, the baby resorts to crying. Babies will respond to a parent’s frown or smile and pick up on attitudes as the parent responds to their needs and communications.    Bonding starts long before birth and continues into the newborn and infant time.  Eye-to-eye contact, breastfeeding, how the baby is met as he or she enters the world all impact how the child and parents connect in relationship.   If we fully accepted that babies are aware, communicating and experiencing life, how would we change to fully welcome our children to our family and community and world?       Suggestions for Bonding: Prenatal:  Spend 5 to 10 minutes daily in relaxed focus, sending love to your baby. Talk, sing or read to your baby on a daily basis.   Manage your stress throughout pregnancy.   Remember: A baby cared for lovingly in the womb will benefit throughout his or her entire life!   Birthing:  Eye-to-eye contact with parents initiates brain functions and bonding for parents and child.   Breastfeed, if possible. This also releases hormones of love and connection.   The process we call labor is a dance between you and your baby; consciously participate in this dance, for it is the miracle of life!   Encouragement to choose a healthy lifestyle is the main theme of care offered by Dolly Lefever, Nurse Practitioner in Obstetrics and Women’s Health Care. Office: 279-2229 and HypnoBirthing: 223-9927.