Monday, July 14, 2008

Mother-Baby Dyad

The other part of the Midwifery Today newsletter article on "Animal Birth" that really interested me was the last paragraph:
"In animal husbandry, the first line of defense for protecting the unborn is to protect and nurture the nutritional needs and comfort of the birthing female. In the case of institutionalized birth for humans, however, in spite of evidence to the contrary, the norm is to act as if the nutritional needs and the comfort of the birthing mothers are of concern to, at most, the marketing and public relations department! It's an affront to common sense that as a society we are currently more accepting of the needs of foaling mares, whelping poodles and high-producing cows than of our birthing humans. From the high rates of fetal distress, meconium staining and breastfeeding problems, the consequences are clearly devastating to our infants, just as any decent horseman would predict."

I have read in other places the term "mother-baby dyad", which is what this article reminded me of - that in animal husbandry, the dyad aspect of the motherbaby relationship is typically respected, while it may or may not be in human care.

Dyad is defined as "a group of two; couple; pair" and "two persons involved in an ongoing relationship or interaction", according to dictionary.com. Birth is certainly an ongoing interaction!

Unfortunately, I think that some caregivers and birth-places set the mother and baby in adversarial positions - that mothers who want to move around instead of lying still for continuous fetal monitoring are putting their babies in danger... that mothers who want to wait for baby to send the signal that (s)he is ready for birth instead of scheduling an induction are putting their babies in danger... that mothers who pay attention to their own needs - for space, support, food/drink, information, etc. - are in some ways being "selfish" by putting their own needs above their babies.

I've flown enough times with my kids to have the whole "oxygen mask for yourself first" speech practically memorized. You know, the one where they advise people traveling with small children to put on their own oxygen masks first before attending to their children. For obvious reasons, that never fail to go through my head in near-panic-inducing detail (again with the labor breathing!).

Is labor that different? I believe that a strong, healthy, comfortable (in mind as well as body, as much as possible), well-fed and hydrated, supported woman is going to have a physiologically easier labor than if she had not taken care of her mind and body. By taking care of herself, she IS taking care of her baby.

If mother is frightened or anxious, her baby is exposed to adrenalin... or baby could receive the positive, long-lasting benefits of endorphins. Mother could feel more comfortable moving around, which helps baby slip into the most advantageous position for traveling down the birth canel...or the baby of a mom lying on her back will have to squirm uphill to be born. The deep breaths a mother's body tells her she needs to breathe in while pushing her baby out provides extra oxygen for the baby... or the breath-holding 1-2-3-4-5-6-7-8-9-10 PUSH HARDER "purple-pushing" scenario stresses baby's system. I could go on & on! What happens to the mother, the decisions she makes to take care of herself (and her baby), truly affects the baby's experience of birth.

Speaking of baby's experience of birth, I love Gayle Peterson's description in An Easier Childbirth:
"the baby’s sensation is one of healthy stimulation – stress but not distress. Your baby is massaged by your uterine contractions, and you may think of your contractions as hugging your baby as he or she moves through labor. Your contractions serve as a firm resistance for your baby to push off from as she or he presses into your cervix . . . your baby presses with his or her feet against the force of the contraction, pushing its head down on the cervix. You can think of it as a child learning to swim, first crouching with feet on the wall of the pool, then pushing forcefully toward the center of the pool. In this way you and your baby work together during labor.

Your baby’s head molds easily, fitting through the cervix as it opens. You might imagine how pleasant it can feel to have hands cupped around your head, as often happens during a massage. It feels good to have a certain amount of pressure on your head as the person’s hands open and slide around the crown of your head, down over your ears, massaging your neck. And so it is for your baby.

Labor is naturally designed to stimulate your baby in preparation for breathing. As the baby comes down the birth canal, mucous is massaged out of the lungs so they will be ready to take in air at birth. The baby’s circulatory system is stimulated by the friction of moving through the vagina, much as you stimulate warmth by rubbing your hands together on a cold day . . . It can be comforting to visualize the normal labor process as a stimulating massage for your baby” (97).

How fantastic is that?

Back on the topic, though, is one of my most favorite sections of Jennifer Block's book Pushed:
"‘Our country has created a mythology of women who are irresponsible and don’t care,’ says Paltrow. ‘We talk about welfare queens, crack moms, and murderous women who have abortions.’ A culture that allows such language to permeate our national subconscious inevitably dehumanizes all women, including mothers. Lyon argues that this thinking perpetuates a phrase often invoked in exam rooms and delivery rooms: The goal is to have a healthy baby. ‘This phrase is used over and over and over to shut down women’s requests,’ she says. ‘The context needs to be that the goal is to have a healthy mom. Because mothers never make decisions without thinking about that healthy baby. And to suggest otherwise is insulting and degrading and disrespectful’ . . . What’s best for women is best for babies. And what’s best for women and babies is minimally invasive births that are physically, emotionally, and socially supported. This is not the experience that most women have. In the age of evidence-based medicine, women need to know that standard American maternity care is not primarily driven by their health and well-being or by the health and well-being of their babies. Care is constrained and determined by liability and financial concerns, by a provider’s licensing regulations and malpractice insurer. The evidence often has nothing to do with it" (271).

I am so fascinated by all of this... If you are too, here's one last interesting link, to an organization I didn't even know existed until I did a search in preparation for this blog entry: the International MotherBaby Childbirth Organization and their International MotherBaby Childbirth Initiative.

Christina @ Birthing Your Baby
Independent Childbirth Classes in Central Maine

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