The Holistic Stages of Birth: a New Perspective

In May I had the great opportunity to study with Whapio Diane Bartlett of The Matrona.  My understanding of birth was changed greatly.  As a new doula, I focused on the more clinical side of birth for my clients.  I looked at numbers of contractions, dilation, fetal heart rates and tried to respond to my client’s needs within this framework.  After the weekend with this amazing midwife, I realize those things are important but my job as doula needed to change.  I needed to focus on the needs of my client in a new way.  I needed to surrender my “need” to “do” to my client and just be there for her and her partner, responding as needed.

As part of the training as a holistic doula, we looked at the stages of birth through a new lens.  It became more about building a relationship with my client instead of focusing on the clinical happenings of birth.  Of course, I want my clients to know all about birth and know what to expect, but I think I can approach it from a different angle; one that will support a client to come to birth with a fresh attitude that is not fear, but excitement and surrender.  From this point on, I will approach the stages of birth from a holistic view.  The following is a summary of what I learned…

The Embarkment (Pre-labor and early labor)

This stage is all about preparing for the journey.  Collecting and packing items necessary  might occur and this is more commonly known as nesting.  There may be some contractions or tightenings and maybe even some discharge of cervical mucous. At this time, the birther is talkative and excited about the coming journey.  She may call her midwife and doula if she is having a home birth.  She may call her doula is she is having a hospital birth. She may feel waves of contractions that repeat with increasing intensity.  In more clinical terms, the would be the first stage of labor.  The cervix is beginning to efface and dilate to about 4 cm. As the contractions increase in number and intensity, the mother may become more centered and away from ordinary reality.  She is being “called away” to enter the veil…

Entering the Veil (First stage, active labor)

The mother reaches the point in her journey when she must go alone.  During this stage, her endorphins begin to change her as she moves inward to the more altered state.  This veil is the curtain between ordinary reality and the altered state of birth.  The deep state of alpha brain waves allows the mother to focus on the journey.  It doesn’t mean she wants to be alone but she will be in a more self-directed space. Mothers may approach the veil several times without going through.  Some things that will prevent the mother from going through the veil include constant questioning or interruptions to a mother’s rhythm she is establishing.

At this point in the journey, the mother becomes less chatty and more focussed. Others may even notice a different smell in the room.  In clinical terms, the cervix may be dilated to 5 cm and the character of labor changes.  Contractions may last for 60 seconds and be about 5 minutes apart. Mother may seem a bit more spacey and unfocused to observers who are still in Beta brainwaves.

Between the Worlds (First stage, active labor)

During this part of the journey, the mother needs privacy, silence, warmth and the dark.  She pulls her partner in to the journey and together they speak a silent language as the sensations become more powerful.  No one should disturb them as they create a rhythm.  The mother moves beyond alpha brain waves and down to theta and delta. Mother will remain upright and move with her labor and her contractions.  Clinically, dilation may move from 5 cm to 8 or 9 cm.  Labor is considered hard at this point in the journey and may be felt as painful, but mother has coping strategies.  She will take what she needs to find her way.  She just needs the presence of her companions and words are often unnecessary. Quiet murmurings of respect and affirmation may offer the simple support needed.  Even soft singing may offer support for this hard leg of the journey. This part of the journey is likened to climbing a steep hill.

The Summoning (End of the first stage – transition)

The mother realises she is close to the peak of the hill in this phase.  She is past anything she has ever known but this is what she has come for- the summoning of her child. She hears this summons and gathers all her reserve and may want to be sure her partner is right there with her in the storm.  While it feels like a storm, in fact, she IS the storm.  She may rage and say she wants to be done, to go home.  She may look wild-eyed at this point, but this is not a need for someone to do something but instead for those witnessing to just be there.  This will often be enough to restore calm. How she faces this part of her journey may be different than the next mother, but she is in her authentic power and however she experiences this leg of the journey is her way and the right way for her. Again, the important thing is to witness, yet not disturb the journey. The clinical notes include dilation of the cervix to 100% or 10 cm.  Contractions may last 90 seconds and be 2- 4 minutes apart.

The Quiescence (The resting phase)

This is a period during labor that is often ignored in our culture.  This is a period of great stillness and rest after transition.  Everything becomes calm and still and the mother may fall asleep. This can last from 5 minutes to 30 minutes or longer.  Think about a time you have climbed a mountain. Did you take a quick look around and then head down the mountain again?  No, you enjoyed the view. At this point, the mother may be deep in her altered state with her brainwaves in Delta. This is the realm of transformation.  The mother knows she is going to meet her babe.  She knows she must head to shore to see the tides.

The Tides (First stage of the second stage)

The mother puts her feet back on the ground at this point in the journey. Contractions may resume, but the mother may not feel ready to push her baby out yet.  Her baby is coming down the birth canal as she comes down the mountain step by step. She may feel little urges to push without fiercely bearing down. But these pushes are bringing baby down the canal and closer to the perineum.  Allowing this to happen undisturbed without directed pushing will protect the perineum.

The Breakers (Second stage of the second stage – Pushing)

At this point in the journey, close to crowning, the mother experiences a rush of adrenaline.  She is in two worlds – her oxytocin birth trance and the earthly reality of imminent birth.  She is ready to bring her baby to “dry land.” If women are left alone in this stage, they will likely drop to one knee to give birth. The partner looms over the woman as he/she takes charge of the birth, protecting the woman and his baby.  Her body pushes the baby down and she may roar through this leg of the journey.

Emergence (the birth)

The mother may rise up at this point and arch her back in order to initiate the fetal ejection reflex as described by Dr. Michel Odent.  Then the mother simply births her baby.  She doesn’t need directions to do so.  She doesn’t need someone to catch the baby.  She gives birth.

The Return (Immediate postpartum)

Baby slides into a new world. A transformation has occurred as mother and baby re-emerge into the ordinary reality. This stage is about 5-10 minutes and is often ignored in our culture.  It is more common for the baby to be birthed and then immediately placed on the mother’s chest. As the mother is seeing her reality through new eyes, baby is changing from fetal circulation to neonatal circulation.  To support this transformation, it would be prudent to give the mother and the baby a minute or two to return.  Then the mother will reach for her baby and it is that moment of bonding that is crucial.  The oxytocin runs high at this point in the journey.  The mother recognizes her baby, the partner recognizes his family.

Acquaintance

At this point in the journey, mother and baby become acquainted.  Partner and mother are in awe of baby and of each other realizing the journey they have completed.  This golden hour is a period of time where no disturbance should happen from others in the room.

Communion

This is point where the parents share the baby with others in the room.

Completion

About 30 minutes after birth, the mother turns her attention to the birth of her placenta. If not rushed, the placenta will be sitting in the yoni (vagina) and is easily birthed. The mother then settles in to her new family.  This is the time for the caregiver to return to the scene and assist the mother and her needs.  The mother may wish to shower and the room may be tidied.  Phone calls are made and the mother may want something to eat.

Weaving the Story (postpartum)

The days and weeks to follow are filled with establishing the rhythm and relationship which will go on forever.  This is also the time of revisiting the journey with others.

This holistic approach to a birth gives the birthing mother the autonomy to travel the journey on her own terms.  As doulas, we need to be witness and hold the space for the birthing woman. Rather than hovering and feeling like we have to be doing something all the time, we can be present and meet her needs as they arise.  If we have built a good relationship, we will know when to step in and when to give space.  Having recently experienced a birth with a client, I could clearly see these holistic stages.  Witnessing the birth through this new lens offered me, as a doula, a calm view of the miracle of birth.  And holding space for the client offered her the autonomy of her birth, her way.

Let us support you in such a holistic way.

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