Have you rested up from the last pregnancy and pain post? Then you're ready for part deux. The following article is a work-in-progress for birthing professionals, but I think everyone can benefit from reading it. Also, one of my favorite writers, Elizabeth Royte (www.royte.com/blog) has graciously allowed me to post my favorite short read, Me Jane, You're Kidding. I fell in love with her story way before I was pregnant, but I remembered it and dragged it out to read every week I was prego. I think it helped my nausea.
The pages are no longer attached. Maybe because the glue is old, or maybe because this book has fallen into the bath tub a few times. And yes, I dog-ear the heck out of my books and don't believe in book marks. (Note to yourself: Never let me borrow a book.)
The post below is my call to arms for pregos and the people that educate them. Pregnancy is ground zero. It is every person's starting point. Pregnancy does not need to be a painful time. It is not a handicap. It is a training program that, when utilized, offers both mother and baby huge physiological and psychological benefit.
Natural Mama by Katy Bowman
When we think of historical birthing culture it is common to focus on the social aspects alone, neglecting to identify how our more modern habits have affected the physical structures and physiological processes that occur daily. The most fascinating and important of these physical adaptations are the changes in pelvic telemetry in the more affluent-yet-sedentary cultures as compared to those populations that are more mobile.
Whole-body mobility of the human has decreased over the ages, as the necessity for movement waned with the development of stationary farming, then industry, and more timely, the increase in technology. Each development, while offering some benefit to mankind, has also left a negative residue on the health of the human. The physical machinery that makes each of us up is dependent on the original quantities and qualities of movement -- qualities and quantities that have been absent in our world-wide population for hundreds, if not thousands of years.
Human movement is a fascinating science when considering mobility’s role in various human functions, from blood pressure regulation to, of course, birthing. Birthing, the single greatest human process, has been affected by our lack of ancestral movement. In fact, vaginal delivery may be the most at-risk process as our population moves farther and farther from the natural biological reflex-based types of movements (i.e. long-distance migrations, squatting for elimination, barefoot gait patterns) to excessive chair sitting, elevated-toilet use, and using “exercise” to compensate for lack of all-day body use.
As a biomechanical scientist specializing in the physics of the birthing process, I often see the primary anatomical hindrance to the natural birthing process being the position of the sacrum relative to the rest of the bony pelvis. Once a highly mobile joint, with the ability to nutate and counternutate, the sacrum is now frozen. Chronic tension in the pelvic floor -- exacerbated by excessive kegels, minimal gluteal strength, and an unyielding piriformis -- reduces what was once ample birthing space.
Modern birthing science has placed a large burden on secreted hormones (like relaxin) to prepare the body for needed mobility. These hormones are designed for and only affect non-contractile tissues (like ligaments) and are not able to override chronic muscle tension. Relying on relaxin alone can lead to excessive tension and possible damage to the muscles (the pelvic floor, especially), and frankly, is only a small part of the natural preparation process.
A natural birth is served both physiologically and anatomically by mother mimicking a natural movement plan, to the best of her ability, for the bulk of her pregnancy. This is how it has been done for thousands of years.
Many birthing professionals have been tuned into this natural preparation for many years, often recommending squatting to prepare the body and maintaining an active walking habit throughout the pregnancy. What often gets lost in translation is how essential this movement prescription is to a healthy birth. Also not conveyed is the difference between "keeping fit during pregnancy" and "preparing the body to deliver vaginally." Fitness-type exercises are not specific enough to prepare for delivery and often times can create additional, counterproductive tensions in the body.
Just as training for a marathon needs to be stretched out over many months for a successful outcome, birth preparation takes many months to develop. Undoing years of accumulated muscular and joint stiffness is necessary if the natural birthing process is allowed to flourish. The removal of habitual, anatomical resistance is a requirement for uterine and pelvic functions, and it takes time.
In 1931, the British Medical Journal published an excellent article by Kathleen Vaughan, M.B. (Bachelor of Medicine), a researcher investigating the difficulties in birthing between the “civilized” populations of London and the ease of birth and the better mother/baby outcomes in the Gypsy or “Tinker" populations:
In England the still soft pelvis [of the pre-pubescent] is bent by long sitting at school, and this is not couteracted as it should be by the proper action of the sacro-iliac joints, which should be used daily, if only during the acts of defaecation [sic.] and urination. The wearing of high heels also limits and cramps their movements, the body weight is thrown forward on to the arch of the foot instead of the heel, the pelvic angle is altered, and the back unduly hollowed to preserve the balance. That these facts are the real explanation of our increasingly difficult maternity is clearly seen when we compare them with the conditions where motherhood is still natural and easy.
The woman who wants to go about a birthing process naturally can follow the lead other “natural” processes women have been doing for millennia – walking 5-6 total miles per day, and squatting to bathroom multiple times daily. The reality is, for the modern, Western mother-to-be, a musculoskeletal “training program” can optimize a safe and fluid delivery, and enhance optimal long-term health of mother and baby. Needing to “train” for delivery does not imply that the birthing process is unnatural, but only that the mother has allowed her “birthing equipment” to adapt to an unnatural lifestyle (sitting in chairs five to ten hours a day, not stretching the bathrooming muscles of the pelvic floor and legs, etc.) and has become "out of shape" when it comes to whole-body endurance.
Whole-body endurance means the ability to walk long distances using the strength of the legs. Being able to support oneself with leg strength will come in handy when needing to labor for an extended (but hopefully not too extended) amount of time. Cycling, aerobics, running, and swimming, while offering many health benefits, do not offer the specificity required for an improved strength-to-weight ratio. A “hunting and gathering” mother would do well to mimic the daily required walking that keeps her birthing muscles in top form.
Some general guidelines for the mom-to-be (best started BEFORE pregnancy):
1. Walk. A lot. If mama is not walking at all, begin with one mile, increasing the distance by 1/2 a mile every two to four weeks, until hitting five to six miles per day. Doing all the mileage at once will help with endurance, but breaking up the distance over the course of a day will help if fatigue or soreness is an issue.
2. Implement a squat (preparation) program.
Hamstring and calf tension (the two major muscle groups down the back of the legs) tuck under the tailbone and pelvis, instantly impacting the mechanics of the SI joint. Before beginning to full squat, it is safest for tender knees and hips to work on stretching the appropriate muscles first. Second, pressure gradients must be understood to avoid Valsalva maneuvers during squats. (Read more about squat prep exercises here: click)
3. Ditch the heels! Barefoot time should be increased (around the house is fine) and positive-heeled shoes should be removed from the Mama-to-be wardrobe until after delivery (if not forever). Heels shorten the muscles down the backs of the legs, which then pull on the pelvis, tucking it under.
Incidentally, this information applies not only to expectant mothers, but to anyone wanting to retain function of the pelvic floor, digestive system, hips and lower back health for an entire lifetime. Any birthing professional who prescribes these exercises (and they should!) should be doing these exercises herself - as a model of pelvic health.
Hi. Me again. I mean, the article was "me", but more in a "I'm wearing a lab coat while I write this" as opposed to this "me"
who is writing this while straddle-stretching on the floor surrounded by a messy house.
When you have a moment, read through Me Jane, You're Kidding. I first found this story in a book called Naked. No, it wasn't a nudie book, but a collection of nature-lovin' stories. Then I found out that this particular story was taken from The Tapir's Morning Bath (you can read more here - click). If you love biological science and people from New York (I do, I do!), then Tapir's Morning is a great read.
Read Me Jane, You're Kidding here: MeJane,You'reKidding