Birth Visuals

Birth visuals will be discussed in Week 6 of Reflective Imagination, but because it is such an important aspect of the birth process, it is highlighted here for you.

• You have no doubt imagined what birth will be like. For some, actually imagining yourself giving birth may be difficult, but we believe it is important to have an understanding of the birth process and a positive, successful image of yourself actually giving birth. At the same time, it is critical that this image of success be flexible and that you mentally prepare to at least accept a “less than desired” outcome. As heartily as we support natural childbirth and as sincerely as we believe in the importance of goals and visions of success, we do understand that labor is like all of life — each one different, with no guarantees that everything will turn out as planned. In other words, don’t be so entrenched in your definition of success that any deviation will make you feel as though you have failed in some way.
• Although a strong determination and an ability to tolerate pain is critical for an unmedicated birth, far too many women approach labor and delivery with a conviction that they will “go completely natural,” only to find that they feel a need for pain medication or that a Caesarean section becomes necessary. As a result, they feel guilty, cheated or inadequate. Some even conclude they have failed. Having any of these feelings as primary concern after birth is a very troublesome way to begin your exciting relationship with your new family. Therefore, focus on the positive by envisioning what you want; set strong intentions, not convictions.
• There are different ways to focus on successful images of birth, using both realistic and symbolic images. You will be working with a symbolic image now, the first of two relating directly to birth. Reflecting on this image will allow you to view birth from the vantage point of the beautiful butterfly, (a view similar to that of your baby’s). Next week you will be reflecting on a realistic birth image, seeing yourself birthing successfully. If you don’t already have a relatively clear understanding of the various stages of labor and the process of delivery, spend this week preparing for next week by learning a bit more about birth. Read, talk with your obstetrician or childbirth educator, or with a mother who has given birth within the last five years (although her facts should not be your sole source of information). Try to gain at least a basic understanding of these terms:

• Having a working understanding of these terms will greatly enhance your birth experience. There is no question that women who have a good understanding of the birth process have less anxiety and consequently, a more pleasurable experience.
• We would also like to direct your attention to the fourth reflection of this image. There we will introduce “Birth Visuals,” a technique which will help you to continue to use your imaginary visual powers during labor to help you through the discomfort of contractions. Regardless of your plans about taking pain medication, realize that you will not be able to use the drug throughout labor; there will be times when you need to get through the discomfort with the help of your coach and the use of any pain management technique you know. The Birth Visuals provided have helped laboring women successfully experience labor and delivery.
• We suggest that you spend part of your Reflective Imagination time in week 6, week 7, and any time thereafter, reviewing and visualizing the Birth Visuals of your choice so that they will be immediately available in your mind if you need to use them during labor. You can start now by simply learning and visualizing the Birth Visuals. As they become familiar and comfortable, envision yourself in labor, during different contractions, using a Birth Visual and successfully going through the contraction. You might imagine contractions of differing intensity from menstrual-like cramps to more painful, contractions of different durations (60 to 90 seconds) and two or more contractions with different lengths of “rest time” between them (from 5 to 1 minute).
• As you read on, you will note that there are variations of the same basic Birth Visual; use variations such as the “protective light” as you imagine the more intense contractions.
• High on our recommendation list: involve your coach as a visual guide. If your coach is willing to participate, practice these Birth Visuals together, to determine which variations you like and believe will work best for you. To be most effective, your coach should be “in synch” with your contractions, specifically, he or she should have a sense of when a particular contraction begins, reaches its peak and begins to subside. This is easy to learn on the spot, during labor, by gently resting a hand on your abdomen, feeling your uterus become tighter and tighter and then noticing when it begins to relax.
• To simulate labor contractions for practice purposes, have your coach place his hand on your upper arm muscle (biceps) while you slowly tighten and hold tight (by pulling your hand towards your shoulder), slowly releasing the tension after about forty five seconds to one minute.
• While you are flexing your arm, he should be “talking you through the contraction” using the Birth Visual. It is helpful if the coach speaks clearly, with reassurance, and makes direct eye contact when possible (of course, not if you plan to labor with your eyes closed). These are techniques that your coach can practice both with and without you prior to labor. Practice until you both feel comfortable with your Birth Visual roles.
• Now we would like to introduce Birth Visuals . . . a way to use your visual powers during labor and delivery to help you manage the discomfort and birth successfully. These special visual techniques can be used with any other pain management birthing techniques you learn. Birth Visuals are designed to take you through each contraction, helping you progress naturally, protecting yourself while tolerating the pain.
• Use your reflective imagination session to learn and practice visualizing Birth Visuals. You should have a basic understanding of the typical events of labor and what different types of contractions might be like.
• Practice with your coach so that you can work as a support team during labor. The following presentation of Birth Visuals is structured to help you and your coach learn about Birth Visuals and to learn to work together. During the auditory presentation of Birth Visuals audio, you can hear an expectant mother during various stages of labor (early, middle, and late phases), experiencing different intensities of contractions. The labor coaches talk their laboring partners through the contraction using the type of Birth Visual appropriate for the intensity. We suggest that you spend a moment recalling this presentation to increase your understanding about Birth Visuals and to reflect on the fact that all people experience and handle labor differently. Discuss any thoughts or feelings about labor that you become aware of after hearing this selection with your coach.
• A coach although valuable, is not absolutely necessary to benefit from Birth Visuals. You can act as your own coach, which you will probably have to be during some part of the labor when your coach just cannot be with you. In preparation, we recommend that you practice birth visuals during this week’s Reflective Imagination sessions so that you can call upon them as needed during labor. If you think you might be without a guide during labor and you wish to use birth visuals, simply learn and mentally practice the following basic scenes and variations to develop an understanding of how the visualization should be used in relation to contractions and the different stages of labor.

Birth Visuals

Notes to the Coach (You may be your own best coach)

A. You will know when another contraction has started by: • A verbal message from your partner; • Signs of discomfort in her eyes, face or body; • Resting your hand lightly on her abdomen to feel the contraction; • If connected to a monitor, there will be an upward movement of the needle;

B. Although you can glance at the monitor, we suggest that you remain focused on your partner as much as possible. Your power to observe, to listen to your partner and to feel contractions through the touch of your hands, will keep you more aware and involved in the birth than constant viewing of the monitor strip.

C. Although you can glance at the monitor, we suggest that you remain focused on your partner as much as possible. Your power to observe, to listen to your partner and to feel contractions through the touch of your hands, will keep you more aware and involved in the birth than constant viewing of the monitor strip.

D. As the labor progresses and the level of discomfort intensifies you can vary the visualization from the basic scene by adding the image of a bright protective light which can be drawn upon for strength which exists at the top of the mountain or wave. Most women begin to see the light between 3 and 6 centimeters of cervical dilation. As your partner needs more support to get through contractions, you can add the light to the visual in the following ways: • Let the light surround you • Let the light fill you up • Let it flow through you, into your pelvis, open your cervix. • Let the light cleanse you of the pain • Use the light to protect yourself • Let the light get brighter and brighter as the pain gets greater.

E. Don’t be hesitant about repeating a sentence or phrase several times over if it seems appropriate at the time. And do feel free to be creative while using plenty of supportive phrases.

Climbing the Mountain

• You are towards the top of a hard mountain climb. There have been hazards along the way and it has been a difficult journey. You are now about 45 seconds away from reaching the peak where you will be able to gently slide down the other side, which is a soft, silky, grassy slope.
• The Basic Mountain Visual:
• (Usually used between 1 and 4 centimeters of dilation.)
• Suggestions for the coach: Examples of what the coach would say:
• (The contraction starts — you maintain good eye contact, if possible, gently place your hand or fingers on your partners abdomen to feel when the contraction peaks and the uterus begins to soften.)
• (As the uterus gets harder and harder you reinforce this, pausing between lines as needed, you say:)
• It’s a hard journey.
• It’s a very hard journey.
• Keep breathing. It’s a hard climb and the pain is doing the work.
• It’s going to take you up the mountain. That’s right, keep climbing.
• (You may say these phrases in different order and use different words and phrases to communicate the same ideas. Do not hesitate to repeat the same line two or three times if it makes sense to do so. But, be sure to bring the scene to a close [sliding down the mountain] when her contractions begins to end.)
• It’s a strenuous trip.
• It takes a lot of work.
• It’s very difficult but you are going to reach the top.
• Climbing higher and higher.
• (When the contraction has peaked and the uterus begins to soften)
• That was terrific, you did it. Now just slide down the other side. Take a deep breath and relax, and slide down the other side of the mountain.
• (This is always a good time to have her take a deeper breath to help her relax, just as her uterus begins to relax.)
• (When the contraction is over:)
• And you can just sink into the bed and let your body go limp.
• Variation 1 on the Basic Mountain Visual
• (Usually used between 3 and 7 centimeters dilation.)
• Suggestions for the coach: Examples of what the coach would say:
• (As the contractions build in intensity and she seems to need more help in getting through each one, add the concept of a bright, protective, strengthening, light, one which can flow through you and open up your cervix.)
• Go up the mountain.
• It’s real strong. This one is really doing some work.
• There is a bright light at the top of the mountain.
• (Again, you may use a different order with the sentences and interchange words and ideas which are similar to those provided here. Repeat lines when appropriate.)
• Climb towards the light.
• Grab it . . . let it SURROUND you.
• It protects you from the pain and the pain is doing the work.
• Keep breathing.
• The light gives you strength, the light gets brighter and brighter. Protect yourself with the light.
• (As the contraction begins to lessen)
• It’s going away and you can take a deep breath and relax. Just slide down the other side of the mountain. Great. You’re doing beautifully.
• Variation 2 on the Basic Mountain Visual
• (Usually used between 5 and 10 centimeters dilation.)
• Suggestions for the coach: Examples of what the coach would say:
• (Change words as desired.)
• You’re climbing the mountain again.
• This is a really hard climb, and you’re doing great work.
• It’s the hardest journey so far.
• Go to the light . . . keep going.
• Fill yourself with the light.
• You can breath it in. Let it fill all of you.
• The light FLOWS THROUGH you, into your pelvis. Let it flow through you and opens your cervix. See it opening.
• Opening more and more.
• That’s right, let it help you, let it protect you.
• (As the uterus begins to soften.)
• And now you can take a deep breath and slide down the other side.

The Wave The Basic Scene

• You are in the water, it is a cloudy overcast day and there are very big swells that periodically, suddenly rise in front of you. Land is within your sight but far out in front of you. There is absolutely no chance of your drowning, but you must put in a great effort to finally reach the shore. The tide is moving towards shore but the waves are very large and you must swim vigorously up and over the top of the wave until you are gently pushed towards shore as you slide along with the other side of the wave.
• The Basic Wave Visual
• Suggestions for the coach: Examples of what the coach would say:
• Contraction starts.
• (As the pain intensifies)
• Here is another big wave and you need to (swim/paddle/row) to the top.
• You’re really working, pulling yourself up.
• That’s right.
• Pulling and pulling. It’s really hard work.
• Keep going. That’s right. Work your way up to the top.
• Keep (swimming/paddling/rowing), you’re almost at the top. You’re finally going to be carried towards the shore.
• (As the uterus softens…)
• The wave is now gently carrying you along towards the shore.
• Variation 1 on the Basic Wave Visual
• (Usually used between 3 and 7 centimeters dilation.)
• Suggestions for the coach: Examples of what the coach would say:
• The contraction starts.
• Here’s another one (wave). It’s going to be a really tough climb to the top. But you can do it. Come on, keep going toward the top. You can do it, pull more.
• Keep working, it’s really a hard journey.
• There is a bright light on the top of the wave. This light is going to SURROUND you and protect you when you reach it.
• Go to that light reach for the light and grab it. Let it SURROUND you, getting brighter and brighter as you as you need it’s protection. Let the light take the pain. Let it protect you. The light protects you.
• You’re at the peak of the wave and being carried along on the crest in the light. Let the light SURROUND you. Getting brighter as the pain gets worse. Use the light to help.
• (As the contraction peaks and the uterus begins to soften)
• And the pain is beginning to ease and you can take a deep breath as you are floating gently down the other side of the wave, being swept along with it.
• Variation 2 on the Basic Wave Visual
• (Usually used between 5 and 10 centimeters dilation.)
• Suggestions for the coach: Examples of what the coach would say:
• (As the contraction begins)
• This is one huge wave. You really have to fight to get up. It is really hard and it’s doing great work.
• It looks really big as you look up but you just have to keep going. Keep struggling up, getting closer to the top. You can see the bright, beautiful light at the top and you want to reach it.
• Stay with it. Keep going. The light is waiting at the top. Go towards the light. Pull yourself towards the light. It is waiting to FILL you and protect you.
• Just a little farther to the light.
• That’s it, now let the light pull you up. That’s it now TAKE THE LIGHT INSIDE of you, let it FILL you and carry you along in its protective powers. Take strength from the light, as it FILLS you up.
• The more pain that you have the brighter the light gets. Getting brighter. Carrying you along, it is so bright.
• (As the contraction peaks and begins to subside)
• You’re finally over the top. Take a nice deep breath as you gently slide down the side. Just relax now and float along with the tide . . . gently carrying you along.
• (When the contraction has ended)
• You were really great. Sink into the bed now and rest.

Prepare for things to discuss with the people who will help deliver my baby: MY BIRTH PLAN The things we hope for during labor and delivery