My Reflections On Labor And Birth

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek

Photos and Article Copyright @ 2000 Judith Elaine Halek

I was sitting at a dinner table with a group of women in their late thirties and forties. I, myself, am in my early forty’s, not married, been working in the birth modalities for the past twelve years and at present, am not seeing anyone in particular. I commented, “I don’t think it’s in the cards for me to have a baby this lifetime.””Really!” exclaimed a couple of the women. “How old are you?” inquired one woman. “Close to my mid forties.” I responded. “Oh, that won’t be a problem,” she said matter of factly, “You can always do invitro, or donor insemination.” I looked at her and then to other women around the table as all eyes were set on my response. I was surprised and disappointed that conception has become a casual ‘technocratic procedure’ in the minds of the public. I began to explain IVF and donor insemination requires massive douses of antibiotics, a large bank account, arranging one’s work schedule around clinic visits, undergoing countless invasive, often painful, always emotionally charged procedures, all for the chance that I might be the one of ten to be blessed with the news of a cyborg conception. Please understand, I am not judging anyone who chooses this path of conception. It is not my preference of choice and thank goodness, we still have a choice.

Or do we? When I reflect back on my experiences the past twelve years as a labor support specialist, childbirth educator, birth counselor, massage therapist, yoga instructor I’ve found far too many women who did not exercise their options of choice and gave their power away to the medical caregivers, especially in hospitals. After attending over 100 births in hospitals, birth centers and homes, I have had the opportunity to experience a variety of possibilities. It is my vision, that all labor and delivery nurses and obstetricians witness 30 home births or birth center births as part of their medical training.

I remember at one hospital, a nurse commented, “Having a baby at home is one of the most dangerous experiences a mother could put her baby and herself through.” I asked if she had ever attended a home birth, or studied the statistics of home birth practices. She admitted she had not attended a one or knew anything about recent studies on home birthwith midwife practices. I asked her, as I’ve asked many people who make blanket statements without any information to back up their claims, “How can you make such a definitive comment when you’ve not any experience with what you are judging?”

It’s rather ironic that we in our intellectual aspects, read, watch videos, attend classes, surf the internet, express our gathering feminine nature, becoming an ‘informed consumer’, yet when it all comes down to the real deal, one of my favorite mentors, Dr. Michel Odent states, “Forget the books, tapes, videos. Go to a quiet, dark place, private and safe, trust the process, surrender to your bodies and have your babies.”

I believe women have forgotten how to birth, trust, listen, go deep inside and communicate with their bodies and their babies. I also believe women can remember.

What are the choices, options, for non-technocratic pregnancies, labors and births? I have treeoflife been an advocate of midwifery for the past 12 years. After researching international statistical outcomes regarding midwifery vs. obstetrical care, midwives have far exceeded the lower infant mortality rates, fewer medical interventions and higher results in more empowering births.

Having a baby with an obstetrition in a hospital? Create a birth plan, a “guide line,” toward the ideal birth you would like to create. Birth plans are generally discussed in your childbirth classes. Look in various childbirth books early on in your pregnancy and begin to educated yourself. A few favorites are, “The Birth Book” by Sears and Sears, MD, “The Complete Book for Pregnancy and Childbirth,” by Sheila Kitzinger and “New Active Birth, a Complete Guide to Natural Childbirth,” by Janet Balaskas. To find out about midwifery based practices in your area, call American College of Nurse Midwives, (ACNM,): 202-728-9860 (general number), 1-888-643-9433, (toll free locator number). Or contact Midwives Alliance of North America, (MANA): 1-888-923-6262.

Bring questions to your medical caregivers, be attentive how they respond. If you experience not being heard or rushed through prenatal visits, go over in your mind and with your partner why you don’t feel supported. If you do your work early on, talking further or switching medical caregivers will not be as problematic.

Over and over I have encouraged women to trust your highly sensitized instincts, do research and own this birth. This labor and birth will only happen once and it’s vital to be with people you feel safe, listened to and trust. I believe, the only way change will take place among the obstetrical practices is through the public. By asking for what you deserve, you educate and introduce the medical profession to another possibility.

Another alternative is a labor support doula. A ‘doula’ is a Greek word for ‘woman assistant.’ She meets with a couple and gathers information prentally. She’s on call before and after the due date, attending to the parents needs during early and later stages of labor and birth, following up with a post-natal visit after the birth. Doulas have statistically proven to lower cesarean sections by 50%, length of labor down 25%, oxytocin use, down 40%, pain medications (narcotics) down 30%, forceps down 30%, and epidurals down 60%. A labor doula is by no means to replace the partner of the mother. No one can replace the relationship or connection of a woman’s partner. The doula helps to relieve the pressure and enhance the experience.

Since 1993, when Doulas of North America, (DONA,) began a certification program there are now over 8,000 certified. For referrals call, 206-324-5440. Book referrals for becoming a doula: “The Birth Partner,” by Penny Simkin, PT, “Mothering The Mother,” by M. Klaus, MD , J. Kennel, MD and Phyllis Klaus, M.Ed., CSW. If someone would be interested in setting up a doula program read, “Doula Programs: How to Start and Run Private or Hospital-Based Programs with Success!,” by Paulina Perez and Deaun Thelen.

An aquatic analgesic alternative to medical pain medication or an epidural is water labor or water birth. As the east coast resource center for water birth, my organization, Birth Balance, has educated countless couples on this unique and growing approach. A shower is great during labor, yet, it can’t compare to submerging half to three quarters of your body in a tub of water. Advantages to water birth for the mother are: easier coping during dilatation of the cervix and the pushing stage, softening of the perennial tissues, bones, muscles so lacerations are minimal, ability to move in whatever position her body organically discovers, less interventions, faster labors and births. Advantages to the baby: a medium which softens the baby’s bones and tissues thus creating a softer birth experience, babies appear to be less traumatized, a drug free beginning and more immediate bonding with mother.

wavecave A concern regarding water labor or birth is infection. When in the water, bacteria is diluted. Unless someone enters the water with an infection of some sort offering foreign bacteria, there wouldn’t be problems with the mothers infecting herself or the baby. A study in 1996 of 1385 women with prelabor rupture of the membranes after 34 weeks gestation concluded a tub bath did not increase the risk of maternal or neonatal infection after premature rupture of the membranes and prolonged latency. (1)

Another randomized, controlled trial was with 785 women. The results were as follows: tub group required fewer pharmacological agents, fewer deliveries by forceps and vacuum, more likely to have intact perineum and an overall positive effect on analgesic requirements, instrumentation rates, condition of the perineum and personal satisfaction. (2)

Another concern people have is the drowning of the baby at birth. The baby is in a womb of water from conception and is born into an extended womb of water later. The baby receives oxygen from the umbilical cord which is attached to the placenta. As the baby is born, the placenta is detaching from the mother, thus the supply of oxygen becomes depleted and bringing the baby up to the surface as soon as possible is imperative. Another atmospheric pressure, such as air or gravity is what stimulates the babies chemoreceptors to take a breath. That is why, in water, the baby will not take a breath.

Water birth has been around for centuries. In the contemporary times the concept began in Russia in the 60’s,, spread to France, England in the 70’s and come to the United States in the 80’s. For further reading on the subject check out: (book and video) “Gentle Birth Choices,” by Barbara Harper, RN, “Water Birth, A Midwife’s Perspective,” by Susanna Napierala and “The Waterbirth Handbook, ” by Dr. Roger Lichy and Eileen Herzberg.

No matter what choices you make for this birth or future, each pregnancy, labor and birth will teach you what to do differently or the same the next time. Remember, everything is an opportunity for learning. Keep an open mind and heart and learn.

(1), (2): MIDIRS Midwifery Digest, (Mar 1997) 7:1.

Tokyo Dives In With Waterbirth

Posted on 25 October, 2013 by Judith Halek

  By Judith Elaine Halek
Photos and Article Copyright @ 2000 Judith Elaine Halek

YAquaHouse1

On February 12, 2000, Judith Elaine Halek, Director of Birth Balance and producer for a NYC cable program on underwater births, through the assistance of Japanese interpreter midwife, Yoshiko Niino, interviewed, Setsuko Yamada, a midwife of 20 years. Yamada, a calm, confident businesswoman is busier than ever despite Japan’s new plunging birthrates. Not only does she run “The Aqua Birth House,” located in the narrow back streets of Tokyo’s Setagaya Ward, she is also the owner of a coffee shop in trendy Aoyama district. Yamada comments “The cafe is a welcome change of atmosphere from my job as a midwife which can become very tense.”

Her philosophy reflected through her two books she co-edited and wrote with a medical doctor on pregnancy and birth reflect a more ‘active birth’ approach. One is written in a comic book fashion with mostly illustrations making it easier for younger mothers to read. The other book has some illustrations but is mostly text covering topics on ‘initial pregnancy and birth.’

Midwifery work in Japan has a long history. The midwife has been included in social welfare work. “Many people use to have their babies at home because they felt pregnancy was natural and they can take care of themselves quite well. But nowadays the society has changed and so do the women. The women who choose a birth center are very educated and they want to eliminate drugs or medical intervention as much as possible,” Yamada comments.

Yamada’s practiced as a registered midwife in Japan first in a hospital, then as a teacher ybooks in a nursing school and continued until she got sick and decided to become an independent midwife.

Why Yamada became a midwife was not from a deep concept. When she had worked with the ‘American system of childbirth’ in the hospital where many of the women had anesthesia she realized, if she was pregnant, she wouldn’t want to have a baby that way. Along with those feelings and her belief about ‘childbirth naturally’ she became more interested in assisting the birth from the beginnings of life.

Almost 2 years as an intern at another birth center, after consulting with her CPA, Yamada decided to set up her own practice in 1995 under the original name, “The Birth House.” In late 1998, Yamada bought property, moved to a roomier location, opened “The Aquatic Birth House” and resides there as well with her husband.

Since 1995 Yamada has attended almost 400 births including the home births and half of these were waterbirths.

She believes the fact that one is 37 doesn’t mean anything if they are healthy and haven’t had any serious illnesses. “These women can birth naturally,” Yamada comments. Three of Yamada’s clients gave birth naturally after having a C-section at a hospital the previous time. “There were no problems,” she added.

There are no doctors or nurses, epidurals, episiotomies, or separate rooms for the newborns at her Aqua Birth House. Instead one is greeted with a waterfall, African carvings of a mother and her child, fresh flowers and a table of birth icons. There are sensitive and beautiful photos of natural birth throughout the House and slippers for everyone provided at the front door.

yoshiko The labor and birth area, downstairs, contains an aqua blue oval tub, covered with a sterile plastic cover, weighted down by sterling sliver dolphin, moon and starburst clips, keeping the tub clean and available to use at any time. The tub is next to a cluttered desk, a bed that rotates up and down, colorful bean bags to sit or lean on, a short low birth chair, a geriatric stool to lean over with a hidden foam pad which Yamada quickly retrieves from under the bed. With a press of a button a heat a toilet is seated. With a press of a few more buttons a genital area is washed and dried automatically. Ah, the wonders of another country. Yamada believes in low light levels and keeps the overhead lights off and the decorative side wall lights on. Midwives utilize an underwater doppler stethoscope to check the babies heart tones. The house includes steep staircases, a modest kitchen, an additional room with a jacuzzi tub, areas for weighing, bathing and checking the jaundice levels of the babies.

There is an antiquated ultrasound machine available if Yamada needs to check the position of the baby. She rarely uses this machine and never charges extra if she does. (Tell that to an American hospital!)

Yamada proudly displays how the ‘regular bed’ not ‘delivery bed’ in the room with the tub has a vibrating massage feature as well as the head reset and the end of the bed rotate up and down. Between the bean chairs, birthing stool, kneeling on the floor, “many positions for the mother,” becomes one of Yamada’s trademark

During the summer, an option in the House for women who want to labor longer in a pool, is the smaller jacuzzi tub in an adjoining room. As a result of longer periods of time in this pool, some women and babies are content to birth here instead of the main tub. During the winter, this room is not available because it doesn’t have the appropriate heating. Yamada’s plans for next year to redesign and install a heater in the space will make this room available year round.

In another area of the cozy Aqua Birth House is a small bathtub set on a ledge near the sink for bathing the baby. There is an external heater on to keep the temperature safe for the baby.

It is the practice of the Birth Center to incorporate the father as the main person to practice YAquaHouse3 washing the baby in the bath before they leave the House. Yamada teaches only the father how to bathe the baby, not the mother. This is a way to establish a special commitment from the father in his assistance and caregiving for the child. The bath is not given the first day of the birth, only the second day after. Every day Yamada checks the babies jaundice with a small, handheld portable machine.

Under the sink where the water source is, there are two different colored tubes. Yamada explains, “One of the most important aspects of a waterbirth is that the water should be very clean.” Therefore she has one tube indicating, clean water in and the other, contaminated water out. She also has a water pump she only utilizes after the mother and baby is out of the tub.

There is also a rather primitive tabletop scale to weigh the baby. Yamada comments, ” This is a scale for the baby. All babies get their mother’s milk and don’t have to be checked after each feeding. It is important to check the weight when the baby is first born.”

We ascend the narrow winding stairs to the postpartum rooms. There are three adjoining rooms with soji sliding screens made of a blonde wood and simulated rice paper. In actuality the paper is the farthest thing from fragile, light rice paper. It is a plaster fibrous material that is actually quite strong to the touch. Futons on the floor with brightly colored linen create a cozy haven to nest in after the arduous miracle of birth. Yamada states, “Some women have their babies in this bed, but not many. Always after the baby is born he/she stays with the mother and the father can stay here too. So the parents and babies sleep together in this bed.”

Yamada continues, “The purpose of placing the rooms so close together was planned. It is our belief when a baby cries and the other people can hear this, they can join in on learning to raise a baby in ‘a family way’ where crying is normal. Sometimes other babies will cry when one baby cries.” There is also a rather large hole in the handle of the sliding door. “The purpose in the planning of this,” Yamada demonstrates “is to keep open to everybody what is going on. For example, those inside the room need to see what is going on outside and those outsides the room can see in so they don’t feel a necessity to go in and interrupt so often. A closed door, not know what’s going on inside or outside needed to be eliminated. This is the way we do that.”

mwass Yamada’s assistant and midwife in training, Ms. Megumi Tanaki was seven months pregnant when I did the interview. Tanaki’s background as a nurse for many years in a private hospital and University Medical Hospital left her feeling limited as a nurse. Tanaki shares, “When I worked as a shift nurse and the Hospital became bigger and bigger, I wasn’t able to manage what I wanted to do as a nurse because it is institutionalized and I had to work as a group organization.”

Tanaki continues, “In the older days, midwives were called ‘sambas.’ They could ork even if they became aged. I felt it was a worthy position, so by the age 30 after I graduate school, I decided I wanted to work with midwife, Yamada.”  Tanaki’s greatest happiness comes from assisting the births. “I don’t have any conflict with what I am doing. I have been married for 6 years but my period was not so regular. Since I have worked with Yamada and the parents and YAquaHouse2 babies, my physical balance is quite good. I believe my hormones become more balanced when I assist the births with the mothers and babies. I work in good circumstances so this is my happiness,” concludes Tanaki.

Judith Elaine Halek is the Founder and Director of Birth Balance, the East Coast resource center for underwater birth, which she began in 1987. One of the original labor support doulas in New York City, she has pioneered alternative choices in childbirth throughout the tri-state area. A birth consultant and counselor, massage and fitness therapist, writer, educator, speaker, photographer, videographer and producer of Birth Balance Presents: Water Birth, a Manhattan Educational Cable Station, Judith is airing her third thirteen-part weekly series on underwater birth and midwifery related issues.

If you would like to contact Judith directly by email she’s at: Judith@BirthBalance.com.
Her contact numbers are: 212-222-4349 (phone/fax) and mailing address: Judith Halek, Birth Balance, 309 W. 109th St., Suite 6D, NYC, NY 10025.

There is a beautiful Photo Documentary by Shin. Sawano, narrator Chara, Music Naoko Etoh, produced by TELEMAC video and CD format available entitled, “Born To Be Loved,” Yamada is featured assisting water births, as well as other professionals and parents labor and birthing in more traditional settings. To purchase a copy of the video or CD, contact: www.LEMITON.com and click on Family Ties. If you would like to contact the Yamada you may write to: The Aqua Birth House, Midwife Setsuko Yamada, 4-16–21 Sakuragaoka, Setagaya Ku, Tokyo, 156-0054, JAPAN. Phone: 03-3427-1314, Fax: 03-3427-1314.

Aquadurals and Douladurals Replace the Epidurals

Posted on 25 October, 2013 by Judith Halek

Photos and Article Copyright @ 1987 Judith Elaine Halek

Printed in 2000 by Midwifery Today

In an ancient tradition of “woman supporting woman,” my friend asked me to do something I’d never done before attend the birth of a child. “Just be there and support me, massage me, talk to me,” she said, then added matter-of-factly: “Oh, by the way, we’re going to have the baby underwater.” It was a cold, blustery evening in November 1987 when baby Maxx appeared, landmarking the first home underwater birth in New York City accompanied by a midwife. Thus was conceived my passion for birth. Without much information available to us at that time, we were all virgins finding our way as comfortably as possible to fulfill the mother’s wishes. We had three resources: books by Erik Sidenbladh1, Timothy Wyllie2 and Dr. Michel Odent.3 In 1987 very few if any hospitals in the United States had birthing tubs. In 1996 a handful of U.S. hospitals offered birthing tubs; today hundreds do. Waterbirth, which started in Russia during the 1950s and 1960s, moved to France and England in the 1970s and to America in the mid-1980s, was once considered a fad. Today it has become the “aquadural,” replacing for many women the epidural. Innovative and controversial, the aquadural involves laboring and/or birthing under water. After my initiation in 1987, I became one of the first of a handful of doulas in New York City. The doula, a specialist in labor, has become another significant element in late twentieth and early twenty-first century birth, one that decreases the need for drugs, interventions and surgical procedures up to 50 percent. 4 A “douladural” is a non-medical person who has certification training or life experience in the birth field. She acts as a liaison between medical caregivers and parents by offering physical, mental, emotional and spiritual support. She does not perform medical procedures or make medical decisions, yet she does advise the parents on these matters.

Safety Reports and Stipulations

During the early 1980s, Estelle Myers, at the Rainbow Dolphin Centre in New Zealand, led the first two waterbirth conferences.5 International waterbirth conferences were held in London, England in 1995 and Greensboro, North Carolina in 1996. Thousands of births reported at these conferences confirmed no increase of infection to baby or mother or fetal or maternal deaths due to the water. 6 The next international waterbirth conference will be held in Portland, Oregon in September 2000 and is co-sponsored by Midwifery Today.

In the late 1980s to mid-1990s, a series of articles in the medical journals noted the death of a baby in Sweden, one death and one brain-damaged baby in Britain and one death in France due to water labor or birth. After further investigations, it was shown that the water was not the cause of these babies’ deaths and brain damage; rather, other mitigating circumstances were evident. 7 As a result of these incidents the following stipulations occurred and were administered: 1) decrease the temperature of the water to body temperature‹ 97 to 99 degrees Fahrenheit or 34 to 38 Celsius; 2) encourage the mother to get in the water no earlier than five centimeters dilated; 3) shorten the labor time a mother is in the tub; 4) shorten the amount of time the baby is submerged. The Royal Society of Medicine delivered an abstract on a comparison of 602 maternal and neonatal outcomes in waterbirths and conventional vaginal deliveries from 1989 to 1994 (301 women electing for waterbirths compared with the same number of age- and parity-matched low-risk women having conventional vaginal deliveries). The Society¹s conclusion: waterbirths in low-risk women delivered by experienced professionals are as safe as normal deliveries. Laboring and delivering in water is associated with a reduction in length of labor and perineal trauma for primigravidae and a reduction in analgesia requirements for all women. If a mother is in a prodromal labor pattern early on, having intense back-to-back contractions with a two to three centimeter dilation, she can become extremely tired. I suggest she sit in the tub for therapeutic rest and encouragement. If the temperature exceeds 99º F or 38º C, it can lead to hyperthermia and dehydration in the mother and baby. It is also imperative that the mother as well as the assistants in the room drink fluids with glucose. If the mother is not well hydrated, it leads to low blood volume and could possibly result in orthostatic hypertension, passing out when standing up to get out of the pool.9 Janet Balaskas states in her book, Water Birth: Maintaining the correct water temperature is very important. If the water temperature is too low the mother’s body temperature particularly if she spends a long time in the pool, will drop. The sweating mechanism for heat loss does not work in water, so if the water is too warm the mother’s body temperature will rise and her energy may be sapped. Doula Linda Cohen in Long Island, New York devised a rather simple recipe for situations in the hospital where the mother is not allowed anything but ice chips and water. She calls this “The Drizzle.” In a cup add: a bit of infused (very strong) hot red raspberry leaf tea and a teaspoon of honey; mix thoroughly and add ice chips. Feed to mother with a spoon while in the tub, on the birth throne (toilet), on a bed, kneeling over a physioball, walking down the hall or up and down stairwells. Once I was fortunate enough to be invited to a home birth with a small group of Russians from Moscow. I saw a small bowl of fresh cranberries on the side of the tub. Periodically the mother would suck on one, put it back in the bowl and go through the contraction. Sucking the cranberries, the mother claimed, helped stimulate her thirst. As an assistant, I periodically ask the mother if the water feels too cool or too warm. Placing a small thermometer in the tub helps monitor the temperature. If the water is too hot and the mother desires it to be even warmer, I suggest she get out of the water and walk. If the water became too cold I would add hot water away from the mother if she remains in the tub or get her out of the tub and add the water. Another trick the Russians taught me is, if the mother is feeling too warm in the tub yet doesn’t want to get out, she can hold onto pieces of ice to cool down, or sit along the edge of the tub with her feet still in the water. Barbara Harper explains: “The greatest benefit to immersion will be experienced in the first hour to two hours. Twenty minutes in the bath is not enough for the physiologic responses to work effectively. That is why some women, both primips and multips, get into the water at 7 cm or 8 cm dilation and begin to experience pushing urges within the first hour of immersion.”11 Keeping a woman in the water for hours is unsafe and unnecessary. I just received a call from a mother who labored in a rented tub at home but didn’t birth there. I asked her why not. She responded: “The water was filthy after being in it for six hours and by the time we had drained it and started to fill it again, the baby was born.” In Bristol, two women who had adverse perinatal outcomes had labored for more than seven hours in the birthing pool. There was one stillborn child with evidence of asphyxia and one baby with severe hypoxic-ischaemic encephalopathy. These women had labored, not birthed in the water. In neither case was any specific cause evident. 12 When helping the woman out of the water, one must be aware of the “fetus ejection reflex,” a term coined by Dr. Michel Odent. 13 This means there is a possibility of the baby slipping through the birth canal unexpectedly because of the change of atmospheric pressure and movement. I focus on the laboring mother¹s pelvic area and keep in touch with the physical sensations she is feeling when assisting her out of the tub. I also make sure if in a birth center or hospital, to wrap the mother in the kind of warm large white thin blanket supplied by the hospital or birth center. I use the small towels to wipe the legs and feet of the shivering woman stepping out of the water. I also make sure the room temperature is as warm as possible so the mother does not chill from water to air. In some facilities, especially hospitals, we have no direct control of the temperature. Most facilities are quite cold. In one hospital we fooled the thermostat by taking a rubber glove, filling it with ice chips, slipping a knot at the opening of the wrist and placing the dangling fingers of ice on the thermostat box. Worked like a charm. It is also important the mother does not slip when exiting the tub. I think it’s a good idea to put a large tarp underneath the portable tub. Towels placed on the floor beside the entrance to the tub help create an absorbent, non-slip surface. If there is full access around the tub, I place towels around the whole area. When a baby completely emerges from the womb it is logical to get the child directly into the mother¹s arms, or better, to assist the mother as she brings the baby to her belly or chest. Oxygen flows to the baby through the umbilical cord attached to the placenta. When the placenta detaches completely or partially from the mother, the baby¹s supply of oxygen is compromised. Thus emergence within a short time is of essence. There was a case during the early 1980s in the United States where a couple, unattended by medical caregivers, left their child under the water after the placenta was birthed. The baby died due to lack of oxygen. 14 When pulling the baby out of the water and onto the mother’s belly or chest, it is important to become aware of the length of the umbilical cord. It’s easy to snap a short cord if one pulls the baby up abruptly. In regard to the physiology of birth, each woman responds differently to pain, yet when mothers get into the water, there is a universal, “AhhhhŠoh my god, why did I wait so long!” After the tenth person responded with the exact words, I wondered if I was experiencing the “hundredth monkey” concept. Barbara Harper, director of Global Maternal Child/Health Association, reports on her survey of close to 2,000 women, when asked the question, “What feelings do you recall?”‹almost 100 percent of women stated in one form or another they were relaxed, calm, at peace in the water. 15 I can say that for every birth I’ve attended where there was a tub of water and a challenging labor or birth, that without the water, the woman would have received an epidural. During one of my interviews for my local cable program, Birth Balance Presents: Waterbirth, I was interviewing a mother who labored in water and birthed her baby in air due to meconium and late due date. When I commented to her, “From my observations of you during the labor, if you had not had the tub available, I believe there was an 80 percent chance you would have gotten an epidural.” “Eighty!” she exclaimed, “200 percent I would have gotten the epidural! The water saved me.” When sticking my hands in the water to massage or support I do not wear gloves. I wash thoroughly with antiseptic soap and make sure I do not have any staph infections on my body. In one case an infection was passed to the baby during a water labor because the father had a staph infection on his foot and was in the water when the baby was born. When I am pressing points on the mother’s back during a contraction or massaging her shoulders, legs or belly in between contractions, the warm water soothes my tired hands and arms. I am also given more breaks from actual hands on at a water labor because the women spend time rocking back and forth on their hands and knees moaning and breathing. This gives me time to talk gently to a birthing mother or massage the father. During my prenatal visits with parents to discuss their birth plans and choices for childbirth, I encourage them to stay open and unattached to birthing in the water. Waterbirth should not be the goal. Often times when a woman becomes fixated on any particular outcome of birth, there potentially are more difficulties because of inflexibility. Dr. Michel Odent speaks often of women getting out of the tubs right when they are to push their babies out, so that they then present right alongside the tub. Or when the water is running into the tub, the woman may grab alongside the tub and begin to scream as her contractions become stronger. In some cases, women actually birth their babies just by the sound of the water running. Listening to one’s body, trusting the process and going with the flow are vital. A question I am commonly asked is: “Is it a good idea to hire a doula who has little or no experience with water labor or birth?” In this day and age, there is so much information about this alternative method of labor and birth. If the doula is more inexperienced it would be worth her time to research through the Internet, read books, watch and listen to video and audiotapes. Anyone can read up, ask questions, talk to parents who’ve had a water labor or birth, and attend lectures or private consultations with a waterbirth consultant. It is more important that parents have a strong connection with the doula they have interviewed. Educating and participating is a moment to moment experience.

Click to View Judith Halek’s toolbaghttp://www.birthbalance.com/articles/toolbag.asp

Judith Elaine Halek is the founder and director of Birth Balance, an East Coast resource center for underwater birth that she started in 1987. One of the original labor support doulas in New York City, she has pioneered alternative choices in childbirth throughout the tri-state area. A birth consultant and counselor, massage and fitness therapist, writer, educator, speaker, photographer, videographer and producer of Birth Balance Presents: Water Birth, a Manhattan Educational Cable Station, Judith is airing her third thirteen-part weekly series on underwater birth and midwifery related issues. If you would like to contact Judith directly by email she’s at: Judith@BirthBalance.com.

Footnotes

1. Sidenbladh, E. (1982). Water Babies, A Book about Igor Tjarkovsky and His Method for Delivering and Training Children in Water. New York City: St. Martin’s Press. 2. Wyllie, T. (1984). Dolphins, Extraterrestrials, Angels, Adventures among Spiritual Intelligences. Boston Enterprises (distributed by Knoll Publishing Company, IN). 3. Odent, M. (1983). Birth under water. Lancet 2:1776-1477. 4. Klaus, M.H. & Kennell, J.H. & Klaus, P.H. (1993). Mothering the Mother, How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth. New York City: Addison-Wesley. 5. Myers, E. (1976, 1999). Cross Your Bridges When You Come to Them. New Zealand: Rainbow Dolphin Centre. 6. Beech, B.L. (1996). Water Birth Unplugged, Proceedings of the First International Water Birth Conference. England: Books For Midwives Press. 7. Ingrey, J. (1993). Water birth press release. Midwifery Matters, Issue 59, Winter. 8. Royal Society of Medicine. A Comparison of Maternal and Neonatal Outcome in Water Births and Conventional Vaginal Deliveries. C171-29C-2986, p.10. 9. Harper, B. (1999). Water birth report. OBC News. 10. Balaskas, J. & Gordon Y. (1990). Water Birth, The Concise Guide to Using Water during Pregnancy Birth and Infancy. Great Britain: Unwin Hyman LTD. 11. Harper, B. (1999). Ibid. 12. Gilbert, R.E. & Tookey, P.A. (1999, Aug. 21). Perinatal mortality and morbidity among babies delivered in water: surveillance study and postal survey. BMJ 319-483. 13. Odent, M. (1987). The fetus ejection reflex. Birth 12(2). 14. Ingrey, J. (1993). Ibid. 15. Harper, B. (1999). Ibid. 16. Napierala, S. (1994). Waterbirth, A Midwives Perspective. Connecticut: Bergin & Garvey (a branch of Greenwood Pub. Inc.). 17. Lichy, R. & Herzberg, E. (1993). The Waterbirth Handbook, The Gentle Art of Waterbirthing. United Kingdom: Gateway Books. 18. Balaskas, J. & Gordon Y. (1990). Water Birth, The Concise Guide to Using Water during Pregnancy Birth and Infancy. Great Britain: Unwin Hyman LTD.

Additional Resources

Gilbert, R.E. & Tookey, P.A. (1999, Aug. 21). Perinatal mortality and morbidity among babies delivered in water: Surveillance study and postal survey. British Medical Journal. 319:483-487.www.bmj.com/cgi/content/abstract/319/7208/483 under Obstetrics and Gynecology: Pregnancy. The conclusions from this paper: “Perinatal mortality is not substantially higher among babies delivered in water than among those born to low risk women who delivered conventionally. The data are compatible with a small increase or decrease in perinatal mortality for babies in water.” I have also found the waterbirth egroups, a group of like-minded people who share and question and learn more about waterbirth, to be informative and educational. To register: www.egroups.com/subscribe/waterbirth An online electronic Waterbirth Newsletter is debuting in April 2000. To subscribe: www.egroups.com/subscribe/WaterbirthNews

“Doula Unto Others…”

Posted on 23 October, 2013 by Judith Halek

Yoga

This is Judith Elaine Halek’s response to:
“Doula unto others – Forget the trendy labor coaches and
midwives – give me doctors and drugs,” an article written
by Martha Brockenbrough at Women Central.
The original article has since been removed from the web.

Martha:

Tribal conditioning has been a powerful imprint for you. It’s obvious you have been indoctrinated into the medical model mentality from utero.

I can’t tell you how many times in the past 14 years I have walked into a hospital and found pubic hair in the showers, (someone’s other than the woman I am with), dried blood under the beds, dry, caked, diarrhea under the toilet lid…sterile? Hairy back seats of cars? I would rather birth my baby in an environment and bacteria my body was USE TO being around.

“..back in the days when hospitals treated pregnancy and childbirth like a disease.”

What century are you living in? THEY STILL TREAT pregnancy and childbirth like a disease!!! As one of the largest industrial nations on this planet, we have one of the HIGHEST c-section rates, 31.5% in the world. This is because women are allowing the “medical experts” to tell them whether their bodies WORK or not.

That’s why so many hospitals have created comfortable birthing rooms (I refuse to call them suites) that simulate a homey environment. Just because a hospital rooms had facelifts…it doesn’t mean there is inner beauty. If the medical model philosophy of “delivering” vs. “birthing,” “drugs” vs. “alternatives such as: water, trust or assistance,” then it doesn’t matter what the room looks like, the treatment will continue to be the same.

“…mother who charges money for their services.”

I am a certified hypnotherapist, childbirth educator, certified labor support specialist, certified bodyworker, herbologist and nutritionist.

As an editor of the world’s third largest web site on waterbirth and labor support doula’s, I must say, like the television program “ER,” your lack of research reflects ‘pontification journalism’ as opposed to ‘legitimate, journalism that indicates intelligence and integrity.

My advice to someone who has such an overt disdain for ANYTHING on the level you do with Doulas is, if you haven’t experienced it, don’t knock it…you speak with false authority on the subject other than your own opinion which for me, as stated above lacks credibility.

In favor of respecting choice that is well informed.

Judith Halek
Director of Birth Balance
NYC, NY

“HeartKeepers,” Birth Caregivers for the 21st Century

Posted on 25 January, 2013 by Judith Halek

HeartKeepers™

by Judith Elaine Halek and Sondra Wynne Fields

& the Foundation for Conscious Evolution)

One-heartedness occurs when every single life form lives in harmony and balance with every other life form. It’s our true nature…encoded in our DNA. – John Kimmey (Last Carrier of the Hopi Prophesy, founder of The Sustainable Native Agriculture Center in New Mexico and author of Light On The Return Path.)

Introduction

The archetypal Wise Old Woman can be seen as the ultimate Heart Keeper as she is the mid-wife of both birth and death. She issues the beating heart of each Being into the world and when the time of the beating heart has ceased, she assists each Being on its evolving journey.

Prior to ten years ago, there was a group of Balinese men called ‘tukang kandung’ which translates as a ‘womb worker’. They assisted hundreds of babies using massage techniques and traditional herbs. These men received information about the traditions of this work from their fathers on their deathbeds. So generation after generation, only the male lineage would receive this sacred and privileged information.

These men could be seen as co-creating with the wise old woman as heart keeper by tapping into this most ancient of feminine archetypes.

Delving into the mystery and intrigue of the heart, take the word earth, put the ‘h’ at the beginning of earth and the new word is heart. Earth and heart are one.

The first peoples of Turtle Island, also known as the United States, honor the beating heart at all ceremonies. For them the beating of the drum represents the heartbeat of mother earth; the heartbeat of the people. For many indigenous people at the center of mother earth and her drum resides the hearth, (earth and heart combined) the center of nourishment brought forth by grandfather fire.

The Virtual SynCon must have a hearth that warms the heart and sustains it’s bright burning fire.

Labor Support Doulas assist women and their partners during labor and birth as Heart Keepers. They ‘hold the space’ for semblance and symmetry. This is done when someone on the birth team, (doctors, midwives, nurses, anesthesiologists, grandmothers, aunts, uncles, friends) becomes out of resonance with the core couple (mom/partner and baby). It is up to the Doula to help bring back the energy through communication, compromise and breath. Doulas help the couple to look at their options and ultimately encourage them to make the final decisions. A Doula, Heart Keeper, requires an inordinate amount of patience, ability to release ego, keep calm and quietly redirect the mother and/or partner into their bodies, breath and connection to their baby. ‘Doula’ is a Greek word meaning, “woman slave.” In Zulu, the word, ‘Dula’ means “To Be.

Doulas and Heart Keepers are ‘Be-ers’ in the group.

Definition and Duties

The Heart Keeper, female or male, attuned to the this ancient feminine energy, welcomes each beating heart into the group heart and stands available to assist each individual as they come forth to contribute and share their gifts. In this way the heart beat of the group is sustained and nourished. Likewise, if a heart no longer is willing or able to beat with the whole, it is the Heart Keeper who helps with the transition out of the group.

The heart is the first organ to develop in the fetus. It begins beating at 3 weeks and one day from fertilization and a group of organs called the circulatory system is the first body system to reach a functioning synergistic state. There are three basic components to the circulatory system. The heart serves as the pump, blood vessels carry the blood throughout the body and the lungs and the heart supplies oxygen.

Like the heart in the physical body, the Heart Keepers become the primary force within the body of the group. They pump support toward the life energy of each of it’s members by reminding everyone to ‘breathe’ when the supply of oxygen has become depleted. Oxygen depletion is indicated through a lack of individual or group resonance. How the Heart Keeper might implement is mentioned below.

In labor and birth when a woman chooses not to cut the umbilical cord and allow the natural uninterrupted detachment from the baby to it’s cord, it’s called a ‘lotus birth.’ The lotus bud blossoms on a flower and offers it’s pure beauty. The ‘lotus mudra’ in yoga represents the awakened heart initiated by Divine Grace. The Heart Keeper is like this lotus blossom. They quietly and succinctly like the flower, respond to the energetic exchanges of sound, breath, air and quiet.

What has been referred to as the Vagus Nerve Breath is a helpful breathing technique for increasing the flow of oxygen and relaxation into the body. This is a recommended tool for Heart Keepers to use and teach other group members:

Take a deep, deep breath into your belly

Let the breath out with an enjoyable, audible sigh…ahhhhh.

You will automatically smile

Your being will begin to open and relax

Breathing in this way activates the vagus nerve, a part of the parasympathetic nervous system, which releases the “cuddle hormone” oxytocin. This breathing technique could be utilized at the beginning of the meeting lead by the Heart Keeper and/or implemented throughout the meeting when the Heart Keeper deems it necessary.

Look at the core word in both heart and earth; ear. It has been said that “the eyes are the window to the soul yet, it is through the voice that we touch the soul.”

One of the duties of a Heart Keeper is being attuned to the individual voices within the group.The Heart Keeper listens to the underlying messages found between the words and underneath the expressions as guides to understanding

When a voice(s) is out of resonance a Heart Keeper will gently and lovingly bring that voice back into resonance if she/he feels this is a disruption to the group resonance.

The heart is the core, the center, the beating pulse. The Heart Keeper could begin and/or end a meeting with a beautiful drum beat after the resonance has been established reminding us all of the importance of keeping the heart of our group in its rhythmic beat.

The Heart Keeper is one who ‘holds the resonant heart space’ for the group to express individually and collectively. To accomplish this the Heart Keeper must be attuned to the heart pulse of the group using their highly sensitized antennae.

How to Sensitize The Heart Keeper Antennae

http://www.heartmath.com/Personal-Growth/Quick-Coherence-Technique.html

The Quick Coherence® Technique helps you create a coherent state, offering access to your heart’s intelligence. It uses the power of your heart to balance thoughts and emotions, helping you to achieve a neutral, poised state for clear thinking. It is a powerful technique that connects you with your energetic heart zone to help you release stress, balance your emotions and feel better fast.”

The Quick Coherence Technique takes–One Minute.

1. Step 1: Heart Focus–Focus your attention on the area around your heart, the area in the center of your chest.

2. Step 2: Heart Breathing–Breathe deeply but normally and feel as if your breath is coming in and out through your heart area.

3. Step 3: Heart Feeling– As you maintain your heart focus and heart breathing activate a positive feeling. Recall a positive feeling, a time when you felt good inside and try to re-experience the feeling. One of the easiest ways to generate a positive, heart based feeling is to remember a special place you’ve been to or the love you feel for a close friend, family member or treasured pet. This is the most important step.

Suggested Methods for Reestablishing Resonance

• First, use breath techniques, your own or those presented here, to bring yourself into coherent resonance and connection with the Divine Source within.

• Through the heartbeat of the drum — in the beginning, middle or end of the meeting — tune into Divine Source, the heart center of each in the group and establish energetic connection.

• Sound the drum for 30 seconds, pause in silence for 30 seconds and take the group through Quick Coherence Technique at the beginning of the meeting. This technique could also be used throughout the meeting requested by the group facilitator or initiated by the Heart Keeper.

• The Heart Keeper communicates with the group with gentle comments or questions to help empower people to speak their truth.

• Observe and witness the group as children in their fascination, curiosity and joyful discoveries.

• Recognize coherent and incoherent feelings in your body at the beginning, during and after the group gathering.

This will help to:

• Create a safe and secure environment for all individuals to speak and be heard.

• Generate a sense of belonging and connectedness.

• Set the tone for honoring each person’s place in the group.

Purpose

The Heart Keeper is here to sustain the group field of energy. The following is a story of how an indigenous culture in Mexico keeps their community in a healthy state by allowing the ebb and flow of life to unfold naturally.

The Huichol Indians of Mexico have access to a kind of genetic memory called the Iyari that connects them with all that has ever been and always will be. Traditionally, “Huichol people remembered this memory and acknowledged it daily.” The Iyari is described by some as being like a cord of light or energy that emanates from a person’s heart connecting one to this ancient memory, not unlike the core of the evolutionary spiral of which Barbara Marx Hubbard speaks. One can “know” or “remember” when the heart is open.

Huichol men still following the traditional way of life have soft feminine faces. Their “feminine side,” psychologists in this country would say, is well integrated; they find great joy in their children, are gentle, firm

Preparation (Before)

The Heart Keeper prepares him/herself by creating an intention to be keeper of heart communication. Space is made conducive to ‘attentive listening’ by closing the door, turning off disruptive rings, knocks or interruptions to create a quiet uninterrupted place.

Helpful Skills for a Heart Keeper to Cultivate

When there is peace within the heart, there is resonance. The Peace Keeper and Heart Keeper share the common goal of creating a peaceful harmony that nurtures creative growth. The following skills were inspired by the teachings of peace keeper, James O’Dea.

Preparation (Before)

Elemental Concepts and Skills to Remember:

1. Everything is frequency–vibrating resonance. Everything is pulsing.

2. These frequencies synchronize with the universe in both qualities and quantities. It is helpful to strive to become a precise interpreter of energy.

3. With energy and consciousness patterns are created.

out and help to find resolution regarding the suggestion or conflict.

1. A non-judgmental mind allows one to see the pattern.

2. Lead from your center, your ground of being.

3. Negative energy is transformed when you speak from your core to the core of another.

4. Use Spiritual Akido. Go around the dissonance by going to the heart or soul of another. Using Spiritual Akido you act to transform the problem, to awake a solution.

5. Find common ground. Breath in new energy.

Energy does not go away: it waits to be transformed. When out of sync energy is present, a Heart Keeper can either step into it in a way that disarms the discordant aspect or step away from it, breathe and become the observer. Either approach will potentially place you in the center of the vortex where stillness and clarity abound.

Procedure (During)

At the beginning of each meeting the Heart Keeper requests everyone to set an intention to proceed with open hearts. While intentions are being initiated, a soft drumming could be sounded for 1 minute, followed by 1 minute of silence, broken by the sound of one drum beat.

SyncCon Pub

As stated in the introduction, every SynCon must have a hearth, (earth and heart) where people can come to kindle and rekindle the warmth of the group heart. That heart center is the SynCon Pub as illustrated in the story below.

In a little mountain town there was once a pub that came to be known as the “town womb.” Much like the pubs in J.R.R. Tolkien’s classic, The Lord of the Rings, this pub was a place where folks came to meet, share good food, drink and laugh together. In this little pub, in this little mountain town much heartfelt news was shared over the years. They celebrated births, graduations, promotions, mourned deaths, supported each other through crisis and generally made it possible for all to remain in this rather rough and sometime difficult climate. Rich, poor, town officials and day labors, educated and uneducated, religious/nonreligious, it didn’t matter; all were accepted for who they were.

At this time in the history of this mountain community there were those who swore that the heart of the town kept beating because of this all inclusive meeting place. Spats and disagreements somehow got worked out and the town maintained it’s integrity. Things were down home, out in the open (it’s hard to hide in a small town) and real.

In a virtual SynCon community, it is paramount as proceedings unfold to openly voice and reinforce the understanding that differences are not just allowed; they are welcomed and embraced. No one need fear being the “odd man out” or the proverbial “rotten apple” disrupting the resonant field of the group. The intention is not to seek out conflicting thoughts, but to allow, accept, appreciate and make room for valued truth and honesty that is inherent in feeling free to voice differences. Differing ideas are welcomed. Questions about orchestration or implementation of group happenings are considered a vibrant and vital element of healthy community building.

SynCon Pub Follow Through

If a situation is too complex or involved to go into depth at any particular meeting, then the SynCon, Heart Keeper Pub is the next step, the safe place for the person(s) to go to express themselves. So often groups shy away from discord because they don’t know how to handle disagreement in a productive manner. They don’t have a pub to go to or a heart keeper to listen.

The Heart Keeper Pub is a virtual forum open 24/7 where members can go to safely have their voice heard if they felt not heard, start a dialogue regarding a disagreement or make suggestions to enhance certain procedures. With permission from an individual, the Heart Keeper can share with the group in the next meeting, what came up and out and help to find resolution regarding the suggestion or conflict.

Malcom Gladwell wrote the book, “Outliers”. Outliers is noun with the definitions: 1: Something that is situated away from or classed differently from a main or related body, 2: a statistical observation that is markedly different in value from the others of the sample.

In the introduction to “Outliers,” Gladwell writes about a community of people, migrating from Roseto Valfortore, one hundred miles southeast of Rome in the Italian province of Foggia. In January of 1882, a group of Rosetans, ten men and one boy, migrated to New York. They relocated to ninety miles west of New York City to the town of Bangor, Pennsylvania. In 1883, fifteen Rosetanas left Italy and joined the original eleven. In 1894, twelve hundred Rosetans migrated to Pennsylvania and left their old village abandoned.

In the 1950’s, studies were conducted by physicians and sociologists on the Rosetan’s and the results were as follows: there was no suicide, no alcoholism, no drug addiction and very little crime. No one was on welfare, no peptic

The Heart Keeper Pub is a virtual forum open 24/7 where members can go to safely have their voice heard if they felt not heard, start a dialogue regarding a disagreement or make suggestions to enhance certain procedures. With permission from an individual, the Heart Keeper can share with the group in the next meeting, what came up and ulcers or heart attacks before 65 years. People were dying of old age. So why were these people, this community considered outliers? And what initiated or supported these kinds of statistics? Was it diet, exercise, genetics, water or location?

After much investigation it was reported the single most crucial element for the health and well being of these people was the fact they lived, related and functioned as a community. People of all walks and economic status ate together, socialized together, and helped each other

There were no divisions or separations. It did not matter if there was someone acting as a Heart Keeper. They were Heart Keeper’s to each other. This community is a key example of how Heart Keeper Resonance is infiltrated within a large group of people where the health of the individuals and the community is influenced.

We can postulate what keeps a community healthy and vital is a strong shared purpose or desire. The Huichol People were bonded together by the spiritual path they walked. The Mountain People were bonded together by their love for the mountains and the environment in which they lived. The Rosetan People shared a deep cultural bond that literally migrated them as a whole community to a new country that offered a potential their country didn’t. Barbara Marx Hubbard, with her visionary eyes of an evolving humanity is the cohesive factor in attracting and holding together like hearted people that compose the SynCon.

“Harness the energies of love, and so for the second time in the history of humanity discover fire.”- Teilhard de Chardin

Closure

• Records any notes needed for further reminders and situations of attention.

• Closes the space energetically.

• Creates a gratitude prayer.

• Is available if an individual is needing a compassionate listener after the program is concluded.

Multi Media Presentation

1. http://www.freesound.org/samplesViewSingle.php?id=21409

2. http://www.youtube.com/watch?v=7eFn8Cgcx8g