There is a village in Southern Tennessee where pregnancy is honoured, and birth is celebrated as a community event. Women are in-tune with their bodies and are committed to supporting one another. In this community it is common for women to witness multiple births prior to their own. You would think that the first hand expereinces would create a sense of fear in these women, but this is far from the case. Instead, these women birth comfortably without the thought of pain mediations or interventions.
This particular farm is known for their midwives, birth centre and outstandingly low caesarean and intervention rates. In fact, from 1971-2010 the midwives had delivered 2, 844 babies of which 1.7% were delivered via caesarean, 0.04% vacuum extraction and 0.37% with the assistance of forceps. In Ontario, nearly 29% of births in 2011/12 were by caesarean and In 2008–2009, the rates of overall assisted delivery, vacuum- assisted delivery and forceps-assisted delivery in Canada were 14.0%, 9.9% and 3.3%, respectively. These rates of Caesarean section and mechanical deliveries are well above the levels recommended by the World Health Organization in 1985 (10-15%).
Clearly at “The Farm” their birth philosophy and approach to care differs in a positive way in order to produce such a difference in birth outcomes. One of the midwives at the farm, Ina May Gaskin, explains in her opinion, interventions occur when the Sphincter Law is not respected. The key to achieving a gentle birth experience she writes has to do with the basis of this law.
Sphincter Law: The Basics
The vagina and the cervix—just like the anus and the urethra—are sphincters. Spinsters are circular muscles that surround the opening of organs which allow for emptying as needed, when necessary. These organs have the ability to contract rhythmically with filling, until the point of urgency which then the sphincter relaxes so that urination, defecation, or birth, can take place.
Ina May observed that all sphincters share similar features:
- Sphincters open best in conditions of privacy and intimacy, without time limits
- Sphincters do not operate under orders such as ‘urinate now!’, ‘push!’, or ‘poop!’ but do respond well to gentle praise and laughter (the owner’s)
- There is the risk of the sphincter closing if the person is suddenly frightened, upset, or embarrassed due to high levels of adrenaline in the bloodstream.
- Most importantly is the observation that the state of relaxation of the mouth and jaw is directly correlated to the ability of the cervix, the vagina, and the anus to open to full capacity. A relaxed and open mouth favours a more open vagina and cervix.
If these basic principles were respected in modern hospital units what would this look like? Firstly, individuals would ask permission before disturbing the rhythm of the birthing space. Women would be respected and seen as the experts of their bodies and babies. Loud voices screaming “PUSH!” would not be heard in a race against the clock on the wall. Bright lights, feeling observed, questioning, and medical jargon would not be tolerated. A lack of progress or stalled labour would not be labelled “dysfunctional” but instead emotional factors, fear and lack of privacy would be considered.
Factors that Positively Influence Sphincters
Visualizations: Do not underestimate the power of perception and our subconscious mind. For this visualization you need to first be seated in a comfortable position. Start by taking large cleansing breaths, focusing on breathing in through your nose and exhaling all tension and thoughts through your mouth. Feel your body relaxing, sinking heavier into your chair. Next, visualize your cervix as a rose. Envision the rose opening until it is a fully blossomed flower. This visualization can be used once you are full-term during meditations as well as during labor and birth. For those of you needing a visual aid, a free rose blooming video can be found here.
Laughter: According to Ina May “A smile is good. A chuckle is better. A good belly laugh is one of the most effective anaesthesia.” Physiology laugher releases endorphins, which help to lift our mood and creates a blissful experience.
Relaxing the Jaw, Mouth & Throat: A guided meditation focused on relaxing specific muscles will benefit a labour at any stage. This is important as the state of relaxation of the mouth and jaw is directly correlated to the ability of the cervix, the vagina, and the anus to open to full capacity. A relaxed and open mouth favours a more open vagina and cervix.
Water: According to Evidence Based Birth women who give birth in the water have a significant decrease or total elimination in the use of vaginal cutting with scissors (episiotomy) by their care providers. Less use of pain medications and higher rates of pregnancy satisfaction. In addition, evidence shows that babies born in the water have similar health outcomes com-pared to babies born on land.
Deep Breathing: Focus on breathing from deep inside your abdomen, while slowing your breaths to five to six times a minute (normal is 10–15 breaths per minute). Aim to inhale for 4 seconds and exhale to a slow count of 8 seconds or as long as you can manage with a human compressing your lungs. If it feels right allow yourself to create a low pitch moaning or signing sound relaxing all tension in your mouth and throat. Practice every day for 15 minutes.
“If a woman doesn’t look like a goddess during labor, then someone isn’t treating her right.” ~ Ina May Gaskin
“Highlights Of 2008–2009 Selected Indicators Describing The Birthing Process In Canada”. Canadian Institute for Health Information. N.p., 2009. Web. 6 July 2016. statistics
Gaskin, Ina May. Ina May’s Guide To Childbirth. New York: Bantam Books, 2003. Print. Chapter 4: Sphincter Law
Gaskin, Ina May. Birth Matters. New York: Seven Stories Press, 2011. Print.
The Farm Midwifery Centre Statistics
Ina May Gaskin, CPM. BRITISH JOURNAL OF MIDWIFERY, SEPTEMBER 2004. VOL 12, NO 9