May 23, 2012
Volume 14, Issue 11
Midwifery Today E-News
“Relaxation in Labor”
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In This Week’s Issue

Quote of the Week

I do not feel obliged to believe that the same God who has endowed us with sense, reason and intellect has intended us to forgo their use.

Galileo Galilei

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The Art of Midwifery

It has been my experience that when the mother is able to labor in an environment of her choice, with persons surrounding her who make her feel respected, loved and safe, that she is free to “give birth to” rather than “be delivered of” her baby. Where else than in her own home, laboring with those she has chosen, should this most important event take place?

Valerie El Halta, excerpted from “Not Among Strangers,” Sharing Midwifery Knowledge, Tricks of the Trade, Vol. IV, a Midwifery Today book

ALL BIRTH PRACTITIONERS: The techniques you’ve perfected over months and years of practice are valuable lessons for others to learn! Share them with E-News readers by sending them to

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Jan’s Corner

Two Conferences, Two Homebirths

Eneyda Spradlin-Ramos, my conference co-planner, and I headed to Harrisburg for the Midwifery Today conference in early April. We went a couple of days early to have a little time of love and prayer before the conference. Our dear friend Diane Goslin was our hostess for those few days. Besides the lovely time in her beautiful bed and breakfast, she invited us to an Amish birth. The mom had phenylketonuria, a metabolic condition medical practitioners check for in infants with a heel prick. This mom was able to control her condition with nutrition. The baby turned out to be good-sized despite mom’s restricted diet. The power of a woman’s body to grow and birth her baby is a miracle!

The second birth took place during our time attending a conference in Puerto Rico. Our friend Gina G. Dacosta, a young midwife from that country, invited Eneyda and I to attend a VBAC home waterbirth with her. The birth happened on the second night of the conference. This mom was so determined to have her homebirth—there seemed to be no fear in her. As the baby came down with her strong pushes, a bit of blood showed up in the tub. We weren’t sure from where it came, but hoped it wasn’t from the placenta. As the baby was born, her head was covered with quite a bit of blood. As mom was holding and bonding with her baby, a gush of blood came and the water became quite red. The placenta had separated, but contractions had stopped and the placenta didn’t want to come. (When Gina checked the mom after the placenta was out, we learned the blood came from a tear in the vagina that happened when the baby’s hand was being pushing alongside its head.)

About an hour later, the cord, which had stopped pulsating, was cut. We were still waiting for the placenta, so Gina cut about one half inch of cord off, wiped the blood off of it and popped it into the mom’s mouth by her cheek. Voilá! A few minutes later, the contractions started and mom pushed out her placenta while standing over the placenta bowl. Gail Hart had told us that we can use the cord or membranes to help the placenta out. She also told us the cord and membranes have more hormones in them than the placenta! Not only can the placenta, cord and membranes be used for hemorrhage control, but they can also be used to start or strengthen contractions. This is the short version of this very sweet, normal birth. We were so thankful to the family and to Gina for such a nice and very complete time in Puerto Rico!

Jan Tritten, mother of Midwifery Today

Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.

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News and Research


Lauren Monk, a mother from Ohio, said that her first birth was difficult. The epidural, which was supposed to provide total pain relief, only worked on half of her body resulting in a considerable amount of pain. So for her second child, she decided to try another way to handle the pain—with relaxation. Monk decided to try the technique called HypnoBirthing, and she said it made giving birth a breeze.

Like Monk, many other pregnant women are turning to the rising trend of using HypnoBirthing as a way to approach labor with relaxation. The birthing method teaches women to go into a “trance-like” state using deep relaxation, imagery and breathing techniques.

HypnoBirthing is meant to encourage mothers to think positively about labor and delivery and, therefore, to be careful about which words are used to describe the process.

Joyce Poplar, a childbirth educator in Ohio says, “We call pain, pressure. We’re not pushing the baby out; we’re breathing the baby down. It’s a little gentler on Mom and on baby doing this.”

— “‘HypnoBirthing’ a rising trend for mothers-to-be.” Last modified January 31, 2012. Accessed April 26, 2012.

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Featured Article

Supporting Women during Labor and Birth

[Editor’s note: Article, sidebars and table reprinted with permission from Chapter 8 in Nurturing Massage for Pregnancy: A Practical Guide to Bodywork for the Perinatal Cycle, by Leslie Stager. ©2009 Wolters Kluwer Health, Lippincott Williams and Wilkins.]

“There is hardly a people, ancient or modern, that do not in some way resort to massage and expression in labor, even if it be a natural and easy one.”
— George Engelmann, 1884

We call giving birth “labor,” meaning work, travail—the monumental effort involved in bearing new life. In Spanish, to give birth is dar a luz or, literally, “to give to light,” reminding us that birth is a unique and powerful journey during which women are deeply transformed as they this bring new life and new light into the world.

After nine months of harboring and nurturing a human being within her body, a woman undergoes this rite of passage in physical and emotional dimensions, as well as for many, a deeply spiritual one. One new mother relayed to her massage therapist that, “The moment my child was born was the most intensely spiritual moment of my entire life!” In many cultures, this spiritual quality of birth is honored as the laboring woman is considered to be in the closest contact possible with a divine energy. Massage therapists touching a woman during her birth may feel this contact themselves as they witness her transformation into the mother of a new child.

As the mother-to-be enters this pulsing dimension of birth potential, she must be able to open herself to an intensity of energy, pain, bliss and surrender. For this to happen easily, she must be in a safe environment and must feel and trust in that safety. For many women, surrendering into this trust involves being strongly supported in the dimensions in which birth occurs, and being reminded of her innate wisdom, which can guide her on this path.

A massage therapist may be at a birth primarily as a physical supporter, but more often than not, she or he will be drawn into the role of emotional supporter as well. Whether or not the mother and the massage therapist have gone through birth themselves or have witnessed another’s birth before this one, they may both be inspired knowing that millions of women have journeyed down this well-traveled path. There are ages of birth wisdom to draw on—either resting in the collective unconscious or still practiced in many cultures. Each woman’s mother, grandmother, and great-grandmother gave birth in a direct line to herself, and their presence, subconsciously or in person, may provide this woman with support as she now becomes mother.

A well-known traditional midwife, Ina May Gaskin, has said, “Motherwit, or mother wisdom, includes knowing that every woman has the knowledge within her about how to give birth, and that for her to have access to this knowledge, she must be protected from fear, distraction, and abusive treatment.”(1) A massage therapist can join in supporting a woman to discover this motherwit and help create the optimum safe environment for birthing.

Meaningful touch and attentive encouragement are often a significant part of creating this safe and precious birth environment. Massage has been repeatedly demonstrated to help a mother have a safer, more relaxing birth, as touch stimulates the parasympathetic nervous system, helping a woman to relax while simultaneously increasing attentiveness.


  1. Gaskin, I.M. 1989. Midwifery and Women’s Power. Woman of Power 28 (14): 27–29.

Leslie Stager
Excerpted from “Supporting Women during Labor and Birth,” Midwifery Today, Issue 92
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From second stage and prematurity to birth change and natural remedies, back issues of Midwifery Today print magazine are packed with informative articles that will help you improve your practice. You’ll also find inspiring birth stories, birth news, poetry and stunning black and white photography. Choose from these available back issues.

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Birth Q&A

Q: What do you do to help a laboring woman enter into a relaxed state during contractions?

— Midwifery Today

A: Many times it helps to remain quiet and keep the space safe for mom to go off into her own rhythms of things—getting down to her level and letting her know she’s safe.

— Alaina John

A: Using accepting words like “greeting,” “welcoming” and “breathing into” the contractions; “singing” or “opening” with the contractions.

— Christy Collins

A: My midwife talked me through each contraction for hours. She explained each one to me as it was happening. She told me when they hit their peak and when it was time to let them go. This kept me together and helped me relax. I don’t know how she does it—she should teach a class on just this topic. She was my labor focal point.

— Crystal Danielsen Moore

A: I give her peace and privacy, so she can move, moan and make love as she pleases.

— Anna Noviello

A: It begins with releasing fear in the first class. When the time comes, she enters into the relaxation breathing technique that she has practiced since the first day we talked together. By the time that moment comes, she’s familiar with the technique and has developed a conditioned response to stress in which she enters into a deeper relaxation with each contraction. Then she layers in the visualization she’s found that lets her support the process in her body. Add in the affirmations we’ve come up with and the focus on releasing all tension in her muscles, and it’s a winning combination for her. It works so well because she’s practiced it for so long. Above all, she feels confident in her ability to cope and has many tools to help her. It’s not a simple answer!

— Melody Bratti Masi

A: If she does not find the level of peace she is searching for, I step in and ask her to listen to me telling her how to breathe. I have experienced it takes three deep breaths and three clean exhales for your body to respond. By changing the rate of your breathing, you’re changing the levels of oxygen and carbon dioxide in your blood. You’re sort of tricking your body into thinking it is in a very low stress place by modifying your breathing, and then in turn you are relaxed. It has to do with lactic acid output. You change your body chemistry with the change of blood chemistry and then—voilá! You’re changed into a relaxed state!

— Babz Covington

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Wisdom from the Web

Although it may seem that relaxing is not a skill, it very much is. Between each contraction, you must fully relax—let go—and retain the energy needed to endure the marathon that natural labor and birth can be.

— Bring Birth Home, empowering and educating women about the choice to birth at home

Relaxation is one of the most helpful techniques for pain relief during childbirth. Let your body do what it is supposed to do. While your uterus is contracting, relax the rest of your body so your energy isn’t working against you. Relaxation is something that should be practiced throughout your pregnancy. There are several different ways to do this. Work with your labor partner throughout your pregnancy to find out what works for you. For me, it was to have my husband stroke my hair. For someone else, it may be massage. It’s funny to think that relaxing is a skill.

— Heather Hill, author of several natural childbirth articles

Make sure the birthing woman’s mind is free from fearful and negative thoughts. The mind will affect the birthing body! Being free from fear will aid a quick and natural birth. Create a relaxing atmosphere; this will truly support the birthing mother. Relaxation creates a less painful labor and liberates the birthing mother to be in her power to birth naturally. A relaxed birthing body assists the release of endorphins. Oxytocin, the love hormone is present during natural labors.

— Skip to My Lou Parenting, conscious parenting for the 21st century

If you’d like to share a bit of wisdom from the Web, please send a 4–5 sentence excerpt, accompanied by a link, to

Conference Chatter

Harrisburg and Puerto Rico

The conference in Harrisburg was one of the nicest we have ever had. The level of teaching was extremely high. Diane Goslin joined us; she has experience with over 6,000 births, many of which are quite complex because she assists with twin, breech and VBAC births in her Amish population. She and the other amazing teachers brought many new insights and extra depth to the subjects covered. Marcos Leite is a very experienced obstetrician from Brazil who added to this unique mix of teachers. Betty-Anne Daviss has been working with breech in a center in Germany that specializes in utilizing a hands and knees position for breech births. She will be teaching at the conference in Eugene next year along with Diane.

Our cultural panel, with many excellent teachers from so many parts of the world, provided insight into birth around the world. We had registrants from many countries including Oman, Saudi Arabia, Egypt, Mexico, the Netherlands and Belgium. The interactions and friends we made added an important dimension to an already great conference. We had Gail Tully of Spinning Babies join us in the class “Assuring Fetal Position,” and with her great knowledge of the subtleties of babies in the pelvis, the sharing was great. You will get to see both Gail and Diane Goslin in Germany, so I hope we will see you there in our favorite spa town.

After Harrisburg, Eneyda and I flew to Puerto Rico and had the red carpet rolled out to us by the organizers there—they did an excellent job on their first conference. We got to teach “Birth Is a Human Rights Issue” and “Visions and Dreams” to a receptive audience of mostly women who are changing birth in Puerto Rico. They brought in presenters from many Latin American countries to share what they are doing in their country. I especially liked the presentation by a doctor from Ecuador named Diego. Two things he said were, “Never separate the mother from the baby,” and, “Never direct the mother when to push as the head is moving down.” He showed us a DVD he made of his practice. All of it is beautiful and tear-evoking, but it was how he did necessary cesareans that made me cry. He brought the baby out more like a vaginal birth and waited for the cord to stop pulsing before cutting it then handed the baby to mom. It was such a gentle cesarean—I want all of the world’s OB doctors to see this DVD.

I think all of the participants came away with many new insights as well as a lot of inspiration from both conferences. We hope to see you at another Midwifery Today Conference soon!

— Jan Tritten


I was at a homebirth and asked the husband if he would put some water on the stove for hot compresses. A few minutes later he brings me a pot with the washcloths in it. I apply one to the mom’s perineum, and when I remove it I do a double take. There are several white stringy things on her perineum that weren’t there before. I pull one off and look at it closer—there are noodles on her perineum! It turns out there was some leftover chicken noodle soup in the pan. The husband never rinsed it out—he just added some water, warmed it up and brought it to me.

— Christa Bartley

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