Academic journal article Journal of Prenatal & Perinatal Psychology & Health

Sharing Space: New Science, New Practices: Slowing Down at Birth for Vulnerable Newborns

Academic journal article Journal of Prenatal & Perinatal Psychology & Health

Sharing Space: New Science, New Practices: Slowing Down at Birth for Vulnerable Newborns

Article excerpt

After poking along for a night and a day, labor was suddenly moving fast with contractions coming strong and close. Rachel, a prenatal yoga teacher, and her husband Jonathan, a farm-to-table chef, were deep into labor with their first baby. I was present as their doula. With new, big contractions and the hint of a grunt, we left Brooklyn for their Manhattan hospital. When we arrived, the midwife told us that Rachel was fully dilated.

Rachel started pushing. The baby, in turn, began experiencing category III decelerations; the fetal heart rate was dipping into the 80s, 70s, and 60s. The midwife told us we would do every-thing to get this baby out as quickly as we could. Rachel made a fantastic effort and with the eventual help of a vacuum, a boy was born, eyes wide-open, cord wrapped elaborately around his neck and torso.

Things moved quickly. "Pull your baby to you!" the midwife called as she unwound the cord. "Pm not ready I'm not ready I'm not ready!" Rachel cried. The midwife placed the baby on Rachel's belly. Someone cut the cord. The baby gave a cry and a nurse lifted him high into the air and towards the exit. I nudged Jonathan and he raced out of the room, following his under-a-minute-old son down the hallway to the nursery.

Rachel caught her breath, and I caught mine. I've attended hundreds of births as a doula. I knew that one of two things was likely to happen in the next few minutes. We would hear that the baby was fine and would return to Rachel after a period of observation in the nursery. Or, we would be told the baby would be going to the NICU. An idea hit me for a third option. I'll call it the slow option. I'd never seen it happen before under these circumstances in a hospital, but why not?

The Birth Pause: Slowing it Down at Birth

My inspiration for this third, slow alternative sprang from trainings and conversations over the years with Karen Strange, a Colorado midwife who has taught over 8,000 people in her course "Integrative Resuscitation of the Newborn." Karen spends much of the year on the road teaching so that doctors, midwives, nurses, doulas, and parents can understand a new way of connecting with babies and assisting babies-especially those who struggle at birth-in this context.

I met Karen six years ago on one of her early New York City workshop tours. I had signed on for my first training with Karen thinking that, as a busy New York City doula who had unexpectedly caught a few babies over the years, brushing up on the basics of reviving a newborn would be the responsible thing to do. I had anticipated-with some dread, I'll admit-a day of "one-one thousand, two-one thousand" along the lines of every CPR class I had ever taken. As it turned out, I learned the basics of neonatal resuscitation, but the scope of the workshop was vast. In particular, I was intrigued by Karen's suggestion that our hurry-up birth culture might be skipping over something hard-wired in the moment a baby is born.

Karen shared an evolutionary perspective, reminding us that birth is designed to work in case no one else is there. "What is in birth in the original?" she asked, and, "In our routines of care for mothers and babies, are we interfering with critical elements in this design?" She described a natural sequence-or blueprint within an age-old template-that includes a slow, mother-baby resting phase at the moment of birth. As I listened to Karen, it seemed probable that as early humans (and pre-humans, and pre-pre-humans) wired for birth through the ages, mothers would have likely birthed babies down onto a surface below, and then rested, as the baby transitioned from gas-cord oxygenation to lung breathing. Once a mother recovered somewhat from her efforts, she would have turned her attention to the baby before her and, studying and discovering her newborn, gathered the baby in. Karen described this slow meeting as a time when a mother and baby begin to integrate all that has happened, a pause that readies both to move forward to breastfeeding and attachment. …

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