In our previous post, you followed the birth journey from Embarking, over the Foothills, through the Veil, and up the Mountain, where you answered The Summoning. Now, you may experience:
Quietude
After the intensity of The Summoning, the body often takes a break from the sensations of the birth process. Your uterus may stop contracting, offering a time of much-needed rest and relaxation. This is good! It’s nature’s perfect design. It’s a time to cuddle up, connect with each other and with your baby, drink lots of water, and maybe have a snack (honey sticks, popsicle, electrolyte drinks, bites of muffin, etc).
What’s Important:
Knowing that this pause in contractions is normal and good. Partner, your job at this point is to protect the space, and ensure that your partner feels undisturbed and enjoys this break. Nothing needs to be fixed or changed, the pause is just a part of the process.
The Tides
On the other side of the mountain, you will find the sea. After a while, the wave-like sensations of the birth process will begin again: building up, peaking, and fading away. During the Quietude, the muscles of the uterus were gathering at the top (called the fundus) of this incredible organ, in order to begin the process of pushing the baby down and out. The Tides is the return of the strong contractions of the uterus. Where earlier the uterine muscles were pulling upward, now the fundus is pushing down from the top, so that your baby will descend through your pelvis.
What to do:
Continue to cope with the intensity of the sensations as your instincts guide you. Using water (bath/shower/pool), sitting on the toilet, standing and swaying, slow dancing like you’re in Grade 8, leaning forward, and sitting on a birth ball or stool, are all good things to try. Be aware that there will be very intense sensations as your baby moves through your pelvis. It may feel like you need to have a bowel movement, or like your bottom will burst. It won't! Our bodies were made for this.
Note:
Some care providers advise people to start to push as soon as their cervix is fully open. This can make for a very long time of pushing, and isn’t as effective as waiting until you feel the urge to push. You can let your care provider know that you’d like to wait until you feel the urge, and until then you will let the baby come down with the strong contractions of the uterus. (This can happen with or without the use of epidural pain relief. With an epidural, folks still feel pressure building as their baby comes down, and can wait until the pressure is intense). Today's midwives call this ‘passive descent’.
The Breakers
The waves are likely coming strong and steadily again. The baby is very low now, and most people will feel a strong urge to push with the powerful sensations. Baby’s head will begin to be visible at the opening, coming out a little more with each push, until the head has fully stretched the perineum and is ready to be born. The birthing person will get a rush of adrenaline at this point, feeling fully energized and focused as they work to meet their baby.
Remember:
Follow your body’s instincts in finding the positions that feel best for you. If you have epidural pain relief, side-lying at this point can be beneficial, as it allows the tailbone to move out of the way as your baby’s head pushes against it.
The burning sensation of the perineum stretching can be very intense. Panting, blowing, or doing horse lips can help to keep your pelvic floor relaxed.
Emergence
The baby’s head is born! After this there is a pause, as the baby turns in order to fit their shoulders through the outlet of your pelvis (a movement called ‘restitution’). You may want to reach down and feel your baby’s head, or take a look, if that’s possible in the position you’ve taken. You can also ask for a mirror! Likely with the next wave, your baby's body will emerge into waiting hands (your own, your partner's, your care providers? Your choice!).
Partner Tip:
Check in with your amazing partner if you’d like to go say hi to your baby once their head is born. What a gift for your baby, to have your familiar voice be the first one they hear clearly, and your face be the first one they see! Of course, your birthing partner may want you to stay near their head, as their grounding comfort. Feel it out in the moment. You might even want to be the one to “catch” your baby as they are born!
Remember to hand your doula your camera/phone, if they don't already have it at this point, to capture pictures of your baby’s first moments!
The Return
In the first 5-10 minutes after birth, the baby and their birthing parent are re-orienting themselves. The birthing person is coming back from behind the Veil, and transforming from pregnancy to the postpartum phase. The baby is undergoing a major transition as well: from a life in water to a life in air. They are taking in their first moments with all of their senses, as their circulatory system undergoes this major change.
These are the moments of earthly bonding. Oxytocin, the love hormone, runs high, reaching its peak in this birthing journey, and your family falls in love with each other.
This can be a peaceful and calm time, with the right care team. The medical team may dry the baby, and keep a watchful eye on their colour, movements, and breathing/crying.
Partner Tip:
Throw your Guardian arms around your loved one and your baby, and protect this space. This is your family's moment, you don't have to share it with anyone. Be prepared to help your partner to hold the baby steady in these first moments, as they may take some time to come fully back into their body.
Acquaintance
You will be in awe that the journey has brought you this tiny little being.
You might begin to speak with your baby, to welcome them, to acknowledge what a journey that was for all of you, and how glad you are that they are finally here! This phase usually lasts another 5-10 minutes, as you marvel at your baby, and smile and kiss each other, and share your first oxytocin-rich moments as a family.
Your doula will be taking photos (if you wish), and doing their best to keep your little family as undisturbed as possible.
Note:
It is not likely that the baby will need to leave you at this point. Guardian, you can advocate for the baby to stay with your partner if there is anything pressing that needs to be done (rubbing baby for stimulation, some gentle suction of fluids from their nose or mouth, etc.)
Communion
This is the point when you’ll be ready to share your baby with others in the room, and marvel in their listening about what you just accomplished. The Return, Acquaintance and Communion together last about 20 to 30 minutes and make up the immediate postpartum time. While they each last only a short amount of time, they are very different stages of birth, each with a unique and important experience that impacts the development and well-being of your family.
Completion
This is the third stage of labour in the standard medical view, where the first stage is cervical dilation, and the second stage is pushing and birth. This final stage is the birth of the placenta.
The placenta has released from the uterine wall, thanks to the rush of oxytocin after your baby was born. You can easily push the soft and pliable placenta out, and it will be caught in a dish or a bowl. Your care providers might offer you a ‘tour’, if you want to check out the organ that nourished your baby from soon after conception until just moments ago. You can choose when or if you would like the umbilical cord to be cut or burned, separating your baby from the placenta. There is no rush or hurry for this to happen.
This stage is when you might notice how hungry you are, and food and drinks will be brought to you as you continue to bond skin-to-skin with your baby.
At some point in the first couple of hours, your baby will show signs of interest in nursing (sticking their tongue out, bobbing their head to find your nipples, sucking on their hands), and you can help them use their instincts to find their way, if it is your plan to breastfeed.
Your care team will continue to monitor how your baby is doing, and at this point they will do some of the newborn procedures (vitamin K shot, newborn exam), if you have consented to them. You will be assessed for any perineal tears or unusual bleeding. Then you will be gently cleaned up and tucked in to enjoy your baby’s first attempts at breastfeeding, after which you will all be ready to have a good sleep.
Partner Tip:
Guard this time, as your baby is ready to find their way to their food source. Ensure that no extra hands are ‘helping’ your baby latch on to your partner’s breast, unless desired. You can remind them that you all want to figure this out together, using your instincts and intuition, and you will ask for help or advice if you need it.
Congratulations! You did it!
If you have questions or comments about this description of the Birth Journey, I'd love to hear from you. If you are looking for holistic doula support, I have limited availability. Get in touch to inquire!
(Much love and gratitude to Whapio of The Matrona, for your work, your teachings, and your much needed presence in our time.)