Creating Optimal Birth Space

The environment in which we live and move and have our being is critical to our physical, mental, spiritual and social functioning. More and more understanding is emerging about how the environment plays a pivotal role in all aspects of our lives. From mice to (wo) men, science is demonstrating that the body's neural network is "plastic", that genes are not destiny and that the "environment" is an integral part of how living creatures function and develop. Every physiological interaction and behaviour, from the way genes are expressed in the sperm and the ovum to our health and experience across the lifecycle depends upon the environment. The environnment gives feedback which will be either nourishing and provide the stimulus to function well and grow or hostile, which disrupts our functioning, leading to disease, distress and decay.

Recognition of the way the environment is integral to optimal functioning is expanding our understanding of the role of maternity care in providing optimal environments for childbearing women. The science is also demonstrating why woman centred care, facilitating the fulfilment of woman's choices and incorporating women's rights into maternity care are so much a part of optimising outcomes for women, their babies, their intimate relationships and society in general.

My friend and colleague, the wonderful Maralyn Foureur, Professor of Midwifery at the University of Technology of Sydney (UTS) presented on this topic at the recent homebirth conference in New Zealand.  Maralyn is heading up a research team exploring birth space and has attracted a highly prized NHMRC grant for this work. 

Click the link below and it will take you to the slide share of her presentation

Creating Optimal Birth Space

I think you will enjoy and get a lot out of her research.

Symbols, power and woman's place in the world

I always enjoy Maria Popover's links and articles. Her Blog has fascinating and often obscure articles which are relevant to my interests. I follow Maria on Twitter  - her twitter name is @brainpicker

So it was with great interest that I followed this link

 

to YouTube to see Symmetry, a short vimeo film by Radiolab that Maria said "explores the dualities of human existence, best short film you'll see all week".

 

The film is very clever - it juxaposes images concerning the dualities of existence to explore

"What the origin of the universe has to do with gender identity, binary parallels and anatomy"

I felt disturbed by the juxtaposition of hot chips and tomato sauce, pepsi and coke, popcorn and movies as typical of life on this beautiful planet of ours, but this following image really bothered me

Why does that bother me?

Positioning these images as the gender divide and to represent masculinity and feminity bothers me because of the inclusion of the disabled sign with the woman figure.

Maria says that:

"Symmetry is a mesmerizing split-screen short film exploring the poetic parallels and contrasts of our world — birth and death, heart and brain, masculinity and femininity, all many more of humanity’s fundamental dualities. It’s the best thing you’ll watch all week, we promise"

Given the producers and Maria are cluey in regards to the messages we receive from the visual stimuli around us, it is hard to believe that they didn’t recognise the way this image can subliminally erode women’s sense of self and personal power. Perhaps they didn’t ‘see’ the message the film is sending because that view of women is 'normal' and that makes it all the more fascinating and concerning.

Maria explains that:

"The film was inspired by Radiolab’s Desperately Seeking Symmetry episode, which examines how symmetry and its pursuit shape the core of our existence, from the origins of the universe to what we see when we look in the mirror"

Is that how you see yourself when you look in the mirror?

Here's the film so you can  make up your own mind

Read more: http://www.brainpickings.org/index.php/2011/04/20/radiolab-symmetry/#ixzz1K7q855ff

Symmetry from Everynone on Vimeo.


Those of us who are birth workers are very aware of the way that in western culture at least, women are being progressively disabled to birth normally. Women are embodying the messages that birth is something to be medicated... avoided... that being delivered surgically is preferable and 'safer for the baby' even though it is certainly not.

Our connection to 'nature' is eroding and our birth DNA, our wild side, is getting switched off and put under the lock and key of medicalisation.

The grunting, groaning, sweating, swearing, movement and effort associated with giving birth is increasingly perceived as unbefitting modern women. Birth is now sanitised with pretty delivery room decorations and epidurals on demand. I've noticed many partners and other family members feel relieved when the woman is neatly in bed, unable to move and 'painfree' for labour. The fact that they can't push or move and end up with baby extractions either with abdominal or perineal cuts doesn't seem to be an issue. The disablity accompanying the pain and difficulty moving for some time after the baby extraction doesn't seem a problem for anyone either. '

We have to ask what it is about the birth process that causes all this angst about 'pain' in labour. That's probably a topic for another time.

Back to the images in this short film and what they represent.  My perception is that the unconscious coupling of a woman with the disabled sign positioned as symmetrical with the male symbol is a striking indicator of how women are culturally constructed as disabled in our world. 

The fact that the message is subliminal and that neither the producers, nor those who understand subliminal marketing and neuroscience recognised the message makes it even more powerful and dangerous to women's sense of self, power and place in the world.

And then there is the message about what it means to be female in western society fostered by the likes of  the ubiquitous Child Beauty Pageants.  As  Heidi Davoren, in her column Dirty Laundry for Life & Style section of the Brisbane Times wrote:

"Shame on us as a society that our daughters are groomed into submission, objectification and sexualisation at such a tender age, in the name of entertainment. In fact, in the name of ‘building self-esteem’."

The rampant sexualisation of girls is another powerful and dangerous threat to women's sense of self, power and place in the world.

Focus, attention and brain connections: What's the implication for birthing women?

In this powerful and informative video, Dr. Fred Travis, Director, Center for Brain, Consciousness, and Cognition in Fairfield, Iowa, explains how repeated mental and physical activity builds and develops brain connections. 





What are the implications for birthing women? 


Every time you watch, imagine or identify with a particular way of giving birth, you are reinforcing and building brain connections about that experience.  This video demonstrates clearly how to build the brain patterns that are most beneficial and in line with what you really want. Patterns of neuronal firing have physical, emotional and mental consequences.


Our brain builds new connections when we are in a learning, curious, open state and reinforces commonly used connections constantly.  The other fascinating aspect of human reality is that we screen out anything that doesn't match our 'patterns' of perception. The following video demonstrates the way our brain is very selective about what it lets into our conscious awareness. 


Take note of how many times the people in white shirts pass the ball to each other.




Then read this account of the experiment. 

The big question is how do we use this information to improve our lives and make birth and parenting more what we want it to be?

First, decide what you want - get a clear idea of that.  Then, keep focusing on that which you want. Hang out with those who support what you want. Avoid those who wish to bring them down, or at least, understand they are coming from a fear based perspective, and as you saw in Dr Fred's video, that violent and unhelpful emotional energy causes holes in people's brain function as well as their thinking. 


You can train your brain!  Pianists, Olympians, typists - anyone who has ever mastered anything demonstrates that clearly.  We are truly amazing - neuroscience is demonstrating how capable we really are!

'Science speak and minifisms': hiding the horrible truth

An article on the Bioethics Forum highlighted the way that medical jargon and a 'scientific' approach can be used to obscure ethical, moral and philosophical breaches in medical interventions.

Recent attention has been paid to the issues around genital mutilation, currently focused on the suggestion taken up and rapidly dropped by the American Pediatric Association that a 'ritual nick' in a young girl's clitoris would reduce the risk of parents taking girls overseas for more debilitating tradition based cutting. 

However, under the guise of medicine, a paediatrician, Dr Poppas, at Cornell University, is performing nerve sparing ventral clitoroplasty on baby girls. What that means is that his surgical team is cutting the sides out of a girl's clitoris. Why are they doing this surgery? The girl's clitoris is deemed too big.

Another blogger suggests that the reason for the clitoral reduction surgery  may be more to do with homophobia than cosmetics because apparently, a woman with a large clitoris is more likely to identify as lesbian. An interesting suggestion.

Whatever the reason, the medical explanation is not in any way acceptable to any thinking person. Far from being benign and helpful, the surgical reduction of a girl's clitoris has been associated with physical, emotional, psychological and relational harm. A most disturbing and chilling aspect of this surgery is the follow up process.

The girls, aged six and over, fully conscious, have their clitorises stimulated with a vibrator by Poppas. Their parents, other researchers and probably students look on.

Alice Dreger, Professor of Clinical Medical Humanities and Bioethics at Northwestern University's Feinberg School of Medicine and Ellen Feder, Associate Professor and Acting Chair in the Department of Philosophy and Religion at American University have been arguing that the surgery performed by Poppas and his team has no benefit for the last decade. Dreger and Feder have only just become aware of the follow up process, which is described in this way:

"Using the vibrator, he also touches her on her inner thigh, her labia minora, and the introitus of her vagina, asking her to report, on a scale of 0 (no sensation) to 5 (maximum), how strongly she feels the touch. Yang, Felsen, and Poppas also report a “capillary perfusion testing,” which means a physician or nurse pushes a finger nail on the girl’s clitoris to see if the blood goes away and comes back, a sign of healthy tissue"

The article states that  "Study received medical institution review board approval".  I can only wonder how. Board approval could reflect the fact that people tend to over ride their ethical and moral compass in favour of the expert's view. Stanley Milgram provided a graphic example of that phenomenon in his research in the 1974. Researchers at Wellcome Trust Centre for Neuroimaging at UCL (University College London) in collaboration with Aarhus University in Denmark  have found activity in the reward centre in the brain shows that the opinion of other people matters and demonstrates why people change their mind to agree with someone they believe is an expert.

Milgram's experiment was repeated on a French reality TV show in March 2010. The show aimed to show how ordinary, decent people could become torturers. The outcome created an uproar.
  

Added to our tendency towards obedience, an illusory sense of superiority has been found to over inflate both self confidence and a sense of competence.  The Wiki page on illusory sense of superiority does a good job of bringing together a lot of the research about our ability to self evaluate and recognise our inherent biases.  There are some very good references on that page that are fascinating to follow up and explore further.

Back to our man Dr Poppas and his team. Does he/they suffer from an illusory sense of superiority and competence and because of that, posed as experts and managed to fool the board?

The webpage of the Pediatric Department at the Cornell University gives no indication that 'clitorplasty' is still contentious and criticised by both clinicians and patient advocates for the last 15 years.

The webpage states:

"The type of surgical repair performed must be tailored according to each individual patient's anatomy. The first important issue is the timing of the reconstruction. This has been a controversial area in the past, but presently the standard of care is to perform reconstructive surgery at an early age rather than delaying until adolescence. Reconstruction is generally initiated between the ages of 3 and 6 months old. An early one stage repair is recommended because female patients are able to undergo a more natural psychological and sexual development when they have a normal appearing vagina. The major features of reconstructive genitoplasty are clitorplasty, labioscrotal reduction, and vaginal exteriorization (vaginoplasty)".

The words on this web page sound so clinical, so medical, so scientific, so right. All those big words that mean nothing to most people. How would parents know anything different? Most parents believe what experts (paediatricians) say and are too intimidated to even ask questions, let alone ask for a second opinion.

Alice Dreger continues

"Yang, Felsen, and Poppas describe the girls “sensory tested” as being older than five. They are, therefore, old enough to remember being asked to lie back, be touched with the vibrator, and report on whether they can still feel sensation. They may also be able to remember their emotions and the physical sensations they experienced. Their parents’ participation may also figure in these memories. We think therefore that most reasonable people will agree with Zucker that Poppas’s techniques are “developmentally inappropriate.”

Each girl child from the time testing starts (about 5 -6 years of age) has her "thigh, her vagina, her labia minora, and her clitoris stroked with a Q-tip while she's asked if she can feel the doctor touching her. ("Can you feel me now?")"

There is doubt as to whether Poppa had/has ethics approval for the sensory testing he and his team conducted. That little detail seems to have slipped through unnoticed. 

We don't know what parents are told or not told. Talking through procedures such as Poppa promotes should take many hours of compassionate counselling and information sharing, shifting through the various ideas and schools of thought about these interventions on what appears to be variations on normal healthy genital structures. Many parents feel concerned about challenging the experts, even if the parents feel uncomfortable with a treatment that is being suggested. Parents can feel anxious about their child being victimised if they as parents 'rock the boat' and ask too many questions of health professionals.  Can you imagine what that 'sensory testing' would be like for those babies and young children and Poppa says testing is ongoing!  Poppa would prefer that the vibrators he uses to test the sensory ability of the surgically altered clitoris are referred to as a 'medical vibratory device'.  This abysmal story is full of 'minifisms' - words used to scale down the significance of the intervention. 

I'm reminded of the Butcher of Bega with this story.

Thank goodness for people like Alice Dreger and Ellen Feder who bring these abominable acts to light. Our job is to write to the authorities asking for an explanation.

Yang, Felson & Poppas (2007) Nerve Sparing Ventral Clitoroplasty: Analysis of Clitoral Sensitivity and Viability, The Journal of Urology, Vol 178, Issue 4, pp 1598-1601 Supplement (October)

Correspondence: Institute for Pediatric Urology, Rodgers Family Professor of Pediatric Urology, New York Presbyterian Hospital, Weill Medical College of Cornell University, 525 East 68th St., Box 94, New York, NY 10021 (telephone: 212-746-5337 begin_of_the_skype_highlighting            212-746-5337      end_of_the_skype_highlighting; FAX: 212-746-8065).

Where's the Placenta in Birth Films?

The placenta is an ignored organ in birth films. 


The following film is beautiful, but the cord is cut early and there is no placenta! I can't help but wonder why.



The way the woman gives birth so calmly and consciously in this video is a delight.  I love the way the tank enables the family, the midwife and the doctor to see what is happening without interfering or interrupting the woman's 'flow'. I also love the way the woman uses her hands to birth her baby's head and how she engages with the baby when the baby's head is born.  This woman was obviously well prepared for the birth of her baby.

BUT - where is the placenta???

The birth of the placenta is missing from most videos.  The fact that the placenta is missing from birth videos sends the wrong and incomplete message about birth.  Giving birth to the placenta is the third stage of labour. The third and fourth stage of labour, during which time the woman adjusts psychologically, physiologically and spiritually to the birth of the baby, are vitally important parts of the birth process. This period is a 'peak experience' time; one where women get surges of the 'love' hormone oxytocin if the environmental conditions are optimal. These surges in oxytocin are essential for optimal psychophysiological functioning for bonding with the baby, contraction of the woman's uterus, haemostasis and the initiation of lactation. 

The placenta is an awesome organ and needs to be given due respect and acknowledgment for the mighty role it plays in the beginning of life.

Many cultures have the Tree of Life symbol which is said to be a metaphor for the placenta; artworks across millenia demonstrate this potent recognition of the placenta's role in the life of a fetus and baby.  Not only is the symbolism missing in modern life, even the placenta itself is written out of the mainstream artform - that of videos.

Ignoring or dismissing the placenta comes at a cost.  Women don't know they have a placenta to birth; if they do know, they don't know the magnificence of it. What that means is they think birth is over when the baby is born. Unfortunately, thinking birth is over sends the wrong message to the neural networks and hormonal system.  Safe birth requires conscious engagement in the process.

A key lesson of modern neuroscience is that a change in the focus of our attention changes our brain firing patterns and changes the neurochemicals associated with the firing pattern. The practical application of this lesson is that our physiology responds to our thinking. The thought that birth is over when a woman doesn't realise that the birth of the placenta requires attention, especially when the feeling of relief is profound and/or the woman is disturbed/distracted from her baby and birth process can result in a blocking of the release of oxytocin.  A drop in the level of oxytocin can  predispose the woman to excessive blood loss because her uterus doesn't get the chemical messages it needs to contract well and seal off the placental site. The attentional network that I suggest is optimal in birthing the placenta and keeping safe in third and fourth stage of labour is the attentional neural network associated with fascination. When a woman is fascinated with her baby, she is safe and her physiology works as it ought. Disrupting, distracting or in any other way interrupting the fascinating network bodes trouble. Midwives have a duty of care to ensure the birth environment is conducive to women's fascination with their babies being enhanced and potentiated; a key aspect of midwifery guardianship. .

I've written a theoretical paper, with my colleague, Professor of Midwifery, Dr Kathleen Fahy,  on midwifery guardianship in the third stage of labour. You can access the abstract here. 

We also conducted a cohort study which showed that women who had active management of third stage were 7-8 times more likely to experience excessive blood loss in third and fourth stages of labour than women who were well prepared and, together with their families and midwives, had a mindful approach to the birth of the placenta.

The answer is: let's talk up the placenta, make sure women know that third and fourth stages are an integral and important part of labour and include the birth of the placenta as an integral part of any film about birth.
 
On this Mother's Day,  the recognition that knowledge is power and education about the placenta is lifesaving and helping women to stay safe in childbirth is a good thing to think about!

The pheromone myth: Sniffing out the truth - 24 February 2010 - New Scientist

Fascinating read

Richard L. Doty is director of the University of Pennsylvania's Smell and Taste Center. His awards include the US National Institutes of Health's James A. Shannon award (1996), and the Association for Chemoreception Sciences' Max Mozell award for outstanding achievement in the chemical senses (2005). This essay is based on his book, The Great Pheromone Myth (Johns Hopkins University Press)

Richard Doty states:

"All in all, it looks as if "pheromonology" has become a modern-day phrenology, providing simple but false explanations for most chemically mediated social behaviours and endocrine responses, satisfying only those who seek simple answers to complex phenomena. Perhaps once the idea that mammals have pheromones is dispelled, we can work towards an appreciation of the real role chemicals play in their lives".

The pheromone myth: Sniffing out the truth - 24 February 2010 - New Scientist

Cognition in pregnancy and motherhood: prospective cohort study -- Christensen et al. 196 (2): 126 -- The British Journal of Psychiatry

Cognition in pregnancy and motherhood: prospective cohort study -- Christensen et al. 196 (2): 126 -- The British Journal of Psychiatry

Background
Research has reported that pregnant women and mothers become forgetful. However, in these studies, women are not recruited prior to pregnancy, samples are not representative and studies are underpowered.
Aims
The current study sought to determine whether pregnancy and motherhood are associated with brief or long-term cognitive deterioration using a representative sample and measuring cognition during and before the onset of pregnancy and motherhood.
Method
Women aged 20–24 years were recruited prospectively and assessed in 1999, 2003 and 2007. Seventy-six women were pregnant at follow-up assessments, 188 became mothers between study waves and 542 remained nulliparous.
Results
No significant differences in cognitive change were found as a function of pregnancy or motherhood, although late pregnancy was associated with deterioration on one of four tests of memory and cognition.
Conclusions
The hypothesis that pregnancy and motherhood are associated with persistent cognitive deterioration was not supported. Previous negative findings may be a result of biased sampling.


This study is interesting on many points. One interesting point is the way the researchers concluded their paper by stating:

"Obstetricians, general family doctors and midwives may need to use the findings from this study to promote the view that ‘placenta brain’ is not inevitable, and that perceptions of impairment may reflect emotional or other unknown factors. Not so long ago pregnancy was ‘confinement’ and motherhood meant the end of career aspirations. Our results challenge the view that mothers are anything other than the intellectual peers of their contemporaries".

 An important point to make!

 The researchers state that:

"one of the weaknesses of our study was our inability to link cognitive change with biological changes associated with pregnancy"

What would have been really interesting is to see the neurological changes that were taking place in women's brains as they were questioned by the researchers.  Emerging insights from neuroscience indicate that different attentional networks are operating, depending upon the task at hand.  Different attentional networks trigger different autonomic nervous system 'states' with correspondingly different biochemical responses and levels.

Pregnant women do not suffer cognitive 'impairment' that much the research has demonstrated, however, the researchers dismisses the fact that many women do forget things in pregnancy, relegating the 'forgetting phenomenon' to the basket of emotionally related factors.  Dismissing women's experience as merely emotionally driven is, in my view, dangerous thinking.

Emotions are powerful chemicals for one thing and have a great deal to do with day to day health and long term wellbeing for both mother and baby.

A far better conclusion is that the pregnant woman's body and subconscious processes are very busy building a baby.  Our innate intelligence has a way of rerouting attention from less important to more important activities. Nothing, in terms of nature's agenda (healthy reproduction) is more important than building a healthy baby.

With an understanding of neuroscience and attentional networks, the fact that a pregnant woman becomes forgetful about 'boring' tasks and 'work' related activities is perfectly understandable and has nothing to do with her intellectual ability and cognition. When a woman's attentional networks are triggered to pay attention, she will, demonstrating, as this study shows that her intellectual ability is 'normal'.

Pregnant women can be assured that forgetting mundane, wordly things is actually very normal and very understandable. Their body intelligence is very consumed in growing a baby and is not bothered or very interested in outside worldly pursuits.

BBC News - Dopamine levels in brain 'influence decision making'

Dopamine, a chemical with a key role in setting people's moods, could have a much wider-ranging impact on their everyday lives, research suggests.

Experiments show that altering levels of the chemical in the brain influences the decisions people make.
Professor John Maule, an expert in decision making, at Leeds University Business School, said that in recent years people had begun to realise emotional or "gut instinct" decision making was just as important in human choices as analytical decision making.

BBC News - Dopamine levels in brain 'influence decision making'

YouTube - Controlling the Brain with Light (Karl Deisseroth, Stanford University)

Optogenetics: controlling brain cells with lasers
New Scientist Story
7th January 2010 by Ewen Callaway

http://www.newscientist.com/article/dn18353-optogenetics-controlling-brain-cells-with-lasers.html

Brain cells can be switched on and off like light bulbs using newly identified microbial proteins that are sensitive to the colour of laser light.

The discovery is the latest in the fast-moving field of optogenetics, which has already given researchers unparalleled control over brain circuits in laboratory animals. The technology may lead to treatments for conditions such as epilepsy, Parkinson's disease and blindness. New Scientist explains the science and its promise.

If you have the patience to sit and watch this video, you will be amazed by what is happening with biotechnology and psychiatry. Great possibilities for much of what ails humanity.

What's this story got to do with birth and midwifery?  Psychiatry seeks to fix brains once they are broken.  The fields of perinatal psychology and epigenetics are explaining how prenatal programming sets the stage and the foundations for many diseases in adulthood.  Depression being one of the diseases that are increasingly linked to prenatal experiences of one kind and another, particularly those to do with elevated hypothalamic, pituitary adrenal axis stimulation in pregnancy (aka the stress response system).

Pregnant women feel better, that is, have lower circulating cortiosteroids (stress hormones) when they feel in control, have choices and feel listened to, valued and respected by their caregiver.  They are more likely to go to term, birth well and breastfeed well . They are also less likely to get gestational diabetes, hypertension and their babies are less likely to need nursery admission.  Midwives are the maternity care specialists who provide the sort of care that women want.  Long term relationships between mothers and babies are better with midwifery care, women feel more satisfied and depression rates are lower.  My take on this is that one to one midwifery care helps by supporting women to feel good, eat well, get enough rest, avoid toxins etc thus giving brains the best opportunity to be built right from the beginning.

YouTube - Controlling the Brain with Light (Karl Deisseroth, Stanford University)

EWG Minority Cord Blood Report Executive Summary | Environmental Working Group

A two-year study involving five independent research laboratories in the United States, Canada and the Netherlands has found up to 232 toxic chemicals in the umbilical cord blood of 10 babies from racial and ethnic minority groups. The findings constitute hard evidence that each child was exposed to a host of dangerous substances while still in its mother’s womb.

Government, academic and independent biomonitoring studies, including those by EWG, have detected up to 358 industrial chemicals, pesticides and pollutants in the cord blood of American infants. Exploring the so-called “additive” effects of possible carcinogens, hormone disrupters and neurotoxins is a new and urgent priority for environmental health scientists. EWG supports this very important work.

But as this science moves forward, we need to act now to reduce exposures that present the greatest health threats based on what we know today, even as scientists struggle to understand how the cocktail of chemicals in the womb could harm current and future generations.

Many of the up to 232 compounds detected in this study have been the target of regulatory action and government controls. As a rule, however, these actions came far too late, well after the environment and the human race were polluted to a degree that has raised serious health concerns. Our failure to act quickly has ensured that these chemicals will continue to pollute future generations for decades, even centuries to come.

EWG Minority Cord Blood Report Executive Summary | Environmental Working Group

If Loved Ones Lessen Our Perceptions of Pain, Do Enemies Make Them Worse? Sarah Master Answers - Science and Religion Today

A great reason to surround ourselves with people we feel good with! Which of course, has implications for birthing women. Midwives have to be good to be around. Birthing women need to be surrounded by people they love and who love and support them for optimal psychophysiological functioning, which includes not only oxytocin release, but includes the endogenous opiods. So, it can be seen, that not just enemies make things worse, but anyone who is not fully 'present' for the woman in labour, therefore setting off her 'alarm' system, can make things worse.

If Loved Ones Lessen Our Perceptions of Pain, Do Enemies Make Them Worse? Sarah Master Answers - Science and Religion Today

Embodied Cognition: Using Movement to Understand the Mind

This study is interesting as it provides an insight into the midwifery maxim first articulated by Ina May Gaskin "fix the mind, fix the body; fix the body, fix the mind". Ina May's midwifery maxim points to a deep understanding of how the nervous system is an embodied system. When we get an appreciation of how the way we think and feel affects the way our body functions, not just in gross physical communication movements but at all levels of movement, (including cellular communication, chemical communication etc) throughout the body, we come to see that attending to the holistic aspects of being is the best way to optimise health.

A clear understanding of the way the mind and the body are inextricably interconnected and integrated helps to explain why midwives work with childbearing women to meet childbearing women's emotional, physical, spiritual, cultural and psychological needs and desires regarding the births of their babies. What some people refer to as 'woo woo' psychobabble or pseudoscience is actually sound midwifery practice.


Embodied Cognition: Using Movement to Understand the Mind

"Interpersonal communication is more than just the exchange of words. Speech, gaze and body coordination are all utilized during conversation. A common example, such as hand gesturing while speaking, shows effective communication is more than just a linguistic dynamic.

This phenomenon, called embodied communication, is the focus of a new study by University of Cincinnati professors in the Department of Psychology.

“Collaborative Research: Dynamics of Interpersonal Coordination and Embodied Communication” is a $418,809 National Science Foundation grant given to Associate Professors Kevin Shockley, Michael Riley and Assistant Professor Michael Richardson to understand coordination of thought by studying coordination of action.

“We’re using movement as a window to understand how people coordinate their thinking,” says Shockley, the principal investigator for the study. “Normally people don’t think of movement when they hear about psychology, but that’s unfortunate because the embodied cognition approach illustrates so nicely how movement is integral to our understanding of the mind.”

BBC NEWS | Health | Hypnosis has 'real' brain effect

"Hypnosis has a "very real" effect that can be picked up on brain scans, say Hull University researchers.
An imaging study of hypnotised participants showed decreased activity in the parts of the brain linked with daydreaming or letting the mind wander.
The same brain patterns were absent in people who had the tests but who were not susceptible to being hypnotised.
One psychologist said the study backed the theory that hypnosis "primes" the brain to be open to suggestion.

Hypnosis is increasingly being used to help people stop smoking or lose weight and advisers recently recommended its use on the NHS to treat irritable bowel syndrome".

Hypnosis is used in programs like 'Hypnobirthing' and 'Calmbirth' to help women give birth normally. This research helps to understand how hypnosis can be effective for some women and not for others. The self management skills that come through these programs are very beneficial for most people.

BBC NEWS | Health | Hypnosis has 'real' brain effect

ScienceDirect - Current Biology : The Privileged Brain Representation of First Olfactory Associations

The first smell you associate with an object is given privileged status in the brain.

Yaara Yeshurun and colleagues at the Weizmann Institute of Science in Rehovot, Israel conducted a study on smells and memory, using functional magnetic resonance imaging. The hippocampus showed a characteristic pattern of neural activity when particular smells were represented to the participants. The researchers concluded that the brain reserves a special pattern of activity for memories that represent the first time we have associated a smell with a particular thing – and that such pairings are most likely to be laid down in childhood.

The brain may have evolved to lay down these privileged memories because it enhanced our ability to sense danger. "This is especially true for unpleasant odours," says Yeshurun.

This makes sense, says Rachel Herz, author of The Scent of Desire: Discovering our enigmatic sense of smell and visiting professor at Brown University in Providence, Rhode Island. "The evolutionary implication is that the situation in which you first encounter an odour is likely a reliable maker for its meaning, and it is highly adaptive to learn that meaning so that the odour can be responded to appropriately in the future."

This study provides more information about the importance of ensuring immediate skin to skin experience for newborn babies and their mothers. When mothers and babies are enabled to maintain skin to skin proximity at birth, both mother and baby are mapped neurologically to each other through their olfactory system. The importance of this neurological olfactory mapping between mother and baby is profound in terms of the baby identifying feeling safe, secure and calm in her/his mother's presence and having those feelings triggered by the scent of the mother. The feelings the mother experiences with the scent of her baby from birth patterning can be recognised to be similarly profound for the vibrancy of the relationship between them.


ScienceDirect - Current Biology : The Privileged Brain Representation of First Olfactory Associations

Review into male circumcision legality - Yahoo!7 News

Laws protect girls from genital surgery but parents wanting to circumcise boys can "go around willy-nilly chopping up bits of their sons", a state children's commissioner says.
Tasmania's commissioner for children Paul Mason and the Tasmanian Law Reform Institute have embarked on what they say is the largest review into the legalities of male circumcision in Australia's history.
Mr Mason said a critical issue for any non-therapeutic circumcision is whether parental consent is sufficient to protect a surgeon from legal action if the child's genital autonomy is thought to have been infringed.
"The only thing that protects a doctor from an action for assault or a civil prosecution is the valid consent of the patient," he said.
"The law is getting pretty hazy about whether a parent can give a valid consent for a child's non-medical procedure."
Mr Mason said about 90 per cent of Australian male babies were circumcised in the 1970s, dropping to about two per cent these days.
Its infrequency nowadays only heightens the chance of a circumcised boy feeling aggrieved as an adult that his rights were ignored as a child, he said.
But High Court rulings and United Nations conventions on the rights of parents and children and legal consent in terms of bodily integrity argue against parental-consent circumcision, he said.
Read more:

Review into male circumcision legality - Yahoo!7 News

Can words hurt? Patient–provider interactions during invasive procedures

In an article in the Journal PAIN (2005) 114 303-309 Lang et al had this to say:

Abstract
Patients are often prepared for procedural discomforts with descriptions of pain or undesirable experiences. This practice is thought to be compassionate and helpful, but there is little data on the effect of such communicative behavior. This study assesses how such descriptions affect patients’ pain and anxiety during medical procedures. The interactions of patients with their healthcare providers during interventional radiological procedures were videotaped during a previously reported 3-arm prospective randomized trial assessing the efficacy of self hypnotic
relaxation. One hundred and fifty-nine videos of the standard care and attention control arms were reviewed. All statements that described painful or undesirable experiences as warning before potentially noxious stimuli or as expression of sympathy afterwards were recorded. Patients’ ratings of pain and anxiety on 0–10 numerical scales (0 No Pain, No Anxiety at All and 10 Worst Pain Possible, Terrified) after the painful event and/or sympathizing statement were the basis for this study. Warning the patient in terms of pain or undesirable experiences resulted in greater pain (P!0.05) and greater anxiety (P!0.001) than not doing so. Sympathizing with the patient in such terms after a painful event did not increase reported pain, but resulted in greater anxiety (P!0.05). Contrary to common belief, warning or sympathizing using language that refers to negative experiences may not make patients feel better. This conclusion has implications for the training in medical communication skills and suggests the need for randomized trials testing different patient–practitioner interactions. q 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

This study provides a perfect example of the way that hypnotic suggestion works.

When will health professionals realise that when they talk, their words are powerful. Pregnant women get this negativity all the time with the talk of 'risk' in relation to their normal, natural process of giving birth. The negative talk creates a self fulfilling prophecy for many women. Then the 'care' givers can use the outcome to reinforce what they think and say, not realising that they created what they believed to be true.

As the above article demonstrates, words are powerful. The sort of words that should be used around birthing women are words that foster a sense of normalcy, increase self efficacy, build self worth and self trust. Every health professional who has anything to do with birthing women should be working to build capacity for wellness and optimal psychophysiological functioning with every woman they interact with.

Mind Movie for Pregnant Women

A mind movie is a visualisation tool that enables a person to provide multisensory input and provide positive suggestions to the subconscious mind about a particular and desired outcome. Quantum physics informs us that we are forever in a field of possibilities. Neuroscience has discovered that the human brain is a quantum processor, making our tomorrows out of our todays.

If we want to create something wonderful in our life, we have to imagine it, in full technicolour, with surround sound and 'be' completely at one with whatever we wish to create.

The experts tell us that imagining/visualising our ideals first thing in the morning and last thing at night is what powerfully impacts our subconscious minds, providing a template for our inner intelligence to express itself through.

Many women do not have experience with birth, other than what they see on that master of suggestion, the television. Unfortunately, what is presented on television is invariably sensationalist, negative, alarming and often, inaccurate or only partially accurate and ultimately distressing. That is particularly true of the birthing process. The birth of our precious babies has been corrupted by false advertising through mainstream media and the ensuing horror stories. That corruption of birth has lead to unbelievable levels of fear and trauma in our society for both mothers and babies. Unmitigated fear is toxic to body and mental function and the reason that is so is explained by our physiology.

Mediated by the nervous system and our 'perceptions', our physiology has two primary modes of 'being'. One, the parasympathetic mode is 'on' when we are calm, relaxed and happy, in love and optimistic. In this mode, the whole body is well perfused with oxygen rich blood, the immune system functions well as do all the other growth and repair functions of the body. In this state, the brain functions optimally, thinking is clear, we are creative and our emotions consist of the positive hormones, such as oxytocin, endorphins and relaxins.

The other mode is switched on when we perceive a threat in our environment, this is the fight, flight or freeze response, the sympathetic branch of our nervous system. When this system is activated, blood is diverted from those parts of us that are not considered essential for immediate survival when attack appears imminent and our life threatened. The parts of us that are deprived of the normal blood flow at these times include our gut and digestion, our reproductive systems and its components, including, for pregnant women, the uterus and baby, plus other maintenance and repair systems. The blood is sent to our arms and legs for fighting and fleeing. The hormones associated with this biobehavioural state are adrenalins, noradrenalins and cortisol. Cortisol is great for helping a person lift a car off someone trapped underneath, we've all heard those kind of heroic stories of unbelievable strength in dire circumstances. However, in day to day life, activation of the sympathetic aspect of our nervous system disrupts cellular and immune system function and shuts down our rational thinking, leading to road rage, neuronal death and illness. It also leads to a self defeating, self reinforcing cycle of negative experiences.

Pregnant women are well advised to avoid horror stories, television dramas and any negative representation of birth, parenting and babies. Pregnant women benefit by being immersed in positive stories, images and surrounding themselves with loving, supportive and encouraging people. Pregnant women also benefit by having someone, preferably a midwife, with whom they can talk though their fears and apprehensions, so that they approach the birth of their precious babies in a loving, confident and calm manner. In this way, women's physiology works optimally and prenates grow well.

A mind movie is designed to provide and develop a positive view and orientation to pregnancy, labour, birth and breastfeeding for pregnant women, their partners and their families.

A woman can make her own mind movie. She can make it in her imagination, or by making a real life video. Either way, collect in your mind or physically, lovely photos of birth, babies and other images that remind you of your body and mind in harmony, working well. Add your favourite music to the mix and every morning and night, soak your mind in the ideas of birth to come, remembering to think about the birth occurring at the perfect time in the perfect way with the perfect people in the perfect place when the baby is fully grown, ready for birth. Imagine the whole process, including the birth of the placenta, your feelings on seeing your baby for the first time, being skin to skin with and breastfeeding your baby. Imagine yourself joyful after the event.

You will be amazed at how effective this process is for helping create a wonderful birth experience for you and your baby.