Uncertainty in Labor

**EDIT** Original post in 2012

Certainty. Why do we seek it? Is it possible to have any sense of certainty going into labor and birth? Isn't that uncertainty some of the beauty and mystery of the sacred event? A hands-on lesson in spontaneity? Join me as I dive into the issue, fueled by my own frustrations in working with moms who crave the elusive predictability.

After 5 weeks of 2 hour classes with a large group of expectant couples at the birth center, I opened the discussion up for further questions. We had spent our 10 hours together by learning a handful of pain coping practices including Breath Awareness, working with our senses and embracing distractions, vocalization during labor…covering countless tips on navigating the culture of birth today, ways to connect with our endurance, a birth art process to move beyond some of our birth worries…Giving book recommendations and local resources… One soon to be mom asks, “Well, do you have and tips on how we can actually prepare for labor?”

Really?....Where are the dots not connecting? Where is the disconnect between preparing for the past 5 weeks and practicing what we’ve learned, and accepting the uncertainties which accompany labor and birth?

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At the end of a birth class individualized for a couple I’ll be doulaing for in the fall, after hours of teaching and mentoring pain coping practices, psychological preparation tools, and tips on fetal positioning during pregnancy, the father asks, “You’ve taught us how to mentally prepare for the pain…but what about actually dealing with the pain?”

Really? Where are the dots not connecting? Where is the disconnect between the psychological mindset required of natural birth and the physiological preparation for the event? Is it me? Do I need to spell out that labor can in no way be predicted?

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During a prenatal doula appointment with a soon to be mom we took some time to talk about pain coping practices after we had gone over some of her birth preferences, namely for a natural birth without medical support including pain medication. After teaching Breath Awareness using “ice contractions”, and Non Focused Awareness, which allows us to use our senses and our breath to embrace distractions and our environment, she seemed to become frustrated. “So far all I’ve learned is that I need to breath. What about the Pain??”

Again I picture a connect-the-dot puzzle and wonder where the disconnect is between inward focus and mental stillness and coping with labor’s uncertainty. The father, bless his heart, asked if labor could be reduced to a certain number of contractions, i.e. if there was a study done on the average number of contractions in an average labor, could he not keep track of the number his wife had so he would be able to predict when she was halfway done. Wow, if only! That would certainly lead us to some certainty. Uh uh. Nothing nice and neat and predictable about labor!

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I sat with these experiences, frustrated at my role as a Birth Mentor, in gently leading couples toward their own knowing. How could I really offer them help in preparing for their labor, when I could offer no certainty at all? As typical in my existence within the Universe, that very week I was invited to participate in a Birthing From Within monthly phone conference titled “Working With Uncertainty in Labor and Birth”. We were discussing a book called “Uncertainty: Turning Fear and Doubt into Fuel for Brilliance” by Jonathan Fields. In his book, he says that when we are uncertain of an outcome, we are living in creativity. Uncertainty causes anxiety and fear. Why? One reason is that our brains are hardwired to avoid this fear and anxiety. Adrenaline is released, we’re ready for fight or flight, and in a nutshell, generally feels bad.

But the other reason is purely our fear of judgment. This judgment comes from ourselves and from others. We fear judgment and so we choose the more certain decision, the less risky choice. If we bridge this to birth, we have a culture of women making choices to avoid judgment, to choose certainty. Scheduled Cesarean? Predictable. However in teaching about natural birth, it is impossible and foolish to make any promise of certainty. I cannot be certain about the intensity of your labor, how you will judge the pain, or how long your labor will last. As Pam England wisely said, and I’m paraphrasing here, birth is a series of hurdles and decisions that we cannot predict. Should we stay on this course? Change course? It’s quite complex. So I sit with numerous couples desiring a natural birth, without the mental or emotional tole