The Mindful Doula: Supporting Mamas One Breath at a Time

As a doula I always understood the mind-body connection during birth, and how the breath supports and helps a woman’s body with the contractions and the downward movement of the baby.

As I started to explore mindfulness and it’s use in birth I noticed that this idea is not one that is well understood by many mamas-to-be, partners, or even doulas. I was surprised to hear that some doulas never talked about how the breath impacts the birth process and how the nervous system reacts to stressful situations.

There’s nothing complicated about this practice and there’s nothing weird about it either. Often times mamas and doulas become frustrated with where to start with mindfulness because it seems like a foreign  or trendy concept. The truth is that the only place to look is in your own body. We all have the natural ability to use mindfulness because we can breathe and we can pay attention to our breathing.

First off, just pay close attention to your breathing right now. Does it make a sound, is it shallow or deep, where does your breathing originate and can you follow its trajectory? Are you a chest breather or a belly breather?

Second, focus your attention to your breath and begin breathing in more deeply and notice how with every breath you become more and more relaxed. Now where is your breathing located? Most likely your breathing in coming from your belly. If it is, good job! Belly breathing is the best way to access your vagus nerve which is connected to your brain stem down to your abdomen We can soothe our vagus nerve by breathing deeply and relaxing. When we breathe and we relax we also activate our parasympathetic nervous system.

The VEGAS what?!

Vagus: Pronouced “vay-gus”

For those of you who are more scientifically minded here is a quick and dirty breakdown of how our breathing impacts the bodies nervous system and how it directly impacts a pregnant woman’s experience during childbirth.

The vagus nerve helps to regulate the heart beat, control muscle movement, keep a person breathing, and to transmit a variety of chemicals through the body. It is also responsible for keeping the digestive tract in working order, contracting the muscles of the stomach and intestines to help process food, and sending back information about what is being digested and what the body is getting out of it. When the vagus nerve is stimulated, the response is often a reduction in heart-rate or breathing.

Your breathing pattern is directly connected to your autonomic nervous system. The autonomic nervous system is broken down in to two separate systems, the parasympathetic and sympathetic nervous systems.

The parasympathetic nervous system is responsible for responsible for stimulation of “rest-and-digest” or “feed and breed” activities that occur when the body is at rest, especially after eating, including arousal, salivation, tears, urination, and digestion. This is your chill-out mode. This is where we should all strive to be.

The sympathetic nervous system is responsible for stimulating activities associated with the fight or flight response. It dilates pupils, increases heart rate, pumps more blood into your heart, circulates adrenaline, activates sweat glands, and slows down your need to urinate and your digestion. Basically this is stress out- freak out mode. Sadly, most people live here permanently which significantly impacts overall health (but that topic is for another day).

Now, let’s imagine that you are in the hospital with the woman who is about to give birth. She is dripping in sweat, screaming in pain, she is yelling at her partner and the nurse just came in to tell her that they can’t give her an epidural yet because it’s too early or if she’s birthing at home, imagine the midwife just called and said she was stuck in traffic. What is her nervous system doing?  Not to mention what is happening to her body is directly impacting her babies reaction. Mama freaks out, baby freaks out.

Answer: She is on Sympathetic over-drive. Her breathing is shallow, her pupils are dilated because the baby is coming and she is in pain. Mama is in fight or flight mode.

How do you as the doula get her to activate her parasympathetic nervous system? How do you get her to come down from her fight or flight mode? How do you use her breathing to get her to calm down? How do you as a doula get her to be in the present moment, while calmly acknowledging and accepting her feelings, thoughts, and bodily sensations?

Things you can do to support her:

1. Ask her to look at you and match her breathing with yours (slow, steady breathing).

2. Help her find a word(s) that helps her and have her focus on that word during each contraction (I am strong, I can do this….).

3. Remind her that after this one contraction she gets a break. Don’t let her use up her break with a freak out. Instead help her realize that after the contraction comes a moment of peace and stillness.

4. Remind her that each contraction means she is closer to meeting her beloved baby.

5. Use walking, pacing of the room can help her see her experience from a different perspective. Open a window, or open the shades, change the lighting in the space or light some candles.

6. Her senses are extremely heightened. Bring in her favorite flowers, a plush pair of slippers or some essential oils and give her a light hand or foot massage or draw a bath for her.

7. One of the most important things you can do is to remind her that she will be okay, remind her how well she is doing. Praise her for her ability endure and remind her that her body is strong and knows exactly what it needs to do.

8. Sometimes as doulas we can come across mama’s who place judgment on themselves for choosing a hospital birth, home birth, midwife, epidural, c-section, whatever the case you job is to help her re-focus that attention back to her experience because it is unique and special. Remind her that her experience is her own and bring it back to her breathing.

As doulas our job is to help women feel comforted and supported. Using the breath mindfully we can help enhance a mothers experience by changing her perspective on pain.  This is not to say that the “pain” of childbirth will disappear, but instead staying in panic mode the goal is to have her notice that for every moment of pain there is a moment of peace. And each contraction gets her one step closer to meeting her beautiful baby.

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