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CHILDBIRTH WITHOUT FEAR by Grantly Dick-Read, M.D. Summary by Linette Landa February 2005 THEMES: Honoring Motherhood – This is perhaps Dick-Read’s greatest gift with this book Childbirth is not only physical but mental and emotional event The author addresses how the mental condition of the woman affects childbirth in many ways and forms from pregnancy health, to labor and birth to influence on the psyche of the child, to mothering abilities. Spiritual nature of childbirth and Motherhood and author’s spiritual nature in general, e.g.: “The natural reward of the physical achievement of pregnancy and parturition is not only a beloved possession, but an endowment of spiritual force enhancing the receptivity of divine guidance in motherhood. From this inestimable gift emerges the power of mother love, which forms the pattern of the infant’s psyche as surely as mother’s milk fashions its physique.” P 41 “Childbirth is not a physical function. The drama of the physical manifestations has blinded its observers to the truth – the birth of a child is the ultimate phenomenon of a series of spiritual experiences, from fantasy to fact and from fact to fruition. P 42. “Its first cry remains an indelible memory on the mind of a mother; it is the song which carried her upon its wings to an ecstasy mere man seems quite unable to comprehend…No mother and no child should be denied that great mystical association…it is not only advantageous for the immediate present, but it lays a foundation of unity of both body and spirit upon which the whole edifice of mother love will stand.” P 176 “When exhilaration and intense joy are experienced, physical changes occur which are readily diagnosable at sight and strangely infectious. The ecstasy of love that floods the whole personality when the earliest call of a new life awakens a woman to the realization of motherhood is a transport akin to mysticism.” P 179 “Young mothers with no pretension to piety have unhesitatingly told me that they felt the nearness of God, or the presence of a superhuman being at the birth of their child…” 179 Physiological Explanation for Childbirth including where pain comes from, why it need not exist and how to avoid it. a) normal function of the uterus b) Role of the nervous system responsible for muscle expulsion (parasympathetic) and inhibiting constrictions (sympathetic) which cause pain. c) How the mind influences the course of childbirth d) The Fear/Tension/Pain cycle e) Exactly how fear not only causes pain to mother but birth complications for mother and baby Everyone on board should understand and be in agreement of what the whole process is about, and professionals must be very careful what they impart e.g. a) The words expressed by assistants can negatively or positively affect the labor b) A woman can feel guilty if she ends us using pain relief even when it is deemed necessary This is also a handbook on childbearing as Nature intended covering not only the philosophy and physiology of childbirth but pregnancy, diet, relaxation, mental health, exercise, teaching methods, breastfeeding (physical, mental, and emotional aspects), postpartum. Good instructions for Birth Companions (p 222-231+), teachers, midwives/obs in general. Should teach young women about natural childbirth and mothering (to prevent buildup of wrong understanding and fear, misery and discontent.) Emphasis on having pain relief options on hand so mother may choose. Prenatal psychology - Surprised there wasn’t more on this and on the influence of the mother on the baby during pregnancy (one short ref is on p87 and a good one on influence of breastfeeding on p 275). Also, the emphasis for natural childbirth in the book is most concerned with the mother being conscious to experience the exhilaration of motherhood, rather than the baby being conscious and not dulled with drugs. [We are blessed to know so much more now about influence on the baby.] New things I learned: 1) How anemia can negatively influence the course of childbirth such as longer labor, lower pain threshold and slower recovery. 2) That mother’s milk contains practically no iron but the baby’s liver stores it for use during the breastfeeding period. I wonder how long. 3) The natural analgesia of the second stage of labor when a woman focuses in on what is to be done: mind becomes clouded, senses dulled, lowered receptivity to certain stimuli, sleepy relaxation between surges, may make noises 4) How relaxation is a two way street – not only mind affects body but vice versa. A state of muscle relaxation affects a person’s interpretations of what they feel e.g. expulsive actins of the uterus as sensations rather than pain p 313 5) Different types of women need different approaches to teaching: 1) Introspective 2) need sympathy 3) negative, cannot be bothered to make an effort 4) enthusiasts, “plus women” doing to excess 5) calm, level-headed and effective. P 315. Group 3 and 4 cannot be taught relaxation! * Quotes I like: 1) “Nothing disturbs the course of natural labor more than fear. That is a known and well-proved scientific fact.” P 244 2) On handling modern day stresses: “Humanity is in the open; the unseen forces of culture which assail the human mind appear in battle array armed with weapons against which we have no provision. It is impossible to escape their devastating effects. The subtlety of the attack is such that time, place and method are ever-changing. The human mind is as helpless under the 3) 4) 5) 6) 7) 8) 9) ravages of civilization as the primitive fighter is against modern methods of warfare.” P 78 Solution: “Faith eliminates fear.” After 30 yrs of close association with physical and mental derangements of health I am persuaded without a shadow of doubt that, with the exception of unforeseen accidents, the origin of every form of disease, both surgical and medical, whether hereditary or not, can be traced by careful investigation to the influence of fear upon the human mechanism. P 79 “Care in the early first stage lays the foundation of a labor… From the midwife and obstetrician it demands patience, peacefulness and personal interest as well as confidence, concentrated observation and cheerfulness. (2 P’s and 3 C’s) p 222 (Add Birth Companion to this!) The profound importance to the baby of the first 48 hours of its neonatal life does not receive the emphasis which many of us would wish it to have. For my own part, I extend that thought to the development of the mother in the first 48 hours of motherhood.” P 274 “Tense woman; tense cervix; Relaxed woman; relaxed cervix” p 313 There is greater discomfort in childbirth among women who have led sedentary lives than among those who live and work out of doors.: p 334…but “ Without the correct mental attitude toward parturition, no amount of physical training will enable a woman to have her baby naturally.” 335 “Millions are spent each year on educating children, a high percentage of whom have suffered the strain of unnatural birth, whereas a few thousands a year spent on educating mothers might eliminate ab initio the congenital conflicts of the mind…” p366 “Motherhood is the common denominator of international relations; it is the one mutual possession which is shared both in body and soul by women of all races, creeds and colors.” 368 CAN I USE? 1) Natural Childbirth description from Milwaukee p 141. See attached (propose to not include the last 3 of the middle section: Hypnosis, birth control, cult…) 2) Birth Companion tips Chpt 15, p 222 +, 238 +, also chpt 18 p 277 3) Information on relaxation in chpt on Antenatal education – p 313 4) Teaching relaxation – emphasis on physical relaxation and the mind will take care of itself; give 10-15 minutes, go around and check. P 330 5) Chest Expansion, actually Yogic Complete Breath (Triple Breath) in class? * I just experienced a case of this and it was the friend whose birth I was supposed to attend a month ago. She was so confident that it would not be painful, was very happy with the pregnancy and “did everything right” that I am afraid she might not have practiced enough or perhaps as Dick-Read says, couldn’t be taught. Her birth was 19 hours and painful every contraction of the way. She managed to have the birth at home and without any medication but it took such concentration that she couldn’t invite me after all for which she apologized profusely. (Then ended up a week in the hospital anyway with the baby due to meconium infection. The baby is gorgeous and peaceful and will be blessed here at the ashram next week) . . . . WHAT IS NATURAL CHILDBIRTH? Facts You should know . . . . Natural childbirth is… FEARLESS childbirth TRAINED childbirth RELAXED childbirth EASIER childbirth SATISFYING childbirth Especially if a mother is helped to give birth to her baby consciously without too much discomfort, instead of “being delivered” while unconscious. TO PREVENT POSSIBLE MISUNDERSTANDINGS, HERE ARE SOME THINGS NATURAL CHILDBIRTH IS NOT: Natural childbirth is NOT… Necessarily painless childbirth An endurance test. Anesthesia is used if needed or wanted. A failure if anesthetic is used A denial of the achievements of modern obstetrics A step backward A denial of the importance of the doctor for physical care during pregnancy and labor, but a belief that psychological care is also important. Hypnosis Connected with “birth control” or “planned parenthood” A cult, nor does it have any religious, political or racial affiliation or bias. THE PRINCIPLE OF NATURAL CHILDBIRTH IS THAT CHILDBIRTH IS A NATURAL/NORMAL/BODILY FUNCTION And should not cause any discomfort that would be unwillingly borne by a normal, happy mother, who… Has the cooperation and encouragement of her husband, Wants her baby and fearlessly and lovingly welcomes its birth, Is healthy in mind and body, Is prepared in mind and body for the great event of birth, Understands what is happening to her and to her baby during the process, Knows how to relax during labor when this is needed, Knows how to work with the forces of labor when this is needed, and Has kindly and understanding support and encouragement from those who attend her is labor. Prepared by the Natural Childbirth Association of Milwaukee and offered as a service to mothers by La Leche League of Franklin Park; reprinted with their permission in “Childbirth Without Fear - The Principles and Practice of Natural Childbirth” by Grantly Dick-Read, M.D. Second Revised Edition, 1959.