Preparing for childbirth: The delicate dance between pushing out and letting go

Observing a friend struggling with, and complaining about, the last days of her pregnancy –constantly posting on Facebook about how she finally wanted her baby to make an appearance in the “real world,” listing details about all the activities she undertook in order to make this happen ASAP — made me reflect on the delicate dance that childbirth is. 

I get it. I’ve been there.

Ready to Push?

Feeling big — no, huge! Not being able to see my toes anymore, let alone tie my shoelaces. Feeling very swollen in the summer heat and out of breath after walking up the stairs to our apartment on the 4th floor. Rolling around on the mat in my prenatal yoga class feeling like a huge whale. Nights spent sleepless with heartburn, an active baby in the belly, and a bladder that never wanted to go to sleep.  

And then, there is all the excitement about finally getting to meet this tiny human being that you have lovingly and patiently grown in your belly for all these long months. The excitement about becoming a parent — for the first, second, third… time. There are all the people around you, asking when the baby is due — which does not really help or make waiting any easier — and so many other good reasons to finally push the baby out of your belly and into the world. 

But First…  

But there is another side to the story, which tends to be forgotten or at least does not enjoy a lot of spotlight.

A more delicate, more sensitive — even darker — side that might not be as limelight-worthy or Facebook post-worthy…a side, which in my opinion, is just as important as the “push side.”

It is the side that mindfully focuses on letting go.

On gentleness, on feeling, on making space for the baby to come into this world…and making space for what is to come and follow.

On becoming aware of and consciously reflecting what is transpiring inside of us: physically, spiritually, and emotionally. 

Facing Our Feelings

This includes facing our anxieties and deepest fears and doubts about birth and about parenthood, about our ability to “do a good job” at delivering and then protecting, nurturing, and growing this delicate, wonderful new being that we already love more than we could have ever imagined. It may also include acknowledging and confronting our fear of failure, our fear of pain, our fear of loss, and our fear of fear. 

Furthermore, it includes facing the reality that things are (again!) about to change tremendously. That not only our everyday life is about to get the next big overhaul, but also our whole universe: The way we relate to the world, and the way we relate to ourselves is going to drastically change.

It includes coping with our bodies changing — yet again — from the pregnant state to a postpartum state, which will look and feel very different from what we are accustomed to and from what we might actually enjoy or expect seeing and feeling. We might feel empty, tired, depleted, sore, and possibly a far cry from attractive and sexy for quite a while.  

I vividly remember mourning my “empty“ belly for several days following my daughter’s birth. It felt empty and somewhat sad to not feel my baby inside my belly anymore. While I was certainly very happy to finally be able to hold her and cuddle up with her in my arms, I missed this innate and exclusive feeling of connection to her.  

Bringing Together the ‘Pushing Out’ and the ‘Letting Go’

I believe that, in order to consciously and mindfully prepare for birthing our child, it is important to take the time to look at and ideally merge both sides of the equation: the “pushing out” and the “letting go.”  

The tiredness of being pregnant and the energetic eagerness to have baby out of my belly have certainly helped me tremendously in getting over my fear of giving birth and all the pain that would be — and certainly was — involved. However, being mindful, open, and receptive to the side of letting go, creating space, and facing anxiety, doubt and fear — even mourning during this transition — has certainly proven to be very helpful as well. I believe it might be one supportive part in the puzzle of alleviating or possibly even preventing feelings of the “baby blues.” 

So, I’m calling on all expecting moms: Take a deep breath and give yourself a mindful moment — and ideally many more — and some space to merge both ends of the continuum. By doing this, you will be giving your body, mind, and spirit a chance to holistically and soulfully prepare for what is to come instead of forcing it into birthing-action mode.

Photo source

Birth education matters

By Lysa Parker and Barbara Nicholson, cofounders of Attachment Parenting International and coauthors of Attached at the Heart

lysa parker

It’s important to remember that a one-time class at a local hospital won’t come close to giving you all the important information you need to be prepared for childbirth.

For the best birth outcomes, parents need to be informed and active participants in all decisions that have to be made, as well as the birth.

barbara nicholsonTo encourage positive birth outcomes, Lamaze International has identified six care practices, adapted from the World Health Organization, that promote, support and protect normal birth. When adopted, these care practices can have a profound effect: instilling confidence in the mother and facilitating a process that results in an active, healthy baby. These care practice include:

  1. Labor Begins on Its Own — Labor is a set of complex, interacting components. Alteration of the natural process can expose a woman and her baby to unneeded risks.
  2. Freedom of Movement throughout Labor — Free movement during labor allows a woman to tolerate contractions and assist the baby’s rotation and movement through the pelvis.
  3. Continuous Labor Support — Current research supports the benefits of continuous emotional and physical support during labor.
  4. No Routine Interventions — Supporting the natural, normal, physiologic process of birth requires clear medical indications prior to any medical intervention.
  5. Spontaneous Pushing in Upright or Gravity-Neutral Positions — Allowing a woman to find the positions of comfort and encouraging her to push in response to what she is feeling is beneficial to the birth process.
  6. No Separation of Mother and Baby, with Unlimited Opportunities for Breastfeeding — When a baby is kept with the mother, there are physiological benefits to both, including the facilitation of breastfeeding.

Lamaze International recommends that care providers, hospitals and birth centers adopt these six practices as standards of care and encourages women and their families to choose care providers and birth settings that employ care practices that promote, support and protect normal birth.

In 1972, a study was published in the book, Why Natural Childbirth? The author, Dr. Deborah Tanzer, was a student of Dr. Abraham Maslow, the theorist who developed the Hierarchy of Needs scale and the theory of the “peak experience,” which he defined what makes life worthwhile and gives it meaning.

Dr. Tanzer was curious about mothers who were delivering babies by the then-“new” method of natural childbirth, which was being touted as a rapturous experience by some mothers.

In her studies, Dr. Tanzer found that as soon as the natural childbirth classes were completed, the women who had taken them showed greatly improved attitudes toward their pregnancies. Five times as many women reporting positive emotions after the birth had taken the childbirth classes.

Another important finding was that the childbirth class takers felt they were much closer to being the type of people they wanted to be. In other words, their self-images were enhanced.

Ironically, the childbirth class takers — most of whom had little-to-no analgesia — reported significantly less pain than the non-childbirth class takers. Almost equal numbers of the two groups reported high pain, but the childbirth class takers outnumbered non-childbirth class takers by eight to one in registering low pain.

The issue that greatly interested Dr. Tanzer was the experience of a peak or rapturous experience. No one in the group that did not take the childbirth classes reported this kind of ecstatic experience, but 10 of the takers in this study did. Overwhelmingly, it was the women whose husbands or partners were with them at both labor and delivery who reported a peak experience.

In summary, here are some of the key points from her research:

  • Certain fears, feelings, fantasies, needs and responses seem to be common to all women.
  • By the introduction of natural childbirth, the character of the total birth experience is changed radically and in a highly positive direction.
  • These differences in childbirth experiences included how the mother viewed herself, the baby and the meaning of the experience. The women in the natural childbirth group emerged happier and healthier.
  • The biggest and most positive differences became apparent in the later stages of labor and during the actual birth of the baby, when the woman could begin to push and thus help to expel the baby.

The act of pushing, sense of meaningful activity, participation in the great drama of the delivery room, ability to welcome her new child in full consciousness, joy in accomplishment — these seem to be the truly important facets of natural childbirth and, for these mothers, were the ultimate in a “peak experience.”

Interestingly, we’ve talked to many women through the years who attended natural childbirth classes, yet for various reasons did not have the “perfect birth” experience that they had wanted. Those women seem to have an easier time dealing with their disappointment than those who wonder what might have happened if they had been more prepared.

It seems to be harder on a mother to accept a disappointing or difficult birth when she was not informed enough about the process of labor and delivery, and the doctor was allowed to make all the decisions.

We feel strongly that birth is such a transformative and empowering experience that each pregnant mother deserves to have the best information, enabling her to make the best decisions for her and her baby. The critical time to gather this information is well before the birth.

Letters, Labyrinths, and Love

This post was originally published on

At 27 weeks into my pregnancy, I started my letter to him.

I didn’t yet know I was carrying a boy. My husband and I had picked out names, but we decided to wait until the birth to know the sex of our baby. So, I addressed my letter to “Dearest Baby Glenn,” and the words poured forth.

I’ve always loved to write. I love the romance between pen and paper, dreams and words. Ideas and letters mingle and merge in me. At my Mormon baptismal celebration, my beloved Aunt Kris presented me with a journal and encouraged my eight-year-old self to write. I’ve filled over fifty books since. I find writing a deeply spiritual path.

Writing to my son added a profound dimension to this practice. I try to imagine how time will bend on an unbeknownst future day when he will read my words. What will it be like for him to see into his early years and into his mother’s heart?

I’ll always remember where I was when I began writing his letter.

Before I knew I was pregnant, I had accepted a teaching job at a private, bilingual school in Bogota, Colombia. My husband and I decided to stay the course of the adventure even as our first child grew inside of me.

I remember the sunlight pouring through my floor-to-ceiling classroom windows. I gazed at the Andes Mountains. My round belly inspired me. I placed my hands on my body and imagined the growing being within. The call to begin writing to this child came from a fiercely impatient muse. My heart was expanding with a love that my mind could not fathom. I closed my work inbox, opened up a blank Word document, and I began to type.

“Dearest Baby Glenn,

Soon I will know if I should address these reflections to Maline or to Taber. However, on the most fundamental level it doesn´t matter. You matter. My love for you matters. Your development, health, strength, inner spirit, beauty, and wonder matter.

I can´t express how much I love you. You are now a permanent part of my heart. I think of you each day and night. I feel you kick and dance and move with joy. I love you, dear baby. You are my child, and I promise to always give you my best efforts and energy as I move into motherhood. … ”

I continue to add to this growing 85-page letter.

I detail milestones, magical moments, and the struggles and hopes of our little family. I share with my son, Taber, my vision for the world. I explain why we choose to spend time outside rather than in front of a television. I write about the day he drew a circle with a crayon, proudly saying, “Moon!”

Composing this letter helps me mother with a deeper sense of wonder, grace, and gratitude. Putting into words the prayers and hopes I have for this child, reminds me of what matters most in life. I want Taber to love this world and her people. I want him to grow up to be courageous, kind, and strong. Most importantly, I want him to know he is loved. Deeply. Truly. Fiercely. Freely.



In Roman mythology, Theseus volunteers to kill the evil Minotaur responsible for the deaths of many brave Athenian youth. The hero enters a dangerous labyrinth to accomplish this task. His beloved Ariadne gives him a sacred thread so he can find his way out of the confusing maze. May our words as parents be revivifying and inspiring to our children. May they carry sacred power and become like Ariadne’s thread offering guidance when our children navigate life’s challenging labyrinths.

Theseus emerges victorious. May our children do the same.

Preserving Bonds at Birth: Scent and Smell

Sometimes, life-saving and injury-preventing medical interventions are necessary for the best birth outcome. Always consult with a trusted and qualified midwife or obstetrician when planning your birth experience. 

I thought about naming this series ‘Bonding at Birth’, but realized that wasn’t an accurate depiction of what happens at birth. The fact is, you and your baby already have a bond at birth. Your baby has spent 9 months in the womb listening to you and your partner’s voice, knowing the sound and tempo of your heartbeat, and living to the rhythm of your lifestyle.

Birth is a transition in your bond, and instead of thinking of it as “the moment” a bond begins, I like to think of it as crucial moments in which a bond must be carefully preserved and a transition in your relationship honored.

Why Bonds Need Preserving

We often think of birth as a series of events: pregnancy, labor, and birth. But, birth is much more than that. To quote midwife Carla Hartley, “Birth is more chemical than it is mechanical.”

Birth is a physiological process that should be left alone when possible. Any non-medical intervention alters the natural state of birth, interfering with the process and complicating things which may have otherwise remained uncomplicated.

Most women have a natural instinct after birth for a quiet, calm environment where they can meet their baby and make the transition from bonding in the womb to bonding “in person”. This type of environment allows the mother and baby close contact, with little interruption, and an exchange of scents, smells, noises, and intimate bonding activities including breastfeeding.

The Role of Scent and Smell in Birth

Scents and smell play a crucial role in birth and in the moments just after birth, both in the transitional bond and in safety. Your baby is comforted by your scent. Your scent plays a role in your baby bonding deeply to you after birth and facilitates breastfeeding.

Research is clear that each mother has a distinct breast odor that can be identified by her baby. This identification, which takes place in both you and your baby’s olfactory system memory, is a crucial part of the mother infant bond and in normal development of your baby.

Scent and smell is not only crucial for your baby. Your ability to smell your baby after birth can also play a major role in preventing postpartum complications, including postpartum hemorrhage.

Biologically, we are designed as mammals to “identify” our babies after birth. Your olfactory and limbic system are waiting for cues that it’s time to proceed to the next step in the physiological process. The smell of your baby let’s your body know that it’s time for oxytocin to be released so that your uterus can contract properly after birth.

How to Preserve Scent and Smell at Birth

Anything that interferes with the ability for you and your baby to smell each other after birth can interfere with bonding and biological cues. So, what can you do to preserve that bond?

Firstly, make sure that your birth attendants and support persons recognize the importance of these factors play during the moments postpartum. A quiet, calm, intimate environment should be created for you and your baby as much as possible.

Your baby should be allowed to stay in your arms as much as possible after the birth, while touching and “checking” by others should be kept to a minimum.

Tips for After Birth:

  • Don’t put a hat on your newborn. It can interfere with scent exchange, and there is not science to support the use of infant hats to regulate body temperature.
  • Stay skin to skin (no clothes) as much as possible. Put a blanket over you and baby if warmth is needed.
  • Allow your baby to explore the breast and breastfeed for the first time without pressure.
  • Avoid bathing your baby for as long as you are comfortable. Bathing washes away the natural scent of your newborn.

Remember, there is a reason our babies are born naked and covered in the scent of birth.

I know that the perfect conditions for bonding will not exist at every birth. When interventions are needed, you can still take steps to preserve as much of the biologically normal bonding process as you can.

Choosing Midwifery Care

Long before I was pregnant, I knew that I wanted to have midwifery care. It was the first decision I made in preparation for pregnancy and birth. Now, looking back as the mother of a 5 1/2-year-old and a 2-year-old, I’m glad that I made that decision. I’ve had two midwife-attended births, and I would choose to have another if I became pregnant again.

I made the choice to seek midwifery care for a few reasons. I wanted to get to know my health care provider, and choosing a midwife team allowed that. My midwives worked in pairs, and I became well-acquainted with both of them through prenatal visits. When I gave birth, it was with someone I knew and trusted. I had a goal of giving birth without medications, and with few or no interventions, and my midwives supported that. And I wanted to be involved in my own care. My midwives’ policy of informed consent, coupled with their hour-long prenatal appointments, ensured that I was able to make my voice heard.

More conclusive results

When I wanted to know more about routine newborn procedures, my midwives took the time to answer my questions, and help me make the decision that was best for me. When I decided to forgo certain tests, and request others, they worked with me. I felt that I was part of a team, working together to ensure not only that my baby and I were healthy, but that we were really cared for.

Where I live, midwives are licensed and regulated. They are covered under our public health care system, in the same way that doctors are. They attend home births or hospital births, and offer follow-up visits at your home in the days after birth. I realize that this is not the case for everyone, and that different medical systems may lead to different choices. But I feel fortunate that my midwifery care was covered in the same way that any other prenatal care would have been covered. I was free to choose my care provider based on what was best for me.

Looking pregnant at 24 weeks

Sometimes, complications arise that require midwives to refer their clients to an obstetrician. This happened during my first birth, when I went into labor at 34 weeks. But even in that high-risk situation, my midwives stayed with me as I gave birth, and provided follow-up care after my baby was born. They referred me, and I had an obstetrician, but they didn’t leave me. It meant so much to have them there to help me and advocate for me as I faced a very medicalized birth situation.

I am not sure where life will lead my children. But I know that they both got their starts with the help of some amazing midwives. I am so thankful to those women who stood with me, and guided me through my entry into motherhood.

Have you used midwifery care? Is it an option where you live? And what is important to you when you’re choosing a care provider for pregnancy and birth? I’d love to hear!

What Makes for a Positive Birth Experience?

My two children were both born in midwife-attended hospital births. I opted against using epidural anesthesia for a number of reasons. But the biggest factor, for me, was that with excellent support and relatively short labors I found the discomfort manageable. I trusted my husband and the midwives who were there with me. Looking back, I feel quite satisfied with my birth experiences.

Recently, a study was released comparing several indicators of childbirth in Canada. One of the findings showed that my home province of British Columbia has one of the lowest epidural rates in the country, at just 30% of vaginal births. There were varying reactions to this statistic. Some people suggested it indicates a shortage of anesthesiologists, and others were concerned that women who requested epidurals were being denied. The truth is, we don’t really know. Epidural rates vary for many reasons, including local economic and education levels.

Smiling between contractions
Smiling in between contractions during my second birth

In the absence of a clear reason, it can be tempting to conjecture. I have my own ideas as to what might be up, too. But I really think that is beside the point. What is most interesting to me is not how many women opt for epidurals – it’s how women feel about their birth experience.

One study reviewed of 137 factors affecting women’s satisfaction with childbirth, and 4 stood out: personal expectations, the amount of support from caregivers, the quality of the caregiver-patient relationship and involvement in decision making. These factors overrode age, socioeconomic status, ethnicity, childbirth preparation, the physical birth environment, pain, immobility, medical interventions and continuity of care. It seems most mothers are more concerned with having people around us who we like, who involve us in decisions, honor our preferences and support us through the process than the epidural rate, specifically.

Baby Jacob
The first photo of baby Jacob, approximately 30 minutes later

One of the principles of Attachment Parenting International is “Prepare for Pregnancy, Birth, and Parenting.” This includes exploring different types of healthcare providers and birthing options, including natural birth and home birth. It includes being alert and physically active during birth, and trusting in your body’s ability to birth. It includes being involved in decisions surrounding birth, and possibly hiring a birth doula. All of these recommendations can help to ensure that we can make informed decisions, and find the support that we need to honor those decisions.

We can’t really say exactly how any birth will go. But if we take the time to prepare ourselves, and find good support, we can maximize our chances of having a positive birth experience, while still ensuring that both mother and baby are safe and healthy.

What do you think makes for a positive birth experience? Please share!

You can read more about Amber’s daily adventures with the two children she birthed on her blog at

Overcoming Isolation When a Baby Arrives

Welcoming your first baby is a very overwhelming experience for many parents. In North American culture very few of us spend much time around newborns until we have our own. I probably clocked in about 17 minutes total holding other people’s new arrivals before my daughter was born. Most of us just don’t see a lot of babies in our daily lives.

Many of us live far away from our families of origin these days. This means that when our babies arrive, they often arrive to a largely empty house. Most fathers don’t get much (or any) time off following their child’s birth, so new moms find themselves at home alone with their babies pretty soon after giving birth. The adjustment came as a big shock to me, and I think it does to many working moms. I was accustomed to spending my days in an office environment. There was order and a schedule and treat time on Wednesdays. In the span of a few weeks it was just me and a tiny baby and I felt totally lost.

This experience of isolation with a newborn is pretty common, but I this is not the way it was meant to be. If we examine the postpartum practices of traditional cultures, for instance, we see a very different story. Most traditional societies held that in the first 30-40 days of life the mother and baby were vulnerable and required special protection. They stayed at home, in bed, and the mother ate special foods, prepared for her by other women. There were rites of passage, and special rituals marked the completion of this confinement period. Mothers were not alone with their newborns, struggling to find some lunch.

Family of three
My husband Jon and I with our newborn daughter, Hannah
Continue reading Overcoming Isolation When a Baby Arrives

Ina May Gaskin to Discuss Birth on API Live

Ina May Gaskin, author of Spiritual Midwifery and Ina May’s Guide to Childbirth, will be joining API Co-Founder and co-author of Attached at the Heart Barbara Nicholson and former NBC anchor Lu Hanessian on API Live on July 27, 2009. Gaskin will be speaking on the topic ”Special Delivery”: The Gift of Loving Your Best Birth (and Making Peace with Plan B).

Topics to be covered during the live teleseminar include

  • Knowing your body and your rights
  • How to have your baby with no regrets
  • What you won’t hear in your birthing classes
  • Why we get stuck in the perfect portrait of birth and how it’s not our true goal
  • Why things don’t always turn out the way we wanted them to (and that’s OK too)
  • and MORE

For more information on this event, visit the API Live blog or register for the teleseminar online.