Ideal birth; an image

We've seen all seen it. In the age of social media dominance, you've seen that gorgeous mom with the high top messy bun, eyeliner on point, perfect manicured nails, in a deep squat or on her back with a doting scruffy faced husband with a furrowed brow or bulging eyes at his instantaneous conversion of seeing his wife the sex goddess become his wife....The Godess. She is 40 weeks to the day, maybe even a few days early, she gained 20 pounds exactly, and only in the past 3 weeks gave up her back squats. She delivers naturally; probably in a birthing center. She is only moments away from the perfect latch and perfect milk let down. She will be enchanted by her baby immediately and will step into motherhood with grace. Because of her authoritative physical presence, no one will ask her when she will start watching what she eats. No one will bat an eye when baby sleeps for 9 hours a night after the first week until the baby is 13 years old. The baby will never have a blow out, ear infection, and certainly will never cry every night between the hours of 4:30pm and 8:00pm. She will wait the appropriate 4 hours after birth and her husband will post an image of mother and baby on instagram, and he will say his wife is the strongest woman he's ever met and he is SO in love with his new baby.

Gah, these people are such jerks! Right!?!? Nope. They aren't. They aren't jerks. They are two people that decided to have sex during the fertile phase of the ovulatory cycle, and as a result, she had a baby. Even that is presumptuous. That baby could have been prayed for, for years. That baby could be a rainbow baby. The point is not how other people do pregnancy and birth. The point is that you don't have to do it that way. 

There are general markers of pregnancy; as a whole, consuming a bottle of wine a night is not the best idea. It's a good idea to have a birth leader; be that a midwife, an obstetrician, or your Aunt Lucy. They are way more attuned to the best practices of pregnancy, but the focus here is that you choose. 

When anyone tells me they are pregnant I send them to the same place. It is my favorite place to send people because it is a webpage that offers, "40 questions for your midwife." Most often I send people there and they immediately say something like, "I don't even know what half of those words mean." This isn't meant to overwhelm you or make you feel stupid. This is meant to call you to a higher level of thinking. The questions asked on that page are going to make you ask questions. Hopefully, when you ask those questions, you get answers that make sense and align with what you want. My goal in practice is to empower parents to be as present with their children as possible and in my mind, this starts right with that first pregnancy test, and probably even before. 

Your ideal birth doesn't have here or there, or up or down, or right or wrong. It must be one where mama is comfortable. In my social circles, if I said, "You know, I really want to deliver in a hospital with an epidural." I would be harshly judged. That judgement would come from a place of education and statistically likely outcomes... but it's judgement nonetheless. I'm sure there are social groups that would faint at the idea of an unassisted childbirth; it would appear that the politicians making the rules on all of our births are in that crowd.

As a newb entrepreneur, I've been attending a lot of personal growth/mindset meetings in my community. 75% of them are amazing and worthy of your time, by the way. In those meetings the final, obnoxiously esoteric and yet also applicable recommendation, is to envision your dream. I don't see why birth should be any different.

When you think of birth, what are your first thoughts? I suspect that a solid 1/3 of the people reading this immediately thought of the financial burden. Ok, so let's take that and place it aside. What next? What do you see? I think, because I saw it right when it occurred to me that I might one day go through birth, I think of Katherine Heigl in Knocked Up; again...maybe not the best image.

Who is in the room? Who holds your hand? Does your hand need holding? Are you quiet and still? or panting and dancing and wild? What do the eyes look like of everyone in the room? Are they old and crinkled into anticipatory smiles? Are they wide open to take in every velvety moment? Are you on a bed? Or are you on the floor? Are there medical masks? What are you wearing? Are you wearing a hospital gown? Are you wearing a cute piece of lingerie, like women wear when they need an extra "oomph" of confidence? Are you wearing your spouse's old shirt? Are there windows in the room? What's the weather like outside? Are you inside or outside? When you give that last push, what is the first thing you want your baby to feel? Will a doctor catch your baby in nitrile gloves? Will your baby go from one aquatic environment to another? Will you pull him to the outside world yourself? And then what? Will there be shrills and screams of pleasure and excitement? Or will everything melt down into liquid serenity. Will anyone else exist in those precious moments?

I've been told a million times, "I thought I wanted to sit on the ball: I didn't want to sit on the ball". "I thought I would want my husband to rub my back: If anyone touched me I threw up." It's ok for things to change. It's ok to want to wear something special and then it gets poop or pee or some other bodily function on it and have to change. It's ok to start at home and end up not at home. It's ok to have a birth plan that goes out the window. But that doesn't make the birth plan any less significant. Have someone, or a team of someones with you to help you. If you don't want pitocin, and you are offered pitocin...that's not ok. If you don't want an epidural and you are offered an epidural, that's not ok! If you don't want your husband's sister's mailman in the room, guess what? THEY DON'T COME IN. You are delivering your baby into the world. Anyone else in the room is merely an observer or an accomplice in miracle work. Make sure your company is worthy of the experience; because birth is nothing short of miraculous. 

Chiropractic and Birth

For the sake of this post we will only discuss pelvic floor and mechanistic views of the pelvis for labor and delivery. There is A LOT more at hand, but this is the best entry point for what will later prove to be a pretty complex relationship.

Round Ligaments
These are best described as the ropes that tether the top of a hot air balloon. Before conception, these ligaments sort of hang off the top of uterus like arms. The fibers of the round ligament actually descend so far as the labia majora (external female genitalia). As the uterus expands to accommodate the growing baby, the round ligaments look like the ropes that go over the top of the hot air balloon keeping it on the ground.

This balloon is tethered, and look how roomy it is! This is what we want the uterus to look like. If a woman has a traumatic pelvic trauma like falling off of a bike, falling off of a horse, even some hard falls when she was a baby, these ligaments can have different tensions. This would lead to something like this:

This is an exaggeration, but our goal is to give baby as much room as possible to flip and flop and wiggle around all they want until the time comes to get serious. Then, when it's time to get serious we want baby to engage and exit with as much ease as possible, for mama and baby.

Sacrotuberous ligament
This ligament deserves a regal entry. This dude is the unsung hero of all pregnancy. So, the sacrotuberous ligament makes a lot of things work: it attaches the spine to the leg (sacrum to biceps femoris, aka major player of the hamstrings), it protects the pudendal nerve (responsible for muscle tone in the perineum--wowzas!!), contains branches of the gluteal artery, Similarly to the round ligaments, if a woman has pelvic trauma, this ligament can lose it's flexibility, thus preventing the pelvis from opening properly during labor.

Sacrospinous ligament
The fibers of the sacrospinous ligament are integrated into the sacrotuberous ligament, but this job of this ligament is to essentially create the greater and lesser sciatic foramen. If you have ever been pregnant, and developed sciatic-like nerve pain...this ligament could be a contributing factor. Again, this ligament, as it is so closely related to the sacrotuberous ligament is going to have heavy influence on the pudendal nerve, which is the nerve that helps determine the muscle tone in the perineum; if the perineum is taut, you are more likely to have perineal tearing and postpartum incontinence [1]

Abdominal muscles
The abdominal muscles are an accessory in birth. While the myometrium of the uterus is responsible for the actual contraction, the abdominal muscles are there for backup and extra "oomph". Guess where the insertion of 2/3 of the abdominal muscles are? Either directly on the vertebrae in your spine, or on the tissue that is attached to those vertebrae,

Pelvic girdle
The Pelvic girdle consists of muscles, bones, and ligaments of the pelvis that ideally open symmetrically to allow baby to exit. Pelvic girdle pain is exceptionally common in the last trimester and up to 16 weeks postpartum. Many of the muscles in this area are innervated by the pudendal nerve. Previously we said that the pudendal nerve was closely related to the sacrotuberous ligament, and that between the round ligament, the sacrotuberous ligament, and the abdominal muscles, the attachment sites for all of these are either on the spine or directly to the bones of the pelvis.

So what does Chiropractic have to do with any of this?
Chiropractors who specialize in pregnancy should know how to address all of these ligaments and bones. Our pelvis is responsible for keeping us moving. Think of it in terms of survival; our arms are held on by a flimsy articulation and 4 main muscles. You can lose an arm and still get away from the lion chasing you.Your legs are held on by one solid ball in socket articulation; in our body this is the most stable a joint can get and still move. Beyond that, there are at least 5 ligaments and 4 muscle groups (multiple muscles working together) to keep your leg on; because you need the leg to escape the lion. So then amplify that by a million, when we incorporate a mother's protective reflex, and you begin to realize the significance of this hammock that we make while pregnant.

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279110/