Women's Bodies, Women's Wisdom (100 page)

Talk to your doctor about progesterone. Studies show that this hormone (available in a weekly shot given from weeks sixteen through thirty-six of gestation or as a vaginal suppository) decreases the risk of prematurity.
²⁷
If you’re carrying twins, however, progesterone may not prevent early preterm birth, probably because the causes of early birth in multiples are different.
²⁸

Get psychological support. Studies have shown that psychological support can decrease the rate of premature birth in those who are at increased risk.
²⁹

Use guided imagery. Psychotherapist, author, and guided imagery innovator Belleruth Naparstek, creator of the popular fifty-two-title Time Warner Health Journeys guided imagery audio series and author of
Staying Well with Guided Imagery
(Warner Books, 1994), explains that guided imagery is “a gentle but powerful technique that focuses and directs the imagination.” Although it has been called “visualization” and “mental imagery,” she explains, guided imagery involves not only the visual sense but all of the senses, all of our emotions, and the whole physical body. “It is precisely this body-based focus that makes for its powerful impact,” she notes, referring to studies showing that guided imagery has a positive impact on health, creativity, and performance. “We now know that in many instances even ten minutes of im agery can reduce blood pressure, lower cholesterol and glucose levels in the blood, and heighten short-term immune cell activity,” she says. “And because it results in a kind of natural trance state, it can be considered a form of hypnosis as well.” Belleruth makes hands-down the best imagery CDs on the market. Everything is scientifically chosen and recorded, including the fabulous music. Her CD entitled
The Healthy Pregnancy and Successful Childbirth
is specifically designed to encourage feelings of confidence, support, relaxation, safety, gratitude, and healthy anticipation during pregnancy, as well as labor imagery to ease discomfort, focus breathing, and underline your trust in the divine wisdom of your body. (For more information, see
www.healthjourneys.com

PREVENTING PREECLAMPSIA

Preeclampsia (or toxemia) is a syndrome in which a pregnant woman develops swelling, high blood pressure, and protein in the urine. It’s sometimes referred to as pregnancy-induced hypertension (PIH). Women with kidney disease and preexisting high blood pressure are more susceptible than others. Diabetes also increases susceptibility. Toxemia is a leading cause of prematurity and pregnancy disability. If untreated, it can lead to seizures—the condition is then called eclampsia. No one knows exactly what causes preeclampsia, although there are many theories. In one study, electrodes were placed into the nerves adjacent to the blood vessels of four different types of women: pregnant women with high blood pressure, nonpregnant women with high blood pressure, pregnant women with normal blood pressure, and nonpregnant women with normal blood pressure. The women who had preeclampsia were found to have high sympathetic nervous system activity (more adrenaline in their bloodstream), which resulted in nar rowing of their blood vessels with a subsequent increase in pressure and inflammatory chemicals at the cellular level. It is well known that the sympathetic nervous system is involved with the fight-or-flight response and perceived stress. One of the researchers in this study suggested that the reason why the preeclamptic women’s blood pressure rises is that they have “a defect in the central conflict processing system,” which may increase certain hormone levels that not only contribute to an in crease in blood pressure but may be associated with feelings of anxiety and hostility.
³⁰
I don’t think there’s any such “defect.” Quite simply, these women don’t have the skills or the resources to get their needs met directly. But they can learn them.

Other studies of pregnant women with preeclampsia suggest that they feel less attractive, less loved, and more helpless than do pregnant women without preeclampsia. They may be excessively sensitive to the opinions of others, and orient themselves to what others expect of them. For these women, pregnancy provides an additional crisis that adds stress to their already overstressed lives. Although they view pregnancy as a crisis, they are ill equipped to deal with their emotions about it. They are unable to cope with what they perceive as others’ expecta tions, taking to heart minor criticisms and injustices done to them. However, they do not show externally that any of this bothers them. Instead, their body reflects this stress as an increase in blood pressure.

This is corroborative of the work of Samuel J. Mann, M.D., a hypertension specialist at New York Presbyterian Hospital/Weill Medical College of Cornell University and author of
Healing Hypertension: A
Revolutionary New Approach
(John Wiley, 1999). Dr. Mann has seen thousands of people with all varieties of high blood pressure. Over time he noticed a pattern that was not in keeping with the common view that stress is linked to this condition. In his book, Dr. Mann writes, “Even patients with severe hypertension did not seem more emotionally distressed than others. If anything, they seemed less distressed. Their high blood pressure appeared to be more related to what they did
not
seem to be feeling than to what they
were
feeling.” He began to see that old, unhealed, repressed trauma seemed to be a major culprit in his patients. I certainly agree. Even though pregnancy-induced hypertension is not considered the same as hypertension in the nonpregnant state, I believe that they have much in common. The bottom line is that it is our hidden emotions, the emotions we do not feel, that lead to hypertension (as well as many other physical condi tions).

Not surprisingly, women with preeclampsia frequently have conflicts with their employers, and their blood pressure often rises when they try to negotiate their maternity leave. They often attempt to get everything settled before the delivery. Compared with women without preeclampsia, these women’s emotions manifest physically through the autonomic (subconscious) nervous system: They frequently blush in the face and neck, talk rapidly, and experience rising blood pressure, dizzi ness, and heart palpitations.
³¹
One study showed that women with a set of conditions including excessive weight gain, premature rupture of membranes (one of the leading causes of premature birth), and preeclampsia display high anxiety, social seclusion, and hypochondria compared with controls.
³²
These symptoms can all be thought of as bodily cries for help and support. If a woman understands what it’s like to have a baby in the intensive care nursery, she can begin the process of seeing her own body as the best intensive care space possible for the baby, not to mention the cheapest. And when she begins to name and put her needs first, this is exactly what often happens. A diet that keeps blood sugar stable is also essential. (See
chapter 17
.)

TURNING A BREECH PRESENTATION

Nowhere is the mind-body connection more interesting than in the case of breech presentation, in which the baby is oriented feet or buttocks first instead of headfirst. By the time a woman has reached the thirty-seventh week of pregnancy, her baby will usually have settled into her pelvis in a headfirst position. But 3 percent of the time, it will be feet first or buttocks first. Though breech babies can turn at any time, the estimated likelihood that a baby will spontaneously convert from a breech to a vertex (headfirst) position after thirty-seven weeks of gestation is only 12 percent. If a woman enters labor with her baby in the breech position, she is almost always delivered by cesarean section. Some babies are breech for structural reasons, such as a septum or wall in the uterus that can interfere with the baby’s position. But in the majority of cases, there is no known medical reason for the breech. It’s clear that in some cases the baby is breech because of the tension that the mother holds in the lower area of her body. It has been observed that anxious and fearful women have a higher incidence of breech presentation than do others, attributable to the fact that fear, anxiety, and stress can activate sympathetic mechanisms that result in tightening of the lower uterine segment.
³³
My obstetrician colleague Bethany Hays feels that a baby may be in the breech position because it is trying to get closer to its mother’s heartbeat—to feel more connected to her.

The key to allowing the baby to turn spontaneously is to help the mother release tension in her lower uterine segment. There are a num ber of ways to do this. Some women have found that acupressure works. (see
figure 17
.) I have personally had about a 40 percent success rate teaching mothers a type of bioenergetic breathing, which works to relax the lower abdomen and lower uterine segment, thus allowing the baby to turn. Dr. Hays also reports that if she can get women to relax their lower abdominals, she can often turn the breech with ease. (This manual turning is known as external cephalic version, or ECV.) Dr. Lewis Mehl-Madrona demonstrated that hypnosis can be used to turn breeches, with a success rate of 81 percent—compared to 41 percent for a control group.
³⁴
Dr. Mehl-Madrona has also used hypnosis to decrease C-section rates for those at risk and to decrease use of oxytocin augmentation of labor. (For more information, contact the Association for Pre-and Perinatal Psychology and Health at 707-887-2838 or check the resources on their website,
www.birthpsychology.com
.)

Our Biggest Challenge:
The Collective Emergency Mind-set

Pregnancy is a time when common sense all too often flies out the window, chased by a culture that is out of balance concerning birth. Nowhere is a woman’s connection or loss of connection to her inner guidance more evident than during pregnancy. Suddenly, her body is no longer her own. Her entire extended family feels that it is pregnant, and all of them give her ad vice about what to eat, what to wear, and what to do. I was amazed by how total strangers would approach me when I was pregnant, pat my belly, and offer suggestions. Friends seem to think it their duty to tell pregnant women the worst stories they can think of about cesarean sections, labor pain, and poor outcomes. (This is another example of our dominator culture— glorifying pain and de struction over the life-enhancing qualities potentially available through pregnancy and birth.) I felt blessed to be an obstetrician because I was spared hearing all these horror stories; perhaps people figured that I had been “socialized” by having already learned these horrible stories firsthand. War stories about the rigors of birth are often passed down from generation to generation. Mothers not uncommonly tell their daughters, “Now you’ll see how I suffered with you.”

FIGURE 17:

ACUPUNCTURE OR ACUPRESSURE POINTS TO TURN A BREECH