Map

Baseline: Parent’s Initial Response to Holding Ice

Before teaching parents any of the pain-coping practices, get their “baseline” response to holding ice, so that they have something to compare their pain-coping experiences to.

(This is done right before you first introduce Breath Awareness; you do not need to re-do the baseline for subsequent pain-coping practices.) 

Set up for Breath Awareness (ice, bowls, towels, etc. – see the Breath Awareness map).

Explain the process:

• When you ring the bell, parents will pick up ice in one hand and grip it.

• While holding the ice, they will focus on what they are feeling – how does it feel to hold ice? Note both physical and mental effects.

• They will do their best to refrain from using any coping techniques that they are already familiar with, or that come to them in the moment. This is not a time to cope, but to instead really feel the experience.

• You may wish to note that you may be talking or asking questions during the process, and that they can answer in their minds – you will discuss out loud together afterwards.

• When you ring the bell again about a minute later, they will put the ice down.

Hold the ice:

• Ring them into the contraction, and check to be sure that everyone has picked up the ice and is gripping it.

• Through the minute, consider giving occasional prompts to help them stay with the experience. “What do you feel?” “Is the sensation staying in one place? Is it traveling? Is it manifesting in other parts of your body?” “What do you find yourself wanting to do or say?”

• Towards the end of the minute, prompt them to “Notice how your mind looks for a way out.”

Discussion:

• Open with a prompt that invites them to focus on sensations and thoughts (rather than whether they “liked” it or not, etc.). “What did you feel in your body?” “What is it like to hold ice for a minute?” “What did you find yourself thinking?”

• If someone reports that the ice didn’t really cause them any discomfort, don’t treat it like a problem. (“Oh, good! Now we know that we need to try some modifications for you!”) Some time before you begin Breath Awareness, make sure that they understand that it’s important that the ice offer some sort of significant resistance, and make suggestions about how they can make that happen. Some ideas for modifications are to hold the ice with two hands instead of one, holding the ice against their wrist, or another more sensitive part of the body, etc.).

• If someone reports that they couldn’t help but employ some coping techniques, validate. (“Isn’t it amazing how our bodies and minds move to help us? Coping comes naturally to us.” etc.)

• Invite parents to specifically describe how they were “looking for a way out.”

Pain vs. Suffering:

• You can note that the experience of focusing on the ice for a minute was a small sample of what we mean by “suffering.”

• Using your own words, experience, metaphors or anecdotes, talk with parents about the difference between “pain,” a physiological event, and “suffering,” the story our minds tell ourselves about the event, or the negative mental chatter that our minds create in response to the event. The mind’s stories can be varied and creative! 

• Acknowledge that it is common for people to want to avoid the word "pain"in thinking about childbirth. Validate the reasoning behind this – the positive intention to not obsess over what seems like negative things. However, the truth is that while painless childbirth can occur, it’s so rare that it’s not really our expectation, and what makes it happen is largely out of our control. More importantly, no matter what, we expect that, at some point, the perinatal process will bring birthing people and their partners intensity that is extreme enough to feel unpleasant or unwished-for. So, rather than make an issue of pain, or unpleasant intensity, we want to focus on the part over which we have a little more control: the suffering, which is something that we actually can affect with coping techniques.

• You might consider talking about the Buddhist concept of “monkey mind,” a metaphor to describe the mental chatter that we sometimes produce, usually involuntarily, in response to various experiences. (Do a little reading about this if you’re interested in raising the topic in this conversation.)

• When we really follow and get invested in the stories our minds create, we have entered the suffering realm. Suffering is all the “stuff” that is wrapped around the sensation. It’s all the things we tell ourselves about how much we can take, how prepared we were, whose fault it is, how long it will last, how much worse it will get, how it would be better or more bearable if only xyz, and on and on. These are habits that have  been cultivated for a lifetime; they are not “bad” per se, but they may not serve us well in the birth process.

• We are going to spend some time exploring techniques that may give us a wider range of possibilities in how we interact with the birth experience. When we practice these techniques enough for them to become new habits, we are more likely to be able to reach for them and use them when we are under pressure (as in labor).

• After processing the experience with parents, move right into Breath Awareness.