Joyous Childbirth Hygienically

Article #1: Joyous Childbirth, Hygienically by Ralph C. Cinque, D.C.

The process of giving birth is a normal, natural and largely spontaneous activity that shares many similarities with the process of defecating. I make this rather crude comparison not to be needlessly distasteful, but rather to emphasize the point that giving birth is as physiologically ordinary as having a bowel movement. Granted, it is inherently more demanding, more prolonged and more intense, but under normal conditions it is just as certain in its outcome. It calls upon many of the same muscles that are required to defecate. It occasions sensations that are very much like the urge to defecate.

If this is true, why has childbirth become such a traumatic, painful and debilitating event that commonly incurs injury to both mother and infant? Why is it that modern childbirth usually requires some kind of surgical intervention? By this I refer not only to outright surgeries, but also to the various manipulations and forcing measures that are so often employed in so-called “natural childbirths.” It is vitally important to realize that under normal conditions, childbirth requires absolutely no intervention whatsoever. “Catching the baby” should be all the attendant has to do. Performing manual rotations, either internally or externally, manipulating the shoulders, guiding the head, stretching the perineum and other related procedures are in no way a normal part of the birth process. If we consider that humans in the remote past, living in a state of nature, had no understanding of the mechanics or the intricacies of birth and were therefore unable to constructively intervene during labor, we must conclude that Nature intended birth to be an entirely spontaneous process. This is certainly true of animals in the wild, who give birth unassisted. No doubt it was also true for women.

An entirely normal and natural childbirth occurs so rarely in this country that it is actually an oddity. By medical standards, anything less than a Caesarean section or a forceps delivery is considered a “natural” birth. No matter how much pain the woman suffers, no matter how prolonged the labor, no matter how much damage is done to the birth canal, whether or not the infant is battered, whether or not difficulty is encountered in obtaining the placenta and no matter how much meddling is necessary in order to accomplish the birth, as long as a major operation is avoided, the birth is considered “natural.”

I attended a childbirth class once where a woman who had recently given birth at home was relating her experience. It seemed that she had succeeded at having a “natural” childbirth, even though she was in labor for over two days, even though tremendous fundal pressure was finally required in order to expel the infant (this entails pushing downward on the uterus through the abdomen to force the baby through the birth canal), even though she was given injections of pitocin (to stimulate uterine contractions), and despite the fact that extensive tearing occurred. Yet, she did avoid being admitted to the hospital,
and therefore felt that she had indeed accomplished a natural childbirth. Her last comment was that, “it was a wonderful experience and I would encourage any woman to have a natural childbirth at home.” Quite frankly, it all sounded less than wonderful to me and I didn’t see how she could expect the other women to eagerly look forward to such a trying experience.

Natural childbirth and home deliveries are very popular today, and the demand for competent home birth attendants is greater than the supply. “Prepared childbirth” classes are being taught in the homes, schools and even in the hospitals. Thorough preparation, we are told, lessens the risk of complications in labor and delivery. We of the Hygienic School have no argument with this statement, but we insist that the most important aspect of this preparation should be achieving a high level of health. More important than learning the mechanisms of birth, more important than practicing breathing routines, and more important than securing sterile sheets and towels, is the attainment of superb health. If a woman begins labor in poor physical condition, the process of giving birth is apt to be an agonizing and grueling ordeal despite adequate preparation, in the usual sense of the word. In contrast, a woman who knows nothing about birth, but who arrives at term in splendid form and exemplary condition, is likely to have an easy and joyous experience in childbirth.

In saying that health is the most important prerequisite for success in childbirth, we imply that truly adequate preparation must begin well in advance of pregnancy. To stop smoking and drinking (alcohol), to cease eating refined foods, to avoid salt, to shun all drugs, to secure sufficient rest and sleep—these will prove to be highly beneficial to the woman who has conceived. But, why wait until conception to stop injuring yourself and to begin to thoroughly supply your body with its needs? Why not acquire high level health before becoming pregnant and thereby provide your unborn child with a perfect internal environment from the moment of its conception? Waiting until pregnancy begins is often too late to achieve one’s desired health goals. The body does not suddenly become well nourished, suddenly become cleansed or suddenly become physically conditioned. These are physiological processes that take time. Furthermore, pregnancy often limits the full application of Hygienic measures. A pregnant woman cannot fast, except for short periods. Although I know of several women who have fasted for as long as two weeks at the beginning of pregnancy, with good results, I would not advise such fasting in the vast majority of cases. Pregnancy also limits a woman’s prerogative to lose weight and physically condition herself. Building health is something that should be avidly pursued years before conception.

Poor health and poor conditioning cause most of the problems that occur during pregnancy. Pre-eclampsia and eclampsia (toxemia of pregnancy) are the direct result of unhygienic practices during pregnancy. This condition, characterized by some degree of edema (swelling), high blood pressure and albuminuria (protein in the urine) is caused by the consumption of large amounts of protein, particularly animal protein, the use of salt and the ingestion of drugs. I would state unequivocably that it is entirely avoidable in virtually all cases if a Hygienic regime is followed.

Malpositions of the fetus, which can impede or suspend the birth process, can also be related to the overall maternal condition. The fetus may assume a transverse lie (which is impossible to deliver naturally) because the tone of the uterine walls is not adequate to force the head downward. Ordinarily, the uterine muscle supplies enough resistance to allow gravity to draw down the heaviest portion of the fetus, which, of course, is the head. However, when the muscle tone of the uterus is weak, the organ may “give” abnormally, resulting in a transverse position of the fetus. Such incidents are often regarded as “accidents” when they are really a matter of cause and effect.

Dystocia, or prolonged labor, is often the result of cephalopelvic disproportion, wherein the fetus is literally too big to readily negotiate the birth canal. Most often this results from excessive weight gain during pregnancy which produces an overly large infant and an overly fat mother. Hygienists have long emphasized that a small, light infant represents the biological norm for humans at birth, as it does for other animals. A birth weight within the six-pound range is ideal. Yet, today, it is not uncommon to encounter births in which the weight of the newborn is 8, 9 or even 10 pounds. Such oversized, fat-encumbered infants are not healthy. They often injured in the birth process. The tendency toward flabbiness and bloatedness will in some cases persist indefinitely.

Excessive weight gain during pregnancy is the result of overeating. Too much food is generally recommended at natural childbirth classes, particularly in regard to high-protein foods. A pregnant woman actually requires only slightly more food than she would require under ordinary circumstances. If we assume that a woman gains approximately 20 pounds over the course of a normal gestational period of 280 days, this would amount to a weight gain of slightly more than one ounce per day, on the average. How much additional food does it require to gain an ounce a day? Quite obviously, not very much.

There is no reason to overemphasize proteins in the diet of a pregnant woman. The protein density of the fetus is actually less than that of the mother. Assuming that she is eating a diet of whole natural foods, largely or wholly uncooked, she will easily obtain the additional protein she needs by increasing her overall food consumption proportionately. Too much protein places a great stress upon the liver and kidneys. Since a pregnant woman already has the burden of eliminating the fetal waste products in addition to her own, it is foolish to add to this burden by overeating on proteins.

William’s Obstetrics provides the following information about maternal weight gain during pregnancy:

“During a normal pregnancy with a single fetus a weight gain of nearly 18 pounds can be accounted for on the basis of obvious pregnancy-induced physiologic changes. They include an increase of almost 11 pounds of intrauterine contents accounted for by fetus (7 1/2 pounds), placenta (a little over 1 pound), and amniotic fluid (2 pounds), in addition to a maternal contribution of 7 pounds accounted for by increase in the weights of the uterus (2 pounds), blood (3 1/2  pounds), and breasts (1 1/2 pounds). The moderate expansion of the volume of interstitial  fluid  in the pelvis and  lower extremities directly attributable to the increased venous pressure created by the large pregnant uterus is a normal event. In the ambulatory woman it most likely adds 2-3 pounds more. There is, therefore, a physiologic basis for a maternal weight gain of about 20 pounds.”

In the case of a Hygienically-conducted pregnancy with a smaller birth weight infant, these figures would be correspondingly lower. This is particularly true in regard to the amount of maternal fluid retention. Most women experience a slight to moderate degree of edema during pregnancy which has come to be accepted as normal. For a Hygienic woman whose weight is normal before pregnancy, we can assume a gain of about 18 pounds represents the physiological ideal. Yet today we find women gaining 30, 40 and more pounds during pregnancy with the blessings of their physicians. These women are fat, bloated, overly distended and often hypertensive. They experience shortness of breath, backaches, constipation, difficulty sleeping and difficulty walking. During their long and trying labors they suffer tremendously and often require intervention of one kind or another in order to facilitate birth. Malpositions of the fetus (such as occiput posterior) is common among this group. Their babies, too, are fat and bloated. It is impossible to look at these women at term without sharing their distress. A pregnant woman should look absolutely radiant, but these women look tired and disabled. It is no wonder that in modern times pregnancy has come to be regarded as a disease and childbirth as a surgical operation.

Exercise during pregnancy is another controversial issue. All childbirth instructors give their prospective mothers exercises to do, but in most cases these exercises are not  vigorous enough to adequately condition the woman. Doing one or two deep-knee bends and tilting the pelvis in various ways hardly constitutes a thorough physical conditioning program. It behooves every pregnant woman to strengthen the muscles of her abdomen, back, thighs and buttocks. Squatting is an excellent exercise during pregnancy, particularly since women give birth in the squatting or semi-squatting position. Doing 50 or more deep squats with the legs spread and the feet turned out will develop the muscles of the thigh and back while at the same time stretching the adductor muscles on the inside of the thighs. Sit-ups or partial sit-ups will develop the abdominal muscles and these can be done safely throughout pregnancy. It is best to perform this exercise with the knees raised to avoid unnecessary strain on the lower back. Leg lefts can be performed lying on the back either outside on the lawn or indoors on the carpet. This will develop the psoas muscles and the lower abdominal muscles. The adductor muscles can be strengthened by assuming the “lotus” position (feet drawn up, heels together, knees apart). Place your hands on the outside of your knees and then try to lower your knees to the floor as you exert enough resistance with your hands to make it difficult. Having your husband or “labor coach” provide resistance is also a good way of performing this exercise. A good stretching exercise can be performed by holding on to a doorknob with one hand and then swinging the opposite leg and thigh in an arc from side to side like a pendulum. Then the exercise would be repeated on the opposite side. These and other calisthenics should be performed repeatedly in order to achieve a high level of fitness. Walking on all fours (on your hands and feet, not hands and knees) is an excellent exercise that works a broad spectrum of muscle groups. Jogging, bicycling, swimming and brisk walking are outstanding “aerobic” activities and there is no reason why a pregnant woman cannot fully participate in these wholesome sports. Consider what Dr. Bradley says in Husband Coached Childbirth about the prospect of injuring the fetus through vigorous activity:

“Dismiss from your mind the idea that if your pregnant wife fell down skating, skiing, or whatever, that she would hurt her baby. Of course, if she doesn’t know how to fall correctly she can hurt herself—just as she could when she’s not pregnant. In my career I have never known a mother to have harmed a baby by an external trauma. The salt water (amniotic fluid) in which the baby is floating equalizes local pressure.
This idea of falling down and thereby losing a baby is a superstition that probably began with the movie Gone With The Wind. Rhett Butler gave his wife a shove at the top of the stairs. She gracefully tumbled down the stairs and conveniently had a miscarriage at the foot of the stairs. Immediately thereafter doctors’ offices and hospital emergency rooms were mobbed with out-of-wed-lock pregnant women who were battered black-and-blue and sore but still very much pregnant! It won’t work.”

Remember that exercise has a toning effect on involuntary muscles as well as voluntary muscles. A hypotonic uterus, either during or immediately after labor, is not likely to occur in a woman who is in prime athletic condition. So, get out and exercise during pregnancy and gradually acquire the strength, endurance, and flexibility that will serve you admirably during labor and delivery.

The dietary needs of a pregnant woman are not radically different from her needs under ordinary circumstances but the consequences of dietary deficiencies are more profound. An abundance of raw foods should be eaten, including fruits, vegetables, nuts, seeds and sprouts. Green leafy vegetables are particularly important. Two large salads per day should be the rule. An overly restricted diet should be avoided. A woman who has been eating the conventional mixed diet should not abruptly switch to an exclusive diet of raw fruits, nuts and vegetables during pregnancy. Although a completely raw food diet is the ideal, a woman who is unaccustomed to it might not be immediately capable of extracting and assimilating a complete array of nutrients from it.

It is unnecessary and undesirable to saturate oneself with “food supplements” during pregnancy. Large amounts of calcium, in particular, are usually foisted upon pregnant women, ignoring the fact that the skeleton of the fetus is largely cartilaginous.

In Oregon, where I attended home births with a naturopathic doctor I saw several instances of calcific deposits in the placenta. a pathological condition, in every instance, dolomite or some other calcium supplement had been administered. I have never witnessed this in cases where only food comprised the diet of the mother. It is possible that these abnormal calcifications can affect the circulation to the fetus. My advice is to add the dolomite to your garden soil and then grow green leafy vegetables. This will provide calcium in a usable form  that will never cause harm.

There are certain Hygienic considerations that we may wish to note regarding the conduct of labor. For many years, elaborate and complicated breathing patterns were popular among natural childbirth circles. Chief among these was the Lamaze method. Fortunately, these methods are corning into disrepute. Remember that breathing is an automatic process and that whether you are eating, sleeping; running, or giving birth, your body is fully capable of regulating its own respiration. Hyperventilation is the most obvious danger of these forced breathing routines.

Until the cervix is fully effaced and dilated, the woman should simply try to relax. Premature pushing is likely to cause injury to the birth canal and may exert unnecessary pressure on the fetal head. Deep, slow, relaxed breathing is all that is necessary during the first stage. There is no need, however, for the woman to remain recumbent. Dr. Robert Caldeyro-Barcia of the American College of Obstetricians and Gynecologists reported recently that “the efficiency of the contractions is greater in the upright position. The greater efficiency combined with the increased force of gravity, and more advantageous drive angle between the fetal and maternal spines results in significant shortening of the first stage of labor.”

Walking about between contractions during the first stage of labor has a gently stretching effect upon the uterine cervix while it also serves to ease tension on the mother-to-be.

In a Hygienically-managed pregnancy, the most likely consideration during the second stage of labor (the actual expulsion of the baby) is how to avoid a precipitous delivery. It is often necessary to discourage a woman from pushing so as to avoid causing vaginal or perineal tears. Having her lie down also helps to slow down the birth, should this be necessary.

Although it is best to avoid bright lights, it is equally unwise to try to give birth in the dark (or nearly so). A very good friend of mine practically lost his son at birth because dim lighting prevented him from immediately recognizing an asphyxiated condition. Provide enough lighting so that the birth attendant can readily observe the progress of the birth, the condition of the mother and the condition of the infant.

The Leboyer bath has become a very popular adjunct to a natural childbirth. Without objecting to this procedure, I hardly think that it is as indispensable as its proponents would lead us to believe. Why try to stimulate uterine conditions for an infant whom Nature has deemed ready to function in the outside world? It seems to me that being cuddled and carressed on mother’s soft tummy is every bit as reassuring as a bath.

The experience of my dear wife Margaret would serve as a fitting example of the efficiency of Hygienic methods during pregnancy and childbirth. Margaret had a joyous pregnancy during which she engaged in vigorous physical exercise on a daily basis. The very day her labor began she went out running. She experienced no backaches, no nausea, no vomiting, no swelling and no shortness of breath. Her weight gain was 18 pounds. She gave birth naturally at home and from the first true labor contractions to the birth of the placenta, all of 3 1/2 hours elapsed.

She suffered some pain with her first stage contractions but claims that it “felt good” to push the baby out. Mark Shelton Cinque was born at 3:00 a.m. on May 12, 1974, weighing 6 pounds, 4 ounces. He was unusually bright and alert from the moment of his birth, as he has continued to be in the five years he has been with us.