PENNY SIMKIN WORKSHOP

Penny Simkin. The name sounded so familiar. Not because she is Andrew Simkin, the Consul General’s mother, but because she is quoted on the back cover of the book I’m currently reading and reviewing – Birthing From Within by Pam England. To meet her was an opportunity I would not have missed for anything in the world, especially since she was in my town and was conducting a workshop for Childbirth educators. The knowledge she was sharing came free.
People from across India were there. Priyanka from Kochi, Divya Deswal from Noida, Dr Manisha Gogri and Shalini from Mumbai, Dr. Padmini Balagopal, Deepa Santhosh, Rekha Sudarshan, Preethi Rao and me from Chennai were part of the morning session for Childbirth Educators.
The session was a beautiful power point presentation. It began dramatically with the statement One’s past experiences shape the birth.
In any pregnant woman, labour pain is the second greatest concern. The first is the survival of the mother and the baby. Pain is an unpleasant sensory or emotional experience associated with an action that causes or may cause tissue damage.
Neuromatrix Theory:
Pain perceptions and reactions are influenced by:
• Painful stimuli
• Pain modulators
• Past experience and learning
• Present circumstances
Essentially pain has three components:
• Cognitive: evaluative components, cultural learning, past experiences, personality variables along with input from brain (attention, expectations, anxiety, depression)
• Sensory: discriminative
• Motivational
Does exercising actually reduce the pain?
On a mental level, it does bring a different thought process. Two of the doctors present did mention that they found women who had done yoga were better able to give birth than those who had not. They were breathing better, and their bodies were able to cope with the physical changes very well. In fact, Dr. Sooriya SreeKumar said she would instantly know when a labouring woman has exercised and when she has not. She went on to state that older mothers were better in the labour room than those in their 20s. She had come to the workshop after a normal delivery by a 41 year old first time mom.
Suffering and trauma during labour may lead to PTSD (Post Traumatic Stress Disorder). The symptoms are often as follows:
• Staying away from location or people involved. One woman who had a bad birth experience actually drove around blocks so she could avoid passing by the hospital where she had delivered
• Panic attacks
• Emotional stress – they need to talk about it. In many cases they don’t stop and in an equal number they don’t want to at all.
When someone is suspected to be going through PTSD, you need to watch out for fear, panic, mental defeat, disassociation, frustration, depression, and the caregiver needs to take steps to make that person normal again.
A birth plan must be made ready by the 32nd week if not earlier.
Asking yourself between contractions what was going through your mind during contractions?
Coping has constructive responses which are positive or neutral
Distress focuses on fatigue, time tis taking, self doubt, inability.
The 3 Rs of labour are rhythm, ritual and relaxation. Rituals come when she enters labourland. Women discover their won rituals. These can be mental, physical, singing, reciting, breathing, moaning, etc.
Epidurals increase the length of labour. They cause numbness waist down and bring about other discomforts. The labouring woman feels helpless and the baby’s wellbeing is at stake. Often epidurals cause a fever which necessitates the baby to be kept in the nursery and undergo a battery of totally un-required tests.
Penny talked about THE CODE WORD. This is something that is predecided and is a word or a phrase that a woman uses when she needs an epidural.
When a woman is allowed to change positions during labour, the following happens:
• Improved contraction intensity
• Shortened labour
• Less need for pain medication
• Fewer variant Fetal Heart Rate patterns
• Increased maternal autonomy and control
• No harmful medical side effects
As far as possible, Penny recommends doctors do not use the episiotomy route as sometimes it can go really wrong, and the mother can suffer from its after effects throughout her life. She could develop incontinence, a deep infection, etc. At this point Dr Sooriya invited those gathered there to her hospital where most mothers deliver normally without an episiotomy. She talked about how older mothers deliver far easier than young women in their twenties. In fact, just the day before a 41-year-old first time mum had delivered normally in her hospital.
Cutting the cord was another point of discussion. It is best for the baby to wait before the cord stops pulsating to prevent anaemia. Even for stem cell collection, place the baby on the mother – skin to skin contact – wait for two minutes and then cut the cord.
During pregnancy, sing to the baby, chant prayers, or simply recite nursery rhymes. The baby doesn’t care how you sound. When baby arrives, into a completely new environment, with bright lights, loud noises, the reassuring sound of the father’s voice is a very welcome feeling. Many babies are known to turn towards their dads almost as soon as they are born.
Ameeta Agnihotri.