The Alexander Technique for Healthy Pregnancy & Childbirth

What lies behind us and lies before us are small matters compared to what lies within us.
— Ralph Waldo Emerson

Many people do not realise that the Technique can be invaluable at the time of pregnancy, childbirth and caring for your baby. The harmful effects of unconscious postural habits are often exacerbated during pregnancy and after childbirth. These postures often result in chronic back pain and general fatigue, much of which could be avoided by having Alexander lessons.

It is also important to realise that each woman may have very different experiences in pregnancy and especially during labour, and there are very few formulae you can follow to achieve 'the perfect birth'. The secret is be ready for anything, because the power of nature is a very formidable and unpredictable force, and once the process has started it is much easier to work with it than against it.

Pregnancy

Some midwives say that they can often predict whether the labour is going to be difficult or easy by the general attitude of the mother-to-be: the more relaxed and easy-going she is, the more likely it is that she will experience an uncomplicated birth. By having Alexander lessons you can prepare yourself, both physically and mentally, for one of the most incredible experiences of your life. If you do suffer from anxiety or tension you may find that the Technique helps enormously in reducing your fear and apprehension about the birth and motherhood. Your heightened awareness of your body, both physically and emotionally, and the fact that your body is naturally undergoing enormous and rapid changes actually facilitates the process of change that the Alexander Technique aims to bring about. You are able to comprehend and let go of unwanted habits more easily at this time in your life than perhaps at any other.

The gain in weight of your unborn baby, the placenta and the amniotic fluid (the protective fluid surrounding the growing foetus) will be about 5.5 kilograms (12 pounds), but the overall increase may be two or even three times this figure. This will obviously vary from woman to woman, but the average increase in weight during pregnancy is a staggering 12.5 kilograms (26 pounds 8 ounces). This will have a dramatic effect on the way you move, sit and stand and unconscious habits will often become magnified during pregnancy due to the additional strain on your body.

A common example of this can be seen when a woman has a tendency to lean back while standing; she is often quite oblivious to the fact that she is arching her back and pushing her hips forward, which results in an imbalance and strain affecting her entire body. The increase in weight of the womb will result in this habit being exaggerated, causing the lower spine to be compressed and increasing the likelihood of severe backache. This swaying back is so common in Western society that many women suffer unnecessarily from chronic backache during pregnancy.

With the extra weight of the developing foetus, many of the muscles in the front of the body are put under more strain, causing them to shorten and perhaps give you a 'pulling down' sensation. To compensate for this feeling, many women tend to arch their lumbar curve, which then leads to the entire body being out of balance. During your lessons you will be taught to release this muscle tension, giving you a sensation of lengthening and releasing both the front and back muscles. You may become taller as your spine lengthens as well as strengthens, which can help to support your baby with less effort. After a number of Alexander Technique lessons these muscles will be more effective in supporting the extra weight, giving you a feeling of increased lightness and ease.

During your pregnancy it is essential that you rest your body as much as possible, even in the early months, when miscarriages are more common. For the first few months it is very helpful to lie down in the semi-supine position as described in chapter 3, as it gives your body one of the best resting positions. This position encourages the lengthening of the spine, as well as the relaxing of over-tense muscles. This will give your baby more room in which to grow, as well as helping you to have a greater capacity for breathing more deeply, which can often enhance a feeling of peace and contentment. As the pregnancy progresses, however, follow these steps to achieve extra comfort when adopting the semi-supine position:

Place your legs up on a chair or sofa
Use a cushion, instead of the books, to support your head (make sure the cushion is of a similar depth)
Lie on extra padding for increased comfort (a few blankets or a folded duvet are ideal)
Or lie with your legs up against the wall

There may come a time in the later stages of pregnancy when lying on your back will become uncomfortable or even painful. Do not persevere - it is the body's way of saying that this is no longer appropriate. Lying on your side with your knees bent may be of some help at this stage. When lying down in a semi-supine position during the last three months of your pregnancy there is a possibility that the weight of your baby may compress the inferior vena cava, one of the major blood vessels that carries the blood from the legs back to the heart. Sometimes this can reduce the blood flow to the placenta, and if this happens you will start to feel faint or nauseous, so roll over and lie on your side straight away.

REMEMBER: learn to listen to your body - it knows best!

There are two other important occurrences that take place during pregnancy. The first is the release of the hormones relaxin and progesterone from the placenta, which naturally cause the connective tissues and ligaments in the body to become more elastic. This allows the joints of the spine and pelvis to become more flexible in preparation for birth. The second is the enormous increase in fluid content within body tissues, causing the muscles to become more pliable. Due to these changes your body becomes much more flexible, and many women experience much more suppleness than usual (this could be another reason why Alexander lessons during pregnancy can often make more dramatic changes than at other times in your life). You also need to be aware that owing to these natural changes to the body's systems you will be more vulnerable to injury and need to take greater care not to stress your body, especially at work or when doing strenuous exercise.

Exercises At Home

Squatting is another useful procedure to practice during pregnancy, in preparation for your labour. During this activity your pelvis is opened to its widest and the downward force of gravity will aid the birth process, but it also has other benefits during the pregnancy. Squatting can:

release your hip joints, increasing mobility
help to release and open your pelvic floor muscles
bring relief by easing the downward pressure of your baby, especially in later pregnancy
help you to breathe more freely

If you find a full squat difficult then try the more shallow type, making sure you do not strain yourself in the process; the deeper squats will get easier with practice.

Due to the additional elasticity of the muscles, you will find that that you can bend with greater ease, and your Alexander Teacher can help you move into and out of the squat as effortlessly as possible. You will also be helped to achieve equilibrium while squatting, which is essential for comfort and the elimination of muscle strain. It is a good idea to practice squatting as a natural part of your everyday activities, so that when it comes to the labour you will be able to maintain the position more easily.

Most teachers of the Alexander Technique do not advocate physical exercises as they only make a habit more ingrained, but practising your directions and releasing tension as you do your pre-natal exercises is more beneficial than forcing muscles to stretch.

Breathing

Breathing is another area in which Alexander re-education can be invaluable. There are many ideas and theories on varying breathing techniques during pregnancy and labour, and while some may be helpful in certain circumstances during labour, most will tend to interfere with the normal respiratory process. The main help you can give your body throughout pregnancy and labour is to be more aware of your breath and allow yourself to finish one before you start another. It is surprising how many adults have forgotten how to breathe freely: habits of snatching or holding the breath during times of anxiety and stress are very common. During your pregnancy it is very useful to practise the 'whispered ah' as described in Chapter Four of The Alexander Technique Manual. Vocalised 'ah' sounds while relaxing the jaw and other facial muscles can also be very beneficial. The secret is always to focus on the out-breath, as this determines the subsequent intake of air. It is a good idea to spend a few minutes each day breathing in these ways so that when your labour starts they will be very familiar to you and therefore can be done without too much concentration.

During your pregnancy you are breathing for two, and there will be changes in your pattern of breathing to cope with these changes. Your growing baby will gradually take up more and more space, giving your lungs and other organs less room to function. This will cause an increase in your respiration rate and you will find that you may become more breathless during activities such as climbing stairs. It can be helpful to imagine breathing through your eyes as you allow the in-breath to expand both downwar and outward, so that the maximum amount of air is taken without straining. It is important that you do not rush any of these breathing techniques, as this can interfere with the breathing and defeat their whole purpose.

Making Choices

There is much controversy over whether home or hospital births provide a safer environment, but when all is said and done it is your birth and therefore has to be your decision. One of the first decisions you will have to make once you know you are pregnant is whether you want to have your baby in hospital or at home, but no matter what you decide don't forget that you always have the right to re-choose, even at the last moment.

Whether the birth takes place at hospital or at home, it is important to have a birth plan that you have decided upon BEFORE labour begins. Make sure anyone present at the birth knows of your wishes - the last thing you need during your labour is the frustration of trying to communicate to the midwife or doctor between contractions what you do or do not want. The two different environments, hospital and home, can provide very different experiences for both mother and child, and each has its own advantages and drawbacks.

Advantages of a hospital birth

Highly-trained and specialist equipment are available if complications arise. This may give you a sense of security, which can help emotionally. You can be cared for immediately after the birth when you may feel exhausted, especially if the labour has been a long one.

Advantages of a home birth

Sometimes, too much intervention can lead to a labour that is increasingly intense and out of the woman's control. This can make the labour more painful so that more intervention becomes necessary, which in turn can affect the baby's breathing, sucking and overall responsiveness. When a birth takes place at home, there is less chance for unnecessary medical intervention to create this type of 'vicious circle'.

Childbirth is ultimately a very private affair and sometimes even heavy contractions can suddenly stop as the mother is exposed to a more public environment or figures of authority. This again may mean more medical intervention. A home birth reduces the chance of this happening. You can be in an environment that you have created for yourself, which can enhance the feeling of love and warmth between you, your partner and your new baby. For example, low lighting, control over temperature and fresh air, relaxing music and scents, as well as having the right kind of food and drink on hand, can all help you to feel more relaxed and therefore assist in the birthing process. You are more likely to have a more natural and therefore safer birth. It is an interesting fact that in Holland, where home-births are common, the mortality rate for both the mother and baby is one of the lowest in the world.

No one can deny that the advancement of medical science has saved the lives of many mothers and babies, but it is important to realise that unnecessary interference with the perfectly natural process of childbirth can cause complications to arise. Do not forget, if you have opted for a home birth and complications do occur, you can normally be taken into hospital within a very short time, depending on your location.

Childbirth

This is often the most unpredictable part of the pregnancy. It is important to remember that there no two labours the same - not even for the same woman. The secret is to be as prepared as possible without having any expectations; this may sound like a contradiction in terms, but there is a fine line between the two. As the labour progresses you may find it hard to recall mentally what you have learned during your Alexander lessons about inhibiting, thinking of your directions and releasing tension, but do not worry because the preparation you have done during your pregnancy will benefit you now. Your body will remember what to do at a very deep instinctual level; all you can hope to do is not to interfere consciously with the powerful process that is taking place. You must forget about everyone around you and not try to please anyone but yourself despite the fact that this sometimes goes against life-long habits and conditioning about politeness and selfishness. The best way to deal with labour is to trust the process and try to let go of any preconceived ideas of how it should proceed. Even the birth plan may have to go by the board in certain situations. Just stay with your breath as much as you are able.

The First Stage

This stage often begins with the onset of regular contractions or the waters breaking. and ends when the cervix is fully dilated. It is extremely difficult to predict how long this phase will last and how uncomfortable it will be. It can take only two or three hours, or it could run into days.

In the first stage your contractions will often start gently and build up until they are very intense, resulting in discomfort and pain. It easy to tense against these contractions rather than letting them work. We naturally associate pain with something not being right, but this is the exception to the rule. It is worth remembering that pain in this case is perfectly natural. It is constructive, and part of the process that brings your baby into the world. The more you can go with the contractions rather than fight against them, the easier birth you will have.

During this first stage of labour it is important to find a comfortable position to suit you, and most women instinctively choose to stand up or walk about - it is common for them to lean or hang on to a convenient object or their partner. When you are upright, the downward force of gravity will assist in your baby's descent and will stimulate contractions and the dilation of the cervix. There will be times when you will need to rest, and sitting on a low stool or on the edge of a chair with your legs apart while leaning forward can be very comfortable. This will also help to lengthen the spine, which will give your body extra support, even if you are not conscious of it at the time. Some women find sitting on the toilet another very comfortable position.

During long labours there may be times when you wish to rest, and it may sometimes be appropriate to lie down on your side with some cushions to support your legs and head. Squatting can be very useful during this stage, especially if the labour is prolonged as it can speed up the contractions. Lying down on your back during labour, however, is probably one of the worst positions to be in, as it hinders the birth process because the contractions now have to push the baby horizontally along the birth canal instead of downwards, where they are assisted by gravity. This will probably increase the length of the labour and, if used during delivery, may result in tearing and cause you to feel too exhausted to push during the second stage. There is also the danger that the baby may exert pressure on to one of the main blood vessels, restricting the blood flow. In fact, the reason why many hospital births have been carried out in this way is because it is easier for the doctors and midwives to assess the progress of the labour. Women also have to lie down when they have oxytocin and epidural drips or if they are wired up to equipment which monitors the contractions and the baby's pulse.

Transition

There is often a definite transition period between the first and second stages. During this time your contractions may be at their most powerful, and there is often a sense of losing control, and your movements may be wildly unpredictable. This is also the time when there is often a feeling of giving up, or that you would do anything to make the pain go away. It is also possible that there is a lull in the contractions and you may be able to get some rest.

The Second Stage

This stage starts when the cervix is fully dilated and ends with the birth of the baby; it can last anything from just a few minutes to a couple of hours. During this stage squatting is one of the most useful position to adopt, and it is probable that women have given birth this way for as long as humans have roamed the earth. In less material societies, like India or Africa, squatting is an everyday activity, so when it comes to childbirth this position is adopted naturally. In Western societies many woman can find squatting unaided very strenuous and you may need to be supported by your partner or midwife (or both). If you have become accustomed to squatting during your pregnancy then you will be happier with this extremely beneficial stance. While you are squatting not only does the force of gravity help to expel your baby, but the pelvic outlet is as much as two centimetres wider than in other positions.

When the baby's head can first be seen, another useful position is to kneel leaning forward over a chair or even to be on 'all fours'. Both these positions will allow more time for the baby to be born, thus reducing the risk of tearing. It is vital not to tense at this point, but to work with the breath: some women naturally find themselves wanting to scream or shout. This can aid the birth process since it forces the abdomen to bear down.

The Third Stage

This stage starts from the moment your baby is born and ends with the expulsion of the placenta. If this is speeded up artificially by using the drug syntometrine (which is extremely common in Western hospitals), then it is best for you to lie down while the doctor or midwife remove the detached placenta. If this drug is used the cord must be clamped and cut without delay. If you opt for the more natural method, then it is better for you to breastfeed your baby immediately, as this will help to speed up the retraction of the uterus, which naturally expels the placenta. It is an interesting fact that the umbilical cord is often long enough to be still attached during that first breastfeed. However, it is important to realise that some babies are not interested in feeding straight away, and this should not be forced. You will have plenty of time to welcome your child, but during the expulsion of the placenta, several minutes later, you will have the choice to be in a position that suits you. You may prefer to stand where gravity once again can assist with the process. When the cord stops pulsating your baby will be breathing independently and the cord can then be clamped and cut without any rush or your baby being forced to gasp for its first breath. Even in childbirth it is beneficial to apply the Alexander principle of inhibition rather than have the process rushed which can lead to mistakes.

Breastfeeding

When it comes to feeding your baby your body knows exactly what to provide. The structure and composition of your own breastmilk has been designed perfectly for a human infant, as opposed to cow's milk which is ideal for a calf! Putting your new-born to the breast soon after it is born can actually help to prevent haemorrhaging, as the action of sucking causes the uterus to contract and reduces the flow of blood.

Many women are led to believe that they are not capable of breastfeeding and therefore do not persevere through the first few days, when it can sometimes be hard work and even painful, but it is actually only under very rare circumstances that bottle-feeding may be necessary. In her controversial book, The Politics of Breast Feeding, Gabrielle Palmer had this to say in favour of breast-feeding:

'If a multinational company developed a product that was a nutritionally balanced and delicious food, a wonder drug that both prevented and treated disease, cost almost nothing to produce and could be delivered in quantities controlled by the consumers' needs, the very announcement of their find would send their shares rocketing to the top of the stock market. The scientists who developed the product would win prizes and the wealth and influence of everyone involved would increase dramatically. Women have been producing such a miraculous substance, breast milk, since the beginning of human existence.'

It is only in recent times that bottle-feeding has become more popular, and this is partly due to the fact that many women feel obliged to return to work within a few weeks of giving birth to their baby. I was amazed recently to hear at a post-natal class that over half the mothers with babies less than six weeks old were already back at full time work; this was having serious repercussions for both the mother and child, as their natural instincts were being ignored, and most mothers who were back at work reported that their babies cried frequently and refused to be comforted - this was putting an enormous strain on their relationship with their partner.

The World Health Organisation also recommends breastfeeding and claims that it gives babies 'the best start in life'. The reasons that they put forward to support breastfeeding are that breastmilk has the perfect nutritional value for the child, and the right composition for the baby's delicate digestive system; it contains antibodies which naturally immunise the baby from outside diseases (it is often the case that breastfed babies are less prone to infections than bottle-fed babies); it also helps to prevent diarrhoea, which is one of the biggest causes of infant mortality, claiming the lives of more than 3.5 million children each year.

Breastmilk has a higher water content during the summer, supplying your baby with the extra fluid it needs in hot weather and as your child grows and has different nutritional needs your milk will automatically change its constitution to suit those new requirements perfectly. The jaw action that the baby has to make in order to obtain milk from the breast (which is quite different with bottle feeding), helps in the natural development of the teeth and jaws. Breastfeeding encourages natural bonding between the mother and child and it is what the baby and the mother's body expect.

Breastfeeding can also save many hours of the new mother's precious time which might be spent in the preparation, sterilisation and washing up which are involved in the process of bottle-feeding, and because breastmilk is available at all times, your baby does not have to wait, often screaming, to be fed, which can be stressful for both the mother and child. Breastmilk is always given at the right temperature, and there is no waste and no incentive to overfeed by 'finishing the bottle'.

Mothers who are breastfeeding totally (i.e. not giving bottle feeds or solid foods) are more likely to have natural contraception for six months or more and are less likely to develop breast cancer later on in life. The hormone prolactin is released into the mother's bloodstream giving her a sense of peace and well-being, which makes it easier for her to get through the exhausting first few weeks, when lack of sleep and broken nights can be very demanding. Lastly, breastmilk costs next to nothing to produce: you do not have to pay out for expensive equipment and infant feeds.

It is essential to realise that the fore-milk is released first; this is more watery than the rich hind-milk and your baby may have to be on the breast for some time before the latter is released. Babies grow in fits and starts and it is better to feed them on demand, as they instinctively know how much and how often they need to feed. Do not worry if there are slight fluctuations in the increase in your baby's weight, as this is perfectly normal.

Some people may think that some of these issues are nothing to do with the Alexander Technique, but in my view the mother is consciously making an informed choice not to interfere with the natural processes of giving birth. The principles of not interfering with nature, increased awareness and exercising free choice are all at the heart of the Alexander Technique.

Posture and Feeding

It is important that you find a comfortable position from which to feed your baby, as you may be there for half-an-hour or more at a time. Lying down on your side can be a good position, as it gives you rest at the same time. If you are sitting up, a bulky cushion behind you will give you support and help you to sit upright. Make sure that you have another, smaller cushion under the baby's head, as it will bring the baby to you rather than encouraging you to stoop while feeding. Having the knee which is under the baby's head higher than the other will also give you support, and this can be achieved by placing the foot on a low stool or even a pile of books. It can be helpful to think of lengthening up the front and widening the shoulders, as this will prevent the common habits of hunching or slumping over your baby which give rise to neck, shoulder and back pain. Make sure you have a drink nearby, as you will probably become very thirsty. New mothers are often tense for fear of dropping their baby, and this tension is transmitted to the child and causes it to become agitated. The Alexander Technique can help you to be more aware of this tension when it arises.

The main obstacle that many women face today in all aspects of pregnancy and raising a child is that they have to battle with a dehumanised society that is based on scientific 'statistics' and 'proven' theories. These more often than not go directly against their own instinctive and intuitive feelings, for which they have no practical 'objective' evidence. They are persuaded to believe that if they do follow their instincts they are putting their unborn child's life at risk and they are often ridiculed or labelled as trouble makers when they stand up for what they feel. Childbirth is an instinctive process and it is essential for that instinct to be listened to by all concerned. The damage that a child may suffer due to drugs, forceps or any other form of over-interference may have far-reaching effects that we have so far underestimated.

The Alexander Technique is a very powerful tool which enables parents to have more choice and less stress in one of the most important experiences of their lives. Releasing tension can help the woman's body to cope with the very powerful changes that take place. It can also help to give your child a less traumatic start in life.

The First Year

The Alexander Technique can also be beneficial to you and your baby by making you aware of harmful feeding and carrying habits that so easily develop. By thinking of the way you hold your child, you will naturally hold less tension, which your baby will automatically respond to. For example, a common way of holding your child is to stand with most of the weight on one leg and use the hip as a 'seat' for the child. This will obviously affect your body alignment as the spine is pulled over to one side. This is a common reason why many parents suffer with backache and neck tension after carrying their children. A better way of holding your baby is to have your weight evenly distributed on both feet and use your arm or a sling under your child to support its weight - as a result your muscles will be less strained and your baby will feel safer.

Mothers can often be seen hunching over their babies when they are feeding them - since this position is adopted for many hours a week it can lead to tense muscles which become very uncomfortable. This discomfort can make you irritable and these feelings will be transmitted to your infant.

Pregnancy and the post-natal year is one of the most important times of your life as you are physically and emotionally caring for a new life. It is important, even in the early stages, for you to be as conscious as possible of the incredible process that is taking place as this will benefit both you and your unborn child. One of the best ways to look after yourself and your baby is to have a course of Alexander lessons as this will help you to prepare yourself (not only physically, but also mentally and emotionally) for giving life to another human being. Although this can be a very joyful and exciting time, it can also be very draining and demanding on your body, mind and emotions. Alexander lessons will stand you in good stead to be able to deal with the stresses and strains that life presents during your pregnancy, childbirth and the early years of motherhood.

The more a woman accomplishes in her feminine, natural functions knowingly and wilfully, particularly in labour, in the birth of her infant, and in its nourishment, the more she learns, both intuitively and consciously. The more she appreciates herself in so doing, the more her self-appreciation radiates towards her infant and others - her husband, her other children, and society.
— Dr. William Hazlett