The Gentle Birth Method: The Month-by-Month Jeyarani Way Programme

Gowri calls her birth preparation ‘Jeyarani’. On a foundation of Ayurveda she combines aspects from a number of disciplines, including nutrition and complementary therapies, such as reflexology, massage, healing, Bowen, Reiki and Cranio-sacral therapy. The accent is on helping women feel profoundly in touch with their bodies and their babies and building their confidence in their natural ability to give birth.

The term ‘midwife’ means, literally, ‘with woman’ and conveys a role of shared wisdom and loving support. Gowri’s team of therapists helps a pregnant mother feel loved, valued, secure and held at a number of levels. Physically, each woman is encouraged to release strain and tension throughout her body, with particular focus on the birthing areas and on the breath. Emotionally, she is welcomed, her feelings are acknowledged and valued, and her confidence is boosted: the Jeyarani technique creates a space that allows each woman to be who she is and access her own very special power to nurture herself and her baby, and prepare for birth. Midwives work from the outside, but the Jeyarani preparation programme encourages the woman’s internal midwife and mothering to blossom.

Visualization plays an important role. Each woman is guided to visualize her power as a woman, the power of her contractions and most importantly the ability of her body to open and give birth. This builds self-confidence and harmonizes body, mind and spirit. The experience of preparation is a source of joy: apprehension and fear diminish and women tend to feel wholly in touch with themselves. Women are also encouraged to eat well, exercise and stretch with Yoga. Gowri also teaches gentle self-massage of the vagina and perineum, which brings women in touch with this important birth area and prepares it for opening and stretching at birth, acting as a type of biofeedback to release tension.

The Jeyarani programme does not focus exclusively on pregnancy and birth: Gowri also encourages women to consider their transition to motherhood and look ahead to bonding with their babies, and adjusting to the birth of a new family.

The stories in this book speak for themselves and are a testament to the Jeyarani Birth Preparation method, but above all to Gowri and her team, who encourage pregnant women to tune into, believe and exercise their power. Working with Gowri does not automatically guarantee a natural birth, as there are many different variables that affect each baby’s unique entry to the world. It does however, make it much more likely. It is a privilege to attend the labours of women who have been assisted by Gowri, and to celebrate the births of their babies who have been welcomed and lovingly nurtured throughout pregnancy.

Introduction (#)

I have always been bemused by the fact that, as pregnant women, we spend longer preparing the nursery for the baby, than our bodies. We sigh over wall-paper swatches, pore over name books and coo over cots without once thinking about conditioning ourselves for birth. Perhaps the inevitability of it just leaves us wanting to bury our heads in the sand, anxiously awaiting those first rumbling contractions, or maybe the thought of it is just too frightening to contemplate. After all, birth is packaged to us as a traumatic, painful and undignified rite of passage that nearly every woman – sooner or later – must go through. Who would want to dwell on that? And yet, we must. The statistics bear out these preconceived notions of what birth must be like: a recent survey reported that over 80 per cent of women were frightened during labour and 53 per cent found giving birth ‘far more shocking’ than they thought it would be. It’s a two-fold problem. On the one hand, some women’s expectations are not being managed, so the birthing experience is a raw shock for them; on the other, there are those women who are going into labour fully expecting it to be horrendous, and so it is. A big part of this latter problem is that the vast majority of young women who are now at childbearing age have grown up with the received wisdom that this is how birth is. But it isn’t what I grew up with. Born in Sri Lanka and educated in India, my notion of childbirth was rooted in a far simpler reality – that it is natural, quick and even reasonably gentle. Please don’t misread ‘gentle’ for ‘painless’, it isn’t and I don’t want to imply that at all. But it is manageable and let’s not forget that as a physical function that has been honed over centuries, childbirth is actually what our bodies are best at.

I only met this negative attitude to birth when I came to England and was struck by the irony that the sophisticated technology that has made childbirth safer for women than ever before has also made it harder. Over-stretched doctors, fearful of complications and litigation, are too quick to intervene at the first sign of difficulty, steadily undermining the fact that childbirth is a naturally occurring event that women are fully capable of achieving.

I should know – I was one of those doctors. As an obstetrician working at various hospitals around London, I delivered hundreds of babies. Unfortunately, most of the mothers were rigid with fear, in poor physical condition and emotionally out of control. By the time I saw them, the best I could do was administer an epidural and apply the forceps. The medical community’s attitude towards childbirth was, and is, of crisis management, of dealing with the complications the pregnant mothers were exhibiting once in labour. Very little thought was given to stopping the problems before they started, of getting to the root of the problem. So I began to wonder – could the quality of a mother’s pregnancy determine her labour experience? If she primed herself with physical stamina and mental resilience, could she condition herself for birth, like an athlete training for a race?

That was 15 years ago and today I have refined my results into a concise birth preparation programme that will hone your body and mind for the birthing process. The programme works on three levels. The first tackles your physical condition, aiming to detoxify and decongest your body through a wholefood diet, physical treatments and daily exercise. The idea is to purify your body so that there is no residual muscle tension, water retention or joint stiffness to impede the pelvic opening and loosening that is a necessary precursor for a gentle birth.

The second level addresses your mental attitude and any resistance you may have towards pregnancy – even if the baby was planned – or any fears about the birth. To do this, we move through carefully conceived visualization and self-hypnosis techniques that re-evaluate your feelings, develop your mental strength and give you the confidence to manage your contractions and remain in control of your labour. And finally, we engage on an emotional level – extending a loving welcome to your unborn baby and learning how to bond with your baby in the womb.

The fact that this programme is holistic and yet underpinned by sound medical judgement and experience means that The Gentle Birth Method is a unique approach to pregnancy and birth. However, if I had to stipulate the fundamental difference between this book and many other pregnancy guides, it is that this is a comprehensive programme for you to follow every day of your pregnancy. It isn’t a reference guide to pick up as and when you have a query, or want a homoeopathic remedy to an ailment. Nor is it a theoretical textbook about pregnancy and childbirth. This book goes further than any other by giving you a framework that shows you how to ‘be’ pregnant. The general attitude towards pregnancy is that it is a passive state of being, something that ‘happens’ to you for nine months. But I firmly believe pregnancy is an interactive, dynamic condition that you can nurture and mould to your own expectations. So keep this book in your handbag, in your desk at work, or on your bedside table – you’re going to find it an invaluable aid.

The Gentle Birth Method is for all mothers, whatever their age, culture, religion, or social status. And it isn’t just for the first-time mother either. In fact, in many ways, it is more relevant to those women who have already had a pregnancy or birth experience. If you have had a traumatic first birth and are terrified of repeating the whole experience – and a shocking amount of women are – this book is for you. If you have tragically suffered a miscarriage or stillbirth, then this programme can help you. Of course, it cannot offer cures to the specific clinical conditions that may have undermined the viability of your previous pregnancy, nor can it change your past. But, by giving you a specific weekly framework within which to operate, you can concentrate on nurturing this baby. The difference this time around is that you are now making yourself ready for the birthing experience.

By the time you read the last page of this book, birth won’t be able to frighten, overwhelm or surprise you. You will know how to reduce the amount of pain you feel, and the clever little shortcuts to full cervical dilatation. You will know not only what is happening to your body during childbirth, but also your baby’s. And whilst it’s doing all this, The Gentle Birth Method will cosset you, restore your faith and return birth to you as a joyous, happy event that is neither feared, nor needs to be interfered with.

More than 1200 mothers have followed the Gentle Birth programme and our results consistently show that we have improved birth for women and their babies. Our figures for total time spent in labour, intervention (i.e. epidurals, ventouse, forceps), episiotomies and Caesarean sections dramatically undercut the national averages and are clear proof that there is another way for women. But numbers aren’t the motivation for The Gentle Birth Method. Motherhood is the greatest gift and it deserves a happy beginning. It is my hope that this programme will help you celebrate pregnancy as one of the most precious chapters in your life, and equip you with the potential for a birth that is a calm, intimate and bonding experience for both you and your baby.

DR GOWRI MOTHA

SECTION A Preparing for Birth (#)

Physical Preparation (#)

Diet

If you imagine that pregnancy means waddling, puffing up stairs and being the size of a house, then you’re going to be pleased you bought this book. Because if there’s one thing that characterizes absolutely all the mothers who follow my programme, it’s this – they’re light on their feet.

At nine months, when most expectant mothers can’t get their shoes on, mine have a spring in their step. When most can’t get off the sofa, mine go off on a two-mile walk – they’ve got energy, confidence and excitement, and the only water they retain is kept in a bottle in their handbags.

You’ve heard of those women who are back in their pre-pregnancy clothes two weeks after giving birth – well, you could be one of them. I’m not advocating no weight gain during pregnancy by any means – in fact it’s crucial that mothers lay down some fat – but I do believe that mothers should control their weight gain in order to modulate the size of their baby. Babies are definitely bigger when the mother is overweight and both factors – big babies and overweight mummies – lead to a higher incidence of complicated births. My studies show that an optimum-sized baby for a mother of average build leads to a gentler birth – and less incidence of post-natal depression, because the mother doesn’t have to add getting her figure back to her ‘To Do’ list.

How can this sort of pregnancy be yours? Well, in the first instance, by following a simple diet. But before you gasp with horror at the thought of expectant mothers on diets, this is absolutely not about losing weight, deprivation or hunger. Yes, it does involve excluding certain foods – I ask all my mothers to cut out wheat, refined carbohydrates (puddings, chocolate, bread, biscuits and so on) and, in the last month, gluten – but here’s why.

When I was working as an obstetrician in an NHS hospital, the same thing happened every night when I was on call: I would be woken from my sleep to attend a mother with complications. The midwives would tell me, ‘this lady has been in labour for 24 hours, she’s now been pushing for two hours and the baby’s stuck’. I would do a vaginal examination and find that the tissues were congested and swollen around the baby’s head, the baby’s head was squashed and moulding, and all around it was oedema (water retention creating an obstruction). It was ghastly and the only option was to apply forceps and drag the babies out. I think I was quite a skilled operator and tried to be as gentle as I could, but this situation necessitates an episiotomy and I despaired of having to carry out this procedure on women night after night.

Birth Story: Pasha

It was a Sunday morning when I awoke with the knowledge that Maya – my first daughter – was coming. It was a wonderful sensation of just knowing. I paced the house beaming ‘my baby is coming’. I called Gowri and she came over at 11am. She examined me – I was 3cm dilated and purring like a fat, happy cat. Gowri talked me through a relaxation process, helping me to access the knowledge that I was safe and well, that my body knew exactly what to do; that I would just be opening, slowly and gently, ready to give birth at the hospital that afternoon.

My husband went ahead and prepared the birthing pool at the hospital, and we followed him when I was about 6cm dilated. On arrival, the midwife asked me how dilated I thought I was. I told her 6cm or so, but she laughed and said she would be very surprised – that I looked far too relaxed to be that far dilated.

To her surprise I was 9cm and my daughter was born within eight hours of the first contraction. She was a very relaxed baby, only crying when hungry. Her first months were spent arms spread out, palms up, completely relaxed, open and trusting in everything. I feel sure this is because of her peaceful birth.

I came to the conclusion that the underlying problem for a lot of these women was the mechanical fit. If you had a smaller baby, and a fit mother with an uncongested pelvis, it would be easier for the baby to pass through the birth passages. I was aware that in China, for example, women working in the paddy fields commonly squatted down and delivered their babies within the hour. Why? The reasons are simple enough. By squatting and rising as they work all day, they naturally encourage their baby into the optimal foetal position, and this exercise also aids lymphatic drainage within the pelvis and increases their pelvic mobility. But crucially, they also eat a wholefood diet of rice and vegetables, so their bodies are clear of toxins and supple. The importance of diet in the equation is highlighted by the fact that in developing countries that have adopted western diets and lifestyles, the number of caesareans and medically-assisted births has risen. Diet is the deciding factor.

However, it was 15 years ago that I came to this conclusion and voiced my concern that we were over-feeding mothers here. Not surprisingly, everyone thought I was crazy at the time and I met with a lot of hostility. There was a huge fear that babies would be born small. However, such scepticism proved unfounded – over the years my mothers have delivered babies of very healthy weights, usually 7lb plus. My emphasis was, and is, simply on having babies in keeping with the mother’s frame. Today the ‘eating for two’ mindset is becoming redundant, as people are much more aware that a pregnant woman only needs an extra 200 calories per day – that’s only an extra bowl of cereal per day.

I remember very clearly one mother who was admitted to the delivery suite in labour. She was a Filipino lady who was naturally petite – she can’t have been any taller than 5ft – but she was grossly overweight. She had been in labour for 18 hours and was still only 3-4cm dilated. The baby’s head was high up, her whole uterus was like a mound and the labour was clearly not progressing any further. I enquired about her diet and learnt that, since coming to England, she had started eating food that was alien to her native diet – such as bread, sausages and pâté – and she’d been eating too much of it. The result? She had to have a caesarean to deliver an 11lb baby when, according to her frame, she should have had a 6-7lb baby.

Invariably, whenever I was presented with mothers with huge abdomens and cervixes that wouldn’t open and I asked about their diet, they would list their preference for comfort foods: ‘Oh I had nausea and couldn’t eat anything but toast’, or ‘I was addicted to chocolate’. This led me to think about dietary deficiencies, such as magnesium or chromium, which can lead to cravings. Soon I was beginning to think like a nutritionist.

What effects do certain foods have on our bodies? Wheat, for example, is known to create water retention. The first thing most nutritionists advise when presented with a patient complaining of neck tension and headaches, is to eliminate wheat from their diets. Eight times out of ten, the headaches disappear. Given that pelvic oedema is very often the underlying cause for inconsistent labours, I reasoned that wheat could be the culprit, congesting the vaginal tissues and restricting the cervix from gently opening and widening. I became even more convinced when I started asking about the birth experiences of women diagnosed with coeliac disease. These women simply cannot eat wheat or gluten and although there has been no formal study into this, my own interviews with some of these women revealed that they enjoy incredibly short labours.

Sugar is problematic too. Sugar is metabolized via the Krebs cycle – the name given to the biochemical process that releases energy from the molecules of sugar. Studies have shown that a large number of free radicals are released during this process. The body finds it hard to neutralize these and they attack connective tissues like muscles, tendons and ligaments. When you are pregnant, you need your pelvic ligaments to be extremely supple and flexible, so avoiding sugar and sugary foods can prevent toxins being deposited in your uterus, cervix and pelvic structures.

Since my eureka moment 15 years ago, I have refined my nutritional guidelines into simple rules that are neither aggressive nor dangerous. Of course, there are times when that cake has your name on it, or it’s difficult to resist the convenience of grabbing a sandwich for lunch. You’re absolutely right, it can be difficult resisting the ‘forbidden foods’ on any diet, let alone whilst pregnant when cravings are enhanced. And of course there will be days when you feel frustrated, angry, or resentful at being forbidden from eating what you want – especially if, as is likely, you’ve grown up with the received wisdom that pregnancy affords you a guilt-free opportunity to eat whatever you like.

But when the sugar’s calling, try to remember this. By buying this book you have already exercised your desire for a beautiful, blooming pregnancy and a gentle, controlled labour – and it is something you can achieve with focus, commitment and belief. Ultimately, no one else can do it for you and if you do cheat, you cheat only yourself.

So think positively. I like the old epithet: ‘Rob Peter to pay Paul’. Compromise now for reward later. You’ve got just 35 weeks to follow this diet and get your body into tip-top condition and pristine ‘birthfitness’. It’s not so long in the grand scheme of things and you’ll thank yourself afterwards. After the birth, my mothers always tell me how glad they are that they followed the eating plan.

Asian Culture and Pregnant Mothers

In South Indian and Sri-Lankan culture – which I was brought up in – it is customary for close relatives on both sides of the family to visit a pregnant mother regularly and take her some prepared food. Feeding a pregnant mother is considered to be one of the most meritorious acts in the Hindu religion and women within the extended family take pride in sending food to the pregnant mother. This time-honoured tradition gives practical support to the mother and enables her to rest, giving her a break from cooking. It also acknowledges the pregnancy and shows that the extended family has already begun to care for the unborn baby.

I tell all my mothers that you don’t need to be Indian to follow this tradition. If your mother, mother-in-law, sister or best friend lives nearby, perhaps they could each cook you one meal a week. It can free up a valuable few hours for you in the evenings, particularly if you are still working. Just subtly give them your diet guidelines first – you don’t want them turning up with a meal that has taken hours to prepare but is unsuitable for you.

General Dietary Guidelines

Below you will find lists of both foods to avoid and foods you should actively look to include in your diet. For brevity’s sake and so as to keep the number of Dos and Don’ts being issued to you at a minimum, you will find that this list is not comprehensive. As a general rule, where a food has not been included on either list, you can assume it is okay to eat it, but be guided by your common sense as to whether or not it is suitable for this programme. Above all, the most important list to abide by is the Foods to Avoid section.

Foods to Avoid

Fruit: bananas (mucus-producing), grapes and mango (very high in sugar), citrus fruits

Wheat: bread, pasta and cereals made from wheat

Sugar: cane and refined sugar, fizzy drinks and fruit squashes, sugared cereals, chocolate, biscuits, cakes, puddings (if you have a sweet tooth you can have 2 teaspoons of honey per day)

Vegetables: restrict cooked tomatoes, reduce consumption of aubergines and potatoes, and eat raw salads, spinach and beetroot greens in moderation. Both in Ayurveda and in the Microbiotic diet lightly steamed vegetables are regarded as highly superior to raw vegetables. This is because plant cellulose is digested in your gut by bacteria and this can release large quantities of gas. Once vegetables are cooked it is easier for the bacteria to digest them. In addition to this, in pregnancy the pancreas slows down its secretions of digestive enzymes. So to avoid abdominal distention and discomfort it is advisable to eat steamed or lightly cooked vegetables.

Meat: preserved meats, sausages, pâtés, pork and red meat

Fish: tuna has recently been given a bad press because of high levels of mercury found in its flesh (as a result to industrial waste dumping in the oceans). The metabolism of the tuna collects the mercury wastes easily and this can be passed on to the baby through the placenta, so it’s best to avoid it while pregnant.

Foods to Enjoy