Vignettes of B.O.T. Processes

Nora shares the story of the B.O.T. process she underwent in preparation for her second birth: 

"What really helped me was to examine in great detail what I had experienced during my first birth. Until my B.O.T. sessions, I didn't really understand what I had felt and experienced back then. Now I understand that my reaction to the pain of the contractions during labor was related to a very painful experience earlier in my life. Because of this, I cut myself off and wasn't really there during the contractions. I cut myself off, was in an entirely different place, yet was completely unaware of what was happening to me on an emotional level.
Following this realization about what happened back then, I stopped blaming myself for failing and began exploring the strategies that would help me be present during the second birth – rather than reliving that other story.  During my second birth, I really felt I was giving birth. I felt as if I were passing through a huge ball of fire from my past, which during my first birth had simply caused me to escape by cutting off.
This might sound like a cliché, but life seems different since this second birth experience. I feel I can do almost anything. Most importantly, I feel bonded with my children in a new way, as if something has opened up inside of me, something that could not have opened any other way except by agreeing to go through this ball of fire."

* B.O.T. sessions for processing the experience of an earlier birth are centered on identifying resources and strategies, and creating conditions for change.

Ruth, who suffers from vaginismus, shares:

"In the course of my previous births, I wouldn't let anyone near my perineum. Any stranger's touch in this area would cause me to jump. My body would contract in fear, and I would immediately start crying, unable to calm down. I felt so helpless, as if I were about to totally lose control at any moment. The epidural helped during my previous births. But this time there was no time for it because the birth was so quick, and there was this small tear that needed to be stitched up."

One of the things Ruth had worked on in B.O.T. sessions throughout her pregnancy and in anticipation of her third birth was identifying the ways she could cope with a vaginal examination, and what was important for her to request from the medical staff.
Ruth describes what took place towards the end of the birth, following her conversation with the doctor who came to stitch up the tear:
"What happened during the entire stitching process was one of the most significant things that happened to me in my life. The doctor explained to me moment-by-moment what he was doing. He put his finger on the opening of my vagina and said quietly: "I'm just putting my finger here, just get used to the feeling. Take your time." And he waited. He waited until I told him I was ready for the next stage. This continued throughout the stitching process. I was the one who controlled the pace, I told him when he could start and when he should stop. Never in my life was I so clear with my explanations and requests. It was really painful despite the local anesthesia, and I had to stop him many times, because I was really contracted and the fear made me unable to breathe. But for the first time in my life, I didn't apologize for my sensitivity, and the doctor went along with me step by step at my own pace. And even though I could see he was sort of hurrying to finish up and leave, he remained attentive and patient until the very end. This was very, very significant for me, this ability to state clearly what I needed, and to have someone there who respected me and my body and feelings, somebody who was attentive to my pace! This birth transformed me into a different person. I discovered I had this ability to be a woman who knows how to say what she needs, who dares to listen to herself and respects herself. It took me many years to find that place within me."

 A midwife who has studied B.O.T.-  shares:

"I am in a room with a woman giving birth for the second time. I ask about her older child, and she tells me he died just over a year ago, when he was eight months old. It was difficult for me to be there. There were moments when I just wanted to leave the room and ask another midwife, who perhaps had a stronger, more stable heart, to receive the baby. But in anticipation of the birth, despite the difficulty of that moment, I came in, and we consciously made room for the previous baby: "What was his name?" I asked. "What is it like to be at the end of a pregnancy and know that it is in fact the end of a very significant period?" and so on. And her husband was crying a little bit, and so was I… (quietly, concealing my tears). She gave birth to a beautiful baby, pink and vital and sweet… and was able to cry and also rejoice, and remember the child who had died while being entirely present with the newborn baby. After the birth she was extremely thankful for the way I had helped them be a whole family."

* During B.O.T. training, when we attend to the subject of grief and loss in the context of birth, one of the main themes is the understanding that in order to be with what is present, we must also make room for what is absent. The children who are no longer present are also part of the experience."

An example of collaborative work among several professionals:

As a child, Ali was sexually abused by a family member. Her first birth was a traumatic experience followed by post-partum depression, which lasted more than six months. She is now preparing for her second birth.

 1. The psychologist who had been working with her refers her to continue preparing for the birth with a doula certified as a birth-oriented therapist.

2. During their B.O.T. sessions, Ali and the therapist go over every detail of the previous birth and identify the triggers that Ali had encountered and the turning-points at which she did not respond. Together, they prepare strategies that could work for her during her second birth.

3. They prepare a support system for the moments immediately after the birth, and coordinate with Ali's extended family for support in the hours and days after the birth.

4. Ali contacts a psychiatrist who will be able to support her immediately after the birth, and the doula also consults with him.

5. Ali, her partner, and the B.O.T doula come together to meet one of the midwives on the hospital staff in preparation for the birth. During the meeting, the midwife prepares an information sheet for the delivery-room staff, and Ali receives information about the options that will be available to her at the hospital, as well as answers to her questions.

Following the birth, Ali remains in close contact with the B.O.T. doula, who is also in contact with the psychiatrist, the psychologist, and her extended family, to ensure maximum support during the initial post-partum period.

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