Exercise in Pregnancy Part Two: Body Trust

Last month I posted about the many physiological benefits for moms and babies that can be reaped by exercising during pregnancy. As promised, this post is a (somewhat delayed!) follow-up to that one, in which I’ll be exploring the concept of ‘body trust’. What does that mean? How does exercise help us get it? And why does it matter? Read on to learn more!

The concept of ‘body trust’ is related to the idea of ‘self-trust’; that is, a sense of autonomy, personal competence and dependability. Body trust is essentially the same, but from a physical perspective: the conviction that one’s body is capable, dependable and strong. Body trust is developed most easily through physical activity and fitness and can have many benefits for pregnant women, both prenatally and during labour, birth and the postpartum period.

How does physical activity generate body trust?

In the human brain there are motor and sensory regions that correspond to the various parts of the body. Subliminal experience of movement activates motor cells, as well as sensory perception. This creates an unconscious sense of one’s physical being; where our various parts are in relation to one another, how they work together and how well they interact under various conditions. The more we challenge the limits of this subliminal sense, the more we enhance these overall understandings and expectations of our bodies. In the same way that pushing a little bit harder encourages a muscle to grow, that push also encourages the brain’s overall sense of the body to grow. This overall body sense is sometimes called the homunculus. The homunculus is not proportional to our actual physical body – in particular, areas with larger numbers of nerve endings (such as the lips and fingers) are experienced as greater than those with smaller numbers of nerve endings.

Visual representation of a homunculus

[Side note: I have never seen a representation of a female homunculus; I would be very interested to see how it would differ from a male representation]. By exercising we can actively shape our homunculi, essentially highlighting or enhancing certain parts as we move them in challenging ways.

When we affect our homunculi in this way, the psychological effect is one of increased confidence and trust in the body.

Why does this matter in pregnancy?

As I have mentioned previously, labour and childbirth were once witnessed and participated in by most women before they themselves were to give birth. Once we shifted away from small, close-knit, geographically proximal communities, however, most of us lost this connection to labour and birth. Today it is very rare for a woman to have been present at even one birth before she gives birth herself. This makes birth an unfamiliar and mysterious terrain. Compounding this problem are misleading and overly negative representations of birth in the media and in so-called educational videos that are often shown in high school health classes as tools for promoting abstinence rather than for understanding the physiology of labour and birth. These images stay with us and impact our expectations and emotional responses to the prospective of giving birth. [Another side note: the film, Labouring Under an Illusion: Mass Media Childbirth vs. the Real Thing  by Anthropologist Vicki Elson is an engaging and at times humourous look at how culture influences birth experiences by contrasting the differences between fiction and reality]. The result of the combined lack of direct experience and over-exposure to negative stereotypes about birth leads many women to actively fear labour and childbirth. This fear is often exacerbated by myths surrounding the dangers of childbirth and misunderstandings of historical fact related to obstetrics, prenatal health care and overall well-being. As a result, a woman’s own fears are often mirrored back to her or increased by well-meaning, but uninformed family and friends.

If birth was a strictly physical experience, perhaps this wouldn’t matter quite so much, but birth is far more than pure physiology. The state of mind of the labouring woman is absolutely central to the experience and how it unfolds. A woman who is stressed or afraid is much more likely to experience slowing or stalling of labour, as well as increased experiences of pain in labour. Hormones work in concert or conflict with one another – the presence of stress hormones, such as adrenaline, suppress the release of the hormone oxytocin (which causes the uterus to contract) and of endorphins (which are the body’s natural painkillers, released in response to the contraction of the uterus in order to assist the woman in coping with the processes of labour). A woman who has significant fears regarding labour and birth and who does not trust in her body’s ability to give birth is much more likely than a woman who does not fear labour and who does trust her body to have a difficult and/or interrupted labour.

By exercising during pregnancy, building body trust in the way I described above, a woman can greatly enhance her sense that her body is capable and reliable – both day to day and when she is in labour. When combined with the physiological benefits of (for example) increased endurance and flexibility, which can make labour easier at a physical level, exercise during pregnancy is clearly a great boon.

In addition to exercise, practising mindfulness while repeating positive affirmations that further encourage a sense of confidence in one’s body and it’s ability to labour and birth with ease have been shown to positively impact the duration and experience of childbirth. This is one of the principles on which Hypnobirthing is based.

Are there particular kinds of exercises that are especially beneficial for building body-trust in pregnancy?

Ann F. Cowlin, a movement specialist in the Yale University Physical Education Program, and founder of Dancing Thru Pregnancy, Inc. advocates a combination of:

Aerobic Exercise 2-3 times per week at a moderately high to high intensity for 20-45 minutes, begun no later than the beginning of the second trimester, to build endurance for labour and birth, as well as confidence in one’s endurance (the conviction that you can go the distance and do the work of labour well).

Strength and Coordination training a couple of times a week to build the muscles of the upper and lower body (to facilitate movement and positioning in labour and birth), as well as the muscles of the pelvic floor (the support system that extends from your abdominals, down and around your pelvis and up to your lower back), which are necessary for pushing and very important postpartum as well. Women who are confident in their understanding of how these muscles work in their own bodies often ‘figure out’ how to push effectively much more quickly and consistently in second stage.

Learning positions that are useful for labour and birth through a prenatal course, especially when practised with a partner at home, can make movement into and between positions during labour easier and reduce stress in the moment. If you are enrolling a prenatal education course, check with the educator to find out if they include this form of instruction in the class. If you have a doula, you can also practice with her during prenatal sessions. Think about which poses you feel you might like best and come up with your own names for them to ease communication with your partner and doula during labour. Examples include, the standing lunge, the dangle, slow dancing, knee-chest pose, etc. This point also raises the importance of having a fit partner – endurance and strength can be of significant benefit in your partner and doula, so prenatal prep may be in order for others too.

Mindfulness and relaxation practice such as those taught in Hypnobirthing classes and some yoga courses are also of significant benefit in terms of building body-trust, according to Cowlin. With Hypnobirthing, your partner will also learn how to ‘cue’ you to relax more deeply and will help you to retain your mindful, relaxed state, even if the going is tough during labour. A doula trained to support Hypnobirthing moms would be a further asset, as she would help to facilitate a space that is conducive to the hypnotic state and could fill in for your partner with touch and affirmation when he or she needs to take a break.

While Cowlin’s combination strategy may be ideal, I believe that any fitness program will go some distance towards helping you to build body-trust, provided that you are challenging yourself and combining your exercise with relaxation practice that helps you to envision yourself as a strong, capable woman, both mentally and physically.

Your body was designed to give birth. As Ina May Gaskin says, “Remember this, for it is as true as true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.”

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