Why Ice?
by Christine D’Esposito
As anyone who has given birth or supported others during birth knows, there are a variety of sensations involved in the process. While it’s true that not everyone experiences birth as painful, it is true that birth is always intense, emotionally and/or physically.
In Birthing from Within, one of the foundational offerings we teach expecting parents in classes, and birth workers in our trainings, is pain coping practices with ice. I can usually tell the people in my birth class who have read Birthing from Within, by their expectant nods when I mention ice; those who have not read the book often look surprised and sometimes shocked that I am asking them to do such a thing within the first hour of the first class. The exercise usually begins with a process we call “baseline,” where parents are invited to pick up the ice “cold turkey,” without any suggestions for coping or getting through it. For most people, this allows for a reality check about their expectations and assumptions about their response to coping with intensity, and often an “oh shit” moment where parents, especially those that will be birthing, wonder, perhaps for the first time, “If it’s this hard to make it through an ice contraction, how the heck am I going to get through labor?” This “aha!” moment can serve as great motivation for why they might want to really pay attention to what's going to happen next in the class.
The next step, offered before they pick up the ice again, is to invite them to sink into their seat a little, and bring their attention to their next outward breath and just begin to notice it with curiosity. I guide them with a few prompts such as, “Notice how deep or shallow your breath is and where your breath rests in your body.” After a few minutes of leading them through this, I ask them to switch hands and pick up the ice again, this time staying focused on their breath, noticing but not attaching to any story or judgment that may arise. After one minute, the average length of an active labor contraction, I tell them to put the ice down and take inventory of their experience: “What are you noticing? What surprised you? What worked?”
This allows the parents to express their experience from a solution-focused perspective, another core element of BfW mentorship. Responses usually range from comments about their physical experience with the sensation and their response to it, to insights about strategies they came up with on the fly, to musings about their internal dialog and how their mind was looking for a way out, a common experience for people in intense labor. After a few more rounds working with the ice and breath, allowing them an opportunity to use repetition and rhythm to deepen their practice, parents usually notice a drastic difference from the first baseline practice to the last ice contraction with Breath Awareness. Learnings range from how they might move their body, or use sound to cope with the intensity, ways to engage with their partners that may enhance or detract from the feeling of coping, and shifts in their mindsets in terms of pain versus intensity and suffering versus coping. All within about fifteen minutes of practice, parents gather a multitude of information about what may be helpful for coping in labor, in addition to what may not be so helpful.
But…why ice?
Over my years as a childbirth educator, I’ve seen other non-BfW trained educators use ice in their classes, but the outcome is always different. The conversation stays focused on the physical experience but fails to dive deeper into the heart of why and how this practice is so effective. I always remind parents that the ice is not intended to simulate a real labor contraction. I assure them that true active labor contractions will likely be much more intense! But the ice provides an edge for them to bump up against. It wakes them up a little, has them sitting up in their chair and engaging with the sensation instead of taking the more passive, relaxed role that might result from just practicing breathing without the ice. The ice allows them to experience intensity in a safe way and make an accounting of their ability and reflex to surrender or resist; it allows them to feel what an uncomfortable minute feels like; and, above all, it helps them to slow down enough to notice their own internal dialog about the sensations.
When parents can tune into what they are telling themselves about the sensation, and how they find themselves coping, they can begin to normalize the idea that sometimes they may look for a way out in labor, and bring awareness to how they can keep going even in moments of great intensity.