Welcome to the Best of Birthful. Creator and host Adriana Lozada curated and edited each selection in this playlist of the show’s most popular episodes. It’s a tailored introduction to the expansive catalog she amassed over the first five years of Birthful’s 300+ shows.
Midwife and pre- and perinatal psychologist Karen Strange talks about birth, but from the baby’s perspective. It turns out that there’s a specific sequence of events that occurs as newborns transition to the outside world. In this episode you’ll learn how to follow the sequence and ensure a joyful experience for your baby and yourself.
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- Simple Tools for Mothers by Karen Strange
- Excerpts from Myrna Martin‘s booklet on Birth and Attachment
- Babies are Born Where They are Born by Mary Esther Malloy
- Waiting to Inhale: How to Unhurry the Moment of Birth Mary Esther Malloy
Karen’s biggest message? Tell the baby what is going to happen before it happens. This is true for adults and children.
Related Birthful episodes:
- How Your Baby Helps During the Birthing Process
- How Long Should You Wait to Clamp the Cord?
- Why the Golden Hour Matters for Your Baby
- Your Baby, The Mammal
[Best of Birthful] What Your Baby Experiences During Birth
Hey, Mighty One. With nearly 300 Birthful episodes in over five years, it may be hard to know where to begin listening to the show. To make it easier, we’ve put together the Best of Birthful series, which showcases some of our favorite or most relevant episodes. This is one of those. If you enjoy what you hear, make sure you subscribe. It’s free, and that way you won’t miss a thing. Enjoy.
Hello, Mighty Parents and Parents-to-Be. As always, thank you so much for listening and for all the love you give the show. Okay, then. So, let’s now talk about the baby’s birth experience. Karen has a unique way of presenting birth from the baby’s perspective, so she’s really great at helping you see through the eyes of the newborn to basically transform what you thought you knew. She’s a Certified Professional Midwife, pre and perinatal psychology educator and lecturer, and she’s been an American Academy of Pediatrics Neonatal Resuscitation Program Instructor since 1992, and has taught over 8,500 people worldwide. I’m honored to have her share with us this often overlooked perspective as well as some of her simple tools to help babies, children, and adults integrate what happens to them before, during, and after birth.
Lozada: Karen, welcome.
Karen Strange: Thank you. Nice to be here.
Lozada: So glad to have you.
Strange: I became a midwife, I trained in 1988 in El Paso at a very high volume birth center on the border. I experienced a lot of births. I had a small home birth practice. And I learned to become a neonatal resuscitation instructor way back when, and one of the things I noticed when I started teaching neonatal resuscitation is how much fear there was around resuscitating babies, and it really became a drive of mine to figure out how do you teach this in a way that works with the fear? And that took many years to learn how to explain it and how to teach it and do it in a way that actually supported not only the baby, but supported the practitioners and the parents. Part of that learning was in El Paso, where I worked on the border, we did a high volume number of births, and it being on the border, we tended to see a lot of complications of pregnancy, and labor, and birth, and postpartum, and when I left El Paso, I realized I had some fear around birth.
And I was trying to figure out, how do I heal that? What do I do with that? And eventually what happened is I started to experience some of my own birth work and I began to learn a little bit about my own birth. I was at a birth workshop really trying to heal my own birth material, and I had the experience of seeing people experience their birth, and it was a little odd, and a little silly, and one of the things I learned from this particular person, Barbara Findeisen, is that we have our memory in our body, and the memory in our body starts from very early on and it… We have an implicit or cellular memory, and our implicit or cellular memory starts from the beginning, and Bruce Lipton, a cellular biologist, would say conception, through 18 months of age. At 18 months of age, explicit memory comes onboard. Explicit memory is, “Oh, I remember that.”
Before 18 months of age, it’s implicit. Implicit is a cellular, fluid, bone memory. In your body memory. And it’s in all of us. So, at this birth workshop I was seeing people do some birth work, and I remember noticing nobody was talking about the mother, which was very difficult for me because as a midwife, it’s all about the mom. Even if we’re really nice to the baby it’s all about the mom, and then as I saw each person sort of doing this little birth work, I noticed that people were expressing what it was like for them, either in utero, or doing the twist and turn to the birth canal, or what happened when they came out, and pretty quickly I noticed nobody was talking about the baby, and I got it, that there was a baby’s experience of birth, and the baby experiences birth and makes a decision about life depending on what happens at birth, and lives from that point on, from that decision, from that point on.
Lozada: So, wait a second. To clarify, you were saying that in the workshop, the people who were there were talking about their experience when they were born?
Strange: They weren’t talking. They were actually going through a little birth tunnel and expressing what it’s like for them at their birth. And this was really shocking to me, that I didn’t know it. I mean, I was one of those people that was very careful with babies, and light, and delicate, and soft, and touching, but I didn’t really get it. The babies were having an experience.
Lozada: So, that was an “a-ha!” moment for you.
Strange: It was. It really changed everything for me, because I thought, “Oh my goodness. Imagine neonatal resuscitation. Those babies are really having an experience.” And I thought, “Oh my God, I’ve gotta start including this in what I teach and with my clients as a midwife.” And of course, I don’t know if you know anything about this, but as soon as I started talking about it with my clients who were pregnant, I was still doing birth back then, everybody just felt guilty. I didn’t want them to feel guilty. I thought, “How do we talk about this? How do we change how we see what happens at birth without creating this guilt?”
And so began my journey in learning not only how to talk about it, but what are some specific tools that can help mothers and care providers manage, deal with, heal, integrate what happens? Because things don’t always go as planned, as all of us know. Sometimes things happen even when it’s the perfect birth, whether you’re at home, whether you’re in the hospital, it doesn’t matter. You could have let’s say a long labor, a long pushing stage, or a precipitous labor, or a hemorrhage, or a resuscitation, or many of the things that can happen in the hospital. And so, what I have come to learn over the years, yes, doing my own healing, but also really learning about memory, when that starts, learning about healing, learning about the nervous system, is that much of what I teach is really ancient, intuitive knowledge. And it has sort of gotten lost over the years, as we’ve moved birth into a more medical perspective, but I always go back to the same thing.
It’s all about optimal survival of our species. That’s how we were designed by God, or nature, or whatever you believe in, that we were set up to survive optimally and embedded in the birth process is not only how to give birth, but where healing takes place naturally, if we allow it to happen, even if things didn’t go as planned.
Lozada: Indeed, and that is… It’s such an intricate process that trying to give the space for that healing can be really tricky when other things come into play, like fear, and guilt, and all the emotions. It’s such an emotional moment. But I love the fact that you bring it back to healing. Karen, one of the things that was in my mind from when you were talking earlier that I wanted to ask you about was muscle memory. Is that connected also to muscle memory, the memories that you were seeing?
Strange: Yes. It is. It’s muscle memory. It’s connective tissue memory. It’s the fluid in our body memory. It’s the felt sense memory, which is different from, “I remember that.” That’s a different memory. That’s the memory that we have at 18 months of age. Up until 18 months of age, it is implicit, not words. Body memory. Muscle memory.
Lozada: And it’s interesting, because that reminds me not in the, “Oh, I remember this,” but after my birth, which was very natural and completely, but still, it’s an intense process, right? We all know this.
Lozada: And I found the few weeks or months afterwards that if I thought back on it, I could feel it in my body kind of thing, and not feel the intensity, but sort of the feelings that I was feeling when giving birth would resurface.
Strange: Yeah, so that would be a body memory, but really the memory I’m trying to talk more about is the memory before we have words and have all of that in place, which is what happens with babies, that babies have implicit memory of what happens before 18 months of age, so they may not have the, “I remember that.” So, I was thinking I would just start with a little bit, a little bit about transitional physiology, and then weave into the sequence of birth, because that is kind of how it all goes, that there’s a species-specific sequence of birth that is true for all mammals, and embedded in the sequence are places for healing and integration.
Lozada: Go for it.
Strange: Okay, so first I’ll just start with simply when babies in utero are not breathing, they’re getting their oxygen through the placenta and the lungs in utero are fluid-filled. They’re very small. The little lungs are fluid filled and all the little blood vessels that surround the lungs are very constricted, because all of the exchange of oxygen is happening through the placenta. So, then when the baby comes out, and the baby’s born, it goes through a pretty tight squeeze if it goes through vaginally, right? And when there’s constriction, there’s very little blood flow, and some blood backs up into the placenta. And then when the baby comes out, there’s this blood in the placenta, it’s warm, it’s pH balanced, it’s highly oxygenated, it’s filled with stem cells. It goes from the placenta, goes through the cord, it goes into the baby, it goes into the constricted little teeny, tiny capillaries that surround the little air sacs, which I said, remember, were fluid filled, and the blood goes in there and it dilates and pulls open those little air sacs that were fluid filled.
And what actually happens is there’s a pressure difference between the air sacs and the capillaries, and so the fluid gets drawn into the capillaries, and this is what begins to clear the fluid to which the breathing finishes off. So, the blood goes into the capillaries, so the babies can then become air breathers. That’s the big thing. They have to become air breathers. The remaining blood, half of it, goes to the lungs, and the other half is gonna go to the rest of the body and do the work that the placenta did, like digestion, elimination, it’s gonna go to the intestines, the liver, the kidney, the spleen. So, it’s a big transition that happens for babies.
They’re going from fluid-filled lungs to air-filled lungs. The blood that goes through the cord into the baby is the baby’s blood. About a third of their total blood volume. And you know, I’m gonna say that most of the blood goes to the baby within the… really, if they have a good pulsing cord, it goes into the baby within about 20 to 30 seconds, most of the blood. Birth was set up to work in case no one is there. And I always refer back to that in every aspect of birth, and it includes the physical transitional physiology of what’s happening, that while we focus on the blood volume, and really maybe only two to five minutes is necessary, there’s more going on.
And so, the next question becomes what would happen if birth happened and no one else was there? Chances are, nobody’s gonna be cutting the cord. Typically, what happens at birth is even if we leave the cord intact, once the baby comes out, it’s usually where the rushing starts. Baby comes out, everybody starts drying the baby, and rubbing the baby, and rubbing the baby, and suctioning the baby, and stimulating the baby, and all the moving, more stimulating, everybody’s making loud sounds, and it’s where our heart is beating rapidly. Anybody that’s in the room, their heart is beating rapidly, because that is an implicit memory. Because what’s coming up in everybody in the room is a memory of their birth is coming up.
Lozada: So, describe to me a little bit more of what that moment would look like.
Strange: That moment, so I usually just say, so you assess the baby as they’re coming out. If it’s the 99% of babies that just need a moment, well, then you better have a practice. Maybe you could just take a breath. Maybe you could, instead of rushing to touch the baby, just notice. Is there a floor in the room? Are you on it? Just something for your body to take a pause and slow down, because the baby feels everybody’s energy in the room. I often say it’s not just what you do that matters, but rather how you are on the inside, and that’s what babies are tracking.
So, our job is to become aware of what’s going on inside us.
Lozada: So, Karen, what’s next on our talk?
Strange: So, I want to switch to the sequence of birth, and to just say there is an embryological blueprint for how we come into being. We’re all kind of familiar with that in terms of gestation. We know it happens, right? Conception, cell division, cell expansion, it all happens without us even knowing. And I want to say that that also happens as part of pre-labor, labor, birth, and the immediate postpartum. And what I mean by that is within the blueprint, the embryological blueprint for gestation is also an embryological blueprint for how to be born. Within this blueprint is a sequence. It has to go according to the sequence. It can’t go out of sequence. Just like you can’t have cell division before cell expansion. That’s also part of pre-labor, labor, birth, and the immediate postpartum.
Sequences building the brain and the nervous system are actually sequence dependent. Within the sequence are pauses or points of integration. And one more thing about this blueprint is it unfolds within the embryological sources, which occur at a much slower pacing. So, how we form actually occurs slowly, and anytime you plug into that slower pacing, it is healing. That’s why people with catastrophic illness will do guided visualization and meditation, to plug into the slower pacing. All trauma work is done at slower pacing. Mothers in labor are in that slower pacing. Babies’ brain waves are 6 to 10 times slower than ours. They’re in the slower pacing.
I like to think about what happens embedded in the birth sequence and to know that mother and baby interactions are extremely complex and precise, like a computerized program. That comes from a website called BreastCrawl.org. Complex and precise. Not important. It’s exact. And if you were to take a computer program and change one zero, it wouldn’t work. So, my goal is in supporting what happens in the birth process and more importantly, what happens after birth.
Lozada: So, how do you do… If something goes not as planned and there’s more separation, or there’s no time for that pause, or that cord gets cut, that somehow throws that birth sequence for a loop, how can you, or can you, repair and integrate later on?
Strange: So, first what you kind of have to understand about the blueprint is babies usually, not always, but usually come out and there’s a pause. So, to be thinking, “Well, if nobody was there, where would she give birth?” Most women, if nobody was there, would probably give birth in a more vertical position. And in a more vertical position, she has the ability to take a pause. Her baby’s probably gonna land on the ground if she’s in a more vertical position, so the baby’s safe. The mother can take a little pause. And normally I simulate what the mother does, and it’s very funny, but she usually has a pause. She takes a breath.
Lozada: And usually she’s like in a squatting position, right?
Strange: Squatting, or leaning, or bending over, but in a more vertical position. The baby goes down. She can take a moment to realize she hasn’t split open, right? It is a big deal pushing a baby through that little hole. It doesn’t matter what baby number. It doesn’t matter what size the baby is. It’s a big deal and most women need a moment. After she’s had a moment, she’s gonna want to look and see what came out. This is part of the sequence. It’s easy to see if you look at some mammals on YouTube being born. She has a pause, she looks at her baby, then she starts touching delicately with her fingertips the edges of the baby. This, of course, can be done even if you put the baby in the mother’s arms, but to really get that there is this pause, because it’s a big deal.
It’s also happening for the baby, and so the simple little scenario I give is being in a flotation tank. Flotation tank is a big tub of water, it’s warm water, it’s filled with salt, you can really relax, it’s enclosed, and it’s dark, and it’s padded, so that it’s quiet. And when you come out of this, you as an adult, come out of this tank, where actually it’s very relaxing, there’s gonna be somebody there to greet you. And they’ve been preparing for this all day, and they brought new towels to dry you with, and a hat, and they made your favorite food, and they’ve got music on, and they brought the new phone with the flash on it, because they want to immortalize this moment, and when you come out and… Oh, one more thing. They’re very excited about seeing you. They are very excited about seeing you! They can’t wait to see you!
So, anyway, it’s time for you to come out, and they’re very nice. They’re very nice, and sweet, and they open the door, and they help you out, and when you come out, they start drying you, and rubbing you, and putting the hat on you, and giving you kisses, and offering you food, and the aromatherapy, and the music is going on. How do you think you might feel?
Lozada: Just a little tad overwhelmed.
Strange: It’s too much. Again, think, if birth was set up to work and no one was there, if no one was there, nobody would be touching the baby. For a moment they would get used to being out. Birth was set up to work. Mary Esther, I don’t know if you know Mary Esther Malloy, she’s from New York. She says you have to exhale the birth before you can inhale the baby. Sequence. And each sequence is built on a less complex to more complex, and the impulse to move forward in the sequence is to head to the food. This is true of all mammals. All mammals will head to the food after a period of rest. It’s part of the sequence. But this is a really critical piece, because sometimes babies are taken away from their mother, or maybe the mother had a hemorrhage, or maybe she just wasn’t ready. Maybe she was in the hospital. Maybe they took the baby away. Maybe it was a premature baby. Maybe it had to have some surgery.
Well, what’s really important to know is that when mother and baby go back together, that is where the healing begins. That’s part of what is known as the first hour, that healing hour, the sacred hour. It is critical, and when the baby goes back onto the mom, whether it’s a day, two days, three days, three weeks, three months, whenever mother and baby go back together, that’s where the healing begins because babies feel safe in one place, and that is their mother.
Lozada: And that healing can happen-
Lozada: At any time.
Strange: Yes. Anytime. And I will say the longer the separation, you are missing the oxytocin hour. So, you probably need to do more skin to skin. Skin to skin turns on the critical sensory needs of the brain. It is critical for healing. I want to add another proponent to laid back breastfeeding. It could be called self-attachment, supported attachment, baby-led breastfeeding. They all have multiple names. It doesn’t matter what you call it. It doesn’t even really matter when you do it. It’s meant to happen at birth. It can happen later. It can happen weeks later, months later, years later. Actually, babies, children crawling up your leg is a self-attachment sequence. So, a couple of things happen in a self-attachment sequence.
It is not only innate, species specific, a biological imperative, as well as part of the birth sequence and actually necessary for optimal development of the brain. It turns on the critical sensory needs of the brain, which lead to higher learning, but is also part of how we organize ourselves and a natural repair, because babies are gonna tell the story of what just happened to them on their journey to the breast. Again, if it were you, and you just went through this big, intense experience, maybe it was hard, maybe it was long, maybe it was difficult, maybe you needed help, maybe you got stuck, when you came out and after you had your pause, don’t you think you might want to tell someone about what that was like? That’s what the baby’s doing. They’re telling you about what happened.
And even if nothing big happened, I’m gonna say that birth is a big experience. Even if nothing big happened. For the baby, going through that hole is a big deal and they want to tell you about it. So, have curiosity for what the baby is showing you. What is she telling you about her journey? Perhaps hold this desire as your baby’s starting to lick and move her little leggies. Hold this desire. I want her to know that I am listening, that I hear her, that I see her, and that what she says matters to me, because babies are always communicating with us. I didn’t really go into how they do that and what the most important thing is to have empathy and reflect back that you get that the baby had an experience.
So, I’ll just wrap with this. The key in understanding all this is not that you have to do it perfectly, because really you can’t. It’s impossible. But you can always make space for the reconnection. That is the repair. Being emotionally available, slowing the pace, the story getting told and heard, and having empathy. Your job is to have reflection, have empathy for their experience when they start crying. You listen to them. And then they no longer have to keep telling you about it, so they’re gonna feel the blueprint through the imprint, and they’re gonna follow their way to the breast.
Lozada: Thank you so much for being so generous with your knowledge.
Lozada: You’ve been listening to a Best of Birthful episode. To listen to the original, longer version of this episode, click on the link in the show notes, and there are many more where this came from. Look for episodes with the words Best of Birthful in the title to continue your deep dive to inform your intuition. You can find the in-depth show notes for this episode at Birthful.com. You can also connect with us directly on Instagram. We’re @BirthfulPodcast.
Birthful was created by me, Adriana Lozada, and is a production of Lantigua Williams & Co. The show’s senior producer is Paulina Velasco. Virginia Lora is the managing producer. Cedric Wilson is our lead producer. Kat Hernandez and Ronald Young Jr. contributed to this episode. Thank you for listening to and sharing Birthful. Be sure to subscribe on Apple Podcasts, Amazon Music, Spotify, and everywhere you listen. Come back every week for more ways to inform your intuition.
Lozada, Adriana, host. “Best of Birthful: What Your Baby Experiences During Birth.” Birthful, Lantigua Williams & Co. August 10, 2022. Birthful.com.
About Karen Strange
Karen H. Strange is a Certified Professional Midwife and an American Academy of Pediatrics/Neonatal Resuscitation Program Instructor, and has been since 1992.
She is founder of the Integrative Resuscitation of the Newborn workshop, which includes the physiology of newborn transition, the evidence-based studies having to do with neonatal resuscitation, and the “when, why and how” to do neonatal resuscitation in a non-traumatizing way.
Karen incorporates the baby’s perspective of birth and tools for healing when things do not go as planned. Laced throughout the day is information and practice of grounding and presence for the skills used everyday and specifically how to use these tools in an emergency.
Karen has taught over 8,500 people worldwide. She has conducted over 900 hours of debriefs with birth professional regarding all aspects and experiences of resuscitation.
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