I use a white board when I teach, and I frequently begin my childbirth preparation classes asking the women to free associate with the word “childbirth.” Every so often, we get a few positive words up on the board like "baby" "exciting" sometimes even "blessing." But more typical are words like "pain" "fear" "overwhelming" "losing control" "death." These are the words that keep me in business.

The idea that pregnancy and birth are painful and dangerous events has been ingrained in us since we were children. I, for one, have never seen a Hollywood movie that portrayed birth as anything other than a medical emergency. In my first pregnancy, I was exposed to the absurdity of modern birth folklore while trying on hats in Jerusalem. A saleswoman rushed over to me as I raised my arms to put a hat onto my head and scolded me saying… 'Don’t lift your arms above your head! You’ll wrap the cord around the baby's neck.’ It is phenomenal how much bad information and negative imagery is accepted as absolute truth and handed down from one generation to the next.

There are four essential attitudes: awareness, humility, patience and commitment

As a childbirth educator, a mother, and a passionate believer in the innate strength and beauty of childbirth, it is my hope to empower women with knowledge and faith in a woman’s innate ability to birth her babies with confidence. There are four attitudes that I see as essential tools in this preparation. They are awareness, humility, patience and commitment.

First and foremost, Awareness: By being aware of our conditioning and the conclusions we've drawn based on that conditioning, we can take an honest look at ourselves and our fears and begin preparing ourselves for birth. Many of us have become accustomed to the "Easy-Street" perks of 21st century life. From dishwashers to wrinkle-free pants to one week weight loss plans to elective C-sections, our culture has conditioned us to shun things that involve hard work.

"Labor," for example, is a great word. It calls it like it is. If you look it up in a thesaurus you'll find the synonyms: work, toil, struggle, sweat, exertion, diligence. I resent the common Israeli blessing "sh'eyeh lach leida kala,” “you should have an easy birth.” There is no such thing as an easy birth- birth is a journey, and it involves hard work. It's not easy. I don't care how quick labor was or how "easy" the birthing mother made it look, giving birth to a child, becoming the mother of this child, is not easy… it's good, it's miraculous, it's empowering, it's mind-blowing, but it is hard work.
Being aware, and accepting the fact that birth involves all these fabulous synonyms, sets the stage for a powerful experience. There's a midwife in Albuquerque named Suzanne Stalls who Pam England quotes in her book Birthing from Within, and she says she prepares her ladies with these ideas in mind: "There are three things that are givens about labor: It's hard work, it hurts a lot, and you can do it. That's the bottom line. All the rest is icing on the cake." Being aware of the realities of birth, the gory and the glory, is an honest approach that promises the opportunity to really BE PRESENT and experience birth in a profound and meaningful way. Being aware of where we are (physically, spiritually, emotionally) with whom we are with, with what it is exactly that we're doing, brings us to our birth in a very deep and sincere way. It allows for the opportunity to connect with the process as an active participant.

Childbirth is a dual process: there is first and foremost the birth of a child, secondly, and often overlooked, is the birth of a mother. So our preparation must be two-fold. What is essential for preparation for both aspects of birth is a deep awareness of ourselves and knowing the questions that define our beliefs about childbirth. For example: "What do I fear?", "What kind of mother will I be?" "Can I handle this"? These are deep questions that house the core of our self image and our belief systems… our beliefs about birth, and our beliefs about ourselves and our bodies. These are the questions that beg to be faced – the same questions, by the way, that will follow us to our birthing room and tag along with us through our labor.

'Labor' is a great word. It calls a spade a spade

Like labor, finding our answers is not easy. This is a promise, But, as my father is fond of saying, “just because it's not easy, doesn't mean it's not good.”

The next step is Humility. Think about this: Who you are in life is who you are in labor. Humbling, no? Many women who are truly relaxed ladies, who really live in the moment and flow with the tides of life, often find it easier to relax and let go in labor. Conversely, those of us who are a bit more tightly wound may have a little more work to do on the "humility" part. When we allow ourselves to be humble—by humble I mean, quiet (internally quiet), open, calm, empty, accepting, letting go, nullifying ourselves and surrendering our control over the unknowns of labor—we make space for the baby to descend. This humility helps us to open and dilate. We need to step aside, and let go. Don't fight it. This step requires acceptance of the fact that there are no promises in labor. Just like there are no promises in life.

Lack of "humility," or in the Chassidic lexicon, "yeshus," actually has a physiological manifestation. When we are hyper-alert, frightened or startled, the body produces a wonderful hormone called adrenaline. Adrenaline is not a "humbling" hormone.

Pam England has a wonderful chapter in her book called "Even Paper Tigers Can Bite" she explains it like this: Imagine that you're giving birth in the jungle. You're laboring beautifully and peacefully, the parrots are serenading you, monkeys are swinging from branch to branch, and you've found a soft, quiet patch of grass to birth your baby. Suddenly, you sense a tiger on the prowl. What do you think would happen to your labor? You may think you have a choice in this situation, but your body has already made the decision. No mother can give birth if she feels unsafe or senses danger. Believing there is a tiger in your birth space, real or not, triggers your body's natural response: the production of adrenaline; which fuels the "fight or flight" which is responsible for uterine contractions. Contractions will stop until safety has been restored.

The thing is, though, that our nervous system is not able to differentiate between real or imagined tigers; it just responds to imagery. So, if we are aiming for a strong and meaningful birth experience, we need to check in with our tigers and make sure that we have created the environment that enables us to feel safe, open, humble.

Another attribute that can help prepare us for a powerful birthing experience is patience. Patience means understanding that labor has its own clock. This can’t just be an intellectual understanding, you've got to own it. So many women have preconceived notions about how long labor "should" be. When we obsess about the timing of contractions, and take excessive mental energy to figure out how long we've been in labor and how much longer it will be and if it already hurts this much and it's been this much time, what will be then… blah blah blah… we can actually give our uterus performance anxiety. Once the uterus knows it's not being watched, it can relax and do what is designed to do. Be patient. Take it one contraction at a time.

No mother can give birth if she feels unsafe or senses danger

Patience by the way is central in helping a woman through her 9th/10th month of pregnancy. The baby's going come when she's done cooking, not before. If you're not in labor, and your body and your baby is not ready for you to be in labor, then castor oil isn't going to do much more than send you to the bathroom. Be patient, the babe's got no other plans— she's going to be born. Once again, that 9th/10th month home stretch is a salient preparation for the patience required in labor – and of course a profound preparation for parenthood.

Finally, we come to commitment. In order to be truly committed to the process, we have to know who we are (that’s the awareness part), then we have to accept our reality (that's the humility part), next we need to be patient as the process unfolds. The final step is to commit to giving birth to your baby. Sometimes in the throws of labor we actually forget that this is all about birthing a baby. The baby is going to be born, there's only a limited amount of time that we can be pregnant… so when labor begins, commit yourself to "being there," to giving birth to your baby. I think one of the best ad campaigns ever run was Nike's "Just do it." I've seen a lot of women in hard labor, usually around transition time or pushing say "I can't do it, make it stop, I don't want to do this anymore." And my response is, "you are doing it."

Commit yourself to being honest about where you're at. Commit yourself to asking for help when you need it. Commit yourself to getting through one contraction at a time. Commit yourself to facing your fears, and facing the hard work that labor brings. Giving birth with confidence demands that you commit to labor, to hard work, with the understanding and acceptance that it is not easy – otherwise they would have called it something else. Know that you can do it; this is what your body is designed to do. So "Just do it."

Having been born and raised in Southern California, imagery that involves oceans have always appealed to me, and I'm especially drawn to the metaphor of waves in the sea in connection with labor. When we're out in the ocean and a big, menacing wave is on it's way, often our instinct is to swim away from it, to try to outrun it. The truth is, as all surfers know, that the faster we swim away, the stronger and larger that wave becomes… and ultimately, trying to out-swim a big wave will simply pull us under its tow and crash all over us. So, what do we do instead? First of all, we take a good look our situation and admit to ourselves that a killer wave is on its way. After we've accepted our situation, we examine our choices, we can sink or we can swim. Then, after a deep breath and with faith in our buoyancy, we swim out and greet the wave. We ride the wave. We relax our body, and allow its force and strength to bring us a little closer to shore. Surfing, like labor, can be nothing short of exhilarating when viewed with the right eyes.