"The Wise Woman works in cycles and seasons, with the turning of the planets, and the pulsation of life." Susun Weed in Wise Woman Herbal for the Childbearing Year.
Prefer to Listen? Find the accompanying podcast episode on the Unschooled Homebirth podcast, Episode 27, wherever you get your podcasts!
I spent the weekend listening to the wonderful herbalist and Wise Woman healer, Susun Weed, about the Seven Rivers of Healing. Each week in my midwifery program, we have to give a short presentation on a specific topic, and this week I was assigned the Wise Woman Tradition of Healing and how it applies to birth, which I was excited for because Susun Weed has such an insightful way with the words she uses to speak about the Wise Woman Traditions and they are also very steeped in Chinese philosophy and medicine, one of my other favorite topics to study.
In fact, as I was going through her books again and listening to one of her Seven Rivers of Healing courses, I was inspired to create a mini Wise Woman Tradition course in my own online childbirth education program. So I just wanted to share some of this inspiring information with you here so it can serve you on your pregnancy and birth journey as well while I work on developing this new mini-course to provide another perspective of health and birth and how to own your own birth experience. If you love it and want to dive in deeper, you can find out more about my online childbirth program at NaturalBirthCompass.com/Course. If you are already in my childbirth course, then you will automatically get access to this course when it is ready!
But before you go check it out, let's figuratively dive into the Seven Rivers of Healing.
The Seven Rivers of Healing are relevant in all aspects of our health, but even more so when it comes to birth. In short, they describe the course we should follow in regard to health and healing.
The Seven Rivers go like this:
- Do Nothing|Embrace Emptiness|Serenity Medicine
- Collect Information|Investigate Options|Story Medicine
- Engage Energy|Restore Energetic Connections|Mind Medicine
- Nourish & Tone|Strengthen & Feed|Lifestyle Medicine
- Stimulate & Sedate|Incite Strong Response|Alternative Medicine
- Take Pills|Ingest Drugs|Pharmaceutical Medicine
- Break & Enter|Destroy & Remove Obstructions|High-Tech Medicine
There is so much I could say about each one of these steps and how we move from one to another, but I won't go into depth on each River itself here, instead I will give you a peek into how these look in regard to a common birth event and how the interventions unfold - going past your expected date of birth, or what you might know of as your due date.
By the medical definition, going post-date is going beyond your 39th completed week of pregnancy, so once you start the first day of your 40th week, you are technically late, by the current standards of the medical model. In most cases, we know that due dates are estimates, all babies have their own date of readiness and we don't have a complete understanding of the miracle of the spontaneous onset of labor, but it nearly always happens on its own at some point.
The question becomes, if you go post-date, how long do you have before your caregiver starts bringing up interventions. The many flaws of calculating the estimated date of birth is a relevant question of study, but also a topic for another day, so in regard to the Seven Rivers of Healing, the situation could look like this:
Imagine, you are now 40 weeks pregnant, your care provider sets you up for "the talk", the talk about what happens now that you are at 40 weeks pregnant with no signs of labor. You listen as they tell you how long they are willing to wait before they schedule an induction or, in the case of an out-of-hospital midwife, at what point they will have to transfer your care to a hospital, which in an otherwise healthy pregnancy is usually 41-42 weeks (again by medical standards, as well as policies and regulations implemented by your health care providers licensing agency).
The First River
At first you may choose to "Do Nothing", especially if you're only just at 40 weeks, you may not feel the urgency to rush into anything. But the First River, "Do Nothing" doesn't mean you literally do nothing, it really means you take time to listen to your body and your baby, eliminate the outside distractions, find a place of silence and listen to what you and your baby need to feel safe, confident, nourished and prepared for birth. What is important in this River is that you can find the space to listen to yourself and not be influenced by what everyone else is telling you to do. The other important aspect is to quantify the time you feel comfortable in this River if labor still doesn't start, maybe a few days, maybe a week, maybe a full two weeks is what feels comfortable to you. Though you will have some idea of how long you are comfortable here, it is also important to maintain flexibility and each day assess how you are feeling about doing nothing.
The Second River
Perhaps after a few days in the First River, you want to take some next steps and see what options are out there. After you have spent time in the quiet, connecting in with you and your baby, you may want to start gathering information from outside yourself in the Second River. This River must be travelled carefully and with a clear head so you can take what you need and leave what you don't. This River requires careful discernment, there are so many opinions offered up when it comes to pregnancy and birth, and you as the mother need to be very discerning in what information is helpful for you and what is not meant for you to carry. I'm sure you have already experienced this throughout your pregnancy, as soon as people find out you're pregnant they suddenly have so many opinions, and "facts" or stories to share with you, and it can feel very overwhelming, especially the variety of opinions offered around birth and babies.
Some examples of gathering information in the Second River may include keeping track of your baby's movements, checking in about your energy levels, and your sleep, assessing how you are feeling, you may opt to have a bio-physical exam or a non-stress test to see how your baby is doing. These tests may not feel necessary to you, in which case, it's your right to refuse, but they are there for you should you want them. Gathering information may also include learning about induction methods, options and side effects, if you get to the point where you have to start making more and more decisions about more and more invasive procedures, you may want to have some idea of what is being presented, especially if being informed helps you feel confident in making decisions and communicating with your care giver. When you have gathered the information you need to make an informed choice, you may choose to return to the First River for a time and just be at peace, or may move into the next River.
The Third River
The Third River, Engaging Energy, starts with carefully evaluating your emotions about the progression of your pregnancy, about your upcoming birth, about becoming a mother. Are you feeling stressed or concerned? Are you excited and confident? Understanding your own emotions and exploring where they come from is an important part of maintaining a harmonious energy flow and being able to let go and open into labor when the time comes.
The Third River can also include using energy medicine such as homeopathy, meditation or relaxation practices. One of the most important aspects when in this River is to become very clear about the desire to control the outcome versus trust the process. When you try to control the onset of labor and you become too attached to the outcome, it forces you to become more and moreinflexible, which is the opposite state you want to be in for the onset of labor. If instead, you engage your energy with the understanding that nature and the process of birth is working for you, and you can find trust in the process, you move into a more flexible state, and this is a state that naturally moves you toward the outcome you seek in a healthy manner.
If you choose to incorporate affirmations, visualization or hypnosis techniques in this River, consider focusing them on building your trust in your body and the nature of birth rather than specifically on initiating labor. The example Susun gives for this is to think about an affirmation for abundance, for the universe to know what you need and to provide versus an affirmation asking for $1 million dollars. If you focus on general abundance and having enough, you will see how the universe provides, but if you are focused on getting the $1 million dollars, you probably have a slim chance of manifesting that with an affirmation. Relax and open up to the process rather than restraining the energy by trying to control what you cannot control.
The Fourth River
Next, in the Fourth River, you will evaluate the many ways you nourish yourself and your baby - are you getting enough protein, are you getting enough rest, are you getting proper exercise without over exercising - you can read more in the article Strength in the Birth Room and Beyond, to learn about optimal exercise approaches for pregnancy. And you may consider incorporating nourishing herbs, such as red raspberry leaf, nettle, and oatstraw infusion - you can learn more about nourishing and strengthening herbs in the article Herbs in Pregnancy Part One, all about using herbal allies in pregnancy. The aspects of River Four will be all about nourishing and strengthening yourself, your body and being physically ready for birth.
The Fifth River
After the Fourth River, if you are still waiting for baby, you may choose to cross the Great Divide into the Fifth River, which is stimulate and sedate, where we incite a strong response with more aggressive therapies and herbs. Once you arrive at the head waters of the Fifth River, things can move fast and the danger of side effects rises. The first Four Rivers are different approaches of strengthening and harmonizing, and when used with your inner wisdom, they do not do harm. When you enter the Fifth River, it is with the intent that the approach and risks inherent in the approach outweigh the harm, or side effect, or impact to your healing and recovery. These therapies have merit when they are needed, but must be used judiciously and when the time is right, which is important to keep in mind. Making decisions about your pregnancy and birth is never about right or wrong, instead it's a question of is this approach necessary and if yes, when is it the right time to enter the respective River for you and your situation.
In the Fifth River you will find approaches to induction such as acupuncture, chiropractic treatment, massage or strong acupressure on specific active points along meridian systems of the body. This River also includes stronger herbal medicines, those which may have side effects, such as black cohosh, dang gui, or castor oil. These are often sought as a "last ditch" effort before a medical induction. It is always wise to ensure you and your baby are healthy enough to receive these therapies before including them on your pregnancy journey, remember that the benefit should outweigh the risk - for you this might simply involve checking into the silence and listening to your intuition, or it may be having a non-stress test or ultrasound before trying any induction technique. None of these are right or wrong, all options should be used judiciously and according to what feels safe and comfortable for you and your pregnancy.
The Sixth & Seventh Rivers
If you have reached the end of your time, whether that means you are no longer comfortable being pregnant or you feel that you need to accept the interventions your care provider is recommending for any reason that is authentic and true to you, (again there is no right or wrong here, only judicious and safe use) then you may cross into the Sixth River of taking medicine by opting for something like Pitocin or Cytotec or you may find yourself in the Seventh River, Breaking and Entering to Destroy and Remove Obstacles with approaches like a membrane sweep and stretch or membrane strip, or maybe a Foley catheter, or even artificially rupturing your amniotic sac. Remember these two final Rivers are the most intense, the fastest paced, with the most rapids, and therefore they are the most prone to side-effects leading to other interventions or disruptions to your postpartum recovery or your baby's transition into the world.
So proceed here with caution and only after you have spent time in the other Rivers, checking in with yourself, gathering all the information you need to make a fully and truly informed choice, exploring and calming your emotions, leaving behind control and transitioning into trust, and nourishing and strengthening yourself and your baby so you can be strong throughout the process and have the easiest recovery possible, even if the Seventh River becomes the River you find you must enter.
If you are not prepared to navigate the Sixth or Seventh River they may lead to interventions such as episiotomy, forceps, vacuum delivery or even a cesarean birth. With the right preparation, you may enter Rivers Six or Seven, and navigate with clear direction of your compass so you finish your journey to birth with exactly the birth you and your baby needed. But failing to prepare can lead you and your baby down an unnecessarily perilous journey that was not guided by you, but by someone on your birth team. Even if you make the choice to accept interventions, you should still remain the one at the helm of your ship, you should feel confident in your decisions and never opting for interventions out of fear, but of necessity that you identified.
There are definitely times in life when the Sixth and Seventh Rivers save lives, it may save your life or my life, but rarely is birth a life saving event. It is a beautiful life event, another turn of the cycle of our life journey that we are all on, and something that is completely in your capacity to experience intervention-free if you choose to accept and trust and be open to the journey in the manner it unfolds.
The Overall Landscape
This is why I love the approach of the Wise Woman Tradition for pregnancy and birth, it's a really practical way to see how many steps there really are between doing nothing and accepting a major intervention such as an induction or even a membrane sweep, which so many women are told is routine, even as early as 35 or 36 weeks in some clinics.
And when we look at the Rivers, we can see that something as invasive as a membrane sweep belongs in the Break and Enter River because it's invasive, it's disrupting a process with a physical manipulation that carries very real risks, risks that may not be shared with you or may be downplayed, like rupturing your membranes prematurely, inducing infection, or altering the pace of your labor, which can result in increased chance of tearing, which is usually a fear for most women, or increasing the chance for other interventions. The timing of your labor is an important part of the process and unique to each labor and birth, there are already so many things that interfere with the natural pace and unfolding of birth that any unnecessary medical intervention is not serving the process, it is simply trying to control the outcome.
The Rivers Beyond Birth
And even beyond your birth, you will use these Rivers as you navigate parenting and become the primary health care provider in your own household, for your own family. I believe that at no time in your life should you be completely dependent upon someone else to make your health care decisions for you or your family. Your health care team should be your advisors, a place you go for information when you are in the Second River, and only move into the Fifth, Sixth or Seventh Rivers by your choice, if that is what you find is the help you need, but that always has to be your choice.
By your choice, I also mean that you are not manipulated into making the choice your caregiver wants or even needs you to make, which unfortunately is an approach used in all kinds of health care settings, even in all kinds of relationships. It's so important for you to be aware of this issue because in some cases, health care providers don't even realize they are doing it because they probably truly believe what they are recommending is the best thing for you. Yet, they do not know all the options, they only know what they know and the approaches they use all the time, but in most cases, other options exist outside of their routines. That's exactly what these Seven Rivers are all about, helping you avoid going to the wrong River at the wrong time or being unprepared to navigate the River that you need.
So to review, the Seven Rivers of Healing in the Wise Woman Tradition as described by Susun Weed are:
- Do Nothing|Embrace Emptiness|Serenity Medicine
- Collect Information|Investigate Options|Story Medicine
- Engage Energy|Restore Energetic Connections|Mind Medicine
- Nourish & Tone|Strengthen & Feed|Lifestyle Medicine
- Stimulate & Sedate|Incite Strong Response|Alternative Medicine
- Take Pills|Ingest Drugs|Pharmaceutical Medicine
- Break & Enter|Destroy & Remove Obstructions|High-Tech Medicine
You can go into more depth on these in her book Healing Wise, which I highly recommend, because there are so many more layers to this. Knowing these Seven Rivers are probably the most important thing you could know, but you would not regret going deeper with her book if you want to keep your health and health care choices in your own hands for your lifetime.
Again, if you want to go deeper on this aspect of pregnancy and birth, and have this tool in your birth kit, I am working on a new mini-course on the Wise Woman Tradition for Pregnancy and Birth in the Natural Birth Compass online childbirth course, so if you would like to continue on with this study, you can learn more at NaturalBirthCompass.com/Course.