For many people, even the word “sphincter” causes their sphincters to contract. And yet, sphincters in our bodies are so vital to our health. Sphincters are circular ring-like muscles surrounding a bodily passage or opening. They are normally constricted, but they relax in order to allow passage through the opening. These muscles are all about either “letting go” or “allowing in”. There are over 50 sphincter muscles in the human body, most of them involuntary. The majority of them are found in our digestive tracts. There is one at the upper portion of the stomach, to prevent acidic contents from moving up into the esophagus (“hopefully”), as well as at the lower end of the stomach, in between the small and large intestine, and to control secretions from the liver, pancreas and gallbladder into the duodenum. We also have them in and around our eyes, to control the amount of light our eyes allow in, to blink and to keep our eyes closed during sleep. Of course, there are the all-important sphincters in our urethras and ani to control the excretion of our waste materials. We have two in each area, and one of each of these is (finally!) a voluntary sphincter. If we have so few voluntary sphincters, meaning ones we can actually control, then why bother talking about them?
I will rewind to the 1970’s and to perhaps the most famous midwife in the United States, Ina May Gaskin, author of Spiritual Midwifery and Ina May’s Guide to Childbirth. She dedicated her life to fighting for natural childbirth and for the right to birth at home. She contributed much to the midwifery movement over the past 45 years, but she is not without controversy. She has been credited with “The Gaskin Maneuver”, a method of resolving shoulder dystocia during childbirth, which she “borrowed” from a Guatemalan midwife, thereby appropriating indigenous ideas without proper attribution. She has also received criticism for putting forth “The Sphincter Laws”, rules by which she claims the vagina, cervix and anus abide. Her critics harp on these “Laws” because neither the vagina nor the cervix are technically structural sphincters, although she describes them as such. She also discusses the sphincters of the mouth and throat, but recent evidence has shown that the round muscle surrounding the mouth which was previously believed to be a sphincter is probably four separate muscles. Her anatomy piece can appear a little loosey goosey, in the eyes of her critics. However, I don’t believe it’s necessary to throw the baby out with the bath water. The fact remains that Gaskin attended over 1200 births as a midwife, and she helped thousands of other women indirectly. She is a birth expert – and while her style may not resonate with everyone, the patterns she recognized in birth should not be ignored. Perhaps a slight reframe is in order. It is my belief that her work surrounding the pelvic sphincters (or functional “sphincters”) can still have a lot of value. By these I mean the cervix (which is not a sphincter but functions as one during pregnancy and childbirth – explained here) and sphincter ani externus, the external voluntary muscle around the anal opening. Understanding how they work can help us relax and open up, which many women have found invaluable during childbirth. The good news is that you don’t have to be pregnant to keep reading, because these properties work for ease in bowel movements, too! (I hope it’s obvious that while I am drawing a parallel between childbirth and bowel movements in that both involve passage through a functional pelvic sphincter, I am in no way comparing or equating the two.)
From my experience, the following three properties of Gaskin’s Sphincter Laws are the most helpful to keep in mind for ease in “letting go”.
- Relaxing the mouth miraculously seems to relax the “sphincters” at the other end. Holding tension in the mouth and jaw makes it harder to allow the vagina to open. In contrast, releasing tension in the mouth also releases tension in the pelvic floor, cervix and vagina during labor. Below are some great ways to do this. The same rules apply to the anal sphincter, so try doing any of these things during your next bowel movement to see if they make you more comfortable:
- Slow, deep breathing
- Opening the mouth and making low, deep “sexy” sounds
- Making “raspberries” or “horse lips”
- Pelvic “sphincters” do not respond well to commands. If you have ever tried to command yourself to poop, you know this doesn’t really work. By the same token, trying to will the cervix or vagina to open during labor doesn’t work either – they don’t respond to pressuring. Instead, try using gentle coaxing through visualization. Imagine the vagina to be big, soft and open. Make this a mantra and repeat it out loud. Another trick learned from Penny Simkin, author of my favorite birth companion book (The Birth Partner), is focusing on the 3 R’s: Rhythm, Relaxation and Ritual. She writes about these in the context of pain coping, but these strategies work wonderfully to open the body’s southern sphincters, too – and not just during childbirth. (Most women I know have a morning ritual, which at least involves relaxation, to encourage them to get on what my boyfriend affectionately calls “the poop train”.)
- Pelvic “sphincters” perform best in an atmosphere of intimacy and privacy. A quiet, calm environment with low lighting and the least number of people tends to work best. Before you say “Duh, Julie”, think about the environment in most hospitals! Bright lighting and lots of hospital staff coming in and out – this environment is not conducive to relaxing and opening. It is well documented that cervical dilation can be going along great at home and stop or reverse the minute a laboring mom reaches a hospital. I am not saying don’t labor in the hospital; if that is where a mom feels the most safe, that is where she should be. I am saying: 1. Relax at home for as long as possible before going to the hospital, and 2. Make the environment in the hospital as intimate and private as humanly possible.
I think of the pelvic floor sphincter muscles as the muscles of “letting go”. Understanding these three properties can help us let go with greater ease, regardless of whether we are discussing something as magical and otherworldly as childbirth or as mundane as the morning elimination.