Tips for Emotional Well-Being During Pregnancy

Jan22

I got a lot of wonderful responses to my question about emotional well-being during pregnancy (associated with my giveaway of the book Birth Space, Safe Place). So, courtesy of a lot of wise women, here are some top tips for supporting your emotional well-being during pregnancy and birth:

Peaceful Beginnings doula services shared “I think my best tip for emotional well-being during pregnancy (and life in general) is to let go of guilt. We can only do the best we can with the information we have at the time, no more, no less.”
Yasmel shared that her most helpful tip, “would be to find whatever gives you positive thoughts and use it, a lot. I loved the book Ina May’s Guide to Childbirth and whenever I started second guessing my homebirth decision, I would open it up and just read the birth stories in it.”
Heather appreciated a helpful tip from her sister: “I was having alot of people question my birthing choices and telling me that my baby and I were going to die. None of which happened. She told me that ‘you can’t expect people to agree with your choices or behave respectfully about them. All you can do is know that you are doing what’s right for you and your child and that is all the matters. Don’t let them change your mind with fear. It has no place in childbirth.’”
And I especially enjoyed Ahmie’s advice: “remember that cats purr while giving birth. Figure out what makes you ‘purr’ while you’re pregnant and find ways to do more of that as well as to bring those tools to the birth-space with you.”
One of the most simple and yet important tips was shared by bubbledumpster, “Trust yourself,” and echoed in several other comments, such as earthmothergypsy who said, “I think one of the best helps emotionally is to encourage mamas to trust in themselves, their bodies and their babies. By giving them support in a way that they don’t feel undermined they can build the above trust in themselves.” And inoakpark who said, ” learning to trust your body (and trusting the people who will be with you at your birth to hold that space), is vital for an emotionally secure pregnancy and birth.”
bee in the balm offered another elegantly simple tip “to breathe, just take the time to come back to center and be and breathe.”

Nicole d shared that her best tip is “meditation on good/safe birth… the normalcy and miraculous nature of it. So much of pregnancy stress is uncertainty and fear of the birth process. The more you can trust in the process of pregnancy and birth, the more joyful and peaceful pregnancy can be.”
For Lee-Ann, “emotional wellbeing came with knowledge, the more I read and the more I normalized the birth process in my mind, the more research I did, the more confident and at peace I became.”
Rebekah made an excellent point about honest during pregnancy: “I think being open and honest with yourself and talking to your baby openly helps. It benefits no one to ‘pretend’ like everything is perfect and is okay to have trials, doubts, and fears.”
Jessica benefited from midwifery care: “One of the things that helped me a lot was having a midwife that I knew and trusted implicitly. I knew that my body and my baby would know what to do, and that I had a wonderful woman who would let it all unfold!”
And whoz_your_doula pointed out the benefit of taking time for yourself: “For me that took the form of meditation and prayer. The early morning is my time for deep reflection before the house begins to stir.”
A similar tip was shared by Gentle Beginnings: “I feel it is very important for a woman’s emotional well being to take a few minutes each day to spend time alone. To sit quietly and think about the precious child growing inside them, to disconnect from the world, to envision how peaceful they want their birth to be, to take a stroll in nature and to connect with their inner self. I think we can all benefit from these simple suggestions, but feel it is especially important during pregnancy and childbirth.”

Helpful for birth educators as well as couples, Janet shared that her favorite tip is “teaching the mom and her partner to work together towards open and honest communication before hand. I find a lot of the mothers I teach think, ‘Oh, well we talked about it once and I think we are on the same page,’ only to be completely blind-sided afterwards. Keeping these lines of communication open before, during and after pregnancy makes for a much better emotional state for all.”
Jamie moved us back to the trust theme: “Trust yourself. Trust that your body knows how to be pregnant and how to give birth. Be positive in the changes your body is going through and how you are being prepared for motherhood in all facets of your being. Know that you can do this—you are doing it!”
And another excellent and simple tip was shared by Heather Richins: “My tip is to make sure you stay well fed and hydrated. It is hard to feel good emotionally if you don’t feel good physically.”
Deborah had more than one to share: “1) Eat well: increase protein and raw fruits & veggies, and drink lots of water. Decrease refined foods, white flour products and sugars. 2) Exercise: walk, swim, yoga, etc. 3) Talk: find someone you trust and be honest about how you are feeling.”
And finally, Kathy offered a comprehensive collection of tips: “to be conscious of their needs each day. This includes physical,emotional, and spiritual. For the physical; Eat well. Whole foods, including whole grains, fruits, vegetables. Protein intakes needs to be adequate for a pregnant woman on a daily basis. Eating often to keep your blood sugars level is especially important for warding off mood swings. For the emotional; Trust yourself and others who care about you. Surround yourself with positive people who support you in what your doing. Communicate your needs and wants. Be willing to be honest and vulnerable. Pregnancy can often ‘stir the pot.’ Being willing to work out your feeling and talk to someone you trust and bring about personal growth and sometimes, bring about healing the past. For the spiritual; It is just as important for the spirit to be fed, as it for the body. Fellowshipping with others of the same faith is uplifting to the spirit. Take time for reflections and meditations each day. Keep a journal.”

I appreciated all the responses and think that emotional well-being is such an important subject. I feel like, especially with a first baby, it is an often overlooked element of birth preparation—a lot of time and energy is spent on the physical health of the pregnant woman, but the emotions are assumed to kind of take care of themselves, to perhaps be no one’s business, or to be dismissed summarily as “crazy pregnancy hormones” and “mood swings of pregnancy!”

Books About Miscarriage

Dec30

I recently made a post to my other blog about books about miscarriage. I wanted to link to the post here as well, because my blogs have different readers and I think it is useful to other childbirth educators to have read some books about miscarriage/childbearing loss and also to have some books available in their own lending libraries.

For the list of miscarriage books I’ve read since November, click here: Books About Miscarriage

You know you’re a childbirth educator when…

Dec12

…you come in from getting the mail and this is what you see:

Three Hours into 1.5 Minutes??

Dec11

I most often write blog posts directed at pregnant women, not birth professionals (though I hope the pros find my posts useful as well!). Via the excellent Passion for Birth blog this morning, I read this article that is very relevant to childbirth educators.

The article addresses how educators/presenters can attempt to cram three hours worth of information into 1 and half minutes and how that is NOT effective or helpful. They do so out of fear that this is their “only chance” to reach those learners (but the cramming style actually does not reach learners either).

Ugh. I found myself cringing a bit when reading because I think I have this tendency for sure. It was also relevant to me in my non-birthwork life. I am faculty at Columbia College and am teaching my first college class this session (final exam tonight!). All of the principles in the article are things I strive to keep in mind when teaching college students as well (and sometimes I succeed and sometimes I fail. The actual class is 5 hours a night—though now six, because I missed one week and made it up sequentially over the following 5 weeks of class—which makes it tricky to keep people engaged, though also gives me plenty of time not to be cramming information into people’s heads).

Anyway, so the summary of points from the article (OMG. I’m taking a metaphorical three hours to get to my point…;-) were as follows:

Learners want relevance
Learners don’t care about history
Learners want minimal detail
Learners want connections
Learners want focus
Learners want applications
Learners want practice

I remember reading somewhere else at some point (I think during my ICEA certification process), that most learners do NOT want the amount of information and level of detail that you can provide. The first three on my list above are things I find myself falling into in birth education—I tend to give lots of details and some end up being irrelvant (I don’t want anyone to miss anything!) and I do have a tendency to give lots of history, background, and overexplanation.

So, good things to keep in mind! I want to be effective, not inefficient or irrelevant. I have been thinking a lot lately about my classes and how I’d like to improve them and change them and “deepen” them. Reading this article made me think even further about my approach and what I hope to accomplish. I have this sense lately that something just isn’t “working” and I want to go beyond—stretch my boundaries and dig in further.

And Even More Birth Quotes

Nov2

Continuing my semi-regular addition of birth quotes I’ve used on the Talk Birth Facebook page recently.

“When women understand what’s available to us at birth, then we won’t ever give that over to an ‘expert’ the birth power, the orgasmic power that’s in our bodies” –Christiane Northrup

“Women have the inner power and the inner knowledge of giving birth. There is a parallel of sexuality and giving birth. Women who are giving birth, trust yourselves. Trust your inner power. Trust your ability to give life. This is something absolutely sacred that is inside all women in the world.” –Ricardo Jones, MD

“If women experienced the ecstasy of birth, they would have the high that would get them through the hormonal changes of the next week. Your body and your inner wisdom give you that high.” –-Christiane Northrup

“While many of us believe that encouraging a laboring woman to move when and how she wants to is healthier and safer than making her stay in bed, waiting for evidence that it produces better health outcomes is putting a burden of proof on normal birth that has never been applied to routine intervention.” –Amy Romano

“Pay attention to the pregnant woman! There is no one as important as she!” –Chagga saying, Uganda

“A pregnant woman is like a beautiful flowering tree, but take care when it comes time for the harvest that you do not shake or bruise the tree, for in doing so, you may harm both the tree and its fruit.” –Peter Jackson

“Can we create a world where all needs are met with dignity and individual culture is retained; where a baby anywhere in the world is born nonviolently and according to the instincts of its mother; where people progress in directions of full potential and spirit is not sacrificed; where women no longer obey, submit and apologize for who they are?” –Sister MorningStar

“If birth were a medical disaster in waiting, routine medical intervention would not disrupt the process. It does. If technology were integral to the process of birth, routine technology would improve outcomes. It hasn’t. If birth were inherently painful, all women would suffer without medicine. They don’t. The initial assumption[s] are proven faulty.” –Kim Wildner

“Having a baby [is] an opportunity to transform a life, because in the moments of labor and birth all the forces of the universe are flowing through a woman’s body…’If you have 12 babies you only get 12 of those opportunities. This is big fun.'” –Sister MorningStar

“I think that women can be just completely surprised by the change in them from giving birth—you have something powerful in you—that fierce thing comes up—and I think babies need moms to have that fierceness—you feel like you can do anything and that’s the feeling we want moms to have.” –Ina May Gaskin

“Birth has been broken. The spirit of women with respect to their innate birthing power has been broken. We can do nothing about the millions of broken births that have already taken place, but by seriously looking at the effect of fear–the powerful emotion that clouds our thinking and causes the birthing body to break down–perhaps we can keep the finely tuned, precision bodies of women whole for future generations…” –Marie Mongan

“When you destroy midwives, you also destroy a body of knowledge that is shared by women, that can’t be put together by a bunch of surgeons or a bunch of male obstetricians, because physiologically, birth doesn’t happen the same way around surgeons, medically trained doctors, as it does around sympathetic women.” –Ina May Gaskin

“In a modern world, ‘getting through’ labour without numbing or dumbing the process can be a very powerful experience for a woman, and very challenging.” –The Pink Kit

“When it comes to pregnancy and birth, we as a culture and as individuals need to wake up and claim our right to literally birth right!” –-Christiane Northrup

“Birth may bring you face-to-face with your insecurities, doubts, inadequacies and fears, as well as your joy, determination, willingness and courage.” –The Pink Kit

“$13 to $20 billion a year could be saved in health care costs by demedicalizing childbirth, developing midwifery, and encouraging breastfeeding.” –Frank Oski, MD

“Let us initiate our daughters into the beauty and mystery of being strong and confident women who claim their right to give birth and raise their children with dignity, power, love, and joy.” –Barbara Harper

When it comes to birth classes, “restricting yourself to what ‘everyone else does’ will only get you what everyone else got. The numbers say this is a very sad limitation to place on yourself.” –-Kim Wildner

“In the absence of the medical indication for which they were developed, birth interventions are at best worthless, at worst, harmful.” –Kim Wildner

“Let parents know that they don’t need special techniques and gadgets to give birth safely and happily. Make sure to communicate to every mother you help, that she has all the essential ingredients for a safe, healthy birth within herself. A womb, a baby, a vagina, and a few warm pieces of fabric make an excellent, complete birth kit.” –Laura Morgan

“Women’s bodies have their own wisdom, and a system of birth refined over 100,000 generations is not so easily overpowered.” –Sarah Buckley

Birth Talk

Oct19

As I have referenced several times before I have a special interest in the language of birth. That is part of the reason my blog/business is so-named—because is it is a blog that “talks birth” (as in, “let’s get together and talk birth!”), but also because the way you talk about birth matters. I have also referenced before that it was originally going to be called Birth Talk, but when I went to get the gmail address, it was already taken (by a childbirth educator I coincidentally later came to know!). I’ve come to really “bond” with my Talk Birth name and now “birth talk” sounds slightly odd to me (though “talk birth” is really the odder phrasing).

A couple of months ago, I read an interesting article by Debra Bingham about Taking Birth Back. It it, she asks you to consider–when talking about birth–how your basic assumptions affect your discourse (the way you talk about birth):

1. Does your discourse include stories about the power of women?
2. Or do the stories shift the locus of control away from women and their bodies to other authority figures such as nurses, physicians, or machines?
3. Does your discourse assume that women are physiologically capable of giving birth and nourishing their own children?
4. Or does your discourse assume that women’s bodies are fundamentally flawed and in need of medical attention and intervention?

I am frequently attempting to shift the locus of control from “authority” figures back to women–it is shocking to me how ingrained the terminology is about medical care providers (even midwives!), “letting” someone do something, etc.

And, an enormous part of my life revolves around stories about the power of women, so I think I have that one down 😉

The prevailing social discourse about birth assumes a locus of control external to the woman and you rarely hear stories about the “power of women” amongst the general public or mainstream media. Ditto for the assumption of women’s bodies as fundamentally flawed, except replace “rarely” with “frequently.” These messages are so dominating that I think it is hard for women to really “hear” positive birth talk–it seems like a “joyful birth” must be a myth or impossible. Likewise, when a woman is striving to keep the birth talk around her positive, it can be very difficult to override the predominately negative messages coming at her from every side. I see this in my classes, “I believe birth is a natural event, etc., etc. BUT….” (followed by a “I trust my doctor’s judgment and if he wants me to have this GTT test or this extra ultrasound to check my fluid level, etc. I guess I will do it…” comment that contributes to the “climate of doubt” in her life). There are also the woman’s own “inner voices” to contend with—I hypothesize that the loudly-shouted cultural voices about birth contribute a good deal to the “negative voice” in her inner dialog.

I don’t know any way to “fix” this other than to continue “talking birth”–good, healthy, positive, normal, humanistic, natural, joyful birth–as widely and frequently as I can!

Birth as a Rite of Passage & ‘Digging Deeper’

Oct16

Childbirth is a powerful rite of passage. One of my favorite resources, The Pink Kit, has some great reflections on this rite of passage and the words we use to describe the powerful, indescribable act of giving birth:

Whatever the culture, when a woman surrenders to the process, accepts the intense sensations, works through each contraction, and digs deep within herself to achieve the end goal–giving birth–she is touched by the Unknown and Unknowable. Many traditional cultures send their young men into initiation rites where they, too, can learn to understand humbleness and achieve the self-control that women learn in childbirth.

All cultures believe that women become better and more generous through the process of giving birth. That is why some cultures use words such as ‘sacrifice,’ ‘suffering’ and ‘labour.’ These terms can seem overwhelming and to be avoided’ however, seen from a different viewpoint, childbirth helps us to become strong, resourceful and determined.

In a modern world, ‘getting through’ labour without numbing or dumbing the process can be a very powerful experience for a woman, and very challenging.

I like the concept of “digging deeper.” This how The Pink Kit explains it:

You might avoid the pain in labour by moving into a position which is comfortable for you (i.e. reduces the sensations), but it slows labour down and then you stay there for hours. Doing that will increase the likelihood of medical intervention because you will become tired, bored, or frightened, and labour doesn’t progress. Instead, consider remaining in positions that keep you open and the labour progressing, while using your skills to manage the sensations. This is ‘digging deeper’.

I have noticed an emphasis in other natural birth preparation books and explanations about finding positions that are “comfortable.” I very much like the concept of finding positions that help you feel “open”—these positions may certainly also comfortable (and that is great!), but if you remain mindful of “staying open,” it may lead you “dig deeper” and find positions that really help move the baby. In my classes, I encourage women to welcome labor “getting bigger” (not more “painful” or “difficult,” but make it “bigger” and be excited by that change!). I think this idea goes hand in hand with digging deeper.

Pelvic Bodywork

Oct12

I’ve added a new option to my single night class offerings. I am also available to give this session to small groups (doulas, etc.) The following is the class description:

Use external bony landmarks on your own pelvis to “map” your pelvis and explore the types of birthing positions that work best for your unique body. Pelvic mapping increases your comfort level with your body and your confidence in the space and flexibility available for birth. Figuring out the shape of your pelvic outlet helps you understand how your baby might use the space within to move through. You will explore the positions that help you feel open-—these are not the same for every woman. Knowing your own pelvis helps you use positions most appropriate for your own anatomy.

We will also learn several skills for birthing that work with the anatomy of the bony pelvis to create more space for the baby as well as skills to work with body sensations and internal relaxation. If you are a pregnant woman, these are great skills to bring with you to birth. If you are a doula, these are great skills to have in your doula “toolbox.” If you are a childbirth educator or midwife, these are good skills to show to your clients prior to labor. If there is time, we will also learn a breath awareness strategy for releasing pelvic tension during labor.

Let labor begin on its own…

Oct9

One of my blog posts that gets the most hits and is a consistently searched for topic is one that I wrote called “how do I know I’m really in labor?” I revised it recently for participation in a blog carnival at Science and Sensibility about letting labor begin on its own. Let Labor Begin on Its Own is the first of Lamaze’s Six Healthy Birth Practices. Why is letting labor begin on its own so important? Well, the onset of labor is a complex biological system that has its own wisdom–when a woman’s body is pushed into labor on someone else’s timetable rather than her own, the whole biochemical “dance” of labor and birth is impacted. What may seem like a harmless “jump start,” actually has a cascading effect on the rest of the birth (and has an impact on the baby as well). A significant impact is that induced labors are often much more painful than spontaneous labors. If a woman is planning an unmedicated birth, the increased intensity of artificial induced contractions coupled with the lack of the biologically trigged endorphin release that helps birthing women naturally cope with pain, often leads directly into a request for medications. The woman is then sometimes left feeling like she “failed” in her “natural birth” plans and that she “wimped out” and “just couldn’t handle it.” However, she was dealing with something much different than a “natural” labor and so it makes sense that a “natural” birth then didn’t happen. Of course, the cascade of other interventions that accompany an induction, such as an IV and continuous monitoring also severely restrict a woman’s mobility (which also has a dramatic impact on her ability to cope).

I am saddened when I hear women blaming themselves for “not being able to handle it” (or, conversely being angry at “natural birth zealots” for misleading them…), when they were actually just missing significant pieces of their “pain coping pie” as well as dealing with a (probably) more difficult labor. We need to remember to look at the overall healthy birth climate of the birth setting and the use of the six healthy birth practices, rather than at personal “failure.”

There are a lot of excellent links on letting labor begin on its own in the rest of the blog carnival!

How do I know I’m really in labor?

Sep28

When I was in early labor with my first son, I spent quite some time upstairs in our computer room googling, “how to know you’re really in labor” or, “signs of true labor,” or “the difference between false labor and real labor,” or, “how do I know I’m in labor,” or, “how to know I’m in labor.” I would do this between contractions and then when I had a contraction I would think, “Wow! This is definitely it!” Then, it would ease, and I’d start googling again, certain I must just really be experiencing “false labor.” One of my biggest fears was arriving at the birth center and only being two centimeters dilated (or possibly not in labor at all!). So, in honor of my former self, I offer a list of some ways to to gauge whether you are experiencing true labor.

It is true labor if/when:

Your contractions fall into a regular pattern. And, that pattern involves contractions that are lasting longer, feeling stronger, and occurring closer together.
If when you walk around or otherwise increase your activity, the contractions also increase.
And if changing positions and drinking plenty of fluids also do not cause the contractions to ease…
The sensation begins in your lower back and spreads like a band around your belly causing a peak of tightness and discomfort in the front and then fades away again.
You have been feeling some gastrointestinal upset and may be experiencing diarrhea also.
You have pinkish or blood streaked, mucousy discharge.
Your membranes have ruptured (keep in mind that labor only begins in this way for roughly 10% of women. So, if your waters have not released, do not be discouraged thinking that you must not be in “real labor.” Many women do not experience their waters breaking until they are pushing or are starting to feel like pushing).
Truly, I think that the best sign that you are in labor is if you really feel like you are in labor. This is one of those things that doesn’t feel that helpful to a first-time mom—“yes, but how will I know?! What if I’m in labor and don’t know it until the baby is coming out?!” I promise that for the wide majority of you, at a certain point, you will just know that you are in labor and there will be no more questions about whether this is “really it”—that is the best sign, when you stop wondering “is this really it?” My observation is that this point comes along when you enter active labor and enter your “birth brain” instead of your analytical, logical brain.

Is this really it?

If you are still wondering, “is this really it?” my best piece of advice is to ignore it! Pretend like nothing is happening. Go about your normal day and your normal routine. If you would normally be sleeping, sleep. If you would normally be eating, eat. Go for a walk, water the plants, feed the dog, bake something, go to the store, etc. When your contractions need your full attention, they will ask for it 🙂

Symptoms of pre-labor (“false labor”)

Some “symptoms” that what you are experiencing is instead practice labor, pre-labor, or “false labor” (I do not usually use the phrase “false labor” because I think it is dismissive of women’s experiences. All contractions are doing something and so I refer to them as “practice” rather than “false.” Another good phrase to use is “pre-labor” contractions. My midwife with my second baby referred to them as “toning contractions”):

The contractions are irregular (no pattern) and are not increasing in frequency or intensity.
If you change positions or drink two large glasses of juice, water, or tea, the contractions subside.
The contractions center in your lower abdomen and do not involve your back.
The contractions go away if you take a walk, take a shower, or lie down.

This is also a popular question in birth classes. Because labor is a new event for you, it can be hard to know what to expect until it actually happens! There is pdf handout here with some additional signs and information. There is also a helpful handout with a sort of flowchart of signs/symptoms here.

Oh, and by the way, when I did finally go to the birth center, I was 10 centimeters dilated and started pushing about 30 minutes later!

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What about induction?!

On a closely related topic, why bother with all this guessing about whether or not you’re in labor? Why not be induced instead? Good questions! There are numerous reasons why you should let labor begin on it’s own—labor that begins on its own is usually safer and healthier for both mother and baby. Also, it is less painful than a labor that is induced with medications such as Pitocin. For more information about letting labor begin on its own, check out Lamaze’s Healthy Birth Practice #1, or this video clip from Mother’s Advocate: