Non-verbal Communication

Apr13

Birthing women tend to enter “birth brain” while focusing during labor–this is a more primal, instinctive, intuitive, primitive part of their brain and it tends to be fairly nonverbal. I often remind fathers-to-be in my classes not to ask their partners too many questions while they focus on birthing, because questions pull women out of “birth brain” and into the more analytical, rational side of the brain that we use in day-to-day life (this “thinking” brain is not as useful during labor!) Instead, I encourage birth partners to just “do” and then pay attention to the woman’s nonverbal cues (or short, verbal cues) about whether to keep it up–an example I often use is with giving her a drink of water or juice. Instead of asking, “do you want another drink?” Just hold the straw up to her lips! If she is thirsty, she will drink, and if she is not she won’t. No words need to be exchanged. Other reactions might be that she might push the drink away, say “no,” or shake her head.

As I referenced in a prior post, I recently finished reading through The Pink Kit. It has some more related thoughts to add:

Childbirth is such intense work that sometimes a woman just can’t get a full sentence (or even a short one) out of her mouth. You can’t read her mind. However, it’s not too difficult to read her body language…During labour, it will be easier for her to push your hand away, say ‘shhhh,’ grab you and hold on, or put your hand on some part of her body, than to talk. Often a woman can THINK something so loudly, she’s certain she’s said it aloud.”

Birth as a Rite of Passage

Apr11

Part of my philosophy of birth is that it is a significant rite of passage for women, men, and families, not a medical event, emergency, or health crisis. I recently finished working through The Pink Kit and the little book that came with it had some thoughts to share on this subject in the “final word” segment of the book:

We would like to warn you against expecting a ‘perfect birth,’ or for that matter anything in particular, except that you will get through it, with your baby–just about everyone does, no matter what they know and do!

The fact is, there is no such a thing as a ‘perfect life.’ Think about what life passages you may have undergone so far–cutting teeth, starting school, menstruation, the first sexual experience, loved ones dying.

Birthing is also a rite of passage–into parenthood–and like any other passage, it comes upon us and we just have to deal with it. It’s an awe-inspiring experience, and it would be perfectly natural to want to prepare in some way. And you can do that. But to some extent the experience is still out of your control.

Giving birth is definitely the most significant and impactful rite of passage of my life–it is the the gateway to motherhood, which has been the single most life-changing role I’ve had. I believe that this significant, transitional, rite of passage is worthy of appropriate level of awe, respect, and preparation. It is a sacred passage. Accordingly, I also believe the birthing woman should be treated with reverence and respect.

For Labor Support Remember TLC or BLT

Apr10

When supporting a woman in labor, remember to use “TLC”:

Touch–this can be massage, hand-holding, foot rubs, stroking her hair, and encouraging frequent position changes. It also includes the use of water (hydrotherapy).

Listen–this is half of the emotional support in labor. Listening builds trust and meets emotional needs. Use active(reflective) listening and lots of encouragement.

Communication–there are two types in labor. One is information sharing–about her progress, her choices, ideas of things to try, interventions, complications. The second is mediation with hospital staff–this can involve reminders about mother’s wishes, and assertiveness about care.

Or, you can use “BLT”:

Breath–remind her to breathe if she is holding her breath. Model a “cleansing breath” if she is stressed. In through the nose and out through the mouth (like a sigh) can be helpful.

Language–this can be mind-body communication, internal conversation, or verbally telling, showing, or modeling (body language).

Touch–as discussed above. Large muscle massage or firm pressure usually feels better to the laboring woman than light patting, stroking, or “tickling” at the skin or clothing level of her body.

Material on TLC is drawn from the International Journal of Childbirth Education, June 1998. Material on BLT from The Pink Kit–New Focus: Breath, Language, and Touch.

Pain, Power, & Accomplishment

Mar21

I love this section from Giving Birth with Confidence (Lamaze). It explores the role of pain in labor and its relationship to personal power and accomplishment:

The pain of labor, like most pain, is protective. Responding to pain with movement, including walking, rocking, and position changes, not only helps the baby rotate and descend through the pelvis, but also protects a woman’s body during the process. As the cervix stretches and dilates, oxytocin levels increase, and contractions strengthen and become more effective. As pain increases, endorphins are released that help women cope with the demands of the stronger contraction and the descent of the baby. Actively responding to the pain..then not only promotes comfort but promotes the progress of labor…Because the pain of labor is not associated with trauma, but is a part of a normal, physiologic process, it is sometimes compared to the pain associated with other challenging physical activities. Those who push themselves to climb the last hill, cross the finish line, or conquer a challenging dance routine often report feelings of euphoria and increased self-esteem. Researchers have found that women who experience natural birth often describe similar feelings of exaltation and increased self-esteem. These feelings of accomplishment, confidence, and strength have the potential to transform women’s lives. In many cultures, the runner who completes a long race is admired, but it is not acknowledged that laboring women may experience the same life-altering feelings. [Birth classes] help each woman find ways to meet the challenges of birth confidently and purposefully, and to discover her strength in birth.

The above explains very well why it is that I do what I do–I want each woman to have the chance to experience that transforming power, that sense of personal accomplishment, the increased self-esteem, and the euphoria of knowing “I did it!” I climbed my mountain, I ran my marathon…I gave birth to MY BABY!

Recent Articles

Mar21

I’ve had a fun month for publications. My Birth Lessons from a Chicken essay was in Midwifery Today and my Respecting the Birth-Breastfeeding Continuum was in International Doula.

Also, the International Journal of Childbirth Education has some of their issues available online now. The September 2008 issue has my Satisfaction with Birth article beginning on page 14. The June 2008 issue has my Celebrating World Breastfeeding Week & the Birth-Breastfeeding Continuum article and my sidebar WBW: A Simple Celebration beginning on page 15.

Fear-Tension-Pain or Excitement-Power-Progress?

Feb14

I love re-framing traditional concepts of birthing to more positive and empowering perspectives. Recently, I was reading an older issue of the International Journal of Childbirth Education and came across a concept that I immediately loved and will incorporate into my birth classes from now on. Most childbirth educators are familiar with the Fear-Tension-Pain cycle–wherein fear raises tension in the body which leads to pain and so on. Reducing one element in the cycle leads to reductions in the others–i.e. reducing tension through relaxation techniques leads to less pain and then less fear.

While this is still a very useful concept and I will continue to use it, the new perspective I just read about was the Excitement-Power-Progress cycle. The idea being that labor can be greeted with excitement and welcome instead of fear and anxiety. As the power of birth grows, so does the progress towards meeting your baby! So, you can greet the increased power with excitement and confidence and know that your body is making beautiful progress.

The author of the article I was reading (Stacey Scarborough), phrased it like this:

“Fear = EXCITEMENT about being labor and having a baby!

Tension = POWER, strength, or energy!

Pain = PROGRESS”

Educators as “bankers” or “midwives”

Feb10

I recently wrote on ICEA about two different approaches educators can take to presenting information (birth educators or otherwise). “Bankers” teach by “making deposits” of information into their students’ minds. “Midwife” teachers do the opposite. Instead of depositing information for the student to store, they “draw out” the information the student already has–so the student “gives birth” to their own inner wisdom.

Click here to read the whole post.

Honesty in Birth Classes

Jan14

I just wrote a quick post at ICEA regarding honesty in birth preparation. I find it a difficult line to walk sometimes—to encourage confidence, trust, and joy in childbearing, while being straightforward about the challenges couples may face when seeking a natural birth experience in a hospital. I always encourage couples to “assume good intent” from hospital staff—they offer medications because they feel like they are helping. I also remind them that routines are powerful and if the majority of births occurring at a specific hospital are induced, medicated, heavily intervened with, etc. it can be difficult to buck the trend. Again, not out of some sketchy motive from hospital staff, but simply because of routine or “this is what we always do” or “this is what mothers want from us.”

No Right Way + Fathers at Birth

Jan10

A few weeks ago, I spoke to a mother from one of my most recent birth classes. She told me something that her husband said to her in labor that I found very profound. Staff at the hospital were becoming concerned that this mother’s labor was “not progressing” and “not normal.” She, in turn, became worried that she wasn’t normal and that something was wrong. Her husband told her: “There is no normal. There is no right way. There is only your birth.”

This was so beautiful, and so true, that it brought tears into my eyes. Last week I finished reading a new book called Fathers at Birth by Rose St. John. In it, she addresses something similar:

“Of course your baby is the greatest gift of labor. but another great gift is you are pressed to your max or beyond, and you succeed. It expands who you know yourself to be…Labor is all about finding your threshold and learning you can go beyond it…If your partner feels, for whatever reason, that labor did not unfold as she had hoped, she needs your assurance. No woman should be judged or judge herself for doing whatever she has to to do to bring her baby forth into this world. And no man should be judged or judge himself for how he attends his partner or how he responds to birth. You are dealing with life on the edge. You do not know what will happen in it, and you are not in control. Together, you are participants in the mystery, and you do the best you can…On some levels, it doesn’t matter how you both get through labor. There is no prescription. No script. No right way. Its commanding power does not depend exclusively on you or your partner to do it. No matter how you get through, it alters and expands you…whether you are powerfully present, totally absent, or anywhere in between; birth deposits its power into your lives. The transformation is enduring. You can never go back.”

She also addresses the “weight” men shoulder when attending their partners in birth:

“Since men are not the ones doing the actual labor and birth, they may be embarrassed to admit how exhausted and relieved they are once it is over and all is well. they may also be reluctant to admit the amount of dedication and work it took them to attend their partner. I don’t think most women (or anyone else) realize the weight many men shoulder during labor and birth. What happens to a man’s partner and his baby, in effect, happens to him…[quote from father re: being present for his wife in labor] I don’t think anyone has any idea of the amount of effort it takes to be in a physically supportive role where you have to take action, yet be in a witness role where you have to be truly present…”

I posted more about this new book at Citizens for Midwifery:

Fathers at Birth

and More About Fathers at Birth

and also at the International Childbirth Education Association:

Fathers at Birth

Fathers’ Roles at Birth

Benefits of Childbirth Education

Dec27

People sometimes wonder what are the benefits of childbirth education. Classes can seem expensive and they wonder what they will get out of them. The main question that researchers have examined is whether classes reduce labor pain (inconclusive). I have a book called Labor Pain that cites research indicating that classes do reduce the need for medication during labor. According to the same book, though study results do not always agree, various researchers have also found:

possible decrease in length of labor
lower levels of uterine dysfunction requiring augmentation
fewer cases of elevated blood pressure
“less maternal illness and less use of antibiotics after birth”
“more stable heart rate readings in babies during labor”
“more involvement by partners”
“more positive feelings about birth and giving birth among women attending”
less pain during labor
“less frequent use of forceps at delivery”
“greater awareness at birth”
“more enjoyment of birth for women who had attended classes than for those who had not”