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Practical Ways to Enhance Knowledge for Birth

Related to my previous posts about information vs. knowledge, I want to share a couple of ideas from an article I wrote some time ago for the International Journal of Childbirth Education. Obviously, I don’t have all the answers, but these are some of my ideas/tips about transferring information into knowledge that will be meaningful to parents when their birthing time comes:

  • Use “The Ice Cube Minute” exercise from Family-Centered Education: The Process of Teaching Birth. In this exercise, couples hold an ice cube in one hand for one minute and see what coping measures spontaneously arise for them. I do this exercise fairly early in my class series, before we’ve done a lot of formal talking about coping measures. It is very empowering for couples to discover what tools and resources come from within as they try the ice cube minute.
  • To illustrate the potency of the mind-body contraction, practice two pretend contractions while holding ice. One contraction has an accompanying “stressful” paragraph read with it (“your body fills with tension…it hurts! Oh no!”) and the second contraction has a soothing paragraph read with it (“you greet the wave….it is YOUR power….”). This illustrates the fear-tension-pain cycle viscerally.
  • Use a five minutes series of birthing room yoga poses to begin the class—birth happens in our bodies, not our heads. Practicing the poses opens space to simultaneously discuss and practice: squatting, pelvic rocks, optimal fetal positioning ideas, healthy sitting, pelvic floor exercises, leg cramp prevention, back pain alleviation, and more.
  • Role playing cards-—talk through various scenarios. I’ve found that couples are more receptive to talking through the cards than actually getting into a role and playing it through. The activity that seems to work best for actual role play is the labor simulation series available on the Transition to Parenthood site.
  • Values clarification exercise—participants cut out values from a list and arrange them in a grid to help them figure out if they are in alignment with each other and with their caregivers.
  • Leg stretch exercise to explore the use of vocalizations and other coping mechanisms during labor.
  • Ask plenty of open ended questions that stimulate discussion and ideas, “what have you heard about XYZ?” or “what is your experience with…?”
  • Use birth art processes to “switch” parents from linear, logical, left-brain thinking into the right-brain mode they will also enter in “laborland.”
  • Media portrayals of birth—show two contrasting clips, such as a birth from a popular TV show (I often show Rachel’s birth from the show Friends) paired with an empowering birth from a film like Birth as We Know It and then have students discuss the two. Sometimes this more clearly brings into focus the influence of our culture on birth practices than a simple discussion does. Since I originally wrote this, the film Laboring Under an Illusion was released which does exactly this—contrast media portrayals of birth with how birth can be. It is a great resource for birth classes.

In classes, I also incorporate the idea of mother-baby symbiosis through:

  • The use of affirmations—“my baby and my body work in harmony to make birthing easier.”
  • A discussion of cardinal movements with an emphasis on how the baby moves to help itself navigate the pelvis (thus, helping you have a smoother birth).
  • Visualization exercises that encourage “seeing” and connecting with the baby while in the womb.
  • Belly Mapping” to get a sense of the baby as a person positioned in the uterus. Talking about what baby is like in the womb—when does it kick more, when is it quiet, does it like music, poke you back with you touch it, etc.
  • Impressing upon participants that it is not selfish to want both a good birth and a healthy baby (I actively challenge statements about, “well, in the end, all that matters is that the baby is healthy”). Laboring women have a basic right to humane care, which supports both a happy, satisfied mother and a healthy baby. I use examples during class to show how these are intertwined—for example, a stressed, unhappy, unsupported, tense mother may have a baby with heart decels and accompanying distress.

I try to build a sense of confidence through:

  • Opening each class with a brief series of “birthing room yoga” poses to help couples become comfortable using their bodies and moving from “head space” into “body space.” Birth is a physical process and I am convinced that it is vital to include physical movement during every class to bring that message home. Additionally, the poses I teach can all be used while in labor (thus, building confidence in coping “tools” for labor).
  • Emphasizing active birth—freedom of movement through labor helps baby rotate and descend and helps mother feel more comfortable.
  • Encouraging active birth on all levels: First, the physical level–being active during the actual physical process of birth. Second, the mental level–mentally engaged with labor. Third, a cultural level—a perspective that sees women as active birthgivers, not victims of birth. Birth is something women do, as opposed to something that “gets” them.
  • Giving couples plenty of time for hands on practice of labor support and coping measures. I have a personal motto for classes of, “talk less, learn more.” Practicing support tools in class helps them develop a sense of confidence in having a well-stocked toolbox for labor, instead of being a victim of pain.

How Do Women Really Learn About Birth?

April 2015 123“I usually claim that pregnant women should not read books about pregnancy and birth. Their time is too precious. They should, rather, watch the moon and sing to their baby in the womb.” –Michel Odent

Related to a previous post about the difference between information and knowledge, I have been pondering how women really learn about birth. Where does birth knowledge they can really use when they need it come from? Is it from birth classes, reading, or from other sources? Though I teach birth classes and believe that childbirth education has important value, I continue to return to thought that what women truly need to give birth does not come from (traditional) classes and it doesn’t come from books either.

Ever since I posted the above quote from Michel Odent on my Facebook page, I have been reflecting back to my pregnancy with my own first baby. Personally, I love books–-of all sorts-–and reading is the top way for me to learn about anything. I think some of the best preparation I did before having my first baby was to read and I always give a recommended reading list to my clients. And, while I “hear” the sentiment in the quote and honor it, my personal opinion is that in our current birth culture it is nearly impossible to go into birth just planning to “go with the flow” and let labor unfold without expectation (if you are birthing in the hospital that is—because the hospital is FULL of expectations and those will often run right over your flow).

When I was pregnant the first time and approaching my first birth, I was hungry for birth information and keenly felt the mystery and unknowableness of the challenge I was about to face. I described it as feeling like I was preparing for the biggest test of my life, but without knowing what the test was. So, how did I learn what I needed to know about giving birth? AND, perhaps most importantly, what had I learned before birth that actually spoke to me while in labor? What did I use and how did I learn about that? Obviously, women are different and have different learning styles and each birth is different, but reflecting on these questions, several things arise as most helpful for me in real preparation:

  • Other women’s experiences—these were frequently what floated through my head during labor and were what I drew on for information and guidance, not “technical” childbirth books, but the stories and opinions and reflections I had read in birth stories and from the participants of the newsgroup misc.kids.pregnancy.
  • Birth art—I created a series of needle felted birth goddess sculptures during my pregnancy that had a “message” for me (that what I needed to give birth—that wild, intuitive knowledge—was already inside me).
  • And yes, reading (and to some extent, classes). I didn’t necessarily use or remember things that I’d read (other than other women’s “voices” through birth stories), but reading definitely helped me prepare—so, while I was not necessarily conscious of book or class-knowledge when I was actually in labor, I was informed by it, yes. During all my reading what I really wanted to to figure out and know was, how am I going to do this? This is the same question that most women who come to my classes have (and my answer is really, “you just will”). The books that were of most value to me were Birthing from Within and An Easier Childbirth. These were the books that had “right brain” lessons to share, even though it was the “left brain” books that I “studied” harder.
  • Yoga—I spontaneously adopted poses used in prenatal yoga during my first labor without even knowing it was “prenatal yoga.” It was an example of how the knowledge already existed inside my body and spontaneously arose when given the space to do so. I also used yoga poses during my other births—not consciously (“I think I’ll try child’s pose now”), but spontaneously and instinct-driven.
  • My blessingway experience/memories—particularly the chant Woman Am I, which I hummed over and over again during my first labor.
  • Voice—talking to myself (inside my head or our loud), verbally coaching myself.
  • My husband—his presence just there with me. I felt like we were one person. This isn’t something I feel like you can “train” for. It too was naturally arising and just pure.
  • Holding a fused glass touchstone and having my favorite pillow (in my third labor, it was holding my goddess of Willendorf pendant).

For me, it all came down to FREEDOM and space for me—I was not in an institutional setting, I was in my own “nest” and that was very key for letting my own body’s wisdom unfold and find expression.

——

A powerful pre-birth lesson in my body’s wisdom actually came from an assassin bug (of all things!). Assassin bugs have very potent, poisonous bites (and in some countries carry hideous diseases). During my first pregnancy I was bitten multiple times in the night by one of them. I had bites on my face (lip) as well as in a row on my arm. The bites caused swelling, ongoing stabbing pain, and joint aching (as well as intense palm-of-hand and sole-of-feet itching when they first occurred). I turned this into a practice experience for myself in coping with labor—figuring that, like labor, this was something uncomfortable and out of my control, but that would eventually pass and that my body would take care of without my needed to actively do anything about it. The stabbing pain was also intermittent (like a pulse), so I thought that was good practice too. I practicing “softening” around the sensations and “being” with the discomfort. I reminded myself that my body knew what to do and that it would heal itself. And, guess what? It did. Each day as the bites healed, I would marvel, “look how much my body knows! Look what it can do without me even knowing what or how it is doing.” Of course, it took several days of stabbing and aching pain for this process to occur, whereas my first labor involved only 5 hours of intense sensation as well as several preceding hours of totally manageable sensation and my subsequent labors only involved 2 hours each of fairly intense sensation. This experience in watching my body take care of itself using its own inherent wisdom was a potent (and unexpected) lesson for me in approaching my first birth.

Book Review: Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child’s First Year

Book Review: Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child’s First Year
By Cassandra Vieten, Ph.D.
New Harbinger, 2009
ISBN 978-061531935-3
200 pages, softcover, $16.95
www.mindfulmotherhood.org

Reviewed by Molly Remer, MSW, CCCE

Written for pregnant women and for mothers embroiled in the intense rite of passage that is baby’s first year, Mindful Motherhood is a practical and simple guide to the practice of mindfulness during everyday life. “Mindfulness is moment-to-moment, nonjudgmental awareness of your present-moment experience…so that you can be connected to your baby even in times of distress, be less overwhelmed by distressing emotions and less caught up in negative thought patterns, and enjoy the simple pleasures that suffuse each day of being a mom.”

The book is composed of many small chapters each containing a 5-10 minute exercise readily incorporated into daily life with a baby. It also includes a line-drawing illustrated “mindful motherhood yoga series” of gentle, basic poses, which are an excellent prelude to meditation.

Mindful Motherhood is rooted in attentiveness to needs of the child, present moment awareness—whether comfortable or uncomfortable—and radical self-compassion. “Mindful motherhood, above all, is a way of approaching your experiences during pregnancy and early motherhood with gentleness and friendliness.” The author models this gentle and friendly approach throughout the accessible, supportive, and important guide. What a lovely gift for a woman approaching new motherhood, or for any mother seeking to explore present-moment awareness in everyday life!


Disclosure: I received a complimentary copy of this book for review purposes.

New Training!

This year, I completed several new trainings that I am very excited about.

Prenatal Yoga Training

This weekend I fulfilled a 7 year old dream and attended a prenatal yoga teacher training in St. Louis. I have wanted to teach prenatal yoga since I was pregnant with my first baby, but a training opportunity just never opened up for me until now. I felt like this was perfect timing. The training was through YogaFit and was pretty basic, but it was just what I needed to feel like I can move forward with this dream. YogaFit is a very “fitness” oriented type of program vs. any kind of holistic-mind/body connection stuff, but I can add those elements in myself. I think I will be able to offer something fairly unique—not just yoga and not just childbirth education but yoga-childbirth-education. There are several other programs like that, of course, but none in the local area! At the training, I also learned some really cool partner yoga stuff that I didn’t know how to do before.

Birth Art Training

In February, I completed something else that I’ve been dreaming about for some time—I took Birthing from Within‘s online course, “How to Lead the Birth Art Process.” Aside from a few minor complaints about the sometimes-frustrating “Zen” underlay and occasional contradictions within the course, I really LOVED this class. I found the online course format to be an ideal format for me—real-person interaction through message board, chat, phone call, and email; written information; writing journals/essay responses; hands-on personal practice with the assignments; and real-life application with other people/clients in birth art sessions. I felt like I got more out of actual use out of this workshop than most of the other classes and workshops I’ve attended—I think this was because the course was spread out over 5 weeks, not just a weekend, which allowed plenty of time to really assimilate and USE the information. It was very affordable too and I was able to attend right from the comfort of my own chair! The class is marketed as suitable for beginners, but personally I found my past background in childbirth education to be very important and I cannot imagine having taken the class with no prior birth class teaching experience—I think the people who had little experience were kind of disadvantaged in this course. Birthing from Within is my all-time favorite birth preparation book/resource and it was so exciting for me to have a little taste of direct training with them. Hopefully at some point in the not-too-distant future, I will take further training with BfW.

Childbirth Educator Certification

In March of this year, I was pleased to earn my childbirth educator certification with CAPPA. Since I am already certified with other organizations, I enrolled in the dual certification program option. I am very excited to be “throwing my hat in” with CAPPA. The organization is very friendly and stable and I really connect with the CAPPA Vision. The program information itself was pretty basic and I didn’t really learn anything new from it, but that makes sense because it isn’t specifically designed for people who already have CBE teaching experience—I think it is a great program for someone starting out in this field.

Comparing CBE Programs:

I get a lot of inquiries from people seeking information about different childbirth education programs and thought I would provide a super-quick mention of the things I enjoyed most about each of my certification programs/organizations. Keep in mind that I certified with ALACE first, hence, I had the most direct experience with their full training program, vs. the other organization’s “accelerated” options (which I SO deeply value and I am SO grateful that ICEA and CAPPA make that option available to people—I’m very, very grateful!). In sequential order:

ALACE (now IBWP)—phenomenally in-depth training program with a wonderful woman-oriented, holistic, midwifery-model. Very homebirth friendly. When I finished this program, I felt like I’d earned another master’s degree—this time in birth. At the present time, however, I do not get a “stable” or professional feeling from the organization and that is very disappointing 😦

ICEA—very professional. Lots of really good information on how to teach and on the principles of adult education in general. I learned the most about the “how” from ICEA (and the “how” is very, very important). They also have several great teaching manuals that are super-affordable. I enjoy the International Journal of Childbirth Education as well. Very professional. The training information assumes educators will be teaching a “mainstream” population, probably in a hospital, but their position papers are very sound and I can really get behind their mission as well. Their certification exam was the most difficult of the three programs and I feel like I really earned my certificate!

CAPPA—I am really pleased with my association with CAPPA. As I noted, they are very friendly and I feel like they will be around for a long time to come. I just get a lovely, warm feeling of “sisterhood” from CAPPA and that is very important to me. I feel connected to the organization and the people and it is a very supportive atmosphere. I recommend them for training, especially for people who are just starting out. I’m excited about the free conferences CAPPA offers as well and I’m going to my first one this July! I also enjoy the CAPPA Quarterly and and I am proud to write the book/film reviews column.

Birthing Room Yoga Handout

In my classes, I teach a short little series of prenatal yoga poses called “Birthing Room Yoga.” I learned the series from the excellent video, Yoga for Your Pregnancy by Yoga Journal and Lamaze. My rationale for including the poses in all my classes is that while academic/intellectual information is useful (and is my personal learning style), birth happens in your body and not your head—-lots of us are uncomfortable with our bodies, so I try to get people to use their bodies a lot during classes. This helps women become comfortable with using their bodies, plus gets them out of their heads-space and into body-space, plus each exercise chosen has pregnancy or birth related benefits. Physical work is important for partners too—-birth is a physical event (both for the person helping and for the partner watching the pregnant woman work during labor).

I didn’t learn this series of poses until after my first two children were born. I was interested to see that I used all of the poses (or variations thereof—I also show a variety of variations during class) during my labor with my first son—even though I didn’t call it “yoga” or consciously “practice” during labor. I think that is a powerful reminder of the wisdom we carry in our bodies—as long as there is space and freedom in which to do so, this “birth yoga” arises spontaneously out of our own inherent wisdom, no training required!

Here is the Birthing Room Yoga handout I give with the pose reminders! The pelvic circles are particularly good and can be done seated on the edge of a hospital bed while having fetal monitoring.