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Centering for Birth

I have a strong commitment to active birth—the use of movements, position changes, and most of all laboring out of bed. As a result, in my classes I tend to emphasize movement-based coping strategies for labor. However, I have also come to realize that coping measures employing relaxation and breath awareness are extremely valuable. These tools cannot be stripped away from the birthing woman. Whatever happens during birth, whatever unforeseen circumstances that arise, or if her need for activity runs smack into the hospital’s need for passivity, the breath—and breath based tools—cannot be taken from her. I do not teach patterned breathing techniques in my classes, but I do teach various breath awareness skills.

Centering is a breath awareness strategy that I’ve adapted for use in birth classes based on the ten second centering process described in the short book Ten Zen Seconds. Using the breath as a “container” for a thought or affirmation is the basis of centering. A meditative technique, the purpose is to “center” and to become mindful of the present moment. The container is a 10 second long breath—a five second in-breath and a five second out-breath—that holds a thought. You think the first half of the phrase on the in breath and the second half on the out breath (Maisel, 2007). Use this technique once or twice to “greet” the contraction and then continue breathing with awareness throughout the remainder of the contraction.

Some suggestions of centering thoughts to use during birthing include:

(I am open) (to birth)

(I am ready) (for my baby)

(I welcome) (my labor)

(I am confident) (and strong)

(Right here) (right now)

(I am equal) (to this challenge)

(I embrace) (this moment)

A pdf handout describing this technique (for use in birth classes), is now available here: Centering.

Another phrase I find useful in daily life, as well as applicable to birth is (I expect) (nothing). While this may initially appear pessimistic, it is a very useful reminder of the idea that most emotional suffering in life is a result of attachment to how something “should” be (i.e. “labor should only be taking 12 hours) (Dyer, 2002).

I frequently remind my birth class participants that coping techniques work best when they are incorporated into daily life rather than “dusted off” for use only during labor. Centering is a skill that is readily incorporated into real life. Indeed, when I first learned the technique, I quickly realized that it was a skill that I will use for the rest of my life. I let my class participants know that I regard this as a life skill, that happens to also be useful for birthing. It is essentially a tiny meditation technique that can be more readily incorporated into one’s daily life (especially a life that includes small children) than traditional, dedicated, more elaborate meditation techniques.

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Molly Remer, MSW, CCCE is a certified birth educator, writer, activist, and mother of two young sons. She is an LLL Leader and editor of the Friends of Missouri Midwives newsletter. She blogs about birth at http://talkbirth.me, midwifery at http://cfmidwifery.blogspot.com, and miscarriage at http://tinyfootprintsonmyheart.wordpress.com

References:

Dyer, Wayne. Ten Secrets for Success and Inner Peace, Hay House. March 2002.

Maisel, Eric. Ten Zen Seconds, Sourcebooks, Inc. March 2007.

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This article is modified from one that originally appeared in The International Journal of Childbirth Education, July 2009 (page 20)

Call for contributions: personal birth stories for new booklet on birthing positions

I received an email this weekend from a woman who is writing a booklet about birthing positions (non-profit and free for distributing when finished!). She is seeking contributions of birth stories to use in the book. Below is her message:

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My name is Megan Layton. I have a strong interest in Women’s Health, current issues in obstetrics, as well as the cultural perceptions towards childbirth in general.

As well as being a Missouri native, a supporter of midwives and a woman’s right to an active role in childbirth, I am also a graduate student at the School of the Art Institute of Chicago. Currently I am working on a small, illustrated publication that focuses on birthing positions. The small book will be informative, fun, attractive, and free for distribution and copying. It is my intent to emphasize a woman’s choice during labor and childbirth, and not advocate for any particular position, provider, or setting, but merely convey the options available as well as the potential for birth to be a profound, empowering experience.

Part of the booklet will be first hand accounts of birth—oral histories from women who have had many different birthing experiences.

This is the reason I write to you: to ask that you share this with women who would be willing to share their personal stories, as well as any advice they could give to a woman who is about to experience childbirth for the first time.

Long or short, joyous or rational, funny or sad–any and all stories are welcome, and will be greatly appreciated. At the end of reviewing the narratives, I will ask those women whose stories best suit the publication for permission to use them. As well, I will send copies to all those who graciously allow me to reproduce their words.

All stories, narratives, and questions can be emailed via this link.

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It sounds like a wonderful project to me!

It also reminded me of my previous postings about how to use a hospital bed without lying down. I tell all my clients if they remember only ONE thing from my classes, it is see the hospital bed as a “platform” and a tool in their toolbox—NOT as a place to lie down!

And, here are links to my own birth stories (each which involved freedom of movement during labor as an integral piece!)

First son’s birth (at freestanding birth center): https://talkbirth.wordpress.com/2009/02/25/my-first-birth/

Second son’s birth (at home): https://talkbirth.wordpress.com/2009/02/25/my-second-birth/

Third son’s birth (miscarriage at home at 15 weeks): https://talkbirth.wordpress.com/2010/05/03/noahs-birth-story-warning-miscarriagebaby-loss/

 

Childbirth Education Curriculum Preparation Resources

Recently, I received a question from a new childbirth educator seeking resources for developing her class curriculum. I emailed her back with a couple of ideas and thought I would also share them here. Here are several of the most useful tools I’ve discovered for birth class curriculum development:

  • Prepared Childbirth, The Family Way: Educator’s Guide (from www.thefamilyway.com)
  • The teaching manuals sold (very affordably) by ICEA are EXTREMELY useful: Family-Centered Education: The Process of Teaching Birth is one of my favorites as is Teaching Pregnancy, Birth and Parenting. If you can get the ICEA Educator’s Guide, it is quite useful too (they used to sell it for around $7, but I don’t see it on their site right now).
  • Empowering Women: Teaching Active Birth, by Andrea Robertson is a class resource for developing birth classes—can be hard to find lately though.
  • I love The Pink Kit for all kinds of strategies and information about the pelvis and working with pelvic mobility.
  • Transition to Parenthood has a full curriculum outline available online as well as several great handouts and activities.

The ICEA resources have been my overall favorite, though I’ve added things from all kinds of other sources, as no single resource everything I want to share in a class-—I add information from all kinds of books, videos, reading, journal articles, etc. Every class I teach is a little bit different because I add and subtract things all the time! I only have one page outline for each week of class and it is PLENTY. I do not use power points or anything like that. Just me, lots of hands-on activities, a few visual aids, and the rapport established with my clients.

Good luck with your journey and enjoy making these classes your own!

Giveaway! The Mother’s Guide to Self-Renewal

The giveaway is now closed! Elizabeth Baer was the winner. Congratulations!

In 2008, my mother-in-law bought me The Mother’s Guide to Self-Renewal for Christmas. When I got this book, I made a commitment to myself that I was really going to DO the book, instead of just reading it, tossing it aside, and gobbling down the next one on my stack. So, I did. It took me about 4 months or so to work through it in this way, though it is actually laid out in a 12-month format. The subtitle is “How to Reclaim, Rejuvenate, and Re-Balance Your Life,” which is just what I felt like I needed! I found it an inspirational, insight-provoking, and enriching journey. Since this time, I have re-read/re-worked through sections of the book many times, as well as recommended it to many other women as one of my favorite resources for balanced living.

As a funny little side note, when I first started reading the book, I had a lovely little leather bound fancy notebook to do the journaling/reflective exercises in. I discovered I was never doing them—it never felt like the right time. Then, I bought a Pirates of the Caribbean notebook at Wal-Mart featuring a large photo of Orlando Bloom on the cover and lo and behold, I started doing the journaling exercises in it and finished the book right up! I had to laugh at myself—Hark! I have found thee, my muse, and thy name is Orlando Bloom (especially in rakish, unbuttoned-pirate-shirt attire!)

The author of the book, Renée Trudeau, offers several other amazing resources that I regularly enjoy: I participate in a free monthly teleclass based on the book (I love these calls—sometimes I have to work really hard to carve out the life space to attend, but I’ve NEVER regretted making it happen), I subscribe to the e-newsletter, and read her thought-provoking blog. Associated with the teleclass and book, is a nurturing “Live Inside Out” Facebook page.

I’m absolutely delighted to host a giveaway for a copy of the book The Mother’s Guide to Self-Renewal. There are several ways to enter:

1. Leave a comment with your favorite tip for self-renewal.

2. Become new fan of Talk Birth on Facebook (and leave a comment here telling me you did so that I know to count your entry).

3. Become a new fan of Live Inside Out on Facebook (and leave a comment here reporting this).

4. Blog about this giveaway on your blog or post a link to your Facebook page (and let me know about it).

The winner of the giveaway will be drawn next Tuesday at noon via random number generator!

Balanced Living and Saying ‘No’

I fairly regularly experience what I term a “crisis of abundance.” There are SO many great things to do in the world: SO many great causes, so many wonderful organizations, so many beautiful books, and just so many good things to do with my time. I prefer this state to having a crisis of scarcity or lack, but abundance brings its own challenges and saying “no” or “enough” to the requests for my time is one of those. I feel fortunate that I am humming with life purpose (most of the time), but I also have to be mindful that this hum of energy does not lead me to overcommit and to stretch myself too thin.

This past week, I said “no” to two birthwork-related opportunities that were very appealing, but that I know in my heart that I don’t have the time, space, or energy for right now. It was very empowering and actually semi-thrilling to say,”no” and to mean it. I felt smart and that in these situations saying no was taking care of myself (saying no to someone else = saying “yes” to myself” sometimes!). Perhaps not coincidentally, after my “No” experiences, I received an article to share from life-balance expert Renée Trudeau. I really like her “Nine Creative Ways to Say No.” Enjoy!

Four Key Strategies for Balanced Living by Renée Peterson Trudeau, life balance expert/speaker

~Know your top priorities & effectively manage your energy: What in life is most important to you? How good are you at managing your energy? What is draining you? What is fueling you? Are you comfortable saying “no” and not over committing? “Things which matter most should never be at the mercy of things which matter least.” Goethe

~Make your self-renewal a priority: By filling your cup first, you’ll have more to give to clients/family/friends, you’re able to function at your optimum and you’ll be setting an example for healthy, balanced living for those around you. Self-care (on all levels physical/mental/emotional/spiritual) should be part of your every day life. “Self-care is not about self-indulgence, it is about self-preservation.” A. Lorde

 

~Build a personal support system: What type of and how much professional & personal support do you need to feel emotionally healthy and stress-free? Learn to ask for and receive help. Re-evaluate your support needs every three months; these change based on your current life stage.

 

~Be more present in all that you do: Stress and overwhelm are often brought on by dwelling on the past or living in the future. By spending more time living in the present and focusing on what is most important in the here and now, the calmer, more effective we become.

Nine Creative Ways to Say “No”

Below you’ll find specific language to support you in saying “no.” Most people find that the more they say “no,” the easier it becomes say “yes” to those things that really matter.

(1) Just No: “Thanks, I’ll have to pass on that.” (Say it, then shut up.)

(2) The Gracious No: “I really appreciate you asking me, but my time is already committed.”

(3) The “I’m Sorry” No: “I wish I could, but it’s just not going to work right now.”

(4) The “It’s Someone Else’s Decision” No: “I promised my coach (therapist, husband, etc.) I wouldn’t take on any more projects right now. I’m working on creating more balance in my life.”

(5) The “My Family is the Reason” No: “Thanks so much for the invite, that’s the day of my son’s soccer game, and I never miss those.”

(6) The “I Know Someone Else” No: “I just don’t have time right now. Let me recommend someone who may be able to help you.”

(7) The “I’m Already Booked” No: “I appreciate you thinking of me, but I’m afraid I’m already booked that day.”

(8) The “Setting Boundaries” No: “Let me tell you what I can do …” Then limit the commitment to what will be comfortable for you.

(9) The “Not No, But Not Yes” No: “Let me think about it, and I’ll get back to you.”

(This list is adapted in part from Work Less, Make More—Stop Working So Hard and Create the Life You Really Want, by Jennifer White.)

Trudeau is a nationally-recognized career/life balance coach, president of Austin-based Career Strategists and the author of The Mother’s Guide to Self-Renewal: How to Reclaim, Rejuvenate and Re-Balance Your Life. Sign up to receive monthly life balance tips, order the book, find out about upcoming retreats/events and  learn more about Trudeau’s coaching groups at www.ReneeTrudeau.com or www.CareerStrategists.net.

DVD Review: Hab It: Pelvic Floor

DVD Review: Hab It: Pelvic Floor

PT Partners, 2008
DVD, 1 hour 42 minutes, $29.95

www.hab-it.com

Reviewed by Molly Remer, MSW, CCCE

Most women, and certainly all birth professionals, are aware of the importance of the pelvic floor. Less well-known are methods and exercises beyond the basic “Kegel” to strengthen and rehabilitate weakened pelvic floor muscles. Hab It: Pelvic Floor is a physical therapy DVD specifically targeting the pelvic floor. It is designed for women who are experiencing incontinence, prolapse, or pelvic floor pain. It is also a preventative tool for women to avert the development of these distressing issues.

Hab It: Pelvic Floor begins with an anatomy overview and Kegel explanation/instruction and moves into correct postural positioning. The DVD contains four progressive workouts each more than 20 minutes long and also “time efficient” versions of each workout. Each workout is coached by physical therapist Tasha Mulligan while being demonstrated by another woman. All of the information is clearly presented and easy to follow and the instructor is pleasant and earnest. The DVD comes with an exercise band for use during some of the exercises and no other equipment or props are required.

A very thorough and complete resource for any woman of any age, Hab It: Pelvic Floor is a relevant, interesting, and worthwhile addition to the libraries of doulas, childbirth educators, and anyone who cares about women’s health.

Note: The DVD is not designed specifically for use by pregnant women and there are several exercises that are not compatible with pregnancy—it is ideal for pre or post-pregnancy however!

Disclosure: I received a complimentary copy of the DVD for review purposes.

Book Review: Giving Birth with Confidence

Since I recently wrote a post inspired by a quote from The Official Lamaze Guide: Giving Birth with Confidence, I figured it was high time that I share the review I wrote of the book! The review was originally written in 2007 for CfM News.

The Official Lamaze Guide: Giving Birth with Confidence. By Judith Lothian & Charlotte DeVries. Published in 2005 by Meadowbrook Press (307p), $12.00. ISBN: 088166474X

Reviewed by Molly Remer, MSW, CCCE

Very few pregnancy books deliver the message that we think pregnant women need to hear most: Birth is a normal and natural part of life….We believe deeply that birth is a process you can trust just as millions of women before you have. This belief isn’t sentimental; it’s based on our thorough understanding of the physiologic birth process and research that confirms interfering in that process is harmful unless there is clear evidence that interference provides benefits.

So begins an opening section of the book The Official Lamaze Guide: Giving Birth with Confidence. The degree to which the book accomplishes its simple message can be summarized with a simple review: Excellent! The Lamaze Guide is digestible and reasonable for busy people to manage at less than 300 pages of text and it contains a simple, profound, and elegant message that women in the U.S. desperately need to hear.

The book begins with defining normal birth as “…a normal birth is one that unfolds naturally, free of unnecessary interventions.” It then briefly explains the history of birth and how and why normal birth is not actually the norm in our culture. The authors then clearly address the following areas in one chapter each: early pregnancy; choosing a caregiver and birth site; middle & late pregnancy; preparing for labor and birth; the simple story of birth; keeping birth normal; finding comfort in labor; creating a birth plan and a baby plan; communication and negotiation; greeting your newborn; and early parenting. The authors are clearly very supportive of midwifery and the Midwives Model of Care (though it is not referenced by name) as well as of the benefits of a doula in the birthing room.

The book is framed in the context of Lamaze International’s powerful foundation, the Six Healthy Birth Practices:

The book is also guided by Lamaze’s comprehensive and lovely philosophy of birth:

  • Birth is normal, natural and healthy.
  • The experience of birth profoundly affects women and their families.
  • Women’s inner wisdom guides them through birth.
  • Women’s confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth.
  • Women have the right to give birth free from routine medical interventions.
  • Birth can safely take place in homes, birth centers and hospitals.
  • Childbirth education empowers women to make informed choices in health care, to assume responsibility for their health and to trust their inner wisdom.

After effectively bolstering the confidence of women in birth, The Lamaze Guide concludes with several useful appendices. The first is the excellent tool “Effective Care in Pregnancy & Childbirth: A Synopsis.” Though this information is easily available on the internet (see www.childbirthconnection.org), I find that many parents do not come across it on their own. How powerful to have it included for easy reference of indisputable evidence based practices. The Mother-Friendly Childbirth Initiative is included in another appendix as well as the always excellent text of The Rights of Childbearing Women. I was delighted to see all of these powerful documents in one place—and, in the hands of consumers who need to be aware of them.

This book is a refreshing presence on the shelves of my local bookstore (yes, there is only one retail book shop in my community and The Lamaze Guide is the only “alternative” birth book stocked in the store!). As I read the book, I kept nodding along and wishing it was in the hands of each pregnant woman in my community. Lamaze has a “name recognition” that gives this book the potential to have a wider and broader impact than other alternative birthing books which, though brilliant contributions, may only end up in the hands of “the choir.” The Lamaze Guide is written in such a matter-of-fact and comforting tone that I cannot see it being off putting to the average consumer as having “hippie” language or “extreme” ideas. The blueprint for normal birth that the book lays out is extreme compared to the standard practices at most hospitals, but the way in which the information is presented opens doors of communication, understanding, and exploration as well as providing the evidence basis to back normal birth. I would not hesitate to lend this book out as it will not scare anyone away with “weird” ideas. With the other books in my personal library, I have to carefully consider my audience before choosing which book has the right style and blend of information—not this one! It is good for everyone with its open, simple message. It is a good addition to lending libraries, personal libraries, to give as a gift, or to recommend to others. The Lamaze Guide is straightforward and clearly written with an unabashedly honest and truthful message of what normal birth is and how it can either be supported or undermined.

My only critique of the book is that in contains no real acknowledgment of the several other well known and effective organizations that train and certify birth educators (other than Lamaze International itself). Conspicuously absent from the resources pages are any of these other organizations.

In conclusion, The Lamaze Guide is a source of information that women need to have and a message that women need to hear. I think Giving Birth with Confidence accomplishes its purpose skillfully and has the potential to be a transformative influence. I hope women read it, absorb it, and begin to Celebrate Birth!