Tag Archive | birth classes

Becoming an Informed Birth Consumer

Though it may not often seem so, birth is a consumer issue. When speaking about their experiences with labor and birth, it is very common to hear women say, “they won’t let you do that here” (such as regarding active birth–moving during labor). They seem to have forgotten that they are customers receiving a service, hiring a service provider not a “boss.” If you went to a grocery store and were told at the entrance that you couldn’t bring your list in with you, that the expert shopping professional would choose your items for you, would you continue to shop in that store? No! If you hired a plumber to fix your toilet and he refused and said he was just going to work on your shower instead, would you pay him, or hire him to work for you again? No! In birth as in the rest of life, YOU are the expert on your own life. In this case, the expert on your body, your labor, your birth, and your baby. The rest are “paid consultants,” not experts whose opinions, ideas, and preferences override your own.

There are several helpful ways to become an informed birth consumer:

Read great books such as Henci Goer’s The Thinking Woman’s Guide to a Better Birth or Pushed by Jennifer Block.
Hire an Independent Childbirth Educator (someone who works independently and is hired by you, not by a hospital). Some organizations that certify childbirth educators are Childbirth and Postpartum Professionals Association (CAPPA), BirthWorks, Bradley, Birthing From Within, Lamaze, and Childbirth International. Regardless of the certifying organization, it is important to take classes from an independent educator who does not teach in a hospital. (I’m sure there are lots of great educators who work in hospitals, but in order to make sure you are not getting a “co-opted” class that is based on “hospital obedience training” rather than informed choice, an independent educator is a good bet.)
Consider hiring a doula—a doula is an experienced non-medical labor support provider who offers her continuous emotional and physical presence during your labor and birth. Organizations that train doulas include CAPPA, DONA, and Birth Arts.
Join birth organizations specifically for consumers such as Citizens for Midwifery or Birth Network National.
Talk to other women in your community. Ask them what they liked about their births and about their care providers. Ask them what they wish had been different.
Ask your provider questions. Ask lots of questions. Make sure your philosophies align. If it isn’t a match, switch care providers. This is not the time for misplaced loyalty. Your baby will only be born once, don’t dismiss concerns your may have over the care you receive or decide that you can make different choices “next time.”
Find a care provider that supports Lamaze’s Six Healthy Birth Practices and is willing to speak with you seriously about them:

Remember that birth is YOURS—it is not the exclusive territory of the doctor, the hospital, the nurse, the midwife, the doula, or the childbirth educator. These people are all paid consultants—hired by you to help you (and what helps you, helps your baby!).

New Post…

Mar20

I spent quite some time writing a new post yesterday and then it disappeared without a trace! I like to make a post here at least once a week, so I’m going to have to just link to the other post I wrote yesterday as part of the Women’s History Month blog carnival from Birth Activist. Birth Activist was the very first birth blog I ever started reading and the blog that sparked my own interest in blogging (a couple of years later).

In addition to teaching the Young Parents classes, which is a new venture for me, I also start teaching my second college class next week. This one is at a college branch about an hour from me, so I’m going to be doing a lot of driving in addition to all the preparation work. I think blogging is going to have to slip down my list of priorities for a while and so I may not be making new posts for a little while—I hope my readers don’t abandon me! Have no fear, I’ve managed to work birth activism into my class in a very appropriate way—I’m going to show them the Reducing Infant Mortality film and possibily The Doula Story as well, during my section of the class on teen pregnancy.

Resource Rack

Mar15

I was pleased as can be when my husband brought home a plastic brochure rack that was getting thrown away at work. As a semi-compulsive gatherer and sharer of information, I have boxes of pamphlets, magazines, brochures, etc. that I put together in packets for my birth class clients. How much more efficient and attractive to organize them this way! I took a picture of it because I’m so happy.

Young Parents Program Prenatal Classes

Mar12

I am getting ready to teach a series of classes for a local Young Parents program. I have had to rework my class outlines a bit to meet some of the program’s requirements/needs. I decided to upload some of the activities here in case they may help someone else avoid reinventing the wheel by typing up their own similar activities.

Birth BINGO–this is a Bingo card with birth terminology. You can enter the terms into one of a variety of bingo card makers online in order to randomize the cards so that they are not all in the same order (which would then make everyone always win together).

Bingo Definitions–this is the list of definitions that goes with the card above. You can cut them apart and draw terms at random to read aloud. Participants yell out the answer and get to put a candy (Smarties, M & M’s, that sort of thing) onto the appropriate square on their card.

Labor Rehearsal–this is a labor walk-through. It is a little more conventional/conservative than I really like. In most of my classes I like to use the Labor Stations from the Transition to Parenthood site. I print them out as cards, not full pages, and hand them over to the parents to practice. The cards walk them through a whole labor early labor through pushing and it is a god opportunity to review and integrate everything they’ve learned and experimented with in class. I do not include the patterned breathing suggestions because I do not teach patterned breathing techniques. There are LOTS of good games and handouts for classes on this site. I really appreciate it!

Communicating with Baby Prenatally–I was specifically asked to include a component of this in this series of classes. This exercise is modified from one in the Nurturing Parents prenatal curriculum. It isn’t my favorite exercise, but I’m going to try it out. I also have another one from ICEA that I am going to use called Sensory Imaging: The Baby Inside You.

You Can’t Be Everything to Everyone…

Feb12

I got the following article in an e-newsletter and though it isn’t birth business specific, I think it has a lot of valuable food for thought in it for childbirth educators/birth professionals. I am going to answer the questions in it and post again with my thoughts!

You Can’t Serve Everyone: Clarifying Your Niche for Better Marketing Results

Before you even start implementing any marketing strategies, it’s important to be crystal clear about whom it is you are trying to reach. Some of the questions you should be able to answer around this include: What is your niche? Who is your target market and what is it that they want? What is your message to them?

Often, small business owners are afraid to narrow down their target market for fear that this will limit them. Countless times I have heard people say “my target market is small business owners” or “my niche is really anyone who needs what I offer.”

The truth is, you can’t be everything to everyone, and it is actually easier to market and attract prospects when you focus on a particular group of people. It is also easier for others to refer people to you when they see you as someone who works with a specific group. To further illustrate, here is a simple example: Instead of “I’m a financial planner,” you could clarify it to say “I’m a financial planner who specializes in families with special needs children.”

Or, instead of “I’m a marketing consultant,” a more descriptive way to say it would be “I’m an online marketing consultant who specializes in social media strategies for coaches.”

Online, a good way to create the type of presence that draws people to you is to clearly communicate who you are, what you are about, and why people should take notice. In order to figure this out, some of the questions you could ask yourself might be:

*How would you describe the essence of who you are in a single word?
*What are your top three passions related to your work or three unrelated to your work?
*What would be three adjectives used to describe your business?
*Who your best clients or the people who are most likely to benefit from your work?

Those are just some of the questions you can ask to really get clear on who you are professionally, as well as who you are personally.

Clarifying your niche is a point of “stuckness” for many business owners and it does take a bit work to discover if you aren’t clear on it yet. But once you have that specific niche narrowed down, reaching them with your marketing becomes a whole lot easier.

Want to use this article on your website or your own e-zine? You can, as long as you include the following:

Christine Gallagher, The Online Marketing and Social Media Success Coach, is founder of Communicate Value, where she is dedicated to teaching small business owners and professionals how to conquer the overwhelming aspects of online and social media marketing to increase business and maximize profits. To get your F.R.E.E. 5-Part E-Course and receive her weekly marketing & success articles on leveraging technology, building relationships and boosting your profits, visit http://communicatevalue.com.

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.

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.

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!

—-

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:

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Favorite Birth Class Videos

Sep15

The question of “what are your favorite teaching videos?” has arisen on several email lists I belong to recently. I decided to re-post my answer here, since I had it freshly typed up!

I have quite a few birth DVDs now and I don’t show them in class anymore, but I offer the selection to my clients and they can borrow anything they want to watch at home.

I have:

Orgasmic Birth (highly recommended! Beautiful births, powerful message)
The Big Stretch (kind of “hippie-ish,” but very lovely. Has naked man riding bicycle at the end–have to warn people about that!). I like how it is women talking about birth, no experts.
Birth, Joy, & Raspberry Leaves (all water births, from Compleat Mother magazine, kind of amateurish, but good).
Birth as We Know It (also hippie-ish, but really peaceful, beautiful births–clients seem to really like it. The voiceover content is mildly annoying).
It’s My Body, My Baby, My Birth (very reasonably priced at like $10–mostly about “natural childbirth” vs. showing a lot of births. Very good introduction to the “whys” of natural birth)
Pregnant in America–more of a birth activism/advocacy film than a birth movie. I give a disclaimer before offering anyone this one, because baby does end up in the NICU and you worry that she is going to die (she doesn’t)

Homebirth Dads–primarily “talking heads” format, a bit on the boring side really, but good to have available for homebirth couples.
Birth Day–nice waterbirth in Mexico.
Noa was Born–another nice waterbirth. Same filmmakers as the It’s My Body one. A lot of my clients love this one!
Gentle Birth Choices–rarely checked out because it is more “dated.” I make sure they know that the quality of the births doesn’t change though, only the hairdos! I like that it comes with the Gentle Birth Choices book (the set is around $15 and the book is a classic).
Penny Simkin‘s Rhythm, Relaxation, and Ritual, which is good to show for labor support purposes. I only have this on VHS and it is rapidly getting a, “how archaic!” reaction!
Laboring Under an Illusion–this one is brand new. Compares 100 birth clips from the media with the real thing and looks at the impact of media perceptions on birth. Clips from I Love Lucy, Coneheads, etc. Pretty funny and a bit of a different “take” than the other films.
Natural Born Babies–can be watched online. Nice, contemporary video that is almost like an extended “commercial” for homebirth/midwifery (in a good way!). No birth scenes, just modern couples talking about homebirth (some of them are doctors, which gives the video a little extra zest!)
Dance of the Womb–lovely instructional bellydancing video. Also includes bonus homebirth video.
The Business of Being Born–I think of this as a “classic” now. A must have. Very good activism video as well as educational.

There is also a nice series of free video clips available on Mother’s Advocate. This series is based on Lamaze’s Healthy Birth Practices and is a great resource for use in birth classes.

I also have several breastfeeding videos (the Mother of 7 ones), a babywearing video (Tummy2Tummy), and several prenatal yoga videos (my favorite is the Yoga Journal/Lamaze Yoga for Your Pregnancy DVD).

On my wishlist is:

The Rebozo Way

What to Expect When You Go to the Hospital for a Natural Childbirth

Sep9

I’ve been debating about whether to share this post or not. I’m concerned that it may come across as unnecessarily negative, pessimistic, or even “combative” or “anti-hospital.” However, I do think it is honest and I’ve decided to share it. There is a fairly “normal” course of events for women having a natural birth in a hospital setting. In order to be truly prepared to give birth in the hospital, it is important to be prepared for “what to expect” there and to know how to deal with hospital procedures. All hospital procedures/routines can be refused, but this requires being informed, being strong, and really paying attention to what is happening. I hope this list of “what to expect” with help you talk with your medical care provider in advance about hospital routines and your own personal choices, as well as help prevent unpleasant surprises upon actually showing up in the birthing room. This list is modified from material found in the book Woman-Centered Pregnancy and Birth. I am not saying that is how your specific hospital operates, but that many American hospitals function in this manner.

Expect to have at least some separation from the person who brought you to the hospital, whether this separation is due to filling out admission paperwork, parking the car, giving a urine sample, being examined in triage, etc.
Expect to remove all your clothing and put on a hospital gown that ties in the back.
Expect to have staff talk over you, not to you, and to have many different people walk into your room whenever they want without your permission and without introducing themselves.
Expect to have your cervix examined by a nurse upon admission and approximately every hour thereafter. Sometimes you may have multiple vaginal exams per hour by more than one person.
Expect to have an IV inserted into your arm, or at minimum a saline lock (sometimes called a Hep lock).
Expect to be denied food and drink (at best, expect clear liquids or ice).
Expect to give a urine sample and perhaps a blood sample.
Expect to have an ID bracelet attached to your arm.
Expect to have to sign a consent form for birth and for application of a fetal monitor that states that your doctor will be responsible for making the decisions about your care (not you).
Expect to have a fetal heart rate monitor attached around your belly—two round discs on straps that will often stay with you continuously until you give birth (or, at best, for 15 minutes out of each hour of your labor).
Expect to have your water manually broken at about 4 centimeters (or at least, strongly suggested that you allow it to be broken). After this point, expect to be encourage to have an electrode screwed into the baby’s scalp to measure the heartbeat and a tube places in your uterus to measure your contractions.
Expect to be offered pain medications repeatedly.
Expect to receive Pitocin at some point during your labor–“to speed things up.”
Expect to be encouraged (or even ordered) to remain in your bed through much of labor, especially pushing.
Expect to either have your legs put in stirrups or held at a 90 degree angle at the hips.
Expect to be told you are not pushing correctly.
Expect to hold your baby on your chest for a few minutes, before it is taken away to be dried, warmed, and checked over.
Expect the baby to have antibiotic eye ointment put into its eyes (without telling you first).
Expect to have your baby suctioned repeatedly.
Expect to be given a shot of Pitocin to make your uterus contract and deliver the placenta.
Expect not to be shown the placenta.
Expect your baby to be given a vitamin K injection.

I think it is important to note that what you can expect is often different than what you deserve and that what you can expect often reduces or eliminates your chances of getting what you deserve. In my classes, I’ve made a conscious decision to present what women deserve in birth and though I also talk about what they can expect and how to work with that, I think sometimes they are left surprised that what they actually experience in the hospital. At minimum, what you deserve are Six Healthy Birth Practices (as articulated by Lamaze):

Let Labor Begin on Its Own – Download PDF
Walk, Move & Change Positions – Download PDF
Have Continuous Support – Download PDF
Avoid Unnecessary Interventions – Download PDF
Get Upright & Follow Urges to Push – Download PDF
Keep Your Baby With You – Download PDF

As an example of what I mean about what you can expect clashing with what you deserve, consider the second healthy birth practice “Walk, Move Around, and Change Positions”—monitoring and IVs directly conflict with the smooth implementation of a practice based on freedom of movement throughout labor.

So, how do you work with or around these routine expectations and your desire for a natural birth?

Discuss in advance the type of nursing care you would like and request that your doctor put any modifications to the normal routines in your chart as “Doctor’s Orders” (if your doctor is unwilling to do so, seek a new medical care provider!)
Labor at home until labor is very well-established.
Go through the above list of “what to expect” and make a decision about how to handle each one on a case by case—you may choose to actively refuse something, you may be okay with accepting certain procedures or routines, and you can develop a coping plan for how specifically to work with any particular issue.
Take independent childbirth classes and learn a variety of techniques and pain coping practices so that your “toolbox” for working with labor is well stocked.
Hire a doula, or bring a knowledgeable, helpful, experienced friend with you. It can help to have a strong advocate with you (this may or may not be a role your husband or partner is willing to take on).
Another tactic is to “never ask permission to do what you want, but to go ahead and do it unless the hospital staff actively stops you.” (An example of this is of getting up and walking around during labor)
“Many people, if they can find no other way to get around a dangerous or unpleasant hospital policy, unobtrusively ignore it”—a good example of this is with regard to eating and drinking during labor. Restricting birthing women to ice chips or clear liquids is not evidence-based care. Bring light foods and drinks and quietly partake as you please.
Leave the hospital early, rather than remaining the full length of stay post-birth. This can minimize separation from baby and other routines you may wish to avoid.
For some additional ideas see my post, “Can I really expect to have a great birth?“

Finally, and most importantly, “birth is not a time in a woman’s life when she should have to FIGHT for anything,” so if you find that you feel you are preparing yourself for “hospital self-defense” I encourage you to explore your options in birth places and care providers, rather than preparing for a “battle” and hoping for the best. If you feel like you are going to have to fight for your rights in birth, STRONGLY consider the implications of birthing in that setting. Also, as The Pink Kit says, “hope is not a plan”—so if you find yourself saying “I hope I can get what I want” it is time to take another, serious look at your plans and choices for your baby’s birth.