Tag Archive | birth classes

Non-verbal Communication

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.”

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!

Fears About Birth and Losing Control

Mar4

A topic that frequently arises in birth classes is about the fear of “losing control” in labor. Losing control, “losing it,” or “freaking out” are concerns expressed by women preparing to give birth. It is important to acknowledge that this is a common fear. I also like to ask parents to think about what “freaking out” or “losing it” would mean to them? I ask them to consider what benefits there may be to losing control. I also say, “What if you do freak out? Maybe, so what?! Maybe it is okay. Maybe it is good. Maybe it is helpful.” (This doesn’t come across in print quite the way it does in real life!) Surrendering to the flow and power of birthing can be of tremendous benefit. Losing it can mean letting go and letting the power BE. Letting the energy be. Letting birth carry you with it, instead of wrestling for control of it. (When discussing this topic, it is important to remain mindful that for mothers-to-be who are survivors of abuse, language about “surrender” and “letting go” can be very threatening and unhelpful.)

Thinking about “losing control” makes me think about the things that you can have over control of when it comes to your birth experience (I’ve also been reading The Big Book of Birth and it addresses this):

1. You can control who who choose as your doctor or midwife (and can choose to switch at any point in pregnancy if the match is not a good one).

2. You can control where you give birth.

3. You can control who you ask to attend your birth as support–your partner, your best friend, your mother, your sister, a doula. (Anyone who attends should be there for YOU, not because they want to “see a birth” or because you feel obligated to have them.)

4. You can control how you prepare yourself for birth and the education you seek to help you explore your options.

5. You can control the type of books you read and the information you seek about birth.

6. You can control how you care for yourself during pregnancy.

7. If you are having your baby in the hospital, you can control when you go to the hospital.

Hypnobabies rephrases the usual concept of “transition” in labor as “transformation.” This is the time in labor in which many women fear “losing control.” Women may also pass through another transformation point as they move from early labor into active labor–this is sort of a “moment of reckoning” in which it becomes clear that it is really time to DO this! Erica Lyon, who wrote The Big Book of Birth referenced above, addressed this subject really well:

“…as a mother shifts from early labor to active labor, she begins to have an awareness that the labor is getting bigger, strong, more powerful. This often translates into a feeling or idea that you are going to ‘lose it’ or ‘lose control.’ This is a temporary, transient feeling that tells you labor is progressing. It does not mean you will go running naked and screaming down the hallway of your birth facility. What is really happening is a momentary emotional state that reflects your ‘social self’ beginning to fold inward. Labor is not a rational process, it is a body function that is experienced as a gradually intensifying event. You do not think your way through it. You do it. “

Essentially, this is a point in labor when you stop fighting with the “birth power” and begin to BE it. The process of birthing becomes your entire focus. I remind and encourage people to welcome the increasing intensity of labor–and suggest taking a “make it bigger!” approach to greeting and welcoming contractions, rather than trying to avoid or minimize them.

Pam England from Birthing From Within also has a great article about “Losing It” in labor.

Other posts about fear and birth:

Birth Fear
Fear & Birth
Fathers, Fear, and Birth
Fear-Tension-Pain or Excitement-Power-Progress?
Cesarean Birth in a Culture of Fear Handout
Worry is the Work of Pregnancy
Fear Release for Birth
What If…She’s Stronger than She Knows…

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”

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.”

What Does Coping Well Mean?

Jan7

“I believe with all my heart that women’s birth noises are often the seat of their power. It’s like a primal birth song, meeting the pain with sound, singing their babies forth. I’ve had my eardrums roared out on occasions, but I love it. Every time. Never let anyone tell you not to make noise in labor. Roar your babies out, Mamas. Roar.” –Louisa Wales

Occasionally, I hear people telling birth stories and emphasizing not making noise as an indicator, or “proof,” of how well they coped with birthing–“I didn’t make any noise at all,” or “she did really well, she only made noise towards the end…” Women also come to classes looking for ways to stay “in control” and to “relaxed.”

This has caused me to do some thinking. Though relaxation is very important and helpful, to me, the goal of “laboring well” is not necessarily “staying in control” or “staying relaxed” or “not making any noises.” Instead, I view “laboring well” as involving: listening to yourself; respecting your own needs and acting on them; working with your body; finding your rhythm; trusting your instincts; following your body’s urges/signals; accessing your inner wisdom; finding your unique way along the path; journeying with openness, curiosity, acceptance, excitement and joy; and responding to coping strategies that spontaneously arise from within.

I have been reading Penny Simkin’s The Labor Progress Handbook and she addresses this subject as well:

“Childbirth education programs first emerged in the 1940s, when much less was known about the powerful, multisensory ways in which women spontaneously cope with labor. Much has been learned since then, but older ideas have left their stamp on Western culture…Many people still think that ‘coping well’ means that the woman remains silent and does not move during contractions. Often, caregivers, partners, and the women themselves believe that women who are physically active and vocal are coping poorly, and may strive to help these women to be quiet. However, we now know that women with kinesthetic and vocal coping styles often find much more effective relief from pain and stress when they move and make sounds, than when they try to use the quiet, still techniques of early childbirth methods.”

During my own births I found movement and sound to be of tremendous importance. With my first baby, I felt more inhibited and primarily coped by humming. I spent a lot of time kneeling on the ground with my head on the bed. With my second, I was alone with my husband for most of the time and was much more vocal–“talking” myself through contractions. I also moved around a great deal and found it very important. Talking (well, really rhythmic word repetition) and moving, for me, are parts of “surrendering” to the power, process, and intensity of giving birth. This fits with my personality as well as in “normal” life I talk a lot (talk-to-think) and I also have a lot of physical energy that leads to my “buzzing” around the room a lot or stepping back-and-forth as I speak.

Edited to add that the Feminist Childbirth Studies blog linked to this post with an interesting and insightful further development/exploration of this subject in the post characteristics of a ‘good’ labor and birth experience?

I revisited this topic in a later post: The Power of Noise in Labor

Birth art sculpture depicting pushing the baby out. Roar, mama, roar!

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”

Sounds like there are lots of benefits to taking birth classes! 🙂

Questions During Labor

Dec20

One of the things I talk about in birth classes is about avoiding asking the laboring woman too many questions. Questions make her leave “birth brain” and throw off her rhythm and coping skills. I recently read a newsletter from Birthing from Within that touches on this issue in a beautifully articulate way:

“Watching this scene reminded me of what frequently happens to mothers in labor being admitted to the hospital. A mother is mustering up courage and immersed in the profound act of creation and personal transformation–but that is overlooked when she is asked, ‘When did you have your last bowel movement?’ and twenty other questions! When we recognize the hard work and intensity of labor, and stay present to the birthing woman’s experience, rather than blindly following our own agenda, we honor her Warrior spirit.“

New Birth Classes for 2009!

Dec13

In addition to my usual six week class series and the single night class options, as of January 2009 I am offering several new classes to meet the varying needs of families in the community.

A four week series of classes for people who are well-read about birth and their choices in childbirth and/or who are having a subsequent child (the six week series is recommended for people expecting their first baby).
A three week “birth share” series–an informal, Q & A, spontaneous approach to childbirth education.
A weekend refresher series (or CBE crash course) offered on a Saturday and Sunday for 3 hours each day.
A 3-4 week Creative Birth series that focuses on birth art and a personal growth approach to birth education (this series is still under development).