Tag Archive | birth

How to Use a Hospital Bed Without Lying Down

In classes, I often suggest that when couples enter their hospital room in labor they pile all of their belongings onto the bed rather than the laboring woman hopping into it. I encourage people to start seeing the bed as a tool they can actively use during labor, rather than a place for labor and birth to passively happen to you. To that end, I’ve made a little handout called “helpful ways to use a hospital bed without lying down.” I’m uploading it here in hopes that others may find it useful as well.

For more about the importance of freedom of movement during labor, make sure to check out Lamaze’s Healthy Birth Practice paper: Walk, Move Around, and Change Positions Throughout Labor or this video clip from Mother’s Advocate.

Top Five Birth Plan…

Apr29

Birth plans are a topic often discussed in birth classes. There are SO many things that could be put onto a birth plan that sometimes it is difficult to sort out the most important. I encourage couples in my classes to complete two different “values clarification” exercises to help them include those things on their plan that are MOST important to them, rather than trying to cover everything on a one page birth plan. They often ask what I think is important to include. So, recently I started thinking that if I needed to create a birth plan for a birth in hospital that was as normal and natural as possible and could only include five elements, what would be most important to me, my baby, and a normal birth?

These are my top five after first going into the hospital as late in labor as possible (this isn’t included on my birth plan and doesn’t need to be on anyone’s birth plan–“I plan to labor at home as long as possible”–because it isn’t relevant by the time you get there and people are reading your plan. It belongs on your own personal plan, but not in your “official” plan):

No pitocin.
Minimal fetal monitoring and preferably with a Doppler only.
Freedom of movement throughout labor (stay out of bed, use it as an active tool rather than as a place to lie down. Stay upright during any necessary monitoring.)
Push with the urge in whatever position works best for me (NO coached, directed, or “cheerleader” style pushing).
Baby immediately to me. NO separation.

Ideas for supporting your partner in labor

Apr16

One of my favorite handouts to give in birth classes is a “Cliff’s Notes” to labor support. It is a two page handout with a variety of reminders and ideas about supporting your partner or wife during her labor. There are small illustrations as well and a review of the stages of labor. The handout is available here from the website Transition to Parenthood. This site offers a variety of useful handouts for childbirth educators and for parents-to-be and I really appreciate the educator’s generosity in making her materials available online like this!

The handout referenced focuses primarily on physical support and comfort measures of the laboring woman. Some additional, less concrete things I like to remind fathers-to-be of are:

Follow her lead. Labor is like a dance and your partner is leading the dance! Anything I say in class or anything you’ve read about is less important than what she is actually doing and you responding to her.
The most important thing you can do is just love her. This is more important than learning “techniques.” Just love her the way you love her and she will feel your love and support.
Let it happen. I encourage women to “let birth happen” and to let it flow. As her support person, you can help her by letting her let it happen (instead of hushing her or telling her to calm down or asking her to do something different than what is working for her).
Don’t interrupt a woman who is coping well with a new technique or idea–if what she is doing is working for her, encourage THAT instead of trying to introduce new ideas or tips.
Remember that as a support person you may also experience the three “emotional signposts” of labor–these are excitement, seriousness, and self-doubt and they correspond to stages of labor. A woman in early labor shows the excitement “signpost” a woman in active labor tends to be very serious and “busy working” and during transition many women show a self-doubt signpost maybe saying they “can’t do this anymore” or “I can’t do this much longer.” It is okay to let your partner know that you are experiencing excitement and seriousness, but try to keep the “self-doubt” signpost under wraps and don’t show her that you are also experiencing that one! Be as calm and supportive and confident and trusting as you can as she journeys through the sometimes challenging time of transition in her labor.

Helping yourself while helping your wife or partner in labor

Mar28

Giving birth is an intensely physical process for the woman giving birth and sometimes we forget what an intensely physical process it is to assist a woman giving birth! Here are a few ideas of ways to take care of yourself while you are helping your wife or partner labor and give birth:

Bring healthy snacks for yourself (avoid anything that is strong smelling, like garlic, and don’t drink coffee)–granola bars, sandwiches, trail mix, crackers.
Wear comfortable clothes and shoes.
Dress in layers–the birth room may be cold or it may be hot.
Wear clothes that you don’t mind getting stained.
Use good “body mechanics” when providing physical support to your wife. Bend your knees slightly and keep your back straight when helping support your wife in a standing squat. If providing counterpressure on her back with your hands, keep your arms straight and lean your body weight down onto her back to provide the counterpressure, rather than using the muscles in your hands or arms to provide it.
Take breaks if you need to–it is okay to take a bathroom break or to get something to drink! If your wife or partner does not want to be left alone, have your doula or a helpful nurse serve as a quick stand-in for you. Use your judgment as to whether to announce to your wife that you are taking a quick bathroom break. Some women may be upset at being “abandoned” without warning, while other are so into the rhythm of labor that they will not notice you taking a quick break and it is better not to disturb their rhythm by making a big announcement that you are leaving.
If you feel yourself getting tense or anxious, take slow, deep breaths from your abdomen or do a few quick tension relieving stretches such as rolling your neck from side to side or rotating your shoulders.
I encourage women to use affirmations during pregnancy and then during labor to help them greet their labors with confidence and acceptance. Though it might seem silly or feel awkward, you may wish to develop some affirmations to use yourself as well as you assist your wife in labor–try things like, “I am calm and confident” or, “each contraction is bringing our baby closer,” or, “my mind is relaxed, my body is relaxed,” or, “her body knows how to birth our baby.”
Trust birth and the process–your wife’s body is well designed to give birth to your baby. She can do it! Believe in her and believe in yourself!

House of Babies

Mar19

During my classes, we talk about how media portrayals of birth impact our perceptions and expectations as well as contribute to our fears about birth. Often media portrayals of birth have a tense, “emergency” atmosphere, with lots of rushing around and communicate that birth is a dangerous, medical event requiring rescuing by medical teams. Usually, when I bring this up, people in my classes nod in agreement and have lots of examples to share. However, in the last two classes, women have responded, “well, on House of Babies, I saw…” or “in House of Babies…” or “House of Babies isn’t like that.” Well, cool! I think I need to see House of Babies! (I don’t get any TV channels though, so alas, I can’t see it. Someone in my current class offered to show me a recording of it though, so I’m excited to see it).

I’m encouraged to know that there are shows like this with positive, affirming messages reaching women and showing them what birth can be like in a supportive, midwifery model of care atmosphere.

“Balanced” Information?

Mar15

Occasionally I read that someone is planning to take a hospital sponsored birth class because they feel they will get more “balanced” information. This usually seems to be said with regard to medications “versus” natural birth. There is an excellent discussion about this issue in the book Mother’s Intention: How Belief Shapes Birth.

“Let us look at [the word] ‘balanced’ first…’to make two parts exactly equal.’ What if the two parts are not equal? What if a parent will be making decisions that will affect her and her baby with both short and long term consequences? Is it fair to distort reality so that the information she has to choose from seems ‘equal,’ even though it really isn’t? Why would a parent want information that appears balanced, but isn’t factual?”

From my perspective, independent classes are better able to provide you with truly helpful, accurate, and factual information (even though they might not feel “balanced” towards all interventions/options), because the educator is working for you and not for an institution.

Climate of Confidence, Climate of Doubt

Mar14

Recently I finished reading (and reviewing) the new book Our Bodies, Ourselves: Pregnancy & Birth. In the opening chapter, they identify a concept that I have *felt* for some time, but hadn’t really put a finger on. The authors refer to it as a “climate of confidence” and a “climate of doubt.” I love this way of articulating the messages swirling around pregnant women in our society.

A Climate of Doubt comes from “The media’s preference for portraying emergency situations, and doctors saving babies, sends a message that birth is fraught with danger. Other factors, including the way doctors are trained, financial incentives in the health care system, and a rushed, risk-averse society, also contribute to the popular perception that childbirth is an unbearably painful, risky process to be ‘managed’ in a hospital with the use of many tests, drugs, and procedures. In such an environment, the high-tech medical care that is essential for a small proportion of mothers and babies has become the norm for almost everyone…[a] ‘climate of doubt’ that increases women’s anxiety and fear.”

A Climate of Confidence “reinforces women’s strengths and abilities and minimizes fear. Some of the factors that nourish a climate of confidence include high-quality prenatal care; healthy food and time to rest and exercise; a safe work and home environment; childbearing leave; clear, accurate information about pregnancy and birth; encouragement, love and support from those close to you; and skilled and compassionate health care providers.”

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I encourage my birth class clients to consider ways in which they can create a climate of confidence in their lives as they prepare for their births and their babies.

Pain Acronym

Mar14

Continuing with my musings about pain and birth, I came across a following acronym in the fall 2007 issue of the International Journal of Childbirth Education (the publication of ICEA):

P (purposeful)

A (anticipated)

I (intermittent)

N (normal)

——-

I was previously unfamiliar with the acronym, but I kind of like it. There are so many fears surrounding pain in birth–often of the unknown–and then stories abound about “excruciating pain,” and “you’re gonna need that epidural!” as well as media portrayals of birth as a scary, emergency event with lots of screaming and stress. This little acronym acknowledges that many women experience birth as painful, but also offers the perspective that it is manageable and doable.

Words for Pain

Mar8

I recently purchased a new educational DVD about natural birth called It’s My Body, My Baby, My Birth. A childbirth educator interviewed during the film briefly discusses pain and says that we need more words for pain, because it is ridiculous that we have only one word that is used to describe a hangnail, a broken leg, being hit by a car, and labor. I had already been musing about pain during labor and how we perceive it, talk about it, and so forth and this comment was additional food for thought for me. I’m thinking that there are many other words used to describe women’s experiences of labor and birth other than pain–a word that is limited in scope and that for some women may well not even apply to the experiences in birth (I’m thinking of the intriguing “comfortable, easy birthing” philosophy of programs such as Hypnobabies).

I reflected on my own birth experiences and how I would describe them, especially my second birth, which was very quick. I would describe it as:

Powerful

Intense

Triumphant

Empowering

Major (this is a word I kept repeating during labor…”This is MAJOR!”)

Beautiful

Special

Amazing

Awesome

If someone then asked me, “yes, but was it painful.” I would have to think a minute and then say, “oh yeah. I guess it was painful.” However, pain is very far from my dominant interpretation, impression, or experience of this birth. It does not make my “top ten” list of descriptors. I’m interested by that. I’m also interested to know about the other words women use to describe their births and where “pain” falls on their lists (feel free to leave a comment sharing your words for your birth experiences! If pain is at the top of your personal list, that is okay! I’m fascinated by women’s experiences of all kinds.)

I have heard people scoff at this kind of language to describe birth–triumphant, empowering, etc.–saying that it is just natural birth “rhetoric” trying to lie to women or that if giving birth is so wonderful why do we use “euphemisms” to describe it, but the words I chose above are truthfully my experience. Why would describe my births as painful, if that truly is NOT the best word to describe them? If I had to pick the best word, I’d probably say triumphant. Or, I might choose intense (particularly with that second, fast labor and birth).

As I said, I’ve been reflecting a great deal about pain and the word pain and how to address the issue of pain during birth classes. I hope to share some more of these thoughts soon.

Benefits of Active Birth

Feb29

From Janet Balaskas’ classic book, Active Birth:

“When birth is active–

There is less need for drugs.
Discomfort and pain are less.
The uterus functions better, so artificial stimulants are not usually necessary.
Labors are shorter.
The supply of oxygen to the baby is improved.
There is less need for forceps or vacuum extraction.
The secretion of hormones that regulate the whole process is not disrupted.”

Make sure to talk to your care provider about your plan for an active birth. You may have to introduce your attendant to the concept and be assertive about your right to have an active, normal birth.