Tag Archive | childbirth classes

Care Practices that Support Normal Birth

The Lamaze Institute for Normal Birth has a powerful series of research based care practice papers describing the six care practices that support normal birth. The papers were updated recently and are available on their website in both HTML and printer-friendly PDF formats. These care practices are of vital importance to the normal birth process. The papers are extensively researched and include many citations and are an excellent resource to share with your doctor or with curious (or doubtful) family members or friends. These care practices form an underlying basis for much of the information I present during classes and are practices that should underlie good care in any birth setting (though, sadly, all too often what women receive from their care providers is NOT evidence based and does not follow these care practices. I will write more about this later). Lamaze’s Care Practices are:

Care Practice #1: Labor Begins on Its Own

Labor is a set of complex, interacting components. Alteration of the natural process can expose a woman and her baby to unneeded risks.”

Care Practice #2: Freedom of Movement Throughout Labor

“Free movement during labor allows a woman to manage contractions and assist the baby’s rotation and movement through the pelvis.”

Care Practice #3: Continuous Labor Support

Current research supports the benefits of continuous emotional and physical support during labor.”

Care Practice #4: No Routine Interventions

“Supporting the natural, normal, physiologic process of birth requires clear medical indications prior to any medical intervention.”

Care Practice #5: Spontaneous Pushing in Upright or Gravity-Neutral Positions

Allowing a woman to find positions of comfort and encouraging her to push in response to what she feels is beneficial to the birth process.”

Care Practice #6: No Separation of Mother and Baby, with Unlimited Opportunities to Breastfeed

“When a baby is kept with the mother, there are physiological benefits to both, including the facilitation of breastfeeding.”

My own short description of the care practices using more direct language would be:

1. Avoid induction.

2. Stay out of bed. Move around a lot!

3. Hire a doula.

4. Demand individualized care–no interventions that are “just because” or “hospital policy.”

5. Squat, kneel, or get on all fours to push.

6. Breastfeed your baby early and often! Keep your baby with you and do not let hospital staff separate you from your baby because of routines or policies.


Worry is the Work of Pregnancy

This is a concept I like to introduce in childbirth classes. I first came across the phrase “worry is the work of pregnancy” in my most favorite of birthing books, Birthing from Within by Pam England. I’ve noticed that women often feel like they shouldn’t have worries during pregnancy and that talking about their fears is somehow “dangerous” (like it will make the fear come true). Bringing fear out into the open and “looking at it” instead of keeping it tucked away and bothering you is actually one of the best ways to work with it. Another common concern is that your worries are “silly” or unfounded. It is okay to have worries, even “silly” ones! The strategy Pam suggest for exploring your worries is as follows:

Explore each worry with questions:

° What would you do if this worry /fear actually came true?

° What do you imagine your partner and/or birth attendant would do/say?

°   What would it mean about you as a mother if this happened?

° How have you faced crises in the past?

 °  What, if anything, can you do to prepare for, or even prevent, what you are worrying about? What is keeping you from doing it?

 °  If there is nothing you can do to prevent it, how would you like to handle the situation?