Tag Archive | childbirth education

Why I do what I do…

I was feeling a little nostalgic this evening going through my childbirth education training manual. My original certifying organization, ALACE, is undergoing some reorganization and a “rebirth” into two new organizations. So, I was thinking back to my beginnings with the program and how excited I was about it and what an absolutely perfect match it was for me philosophically. I came across this section in the beginning part of the manual and thought about how perfectly it sums up why I do what I do. It also sums up the attitude and perspective that drew me so strongly to ALACE in the first place:

“Do you ever wonder why you are drawn to childbirth education when there are so many other pressing environmental/social/political causes clamoring for your devoted service? Perhaps you already see how our work is related to many other forms of activism. Cultivating respect for the mother and the process of birth is part of the larger process of understanding the interdependent patterns of nature…Giving birth, knowing you have done it yourself, your way, is a rebellious act in our technocratic society. In an age that promises to fix technology’s side effects with more technology, it is an act of faith in nature, and in oneself. The people who choose this route are often the same people whose hope for the future inspires them to work for a better world, not just for themselves, but for everyone.”

“A self-determined birth is a potent symbol of womanly power, of human courage, of loving compassion, even of ecological holism. It may look like childbirth educators are just showing charts and teaching relaxation, but we are also helping to create a gentle atmosphere in which personal and cultural transformation can take place.” (emphasis mine)

Empowering Women, Transforming Birth

Trusting Your Doctor

Jun22

Something that occasionally comes up during birth classes when talking about birth plans is, “well, I completely trust my doctor, so I feel like his judgment will be right for me…” (the reverse comes up more frequently, see my previous post!). I recently finished reading an older book called Education and Counseling for Childbirth and the author mentions this:

“‘Trust’ in doctor or midwife, valuable as it is, is not always a sure recipe for a happy labour. It may be enough for a woman to be healthy and hopeful and to know what is happening to her; it may be enough for her to be looking forward to her baby and to trust her attendants; enough for her to learn some breathing exercises and leave it at that. But it may not. Time and time again I meet women who need more time and care than is given by an overworked general practitioner or the enthusiastic but psychologically uninformed antenatal teacher—-women who need an opportunity to talk, express their fears and worries, and work through their problems in pregnancy in readiness for the responsibilities of motherhood.”

Trust is important—though I really emphasis trust in yourself, trust in your body, and trust in birth rather than exclusive trust in provider—but there is a lot more involved in preparing for a great birth than simply trusting your care provider. Additionally, there is definitely a lot more to birth education and preparing for birth than knowing medical terminology, anatomy & physiology, and the phases of labor! I continue to strive for classes to will help build women’s inner knowing and sense of self-confidence. One primary benefit I see to teaching private classes, as I do, is that the couple is my sole focus of attention and so are able to have all their questions answered without feeling as if they are monopolizing class time (or embarassed to ask questions in front of other couples).

Skipping Birth Class?

Jun11

Yesterday, I watched a short clip on why people don’t take birth classes. The comment that I found most interesting from the expert interviewed was: “The instructors in a lot of these classes –are a little bit doctrinaire about their point of view. They made an issue out of saying ‘You’re not a real woman if you need drugs. She should go through labor and childbirth on her own with help from your spouse with breathing techniques. They made it a kind of a contest. A lot of mothers today don’t want it — they want to go in and have their baby with a pain free a time as possible.” I find this perspective about “a contest” sad and disheartening and inaccurate. It is also slightly amusing–seriously, I know NO ONE who would say to someone else “you’re not a real woman if you need drugs” least of all a professional person teaching a birth class! I think this might be an example of what someone says being different than what someone else hears: i.e. the instructor says, “all medications have an impact on the baby. Additionally, many women find a very satisfying sense of personal mastery from giving birth without medication.” The person hears, “you’re not a real woman if you need drugs.”

This reminds me of an excellent section I’m re-reading in the book Mother’s Intention: How Belief Shapes Birth about judgment and bias. The author also address how the word “balanced” is misused in childbirth education–as in, “I’m taking a class at the hospital because it will be more balanced.” Balance means “to make two parts equal”–what if the two parts aren’t equal though? What is the value of information that appears balanced, but is not factually accurate? Pointing out inequalities and giving evidence-based information does not make an educator “biased” or judgmental–it makes her honest! (though honesty can be “heard” as judgment when it does not reflect one’s own opinions or experiences). She says, “Every person has a lens. Every opinion is biased, including the ones you hold. The question is, what created the perception leading to a particular bias?…When it comes to childbirth and parenting, when someone dismissed information as ‘biased,’ what it actually means is the information does not fit their already held biases. It is our insecurities that bring up defensiveness in the face of judgment, or perceived judgment, as the case may be…You may never even have a thought in your head that the other person could have or should have done anything differently, but they are seeing your actions through their own lens and making assumptions.” (i.e. if a mother had a homebirth it may be assumed she hates doctors and hospitals). I think this is exactly what was happening in the video clip–because a birth educator shares the benefits of natural birth, the assumption is that she “hates epidurals” and thinks you’re “not a real woman” if you have one!

As far as the “contest” idea goes, I’ve mentioned this before–just because someone runs a marathon, for example, doesn’t make the person who opted out of the marathon bad or “less than” 🙂

The expert in the video clip referenced above also emphasized several times that the time investment in classes is just too much and parents just “don’t want to invest.” So, now perhaps this IS “doctrinaire” or unpleasant of me, but I also find it a little frustrating that people are apparently unwilling to invest the time in preparing for their children’s births–most people watch more than 8 hours of TV a WEEK, but 8 or 10 hours of birth classes total is too much to invest? I hope my classes are exciting and informative and useful to the parents that come to them. I also realize that week after week CAN feel like a lot, which is why I designed my single session classes. I get a lot of interest in the single session classes and I’m glad I came up with them, because I think it allows me to better meet more people’s unique needs! In fact, so far this year, I’ve done only mix-and-match classes (from 1-4 weeks), no full six-week-series’ (perhaps they are a thing of the past?). I find I get clients who are very well-informed and interested and that these classes “hightlight” the things they are most interested in learning about, though they often tell me at the end that they wish they had signed up for more classes!

The Daddy Brain

Jun10

Two media items caught my eye today that relate to fathers. One was a short clip from “DadLabs: taking back paternity” called “Are birth classes worth it for dads?” The clip debates whether men belong in birth classes–as a birth educator who strives really hard to “reach” men in my birth classes, I was holding my breath on this one! They talk to several fathers, mothers, and one doula. I think the conclusion seemed to be that birthing classes are important and dads can benefit from them, but I’m not totally sure because the two hosts were kind of arguing about it!

The second piece was an article from Greater Good Magazine called The Daddy Brain. The article is about a stay-at-home dad and also addresses biology and child-rearing. A section I liked explains:

“In researching my new book, The Daddy Shift, I read every word I could find in peer-reviewed scholarly journals about caregiving fathers, breadwinning moms, and the science of sexual difference. I also interviewed dozens of parents….Here’s what I discovered: Where once it was thought that the minds and bodies of men were hardly affected by fatherhood, today scientists are discovering that fatherhood changes men down to the cellular level. [emphasis mine] For more than a century, it was assumed that mothers, not fathers, were solely responsible for the care, life chances, and happiness of children. In recent years, however, we have discovered that father involvement is essential to a child’s well being, and that dads provide unique kinds of care and play that mothers often do not.”

Fear & Birth

Jun8

I was interested to read a short segment in the book Labor Pain about studies on fear about birth. A Swedish study indicated that it was not pain that caused women the most anxiety about labor (44% of women had fear of pain). It also wasn’t fear of death of the mother or baby (55% worried about this). It wasn’t fear of their physical or mental capacity to give birth (65% feared this), but it was “lack of trust of obstetric staff during delivery” (73%).

This is tremendously significant! As I mentioned in the post, can I really expect to have a great birth, it is important to choose your birth care giver and place of birth carefully–to ask questions before your chile is roasted! Considering that the Listening to Mothers reports by Childbirth Connection and the Millbank Report on Evidence-Based Maternity Care reveal that many doctors do not utilize evidence-based practices, it seems that women’s top fear is very warranted.

Timing Poem

May30

I recently finished reading Teaching Natural Birth. In it, the author shares a poem called Timing, by Anne Clark. I haven’t read it anywhere else and a google search didn’t turn it up, so I wanted to share it here. I especially liked the closing paragraph.

Timing

by Anne Clark

Some people live life at fast and furious rates.

It’s the fast-food burger, the instant photo, the 12-hour birth.

Some thoughts that life, children and birth cannot be hurried:

A baby’s needs and wants are the same.

Meet the cries for dependence in a toddler, and a year later you’ll rarely have him on your lap.

Push him from your breast, out of your bed before he’s ready, and as an adult he’ll be on your lap, or worse, lost.

Some thoughts when my first couple asked me to provide labor support:

I should have paid them for the experience.

Hours of labor; a tender soul slow to yield to the pressure of insistence; a novice support person petrified by the intensity of it all; a center in myself created for the needs of this mother and father and baby.

To the mother, gently suggested, no rush, you’re fine, feel your baby, he’s strong. Let him come.

Mothers deliver their own babies.

My waiting hands caught him, a living, flowing, glistening sunbeam.

Forever hooked on Birth.

And from that day determined to give up anything instant (the hamburgers were agony.)

Delivery is drugged, controlled, guilt producing, hurried.

Birth is natural, forgiving, unhurried.

As a teacher of natural childbirth I try to teach the difference between Birth and delivery. Any woman can be delivered of her baby. It is up to us, the natural childbirth educators, to elicit the deep-down birthing knowledge that every woman possesses and to enourage patience in a natural process that, like life and children, cannot be hurried.

————

Personality and Birth

May6

From Sheila Kitzinger’s book The Experience of Childbirth:

In a normal, straightforward labour a woman’s attitude of mind, her approach to the task that awaits her, and her preconceptions concerning the nature of the work that her body has to do, are more important than any sort of physical preparation she can make in advance. Whatever athletic exercises she may essay, however controlled her breathing, however complete her muscular relaxation, in the last resort the thing that matters most is essentially the kind of woman she is, and the sort of personality she has [emphasis mine]. That is why preparation for labour cannot rest in purely physical training and in mechanical techniques of control and release alone. Controlled muscular activity can assist her in making of her labour something she creates, rather than something she passively suffers, but her capacity for achieving this physical coordination is dependent upon her mind–upon her fearlessness and sense of security, her intelligence, her joy in the baby’s coming, her courage, her self-confidence, and the understanding she has of herself. The experience she has of childbirth is a function of her whole personality and ideally the preparation should involve increased self-knowledge and a growing towards maturity.

While there is a certain element of “blame the victim” in this quote that I find distasteful (i.e. “she had XYZ intervention, must be her bad personality…”), I recognize something here that speaks to me. I have observed in some of my clients a certain “quality” of personality (or perhaps determination) that makes me feel secure that they will be fine with or without me–they have something that comes from within that will guide them through birth. There are others who are more ambivilant, who say they want to “try” natural birth. Sometimes they blossom into confidence as the classes proceed, sometimes nothing really changes. I do not really take responsibility for any birth outcome, because birth classes are just a piece of a much more multifaceted puzzle of a woman’s experience. However, I feel like you can see that some women just “have it in them” and in others, that “it” has to be nurtured and grown. I’m not sure exactly what this “it” is, which is why Kitzinger’s quote caught my attention.

Births & Marathons

Apr22

A parallel is often drawn between giving birth and running a marathon. There was a great article called “The Gift of Leaping” in the most recent issue of the International Journal of Childbirth Education (available to download as a pdf here) that was based on this theme.

In it, the author discusses how in both experiences your mind’s strength can be called upon to surpass your physical strength and she notes, “The pain of accomplishment is so much easier than pain endured.” I loved that!

She goes on to share: “I want that feeling of going beyond what you think is possible for laboring women. If you let go of control and allow the process to unfold, you are so proud of yourself. Then pride morphs into self-confidence and trust. What a perfect combination for parenting. When it comes down to it, you have to do this by yourself, be it labor or running. You might hear other laboring women around you or have the support of crowds in a race, but it’s still up to you. there’s a start and a finish and only you can see it through. Fortitude brings a new self-awareness and strength that feels overwhelming…I know one of my greatest challenges in the vocation of perinatal education is getting women to trust the process and her own capabilities before labor. My practice runs helped prepare me for the marathon, but there is no practice run for labor. Women must rely on their confidence and the legacy of the many women who have birthed before them…”

I share her feelings about her greatest challenge. The whole point of my birth classes is for the participants to develop confidence and trust in their ability to give birth naturally. It is difficult to share what birth is really like–it is a singular experience (each birth is different too, so even if you’ve done it before, there are still surprises ahead!) I also feel like it is irreplaceable to start off the parenting journey with a overwhelming sense of power, pride, and capability–a sense that often comes with the “I did it!” of giving birth!

Non-verbal Communication

Apr13

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.”

Birth as a Rite of Passage

Apr11

Part of my philosophy of birth is that it is a significant rite of passage for women, men, and families, not a medical event, emergency, or health crisis. I recently finished working through The Pink Kit and the little book that came with it had some thoughts to share on this subject in the “final word” segment of the book:

We would like to warn you against expecting a ‘perfect birth,’ or for that matter anything in particular, except that you will get through it, with your baby–just about everyone does, no matter what they know and do!

The fact is, there is no such a thing as a ‘perfect life.’ Think about what life passages you may have undergone so far–cutting teeth, starting school, menstruation, the first sexual experience, loved ones dying.

Birthing is also a rite of passage–into parenthood–and like any other passage, it comes upon us and we just have to deal with it. It’s an awe-inspiring experience, and it would be perfectly natural to want to prepare in some way. And you can do that. But to some extent the experience is still out of your control.

Giving birth is definitely the most significant and impactful rite of passage of my life–it is the the gateway to motherhood, which has been the single most life-changing role I’ve had. I believe that this significant, transitional, rite of passage is worthy of appropriate level of awe, respect, and preparation. It is a sacred passage. Accordingly, I also believe the birthing woman should be treated with reverence and respect.