Between expectation and reality lies potential disappointment

Expect

What are your expectations for your birth? I have been teaching for 16+ years. That equals thousands of couples, and not one of them has had the birth that they expected. Don’t misunderstand me, they haven’t been disappointed necessarily, they just didn’t have a birth that went “according to plan.” I’m concerned about the gap that exists between expectations and reality – especially when it comes to giving birth.

When I first started teaching, I was a cheerleader of the almighty Birth Plan. I wanted women to declare what kind of birth they were wanting to have and then go out and achieve that exact birth. But at our class reunions, each one of the women who were anywhere from 6 weeks to 3 months postpartum would give the same answer to my question, “How was your birth?”

“Well, it wasn’t what I expected, that’s for sure!”

After hearing this a few hundred times, I had learned to not write a birth plan for myself when it was my turn. It made sense to me to go in with zero expectations and no real written birth plan so that I wouldn’t end up disappointed in a birth that went “rogue.” Don’t get me wrong, I definitely had my own idea of what I wanted to occur. My ideal labor would have been one that had no medication and no interventions – one where I would grunt my baby out and go home a couple of days later. That is definitely not what happened for me. But somehow, because I’d not written up a lengthy birth plan and went in with pretty broad expectations of all the possibilities, I wasn’t disappointed. I found that I wasn’t wedded to any particular outcome and this allowed me to remain flexible and ready to make decisions on the fly. 

Easier said than done. I’m concerned that some might misinterpret that I’m suggesting women forego the birth plan altogether and just be happy with “whatever they get.” But nothing could be farther from the truth! I want women, all women, to have a positive birth experience. I want them to be able to tell their birth stories with a sense of pride and satisfaction in their voices. I want them to feel confident and secure in their new parenting abilities – and this begins at birth.

But what also begins at birth is the roller coaster ride of parenting. Talk about something not going according to a set of expectations! You might have expectations about how breastfeeding will go, or how much your baby will sleep at night, or what their temperament might be. Guess what? You can have all the expectations you want about this stuff –  and “Que sera, sera!” translation: “Whatever will be, will be!” The same is true for your birth. 

I had a reunion this past weekend and 5 couples were able to make it. None of them had a birth that went according to their plan or set of expectations. Two of the Mommas had been wanting a medication free labor, and close to the end, changed their minds and got an epidural. One Momma had been fully hoping for an epidural but as a 3rd timer, her birth went unexpectedly fast and she ended up going medication free. And there was still one other Momma who had been hoping for a vaginal birth with little or no interventions, but ended up with an unexpected Cesarean after many hours of pushing.

Despite none of them having their “ideal” birth, as each one told their birth story, they were smiling. Their eyes were shining as they spoke of this most important day of their lives. They weren’t dwelling on what didn’t go right, but instead celebrating what did go right. Their expectations of birth were broad going in, they focused on those things that were under their control and made the best decisions they could in the moment as birth unfolded. As I held each one of their babies in turn and listened to them speak, I followed up with a couple more questions.“Was it what you expected?” And to the woman, they all said, “No. Not at all.” But then I followed up with, “Was it a good experience for you?” And each of them replied, “Oh, yes.” Some of them are already considering baby #2!

Having an idea of what kind of birth you’re wanting to have is very important because it will help you to find the right provider and the right place to give birth. It will help you understand the level of participation that is required of you. It will encourage you to avoid interventions unless they’re medically necessary. But more importantly, it will allow you to engage your provider in open, honest dialogue about the birth of your baby. It’s through this dialogue that you gain the most benefit. Dialoguing with all the members of your birth team, as opposed just handing them a written birth plan, creates connection between you. It’s also an opportunity for them to know what your hopes and fears are around giving birth. It gives them insight into any specific or particular concerns you might have and provides them with ideas of how they can best support you.

Once you have built that mutual trust with your birth support team, you’ll really start to feel like a team. All working together as birth unfolds so that you can make the very best decisions possible for yourself, your baby and your labor.

Birth happens – and then you’ll tell your story. Little or no expectations of having the “perfect birth” will free you up to recognize what’s happening in your birth right now and allow you to adapt better as it unfolds in real time.

You can still have a positive, empowering birth experience even if, sometimes especially if, your birth is not tied to a specific set of expectations. When you realize that birth is too big for an 8 1/2 x 11 piece of paper, you’ll find yourself relying more on your birth team, digging deeper than you thought you could, and embracing the vulnerability that is birth.

Your birth can be so much more than a rigid set of expectations about what is and what isn’t a good birth. Open yourself up to all the possibilities that birth holds for you. 

What if you wrote out your Birth Hopes, Birth Wishes or Birth Desires instead of a Birth Plan? How does switching that word up make a difference? If you’ve given birth before, how did your reality match up with your expectations? How big was the gap?

Kick fear to the curb!

Fear

Fear of labor – why does it happen and what can you do about it?

It’s important to look at the underlying causes of fear around birth to normalize and understand why we feel this way. But it’s more important to be empowered and discover some ways that we can work to combat that fear and – maybe – even turn it into excitement.

What did your first teachers have to tell you about birth? By first teachers, I mean your parents. Were they open in talking to you about sex, birth and babies? Or was this considered taboo – certainly not to be talked about at the dinner table? (Apologies to my own children who hear about these subjects at the dinner table on a very regular basis…) Did your parents reserve telling you the details of your birth unless they were angry with you? “Do you even know how many hours it took me to push you out?!” The way our parents talked about birth around us either directly or indirectly has huge impact on how we approach the very idea of giving birth. What our parents have (or haven’t) shared with us, results in deep-seated and sometimes unconscious attitudes about birth – many of them revolving around fear.

If you’ve grown up in Western culture, you’ve been exposed to images of women giving birth that should probably terrify you! We’re bombarded with images of women screaming their heads off, suffering through an incredibly complicated and life-threatening situation where Momma and baby are in imminent danger! Writers for movies and TV know exactly what they’re doing! They’re manipulating the oldest story in the world, birth, to be as exciting and dramatic as possible so that you won’t change the channel.

There are women who have had less than positive birth experiences, some of them truly traumatic, who’ve been told by everyone in their closest circles to “move on” and that “healthy Momma, healthy baby” is all that matters. They’re being told to stop processing this event. But as women, we need to process until we’re done processing! My husband could talk to you about this! If we get into an argument, and we talk it out for an hour or so, he might mistakenly think that I’m all done and we’re good the next morning. But if I still need to process, we’ll be having another session – and soon. These women who have effectively been silenced in their efforts to process their negative birth story need to find other outlets for healing. They see a pregnant belly and unconsciously decide they will process with you! They seem so nice at first, when they approach and ask sweetly, “How many weeks do you have left?” But then, their demeanor seems to change instantly as they vomit a horrible birth story all over you. As an unsuspecting pregnant and highly vulnerable woman, you can’t just hear this story and let it go. It gets packed away as one more thing to worry about as you get ready to give birth yourself.

These are all very real examples of why a woman might have fear about labor. Why do we care about this?

Because what happens in your mind plays itself out in your body.

If you respond to your first real-deal contraction with, “Oh no! I think this might be it!” Your body responds with fear – and the ancient autonomic nervous system response of “Fight or Flight” kicks in. This is an okay response to have in pretty much every other situation besides labor.

When your body is in fight or flight mode, your blood flow and oxygen will be shunted away from unnecessary muscles and organs and fed directly to those that need it for fighting or fleeing: your brain, arms and legs. When you’re ready to give birth, your uterus will be the largest muscle in your entire body. It needs a boatload of blood flow and oxygen in order to do it’s job well. The uterus is made up of smooth muscle tissue that in my mind makes it a “pre-programmed” organ. It knows what it needs to do and on the appointed day and hour when labor begins, it will contract. But how well it will contract depends largely on whether or not you are stuck in fight or flight mode. If you respond to your contractions with fear, your body doesn’t recognize your uterus as essential to fighting or fleeing. The uterus will not get what it needs to function. You will most certainly increase your levels of tension and pain with each contraction which is likely to only increase your fear, tension and pain.

So how do we break this vicious cycle?

I like to pass along  a few “Fear Busters” to my students. If you start using these – now – you might be able to break the F-T-P cycle before it ever begins!

1) Information: Please stop relying on Dr. Google for all of your pregnancy, birth and parenting concerns. Instead, make sure that your information comes from solid, non-biased and evidence-based sources. Knowledge is power – but only if the knowledge is accurate, current and not based on opinion! Knowing what to expect, how you can work with yourself and members of your birth team to cope with contractions, what options are available to you if the situation requires it – this information can be a huge help. Studies show childbirth preparation classes can result in women reporting (perceived) less painful and shorter labors. Note: They might not actually have shorter or less painful labors, but the perception is what matters here.

2) Affirmation: With all the negative images and stories swirling around you during your pregnancy, you need to actively seek out the positive, for yourself and from others. Pick up a few good books that highlight birth as a normal, physiologic process – and one that shares positive birth stories generously. One book I love for this very reason is Spiritual Midwifery, by Ina May Gaskin. I think close to half of her book is devoted to positive birth stories – go fill yourself up with the good stuff to combat the bad! Write yourself a little affirmation statement! It might sound cheesy, but it can pack a powerful punch! Write the words, “I am strong” on a sticky note and tape it to your mirror so that at least 2x a day while brushing your teeth, you’re reminded of just how strong you are. Dads can write their own, “I”ll be there” and stick it next to yours. This can mean different things to different people, but remember your presence alone is what matters most to her during the birth.

3) Relaxation: You will probably have to work hard through your contractions. But if you take advantage of the rest and relaxation available between contractions by breathing slowly and deeply, not only are you allowing your blood flow and oxygen to be available for your uterus, but you’re also quieting the fear gremlins in your mind that are causing you to be fearful in the first place. Being truly relaxed between contractions will allow you to enter the “No-Pain Zone” and get recharged for the work that will be required throughout the rest of your birth.

4) Reclaiming Trust: Your body is designed for the purpose of giving birth. And on the day that you are in labor there will be approximately 300,000 other women in the world doing the exact same thing! Some will be in beautifully appointed hospitals or birthing centers, some will be giving birth in water at home, still others will be giving birth somewhere in the middle of a jungle or in a tiny village. When you’re feeling fear remember every single person alive today, has been born of a woman. You and your body can do this!

When you take these fear busters and apply them, you can completely change the    F-T-P cycle into the E-P-P cycle: the Excitement, Power, Progress cycle.

When you feel that first real-deal contraction, instead of reacting with fear, how about responding with excitement? “Oh my gosh, I think this might be it!” said with a smile on your lips. If you can’t get excited about going into labor, then get excited about ending pregnancy! I don’t care how or what you get excited about, but entering labor with this mindset makes all the difference in your ability to cope with contractions. None of your contractions will ever be more powerful than you – because they come from inside of you! You are powerful beyond measure. On the day you give birth, your body will open up and push a brand new human being into this world. There’s nothing more powerful than that! This sense of empowerment is available to every woman, regardless of medication choices or even mode of delivery. You are powerful. Claim your power. And finally, as the contractions get longer, stronger and closer together this is your very best indication of making progress toward what you’ve been wanting for so long: to hold your baby in your arms!

Taking fear out of the equation of giving birth is not necessarily easy – but it’s key to being able to progress in labor and give birth with as little intervention as possible. Work hard to master these Fear Busters and you might be able to enjoy the E-P-P cycle of birth.

Did you have any fears going into your birth? Were you able to overcome your fears of birth? How?

This one is for the Dads…

Honor

This blog post is dedicated to the guys – the guys who are or will become Dads someday.

I have to admit that I’ve always loved guys. I was a really big “tom-boy” as a little girl and could always be found outside either climbing a tree, playing with crawdads, digging up night crawlers to go fishing with my brothers, or choosing the teams for neighborhood football games. I played with boys all the time. I even had an imaginary friend, Tommy, that I used to play with for hours on end because he saved me from having to play dolls with either of my sisters! The irony of ending up in such a feminine profession is not lost on me. As a childbirth educator, everything I do is associated with women – women empowerment, women as mothers, babies coming out of women body parts. But… I have never stopped loving guys. And I think that it’s time that we do ao better job honoring them as expectant-Dads-to-be.

Gone are the days of, “”Go smoke in the waiting room and we’ll come get you when the baby’s born!” This is a wonderful advance in terms of welcoming Dads into the labor room – but sometimes I wonder if we haven’t swung the pendulum totally in the opposite direction without any real thought. We’ve now told our expectant Dads, “You’re it! Get in there and be her everything!” But we haven’t done our due diligence with these Dads to check in and find out 1) if they even want to be present at the birth and 2) if they feel adequately trained to be the laboring woman’s main (and sometimes only!) labor support.

Often, when men accompany their pregnant partner to the first childbirth class, they’re not very excited to be there. For a lot of them, they’ve felt pretty left out of the whole pregnancy, and they’re worried that these classes will just be more of the same. From a physical standpoint, there’s no way that a man and a woman can experience pregnancy the same way. But this doesn’t mean that his experience of the pregnancy is any less than hers.

Sometimes women are upset that their partner doesn’t react the way they want them to at the news, “I’m pregnant!” I’m not sure exactly what women are expecting, but if there’s any hesitation, or a question like, “Are you sure?” too often the woman thinks that he’s not excited, that he doesn’t want the baby, that he’s not ready to become a Dad. But most men and women, have a lot of mixed emotions when they find out they’re pregnant. They’re happy, but also completely freaked out. They’re excited, but scared to death! They can’t wait to meet this little person, but are super anxious about how the baby will change their relationship. Women don’t cut guys any slack on their initial reaction to this news! Even if their reaction was exactly the same as the woman’s reaction 6 hours earlier when she first saw a double line on the pee stick!

Initially, most Dads are pretty psyched about the pregnancy – his boys can swim! He got his woman pregnant – yes! But soon after, it sinks in that he needs to be able to provide for his family. It doesn’t matter if  the Momma will be going back to work after maternity leave or not! He also worries about wether he’ll be able to fill his own father’s shoes in the parenting department or if he’ll be able to avoid resembling his father in every way, depending on his own relationship with his Dad.

What I know about today’s Dad is that he wants to be involved – way more involved than his own father had been before him. He’s looking forward to meeting his baby and can’t wait to be a part of their life. But guess what? He’s unsure of himself. When the sexual revolution occurred, the message was clear. I can remember seeing the perfume commercial as a young girl – “I can bring home the bacon, fry it up in the pan, and never, ever, ever let you forget you’re a man! Cuz’ I’m a woman – Enjoli!” But where was the equivalent commercial (or revolution) that told men they could be as good or better than a woman in the sensitive, nurturing parenting department. We just need to do better about welcoming men into this world of women.

How does this happen? First of all, women need to include men in every aspect of their pregnancy – if they want to be included, that is! Not every man wants to know every little detail of the pregnancy. Men, like women, do not become completely different people just because his partner is pregnant. Women need to stop placing unrealistic expectations on their partners. But if the guy wants to be included, then by all means, the woman should be carving out space for him to feel welcome and accepted into this mysterious and powerful experience of pregnancy and birth.

Men must be seen as co-creators of this new little person and given the honor and respect that the role of “father” deserves. If the expectant Dad takes time off work to attend clinic appointments, comes prepared with questions or concerns, and voices these during the appointment, it’s imperative that the provider or staff make eye contact with him and answer him directly. Dads who say they felt ignored or invisible during the pregnancy is just not okay.

Prenatal education classes must address the unique needs and concerns of the expectant father in a way that is honest and real, but not in any way condescending. His role should be elevated in front of the expectant Momma – she needs to see how important his role is to the overall success of her pregnancy, birth and parenting experience. It’s not enough to tell Dads how important it is for him to be there for his laboring partner – he needs to know that no one else can claim the emotional connection he has with both Momma and baby.

He needs to be prepared for all of the different emotional responses he might have to the birth itself. The physical aspect of helping her through contractions will not the be the challenge for him. But watching the woman he loves really struggle as she moves through contractions will be incredibly painful for him.

He needs to know that he doesn’t have to be her everything in birth. That he doesn’t have to try and be her doula. He just needs to be there. Be present and available to her for each and every contraction. His role during the birth is not unlike everything he’s already been doing for her during this pregnancy –  he’s probably held her hair back once or twice while she threw up, he’s had to listen to her when she’s had a bad day, he’s probably given her countless back massages. All he needs to do on the Big Day is make sure that he’s bringing all of that and a little more to help her cope with her contractions.

Basically, he needs to be prepared to love her straight through from the first contraction to the moment when his little baby makes it into this world – and then beyond.

Just as I feel that every woman is fully capable of giving birth, I feel that every man is fully capable of providing excellent labor support to the woman he loves. But I also think that having additional birth support team members might be exactly what is necessary for this birth experience to be a positive memory and birth story worth telling for both of them. Maybe it makes sense to have a doula or other labor companions in addition to Dad.

I often tell women in my classes, “If you need warm and fuzzy there when you give birth, and he is not warm and fuzzy – then make sure you bring yourself some warm and fuzzy!” It’s so important that we allow the Dads to be themselves during the birth – which means some of them will want to put on their catcher’s mitt and take charge, while others will want to sit at the head of  the bed and hold hands with the laboring woman making sure to never look “south of the border”! Either way, that’s excellent knowledge going in and will allow the couple to choose the members of their birth support team well so that Dad can do whatever he needs to make sure this experience positive for him as well.

If we want men to be great Dads, we need to welcome them into this experience first. Then we need to acknowledge and honor their role during pregnancy, birth and parenting. We need to give them the space to explore their own vulnerabilities around becoming a Dad and support them better in their role as birth support partner. We need to explore how and why a doula or other support person can free them up to be fully present during the birth of their baby. This way they can witness their partner’s strength, be truly present for the miracle that is their baby’s birth and better prepare to bond and attach to their newborn soon after delivery.

I love guys. Almost as much as I love guys who are about to become Dads.

Did you feel like your role as expectant Dad was honored? In what ways did you feel welcomed into this world of women? What changes could be made so that you felt more included during the pregnancy and birth?

Guess why it’s called labor…

Work3

On night two of a four-week class series, we watch our first birth film. It’s always a birth film using non-medicated coping techniques and comfort measures (i.e., no drugs.) We’ll get to epidurals and Cesarean birth eventually, but I try to show my couples what birth looks like when nothing’s been added to the mix.

Currently, the hot movie that’s probably shown in lots of classes around the country is “Adam & Christina.” They’re a really likable couple and the demographic works well with my Portland peeps – Christina wears a little labor skirt instead of a hospital gown, she wears 20 different cute bras throughout the movie, and her butterfly tattoo is clearly visible on her low back while she’s pushing.

Christina has back labor and is pretty emotional but most importantly, she’s working – hard. It’s my favorite part of the movie. We get to see her in a mostly hands and knees position to get the extra pressure off of her back while Adam applies a heating pad and counter pressure to help with the pain. She gets in and out of the tub, uses the birth ball, squatting bar, patterned breathing and vocalization, she takes quick sips of water and sucks on a popsicle. In the voice over, Adam says something to the effect of “While it might not seem like much, it was quite a lot of work to keep up with her.”

In the debrief after the film, I acknowledge that there’s lots of different people in the class. Those who are wanting the “At-Home-Do-It-Yourself-Epidural-Kit” and those who are wanting to to go all the way or as far as they can without any drugs. Either way, they need to know that they’ll be working hard before medication even becomes a possibility. For those who are looking to give birth without drugs, they’ll be working harder.

It’s not enough to write on their Birth Plan, “Desire no pain medications to be offered unless I specifically request them.” They need to go into this labor and delivery room ready to participate actively in their birth to cope with their contractions. When we cover non-medicated coping techniques, they better be paying close attention – with eyes and ears wide open! And they better practice outside of the 4 weeks that we’re together if they expect breathing, position changes, massage, relaxation, and hydrotherapy to be effective in helping them cope without medication.

Do I believe every woman is capable of giving birth without medication? Yes, absolutely! Because I believe birth is normal and our bodies are designed to do it very well. Having said that, there are reasons why this might not be possible for an individual woman in labor on any given day. Due to circumstances like the health of baby or Momma, the length of the labor, the support (or lack thereof) of her birth team, even her desire – an unmedicated, non-interventive birth might not happen for her.

If she’s internally motivated for this birth to be drug free, however, she better be prepared to work hard for that reality. Her partner better be prepared, too. I’m fond of saying, “If she has a 24 hour labor, you do too!” because I want partners to understand what their role will require. There will be no sitting around and checking FB posts or texting to the in-laws about the birth – these partners will be working hard to help this woman get through each and every contraction.

I’m a big fan of couples having realistic expectations about pregnancy, birth and parenting. The participation level that’s required of women and their partners when they’re bringing their babies into this world must be emphasized. The vast majority of women describe their contractions as painful – they hurt. And I think it’s okay to use the “P” word in childbirth preparation classes. In fact, I think it’s more helpful than not.

I’ve heard some women say that they really believed that if they had just breathed or relaxed “enough” they’d be able to labor pain-free or maybe even have an orgasm while giving birth. I’m going off on a tangent here for a moment, but you might think that sounds crazy! An orgasm while giving birth – is that even possible? Yeah, it is! I actually met a woman in person who told me she had, “The best orgasm of her life!” when she gave birth to her baby. I’m sorry, but who wouldn’t want that to be their birth story?!

Ladies can testify to this one, though. If you go in search of the best orgasm of your life, you’re never going to find it. If the conditions are just perfect, it might sneak up on you and – Whoa! But isn’t it better to be pleasantly surprised rather than horribly disappointed?

Instead, be prepared to work hard through each and every contraction and make your way to the break that is waiting for you in between. Know what you’re signing up for in advance so you can better prepare yourself, your partner, and your whole birth team for how they can best support you. If you’re wanting to give birth drug-free all of you need to know what non-medicated comfort and coping techniques are available and feel good about using any and/or all of them to help you get through.

What I don’t want for any of my couples is to feel like they had no idea how much would be required of them in an unmedicated birth. That would mean that I had completely fallen down in my job of preparing them for their birth experience. The bonus is that if everyone in my classes hears the same message from me no matter what their medication preference might be, then they’ll know what they have to do – actively participate in their labor.

And the super sly thing about all of this is: the more actively a woman participates in coping with her contractions by using different comfort techniques, the stronger she’ll feel. Even if circumstances or desires shift during the birth and a woman chooses medication to help her cope with contractions, she will retain that feeling of being strong and powerful by remembering how well she had been coping with her labor up to that point. She will feel less “victim” and more “decision-maker”. This has huge positive impact on how she will remember her birth and tell her story.

And I’m all about that – women feeling strong, empowered and positive about how they gave birth to their babies. Able to tell their story with their heads held high, a sense of pride and satisfaction backing every word. This can only happen when we work hard at something. That sense of pride and satisfaction comes with the struggle. The key here is that it doesn’t have to be all or nothing. 

Hard work is good for us. And there is no harder work, or better work for that matter, than birthing our babies.

Work

(Bonus image)

Was giving birth something you would describe as hard work? How much did you participate in the birth of your baby, as birthing woman or her birth partner?

I didn’t know all that I didn’t know…

Know

While pregnant with my first, I had gotten used to getting kicked awake. But one morning, I woke up and – no movement. I made my way to the bathroom thinking the baby would start kicking any second, but no. I’d been up and out of bed for maybe 5 minutes, when I started to completely freak out. Frantically, I called my doula.

“The baby’s not moving! What do I do?!”

“Drink a glass of juice, sit someplace quiet and count any movements from the baby until you get to 20 and then call me back,” she calmly explained.

“Oh, count fetal movements, yeah. Just like I teach people to do in my own classes all the time,” I replied lamely.

In that moment it didn’t matter how many books I’d read, how many conferences I’d attended, or even how many couples I’d taught in my own classes! Suddenly, it all became so clear! I was just another pregnant woman – feeling anxious and vulnerable and unable to remember all the information I’d been teaching others for close to two years! There was so much I didn’t know, that I didn’t know.  

This also happens to a lot of people in my classes. They, too, are surprised and startled when they realize: They don’t know how much they don’t know. These are well-read people. They’re really intelligent. Many have amassed a small library on the subject of birth, but still in the end they’re blown away by how little they really know.

The reason is two-fold. When a couple finds themselves pregnant for the first time, the woman’s life changes dramatically. She sees the plus sign on the pee stick and her whole world changes overnight. But her partner’s? Not so much. She might start noticing breast tenderness or nausea, but physically most guys are feeling pretty normal. The physical changes of pregnancy usually prompts a woman to want to learn more about it. So she Googles, she buys books, she talks to her own mom and sisters. She basically turns into a fact-finding machine wanting to know all she can about what she’s about to go through.

Some partners try to match her in this quest and start looking for their own sources of information. But all too often they are disappointed in the offerings! Many of the most popular books on the shelves have one, maybe two chapters dedicated to the expectant father’s experience of pregnancy and birth. And a lot of the books that are designed specifically for men are condescending to the male experience. By the time a Childbirth Preparation class becomes their reality, a lot of guys admit to not being very well-informed at all.

Pregnant Mommas, on the other hand, feel like they know just about everything! Except that many of them stopped reading the books and Googling the articles when they got to the parts that involve the actual act of giving birth. Many of them are not ready to go there yet.

A long time I ago I had an “Aha!” moment as a Childbirth Educator: The baby will come out. One way or another, the baby will come out. And so I teach my couples about all the ways that a baby might make their entrance into this world. But really, I’m teaching them much more than that. I’m not just teaching them how to breathe, and what positions are best for bringing the baby down and out. I’m not just clarifying the differences between analgesic medication and an epidural. I’m not just teaching them how to become well-informed health care consumers, either.

How I set up my classroom experience and even how my couples introduce themselves to one another sets the tone for the entire series. They should feel like they’re in a a safe place to ask questions, explore vulnerability, and meet a community of people who are going through the same experience. It’s important that my couples stop feeling isolated during this huge transformation. I spend a lot of time nudging the individuals who’ve been walking their separate paths of pregnancy to step into one another’s shoes for a bit so that they can move together as a couple onto a merged path of shared experience – all in an effort to better prepare them to welcome their baby into their relationship.

When I was a rookie teacher, I really believed that my role was all about teaching folks how to have the “best” birth experience possible – a vaginal birth with no need for medications or interventions! My focus was so narrow on how best to get the baby out, that I left out all the most important stuff! Now a veteran, I spend a lot of this time teaching – yes, how to get the baby out – but so much more.

I know I’ve done my job well when I read these sorts of comments on their evaluations, “Didn’t realize how important my role as the partner was to her whole experience.” Or, “Liked the emphasis placed on the postpartum period and how we can work to make our relationship stronger.” These are the intangibles they can’t get from a computer screen, or even a book. Which is ironic, because I’m currently writing a book about birth! Throughout my book, I encourage women and their partners to seek out a live class for these very reasons. I want them to have that experience at the end of a class, “Wow! I didn’t know what I didn’t know.”

And it’s helpful to be in that place before giving birth – that place of knowing all that you don’t know. Because that’s what parenting really is, having to learn on the job, day to day. And this can be quite the shock to someone who hasn’t eased into it during their pregnancy.

Knowing something because you’ve researched it or read a ton about it, is nothing like knowing it from lived experience. There’s a very big difference between a couple prepping for birth the first time versus a couple prepping for their second or third. It might be assumed that a couple doesn’t have to prepare for birth the second time because they already know everything there is to know. The truth is, they’re better prepared because they are humbled by the fact that there is so much that they do not know.

And they know it.

What topics in your childbirth class do you wish had been covered? When did you realize that you didn’t know what you didn’t know?

Help me, I’m stuck!

Stuck

There’s a term thrown about by those in the birth profession, “Failure to Progress.” Basically, they’re diagnosing a woman in the midst of her labor as being stuck – not moving forward or backward. She’s really trying to have a baby, but the process has stopped.

I get super irritated with this phrase. What do you think happens to a woman in labor when she overhears “failure to progress?” I can’t help but think if she wasn’t stuck before, she will be now! Stuck not only in her body, but also in her own mind with swirling thoughts of, “What’s wrong with me? Why won’t my body do what it’s supposed to?” And what’s happening in her mind has a direct effect on what happens in her body.

The remedy for “failure to progress” is all too often medical in it’s approach: break her bag of waters, give her some pitocin. This approach doesn’t begin to take into account the reason why she’s stuck. If there’s time (and in labor there’s almost always time) why not change things up to see if she could get unstuck?

What’s the lighting like where she’s giving birth? There’s not a woman alive who’s looking forward to giving birth under the bright glare of fluorescent lighting, I promise you! Laboring women are animals. And all other animals require a sense of privacy when giving birth. Usually, animals do best when it’s dark. If the lighting is low while a woman is giving birth, it frees her to say and do whatever will allow her to be in her animal body and not her human brain. Dim lighting enhances whatever rhythm and rituals she chooses to release tension, thereby enhancing her progress.

And how’s the temperature in her space? It needs to be comfortable for her, not the birth team. So that means everyone else better bring a hoodie, because that thermostat will be getting a workout – up and down, up and down! Birth can be hot and sweaty work, especially near the end – but she might feel chilly from time to time. In order to make progress she needs the temperature to be just right.  

When was the last time she had anything to eat or drink? I know hospital policies sometimes work against this, and for a woman in strong, active labor eating is usually the last thing on her mind! But giving birth is an awful lot like running a marathon. We’d never expect anyone to complete that endeavor without food and drink to fuel them. Making sure a woman is well nourished and well hydrated throughout her labor goes a very long way toward making good progress.

When was the last time she changed position? Babies really do need their mothers to continue moving throughout labor so they can make all the twists and turns necessary to be born. Gravity always helps in this process – the baby must come down before they can come out. Encouraging a woman who hasn’t changed position in the last 30 minutes or so might be just the nudge that her baby needs to move into a more favorable position for labor progress to continue.

Has she gotten into the shower or tub? Hydrotherapy – a fancy word for using water during labor – has a calming and relaxing effect. And closing the door to the bathroom affords more privacy which allows her to let go even more and move deeper into labor.

But after addressing all of these physical needs – it’s vital that we check in with the laboring woman about her emotional needs. In fact, this might be the real reason why she’s stuck.

Did she and her partner have a fight the night before labor began? Did it ever get resolved? A laboring woman might be thinking: “How can I bring my baby into this disconnected family?” This might seem overblown. But these emotions don’t have to be “rational” to have an impact on a woman’s labor progress.

Who’s in the birthing room with her? Are they helping or hurting her progress? I’ve been at a birth where there were 8 people in the room when the baby was born. The laboring woman spoke of how amazing it was to feel like everyone was pushing with her to bring her baby into this world. But I’ve also been at a birth where one wrong person in the room has shut the whole labor down. The laboring woman was unable to make any progress until the person was asked to leave.

What kind of anxieties does she have about the baby’s health? Or concerns she might have about becoming a mother? This mental anguish can be so powerful that it can bring her labor to a screeching halt.

I know a couple who’d been married for almost 10 years when they finally decided to have a baby. Her home birth was carefully planned out and she had an excellent birth team assembled. But after 3 days of contractions – she still wasn’t in labor. Her midwives thought some privacy would be helpful and asked everyone to leave the couple alone. What happened next was astounding! The woman looked at her husband, announced “I don’t think I’m going to be a very good mother!” and started sobbing. Her husband reassured her, saying she was already a good mother, he acknowledged that he was scared too, and that they would take this parenting thing on together – it was all going to be okay. She had a baby in her arms about 6 hours later!

If we spent as much time checking in with women about their emotional well being as we do her physical well being in the weeks and months prior to giving birth, she might be able to clear her emotional landscape and prevent getting stuck in the first place. If we check in with her emotional needs during the actual labor, create an atmosphere that is physically conducive to giving birth and stop using that awful phrase “failure to progress” – we might be able to get her unstuck in the moment.

Every laboring woman deserves the right physical and emotional space to express her needs so that she can progress in her labor. She should never have to feel stuck. 

Did you ever get stuck while giving birth? What helped you to get unstuck?

Life-long learner

LearnIt’s way too easy as an educator, especially after so many years, to fall into the trap of thinking, “I know all there is to know about ___________.” (Fill in the blank.) But when we do that we’re in grave danger of letting our own thoughts, ideas and ways of teaching on any given subject to become locked up – untouchable and beyond reproach. We also run the risk of having a curriculum for our classes that is stale, outdated and less than engaging.

If we want to be educators worthy of the honor that is teaching, we need to to be learners, too. Always on the quest to learn more, learn better and learn from our students we are called to teach.

In my role as a Childbirth Educator for a large 5-hospital health care system, we’ve always been encouraged to ask for feedback from our students at the end of a series of classes, using the sometimes dreaded “Evaluation Form.” Because of my class schedule, that means that I get evaluated about 24 times a year by my students. I know some educators who’d prefer to avoid these repeated evaluations if they could, but personally, I love them! They help me see clearly where my teaching is effective  – and also, where I’m missing the mark. After close to 2 decades of being an educator, I’m happy that I hit the target more often than not. But why is it that all the glowing, positive feedback sits with you for just a minute, while the even slightly negative never leaves your memory?

In my first year as an Educator, one couple wrote in the area for Feedback for the Instructor, “Remember that we’re not all blank slates. Many of us come into these classes with a lot of reading and education under our belts.” Ouch! That feedback stung and I can still quote it verbatim 16+ years later. On that particular day, I quickly put this evaluation away and didn’t look at it again for a couple of weeks.

“Not all blank slates,” I read again. And now with a little more distance and perspective, the words no longer stung, they were encouragement from my students on how I could become a better educator. From that moment on, I found myself asking students for information and input, encouraging them toward self-discovery, rather than telling them all that I knew in an effort to “educate” them.

It was a simple sentence that forever changed not only how I taught my classes, but how I looked at my students. I lowered my self down off of that self-created pedestal of “I know and you don’t” and realized with humility how much my students teach me in every single class and series. And it’s not just about things related to birth: what they think and feel as pregnant women, what is most important to them as expectant fathers, how to encourage them to become closer as a couple, but also how they best learn as individuals, how to engage them and keep them engaged throughout a  2 1/2 hour class. Some of this remains similar from class to class, but I’ve also received some intuitive and game-changing feedback over the years.

The more I listen and learn from my students, the better educator I am, period.

When I taught that first series, I’d never given birth before. I was actually younger than many of the students themselves. I’d read a lot, gone to some great trainings and conferences, I’d observed many other excellent educators in preparation of teaching my own classes and I knew an awful lot.

But I needed that one couple to teach me something very important: I didn’t know everything. And I’m grateful that their words echo in my memory all these years later. If I want to pursue excellence in my field, I need to continue to be not only a teacher, but a student as well.  I need to be always learning, always eager to gain new perspective and insight, always seeking to be educated by others – especially by my students.

This has and continues to be one of my greatest lessons in learning.

What is one of your greatest lessons in learning or teaching?