BREAKING NEWS!!!

“Partner’s Touch Reduces Pain For Laboring Woman”

receiving-hands-1920865_1920In a recent study published in Nature, it was discovered that a partner’s touch resulted in something the researchers termed, “physiological coupling.” The same study also found that empathetic touch from the partner contributed to an analgesic effect via the woman’s autonomic nervous system.

In other words, when a partner held the hand of the woman they cared for and a pain stimulus was activated, the couple would begin to synchronize their breathing and heart rate patterns, otherwise known as physiological coupling. In addition, the woman would report that her pain lessened while holding hands with her partner. If they were sitting next to one another, but not holding hands, her pain level would not be affected.

Obviously, this has implications for the families I teach, which is why I joke about this study being big news and something I didn’t already know about. But it’s important to share this news far and wide, because even though I’ve been preaching it for close to 20 years – “Everything you do for your partner while she’s in labor makes a difference! Even if all you do is hold her hand!” – partners still don’t seem to believe it!

Labor is not just something that a birthing woman experiences. Her partner experiences labor too, just in a very different way. For far too long, we’ve either diminished or ignored the partner’s experience of labor – to everyone’s detriment.

I’ve mentioned many times before that I have a soft spot in my heart for the partner’s experience. I realize that it makes sense to pay close attention to how a woman experiences and moves through her pregnancy, labor and birth. But if we’re not paying equal attention to her partner’s experience, we’re not setting this new family up for success. In fact, we might be doing the exact opposite.

I spend a lot of time discussing the second stage of labor (pushing and delivery of the baby) using my uterus and baby doll props to share what to expect and what it will look like from the partner’s perspective. At this point, the nurses and provider have their attention focused on the laboring woman and baby – with good reason. They need to be aware of any changes in the heart rate as the baby moves through the birth canal, and they need to remain alert as the baby’s shoulders make their way through the woman’s pelvis.

But not enough attention is being paid to what the partner experiences during this critical time. Partners need to know what a newborn baby really looks like and what the process entails so that the moment their baby enters the world it’s a moment full of joy for the whole family! When we forget about the partner’s experience, and they have no idea what to expect, that moment can result in a partner frozen with fear and in a state of shock at what they’re seeing and what’s happening – and this can negatively impact their transition as a new parent in a significant way.

Likewise, if partners don’t realize the importance their words, actions and touch can have on the laboring woman’s experience, many partners will freeze up and feel helpless as they witness the power and intensity of labor and birth. They may end up feeling as if their efforts and suggestions for comfort measures are without any effect. But this couldn’t be farther from the truth!

Sometimes I use a marathon analogy to discuss how important the efforts of the partner can be in helping a woman through labor and birth.

Imagine you’re running your first marathon. You’ve heard from friends and family how challenging it can be, but you’ve also heard about all of the “extras” along the race route that will help you make it across the finish line: the excitement and camaraderie of other runners, the music blaring at checkpoints, the mileage post signs marking your progress, the water stations providing hydration, snacking on energy-packed gummies, reading signs of encouragement from strangers, and awaiting you at the finish line, cheering crowds and some of the best peanut butter sandwiches and chocolate milk you’ve ever tasted! Now, these “extras” might not seem very important – until we take them all away.

What if I painted a very different picture of your marathon experience?

You’re told to stand at the starting line alone and when the gun goes off, run for 26.2 miles toward the finish line with nothing to help you along the way – no water stations, no music, no snacks, no encouraging crowds, no one waiting for you at the finish line… nothing.

The difference between the first scenario and the second is stark. Without all of those “extras” even the experienced marathon veteran would have a hard time completing the race. Let alone, crossing the finish line with even a hint of a smile.

So it is that every little thing a partner does to make the laboring woman more comfortable matters, and it matters immensely. Every sip of water offered, every new position suggested, every word of encouragement, every reminder to breathe, every single touch, provides comfort to the laboring woman. And partners need to know this and believe in the power that their undivided attention and connection can bring to the laboring woman.

I’m reminded of this when I think back to being in labor with my first, some seventeen+ years ago…

I had two doulas – one for me, and one for my husband! I came prepared with a full team of support for this birth. They all worked so hard to support me in what ended up being a long labor that began, as most labors do, in the wee hours of the morning. I wasn’t the only one exhausted some 20 hours into the experience – my husband had been awake and working hard just as long as I’d been. And he was getting tired.

I remember hearing my two doulas talking in a stage whisper with my husband: “Go ahead and lie down. Try to get a quick nap in now before the really intense labor begins. We’re both here – we can take care of her.”

A statement that was completely true! One of my doulas was an L&D nurse (soon-to-be-midwife) and the other was my best friend who knew my husband and me almost as well as we knew ourselves! They were more than capable of helping me through contractions, which up to this point I’d been handling really well.

Upon their urging, my husband walked about three feet away and lay down on the daybed in the labor and delivery room. And then strangest thing happened – I completely lost my rhythm and my ability to breathe through contractions! It was as though I’d lost my way, somehow. The next handful of contractions felt incredibly painful to me. So much so, that I cried out in anguish which woke my husband up and he hurried to my side and held my hand once more. And then, just as quickly, I found my rhythm, my breathing returned, and I was able to continue and handle my contractions, until I gave birth several hours later.

I know from talking with my husband and other partners about their own experiences how challenging it is to watch the person you love go through labor and birth. It pulls strongly on the heartstrings and can leave partners feeling incredibly helpless to do anything that will be effective in increasing their partner’s comfort level.

But here’s why I think the findings from this latest study are so important: it’s the feeling of shared empathy between the laboring woman and her partner that causes the physiological coupling and analgesic effect that help a woman when she’s experiencing pain.

That’s why I’ve always told the partners in my classes that even if they hired an army of the world’s greatest labor doulas, if the partner provides the laboring woman with their unwavering, focused and empathetic attention during the labor, she will tell everyone that she could not have made it through without her partner – even if all they did was hold her hand!

I love it when someone else does the research and publishes findings that support what I’ve been teaching my families for the past twenty years!

Because, let’s face it… Some partners in my classes may think that I’m just trying to make them feel better or elevate their role in the birth experience. (Which is exactly what I’m trying to do, by the way!)

But I’ve also known forever that empathetic touch – combined with all of the other wonderful comfort measures partners learn in our time together – really can help a laboring woman when she needs it the most.

And now, I have the science to prove it.

Can you relate to this post as a laboring woman? Did your partner’s touch (among other things) actually make labor and birth easier for you? What about partners – have you felt helpless in labor? Does this information about how your words, actions and touch really helped her through labor and birth make you feel any better? Let me know your thoughts. I love hearing from you!

In My Humble Opinion…

bees

So, the world of birth is abuzz this month as ACOG (The American Congress of Obstetricians and Gynecologists) has released their newest Committee Opinion: “Approaches to Limit Interventions During Labor and Birth.”

This opinion might have left some scratching their head and saying, “Duh!” But I want to jump up and down squealing with joy! I think this is a fantastic step in the right direction from the OB/GYN leaders of America. They’re asking their members to consider: “If a pregnant Momma is low-risk, how can we keep her low-risk?”

The answer is: “Don’t intervene unless it’s medically necessary!”

I’m going to break down the recommendations and conclusions section of this Committee Opinion for you here, because there are lots of big, fancy words – and you might appreciate my attempt at a simpler translation. Also, we know that when information comes from people who wear white coats and carry stethoscopes around their necks, it sometimes carries more weight – even if we’ve already heard this same information from different sources. Just saying… In our culture, there’s a hierarchy when it comes to medical advice and opinion – evidence or bias, be damned!

So, this is not a perfect translation (and my editorial comments are included in italics) but in a nutshell here’s what the ACOG has stated in it’s Committee Opinion, Number 687 for February 2017: Approaches to Limit Interventions in Labor and Birth.

  • If a woman is between 39-41 weeks, and is in labor that’s started on its own, and has a baby that’s head down, the use of intermittent fetal monitoring and unmedicated comfort and coping techniques is a good idea. (Full-term according to ACOG. Intermittent – the fancy word that means there are breaks in between periods of monitoring.)
  • If a woman is still in early labor, she doesn’t have to come to the hospital right away as long as she and the baby are doing okay. It’d be great if she was offered frequent contact and support, as well as unmedicated comfort and coping techniques. (See what I wrote here, here and here (It’s a 3-part series!) about how to stay comfortable and pass the time of early labor at home before coming into the hospital.)
  • When women come into the hospital in early labor due to pain or exhaustion, they should be offered education and support, water to drink, encouraged to try various positions that might provide more comfort, and other unmedicated comfort and coping techniques like massage and how using the shower or sitting in warm water can be very helpful. (Hydrotherapy – the fancy word for drinking water, showering and/or sitting in the tub – are great ideas for comfort and can also help labor progress!)
  • OBs and other providers should inform those women whose water has broken at the onset of labor about any risks associated with waiting for labor to start on its own. If there are no other reasons to be concerned for the baby’s health, an informed woman can choose, and should be supported in her choice, to wait for labor to start on it’s own. The exception would be if a woman has tested positive for Group B Strep – antibiotics shouldn’t be delayed, and there may be a preference from both the provider and laboring woman to induce labor immediately, rather than wait for it to start on its own. (Many providers already use “expectant management of labor” – the fancy word for “watching and waiting,” but more providers might now be encouraged to wait before inducing immediately if water breaks at the start of labor.)
  • Evidence suggests that in addition to regular nursing care, continuous one-to-one emotional support is associated with improved outcomes for women in labor. (YAY DOULAS! And partners, and Grandmas, and BFFs and… DOULAS! You can read my post here about how a doula can be a great addition to your birth team.)
  • For women with a labor that’s progressing and a baby that’s doing well, routine breaking of the bag of waters is not necessary unless needed for internal monitoring. (Amniotomy – the fancy word for breaking the bag of waters before it has broken on its own – is often suggested as a way to “speed things up” but can be associated with more interventions and increased risk for Cesarean Birth if it doesn’t work.)
  • In order to promote intermittent monitoring, hospitals should adopt protocols and train staff on how to use hand-held Doppler monitors for low-risk women who would prefer this type of monitoring. (This one even surprised me! I thought they would suggest using the external monitoring belts less frequently, but hand-held Dopplers would be a fantastic improvement over current practice. So much easier and comfortable for laboring Mommas!)
  • Using a coping scale and the use of medicated and unmedicated coping techniques will help providers tailor interventions to meet the needs of each woman. (Some hospitals have already adopted the use of a coping scale instead of a pain scale, but this little tool can be very helpful in changing the mindset of a laboring woman from focusing on the level of pain she’s feeling to whether or not she’s coping well.)
figure-1-the-pain-intensity-scale-0-to-10-adapted-from-wong-baker-faces-pain-rating

Figure 1. The Pain Intensity Scale: 0 to 10. Adapted from “Wong-Baker Faces Pain Rating Scale”

coping

Figure 2. The Pain Coping Scale: 10 to 0, developed to assess coping during labor and birth. Adapted from “Wong-Baker Faces Pain Rating Scale”

  • As long as there are no complications and fetal monitoring is still possible, a woman should be encouraged and supported to change positions often during labor – it will make her feel more comfortable and will help move the baby into the best position for birth. (Being upright and changing positions as often as possible, for as long as possible, allows babies to make all the twists and turns necessary to be born.)
  • Women should be encouraged to use whatever kind of pushing technique she likes and is most effective. (Gone are the days of telling women to assume certain positions and hold their breath for ten seconds! Yeehah!)
  • Unless it’s medically necessary to deliver quickly, women (especially those with an epidural) can be offered a period of rest before pushing – unless she feels a strong urge to push sooner. (“Laboring down” is a really nice way to allow your body to catch up with your labor. Your contractions might have already opened your cervix all the way, but until your baby moves down into a better position for birth, pushing just because “You’re 10 cm dilated – let’s go!” might not be as effective and could lengthen the overall time of pushing, causing undue exhaustion.)

Can you see why I’m so excited about this Committee Opinion?! It aligns so beautifully with what I know to be true for women in labor. Interventions are not “bad” and can be life-saving in certain circumstances.

But if we limit the routine use of these interventions and only use them when medically necessary, we are protecting the normal physiology of birth. And this will result in better outcomes for Mommas and babies.

I am so heartened by this statement from the ACOG and excited to see the impact this will have for laboring women and birth in this country. My sincere hope is that members of ACOG will review their own personal practice based on this Committee Opinion and see where they might step back from intervening too soon or too often. I also hope that pregnant women will read this and know that they should talk with their provider about limiting the use of intervention in their own pregnancy and birth.

Knowledge is power. Be informed.

(You can access the entire ACOG Committee Opinion here in all of its medical terminology, further explanation and extensively cited form. It’s a great read, in my humble opinion…)

I’m One of the “Spokes” on Red Tricycle!

redtricycle-spoke-contributor

Whoop! Whoop!

Just found out that one of my blogposts from about a year ago has been picked up and published on Red Tricycle. If you’re not one of the 8 million parents that access this site on a regular basis, Red Tricycle is a kind of go-to, online parenting website where families can discover cool things to do with their kiddos, both nationally and locally. Over the years, if I’ve had a long weekend ahead of me, I’m not scheduled to teach a class, and I need some ideas about what to do with the kiddos, I’ve definitely checked them out!

Recently, they’ve started posting articles that are not just about fun things to do as a family, but more about the experience of parenting. That’s where I come in!

I submitted a blog post I wrote about a year ago which is titled, The Parental Code of Honor. It’s my offering to get all parents – expectant, newbies, even veterans – to support one another as we try our very best to do the hardest, most rewarding job many of us will ever have: the job of raising our children.

None of us is perfect at this. Thankfully, none of us have to be.

But the first step in supporting one another in this parenting journey is to only offer suggestions and advice – when specifically asked to do so.

You can find this and other tips about how to support one another in The Parental Code of Honor published just this morning at Red Tricycle. And if you haven’t checked them out before, stay awhile and poke around. They have lots of cool ideas about how to make the most of your life with little people. Including this list of 20 awesome things to do with your kids in Portland over the long Labor Day weekend. By the way, MY family will be busy doing #14! 

PS – Have a great holiday weekend, and thanks so much for your support. 

To Clone or Not to Clone?

Dolly

That is the question… Well, not really.

I’ve often wished that I could clone myself – not for any weird reasons, I think there really should only be one unique version of us in the world. It’s just that there’s an awful lot I’d like to accomplish in this one, wild life I’ve been given and sometimes it feels like too much for just one of me to try and get it all done.

One thing I really wish I had time for is helping more Mommas process their birth stories.

On a small scale, I’m already doing this. My families know how much I love birth stories. When my classes gather for reunions, I spend time listening to the birth stories of everyone gathered. I’m on the lookout for key information to help them reframe their births, if needed. I want them to know where they were strong. I want them to acknowledge who supported them and how, specifically.  And I want them to be proud of their level of participation in this life-changing event.

In short, I want all women to have a birth story they can look back on as a positive experience. One that informs who they are now as a woman, mother, partner, friend, and professional. I want all women to recognize what they’ve gone through in the ultimate Hero’s Journey that they’ve traveled in a matter of hours or days, that marks their lives as forever different, forever changed in ways both obvious and hidden – even to themselves.

So… nothing too important!

I’m happy to say that most of the women I’ve had the honor of working with over the years have a positive birth story to tell – despite it looking anything like that on the surface. The majority of this has to do with her individual attitude, flexibility and openness to responding to birth as it unfolds in real time. But, I’d like to think that they learned a little bit about this from being in my classes. I’d like to think that the preparation I offered around expanding expectations, and embracing vulnerability before birth helped them process the reality of their birth experience.

But what about the women who haven’t had a positive birth experience and haven’t been in one of my classes? Maybe their birth happened just last week, or maybe 20 years ago. All too often, these women are told that a “healthy Momma, healthy baby” is all that matters and they don’t get to finish processing this event in a way that allows them to move forward in their parenting journey. It’s my theory that these women continue to process their birth stories (as I feel they must, until they can come to some form of closure) with unsuspecting and extremely vulnerable pregnant women.

I hear about it all the time in my classes. Mommas will complain how all they hear are the “horror stories” that other women, many of them complete strangers, tell them about their own birth experiences. I think this is happening on a subconscious level. I don’t believe for a second that a woman processing her birth is intentionally trying to scare pregnant women with a negative birth story. I just think it’s the loop that they find themselves in as they try to make meaning from this experience that was life-changing, but not in a positive way.

Oh, how I wish I could meet all of these women! I’d love to be able to sit with them and listen deeply to their stories. I’d let them process as much or as little as they felt comfortable with sharing. And maybe in the retelling of their story, I could try to help them reframe and then reclaim their birth story as their own. I’d love for them to see, maybe for the first time, where they were strong, who supported them and how. Maybe they could finally begin to integrate this experience into the woman they are now. Maybe, in the process of this reclaiming, they could finally stop that negative birth experience processing loop with younger, vulnerable pregnant women.

To that end, about six months ago, I created a document that I’m calling: “Retelling and Reclaiming Your Birth Story: An Exercise to Give Meaning to Your Experience.”

I’ve had a few Mommas from my classes go through the five step process and a few have agreed to share the results here as future posts. It’s been a desire of mine to share some birth stories on my blog. Real birth stories from real women but with an eye on being able to acknowledge birth as a positive experience, even if it didn’t go according to plan.

I think my invitation to retell and reclaim your birth story can be helpful as a tool to get the details of your birth down in a way that has structure. This can be a beautiful gift to your child. You can remember and reflect on their birth-day every year, and they’ll have something to refer to in preparation for the time when they’re ready to have children of their own.

I’d also like to extend this offer to any woman who’s had a negative birth experience that they’re still trying to process. I believe it can be a tool for healing and integration. I’m not a professional counselor, I make no claims about this. But in the busy-ness of our daily lives, we have forgotten the power of story and how it can transform us.

I think every woman deserves that opportunity for transformation.

If you, or anyone you know, might benefit from taking part in this exercise, please take this short four-question survey and I will send a pdf file of the “Retelling and Reclaiming Your Birth Story: An Exercise to Give Meaning to Your Experience” out to you as soon as possible. Please feel free to share this offering far and wide – I’d love to help as many women as possible!

Thanks for your support. And thanks for allowing me to try and accomplish even more with my one, wild life (this way I don’t have to clone myself!)

Educating Educators!

TTR

Here, I’m making an important point about increasing student engagement…

I had the pleasure of working with a room full of Health Educators a few days ago for a training session I’d developed to help these professionals increase the level of engagement they have with their students.

No pressure, or anything, but when the title of your presentation is: “Teach to Reach: Six Rules of Engagement,” you’d better be able to bring it! Thankfully, I think I did. The evaluations were really positive: most attendees were wishing that the training had been longer, and I’ve already been asked to come back. So, that’s good.

I love doing presentations and trainings. There’s a reason why this is such a good fit for me. I’ve said it many times before, but it bears repeating – I am the most extroverted person I’ve ever known. So, getting up in front of a group of people doesn’t rattle me at all. I have no nerves in this situation.

In fact, the bigger the crowd, the more excited I get. The original number of people attending this training was supposed to be about 20. The day before, I found out it would be closer to 35. For some presenters, that might make them freak out. But not me – I was psyched! The energy from the audience totally feeds me.

The idea of being an “efficient communicator,” intrigues me. The larger the group, the more people receive the message I’m trying to convey at one time. Getting the most “bang for your buck” is a personal credo of mine!

And I really enjoy working with other educators, too. There’s a shared understanding of what it is to do group facilitation and to do it well. We communicate in the same “language” and can dive right in and get to work.

I’m especially interested in encouraging health educators to work harder at their craft because so much of our message we want or need to convey has the potential to be truly life-changing for the students in our classes. But not if they’re bored or checked out!

I started the training by asking participants to identify their greatest challenge as an educator. But I also asked them to claim ownership of their greatest strength. I think it matters as an educator, presenter, or human being, really –  that we take stock of what we’re really good at and then capitalize on that skill because it comes relatively easy to us and it also authentically represents who we are.

Participants shared that they were great listeners. That they had a lot of knowledge and expertise. They shared that they were able to connect well with their students. And my personal favorite, some felt they were able to make good use of their sense of humor while teaching. It’s a great feeling to be among such a strong group of professionals.

But there’s a little bit of extra pressure when you’ve been asked to train members of your own tribe. What if they already know everything? How can I make this information new and something they’ll actually be able to use? How do I keep them engaged and with me for two solid hours?

Turns out, these are the same questions we, as educators, should be asking about every class of students we teach, members of our tribe, or not. But, still – I knew that this particular group of people would be able to tell where the holes (if any!) were in my presentation and would be ready to point them out to me on the class evaluations. Which is why it matters even more that they were really positive.

My hope is that in some small (or potentially big) ways, what I offered this group of fantastic educators will help them get their messages out into the world with even greater impact!

If you’re an educator or work with educators who might benefit from having me present on this or other topics to increase student engagement and the impact of their message, please contact me here for more information.

Educating educators is just one more thing I love to do – it’s usually a lot of prep-work, but always a lot of fun!

PS – I’ve been asked to present at the ICEA Conference in Denver in the middle of October. My presentation there will be very Childbirth Educator focused and is titled: “Birth Plans: Helpful or Harmful?” I love getting the opportunity to be in front of my peers, create new presentations and content, and be a part of the conversation about topics that matter.

Lucky me!

Whether you’re an educator or not, take stock of your greatest challenges, but also remember to take stock of your greatest strengths! These are the ways in which you shine – let others see your light and bask in its warmth and glow! Claim your gifts TODAY!

Hopelessly Devoted to You…

Devoted

de·vot·ed
/dəˈvōdəd/

adjective
adjective: devoted
1. very loving or loyal.
“he was a devoted husband”
synonyms: loyal, faithful, true, staunch, steadfast, constant, committed, dedicated, devout; fond, loving, affectionate, caring, admiring
“a devoted follower of the writer”
2. given over to the display, study, or discussion of.
“there is a museum devoted to her work”

I love this dictionary entry for “devoted.” I would consider myself a very devoted Momma, partner, friend, daughter, sister, employee and Childbirth Educator. When I’ve found someone or something that I believe in, then it’s deserving of my full devotion. I resonate with both of these definitions, because I don’t think it’s enough to say that you’re “very loving and loyal” to a person or an idea. I think you need to show that devotion through action, which is where, “given over to the display, study or discussion of” comes in.

But being devoted to someone or something might mean saying or taking action that’s not very popular. Sometimes, being devoted means standing up for your own truth – even when others, maybe especially when others, try to tell you your truth is wrong or has no merit. Being devoted doesn’t mean that you always agree. Being devoted to a person or an idea, means you have to be the mirror at times. In wanting this person or idea to reach full potential, you have to be willing to shine a light in the darkness. Being devoted is both thrilling and frightening at the same time. But it’s not usually easy to be on the giving or receiving end of real devotion.

I can remember a few times in my marriage, where my incredibly devoted husband told me what I needed to hear. Let’s be very clear: it wasn’t what I wanted to hear, but it was exactly what I needed to hear. And I’m sure he can tell you some stories about my job as his personal mirror: “This is what I see. This is not who I know your best self to be.” Not easy discussions to have, but they can be game-changers, in my opinion.

When it comes to my work with expectant families I am devoted to the overall well-being of new Mommas, partners and their babies on their transformative journey of becoming a family.

But sometimes, that devotion can look a little bit more like “tough-love.”

I’m very devoted to the idea that women have positive and empowering birth experiences because I feel like this moment in a woman’s life can truly be transformative. It can set the stage for how well she moves into her role of Momma. It can either positively or negatively affect the couple’s relationship right from the very start. She can end up parenting from a place of inner strength, wisdom and confidence – or spend her entire parenting journey second-guessing every move. Her birth experience might only be a day in her life, but it can affect the rest of her life.

Wow – that’s big stuff.

And now for the tough-love talk. (Please remember that this is coming from a very loving and loyal place.)

Women need to start taking more personal responsibility for their births.

There are some providers, nurses and hospital policies that can get in the way of a woman’s positive and empowering birth experience. And there are plenty of other birth advocates decrying this very issue. But that’s not the whole issue. Women need to recognize their role in all of this. They need to take more personal responsibility for their birth experiences because if they don’t, birthing women, their partners and the families they’re trying to create together end up paying the price.

Women giving birth today, are doing so in a climate where information is everywhere and available all the time. Even though “Dr. Google” is not a great resource, it’s who they most often turn to for information – much of it biased, out-dated, and not evidence based.

Our maternity care system has become “us against them” when it comes to birth. I’m not sure it’s even possible to have a positive and empowering birth experience if you believe that having a hospital birth is going to suck. But if you really do feel this way, than take some personal responsibility for yourself and make different choices about where and with whom you’ll be giving birth. Your reaction might be, “It’s not that easy.” I know it’s not easy. I’m not saying that it is. What I’m saying is that it’s vital to own your role in the birth experience – even when it’s not easy.

When I was pregnant with my second baby, I had to make some big decisions. My beloved provider had moved out of town and our insurance had changed. So, I was going to have a choose a new provider and place to give birth.

Instead of doing my own research, I listened to a colleague and chose a midwife at a hospital that didn’t have the best reputation in town: too big and impersonal. Red flag #1 The clinic was pretty far away from where we lived, which meant my toddler and I had to deal with 40 minutes of driving for an appointment that lasted only 10 minutes. I hated it. Red flag #2 The hospital tour guide focused more on the big-screen TV than answering my questions about birth balls and squatting bars. Red flag #3 My midwife was part of a group practice, so it was not guaranteed that I would have her for my birth. Red flag #4 Now, none of these might pop up on your list as red flags – but they were on mine and I chose to ignore all of them. I knew, at several points along my pregnancy journey, that this was not the right choice for me, but I refused to take personal responsibility for this. And although my birth was quick and easy, my overall birth experience was very negative.

I hadn’t done my due diligence to make the best decisions for myself when and where I could. And it was this piece that I struggled with most in my early postpartum days with my newborn. I look back and realize my negative feelings around that birth experience had nothing to do with the birth outcome. It had everything to do with how I had dishonored myself and failed to make the best (although not easy) decisions I could to set myself up for the best experience possible.

Writing a Birth Plan is not enough. Having good intentions is not enough. Hiring a doula is not enough. You need to understand just how much work is involved in making this birth experience positive and empowering for yourself. No one will be making that happen for you. You need to make it happen. And that means getting real with yourself before you ever put pen to paper to capture your birth preferences.

Are you making choices that resonate with you? Don’t concern yourself with what your sister, BFF or members of your book club would choose. What do you want? Make some decisions for yourself. But don’t stop there! Get some quality, unbiased, evidence-based information that supports these decisions as being right for you. And then own those decisions – at least until you go into labor.

Once labor begins, you have to be prepared to make some decisions in real-time, as birth unfolds. Birth is too big to be planned out on an 8 1/2 x 11 piece of paper! And that scale you used to weigh benefits and risks in the classroom doesn’t get to come into labor and delivery with you. You get a brand new scale that you’ll have to use to weigh the benefits and risks all over again to make the most informed decision you can – while you’re in labor.

You must be a full participant in this birth from the very beginning all the way through to the end in order to feel that transformative strength and empowerment. My own personal experience, coupled with 20 years of working with thousands of couples, allows me to make this statement from a place of confidence: Feeling empowered and positive about your birth experience is less connected to how your baby is born, and more directly linked to how you feel as your baby is being born.

When you give birth from a place of confidence that you did everything you could in the moment to honor yourself and your process, it’s hard to feel anything but empowered. There are moments throughout your pregnancy and birth where you’re called to stand up and make a decision that might not be easy, that might not be popular, that might not even be what you wanted. But in honoring yourself in this way, you can claim full participation and own your birth experience.

When you do this, you show devotion to yourself, your partner, your baby, your family – and this is where it all begins.

What are you devoted to? Does this resonate with you? Are you still able to feel my deep devotion to you (despite my tough love)? I really do only want the best possible experience for you. And I can’t use this title for the post without giving you this link to the ever wonderful ONJ singing her heart out – enjoy, you’ll be singing it all weekend.

This was part of an exercise from The Writing Den, where we were asked to define what we are devoted to. Bringing more personal responsibility into the birthing experience is one of those things I’m devoted to. If you’d like to find out what your true devotion is, come join this group of committed individuals answering the call. It’s an inspiring place to be!

It’s a Question of Quality

Quality

Of these 3 options, which one is most important in your work right now:

Quality of Life

Quality of Work

Quality of Compensation

This was the latest prompt on my Quest journey and it comes from visionary, Sally Hogshead. (There’s still time to jump on board for all the goodness that Quest 2016 has to offer for anyone who’s wanting to do business as unusual for the coming year. Join in. It’s fun, thought-provoking, and free!)

I’ve answered all of the Quest prompts so far, but most of them have landed on the private Facebook page set up for our group. All have asked me how or what I want to do differently in 2016, but I wasn’t sure my answers aligned with this blog. But this one does. I’m always trying to talk people into becoming a Childbirth Educator, because I feel my job hits all three options.

Quality of Life:

I work only evenings and weekends. To some, this might sound like a terrible schedule! But when you have four kids you need to get really creative about how you’re going to work so you don’t end up with a full-time job you hate – just to pay the childcare bills. My job allows me to have the best of both worlds: I am there for school drop-off and pick-up, I attend field trips (at least those that involve theater or dance performances), I’m able to have a presence at my kids’ school, but I still have outside work – which matters way more to me than I would have guessed. My own Momma was a stay-at-homer and I grew up thinking that parenting was the most important job a person could ever do (for the record, I still feel that way!) so I expected to be content with doing the work of mothering “only” – but I was mistaken. I very much appreciate having out-of-the-home work, too. That was a surprise. I have a job that allows for true work-life balance.

Quality of Work:

I love my job. It’s constantly changing. Each and every classroom of students informs me and makes me a better educator. I’ve been able to grow and evolve over the years, expand my repertoire in and outside of the classroom, and have gotten to the point of feeling ready to write about this subject that matters so much to me. I’m encouraged by my colleagues and students to pursue writing my book to have even greater impact in my field of perinatal and parenting education. Close to twenty years in this career, and I still haven’t experienced any boredom with the subject matter. Likewise, I’ve never stopped feeling like I couldn’t continue to improve my presentation and teaching skills. I think this is extraordinary!

Quality of Compensation:

Well, the “joke” is that you’ll never get rich being a Childbirth Educator. This is true. It’s hard for any CBE to be able to work this job only and be able to support her family. Thankfully, I have a husband who works full-time, carries our health insurance, and is a fantastic co-parent in the off-hours when I’m gone. I don’t have the same worries others do when their work is sporadic and part-time. I’m lucky for that. And all things being equal, I get paid a decent hourly wage. It’s my job that pays for all the “extras.” I pay for Summer Camps, dance and saxophone lessons, acting classes and soccer. Having four kids means having lots of extras and I’m happy to contribute in this way. I know how much these extras enhance the overall quality of our family life.

If I were to focus on any of these options for 2016, receiving more compensation for my offerings would be great!  But I need to focus on what those offerings might be, first.

I’ve done some one-on-one phone consultations for people who are not in the Portland Metro area. Is this something I could charge for? It’s certainly something I enjoy doing, and it would only positively impact my quality of life and work.

The book I’m busy writing – it would be nice to be compensated for this offering, but this is unlikely to bring in much income in 2016. There’s still much work to do, as my focus has shifted and I’m more realistic about the timeline. But what offers ancillary to the book could I be working on that might bring in some form of compensation?

What about presentations and trainings? I love to give presentations and I’m good at it. Is this an area that I can expand, maybe even outside of my own field, and be compensated for it? I love to train new educators. How could this be rolled into my toolbox of offerings that would continue to feed all three options: quality of life, work and compensation?

All good things to consider as I move into 2016. I feel like this year I’m finally ready to take the necessary steps forward to increase the quality of my life, work and compensation.

How about you? What are you doing now that supports these options? What might you do differently in 2016 to better support one or more of these options?