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It Takes a Village: Preparing for Postpartum

27 Sep

And, drumroll please…after taking a few weeks of vacation and sharing birth stories, we’re finally up to the last point in our “11 Ways to Prepare for Your Best Birth” series.

#11 Arm yourself with support and resources for postpartum (postpartum doula, lactation consultant, moms’ groups, etc.)

What are the resources you might need as you become a good parent? Smart idea to consider these things now. What follows is not an exhaustive list, but can start helping you to think through the possibilities.

Your Village

First, rally any and all willing family and/or friends! This is the best time in your life to accept help if it’s being offered, or reach out and be proactive in asking if necessary. The biggest helps in early parenting are a) meals and b) housework. These are things you just don’t have time or energy for in the first few weeks. There are several great and free meal train websites (look here, here and here), so see if you have a friend, family member, or if someone at your church/temple/other religious community who can coordinate meals for the first few days or weeks after baby’s birth. (After my husband and I received the enormous blessing of meals upon both of our babies’ births, I “got” the power of it so much that I volunteered to be our church’s meals ministry coordinator.)

Lactation Consultant

While breastfeeding is certainly natural and can feel instinctive, it’s also a learned skill. Any learned skill takes time and usually requires some working out of kinks. Therefore, it’s wise to have a few names of and contact info for lactation consultants on hand in the event you could benefit from the expert support. There are multiple kinds of certifications; the main ones in my geographic area are: International Board Certified Lactation Consultant (IBCLC) and Certified Lactation Counselor (CLC). According to the International Lactation Consultant Association, an IBCLC is, “a healthcare professional who specializes in the clinical management of breastfeeding.” An IBCLC is considered a clinical caregiver vs. CLC more an educator. Because of this distinction, you will see more of a possibility of getting insurance to cover/reimburse for an IBCLC than for a CLC.

Postpartum Support & Counseling

Sometimes a new parent doesn’t feel like oneself on the other side of birth. If the not-quite-rightness lasts beyond 2-3 weeks after the birth, it’s very important to reach out for help. Help is readily available and no one should suffer in silence!

The different routes a parent could go for this kind of support:

  • Parent groups (generalized, or even better to seek out one specifically tailored to postpartum depression / perinatal mood & anxiety disorders)
  • Therapist / counselor (who can refer to psychiatrist if appropriate)
  • Psychiatrist

Postpartum Doula

A postpartum doula is a wonderful consideration, particularly for families who might not have family or friends who can support them through this major life transition. They are different from a baby nurse in that they are all about supporting the postpartum parent’s healing and helping the new parent(s) gain any tools, strategies, and skills they need to become more confident in parenting—as opposed to coming in and simply taking care of the baby. They are usually priced in a different way from a birth doula (who usually is a flat rate for her package) in that parents pay by the hour, often with a front-end minimum.

The most critical times to consider buffering with extra support: 1) the 1st couple of weeks after birth; 2) if/when one partner or helper leaves one parent home alone with baby for long stretches anytime in the first 3 months; 3) ~2 months after birth, when many babies’ amount that they cry every day peaks.


Helpful to equip yourself with plenty of local resources, but it’s also good to have some online/broader resources at the ready as well. Try to gather these resources before you give birth as you won’t have as much energy or time in postpartum to do research. There are several places you can gather these kinds of resources:

  • Talk to local parents. Word of mouth is the best way to find stellar local parents groups as well as postpartum professionals. If you don’t know any parents, you can connect with them by attending your local La Leche League meeting, searching on Facebook by your town, visiting churches, temples, community centers, or libraries. One awesome midwifery group I know in NYC creates moms’ cohorts based on due time and neighborhood — how awesome is that?
  • When you look for a birth class and/or doula, seek out a well-connected professional with a solid resource list available for clients. Often those professionals will have a resources page on their website plus a more expansive private resource list to support her clients
  • Seek out local family-oriented retail or educational establishments (this is could be in the form of a baby wearing or breastfeeding boutique, a retail or consignment baby/maternity shop, etc.). These venues, and sometimes your local library, often have personal connections, a resource list, or a community bulletin board with local postpartum professionals’ business cards.

Physical Therapy

Sometimes our birth and/or healing doesn’t go as we expect. Occasionally we might have some physical issues to work out such as abdominal separation or pelvic floor muscle issues. In the event that this is a felt need for you on the other side, there are available resources such as pelvic floor specialists as well as other more general physical therapists who could work on abdominal issues. I would encourage seeking out a PT or other body worker who specializes in the perinatal phase of life.


A few of my favorite online resources:

Breastfeeding

Perinatal / Postpartum Counseling & Support

A few of my favorite NYC local resources:

Breastfeeding

Postpartum Support & Counseling

Other

Mother-Baby Dyad: Snuggle to Heal, Grow & Thrive

27 Jul

We’re on the home stretch in our “11 Ways to Prepare for Your Best Birth” series and only have 2 left!

#10 Keep mother and baby together, with lots of skin-to-skin – it’s best for mother, baby, and breastfeeding

To clarify the title of today’s post: Think of the mother and baby as one unit in the first 3 months of baby’s life; we call it the “mother-baby dyad”. They need almost all the same things in the postpartum period — lots of snuggling, nourishment, rest, support, love.

I previously wrote a blog post on this topic after attending an all-day class with renowned perinatal neuroscientist and neonatologist Nils Bergman, so will refer you to it here: Snuggle with Your Baby: Benefits of Skin-to-Skin. The focus of that post was mostly about the benefits to the baby of skin-to-skin (aka “kangaroo care”).

I want to also detail a few benefits of this closeness for the mom (or non-postpartum/breastfeeding parent or family member, for select bullets):

  • Helps parent to bond and connect with baby
  • Helps parent get to know and understand their unique baby and baby’s more subtle signs in an acute and helpful way
  • The closer baby can stay to breastfeeding mom, the more restful it is and therefore the more conducive to healing from giving birth
  • Thanks to oxytocin (the “love” hormone) produced by skin-to-skin and, in even greater amounts, through breastfeeding helps mom feel happier and more relaxed, thereby reducing the chance of suffering from postpartum depression
  • The oxytocin is also helping your uterus heal, helping shrink your uterus (called “involution”) toward its pre-pregnant size each time you feed your baby in the first few weeks
  • The more mom can hold your baby skin-to-skin, the more frequently baby will tend to breastfeed, which bodes well for a healthy milk supply

I want to acknowledge that there are instances in which mom is not available to hold baby skin-to-skin, and absolutely it’s still helpful from a physiological perspective for dad, partner, or another family member or friend to hold baby skin-to-skin. So boost those endorphins and have fun snuggling away on your sweet baby!

More reading

Snuggle with Your Baby: Benefits of Skin-to-Skin (Birth Matters NYC)
7 Reasons To Be Skin-To-Skin With Your Baby After Birth
 (Mommypotamus)
Skin-To-Skin Care After Birth: A Practical Guide (Mommypotamus)
Birthful podcast: Ep. 56, SylviaHouston, Skin-to-Skin
Video: Dr. Nils Bergman on Skin to Skin
http://ninobirth.org/
http://www.skintoskincontact.com/home.aspx
http://www.kangaroomothercare.com/
Giving Birth with Confidence (Lamaze) – The Wonder of Mothers: Skin-to-Skin Care
Video: Keep Your Baby with You After Birth
Birthful podcast: Ep. 56, SylviaHouston, Skin-to-Skin

 

Push it, Girl, Push It Real Good: 2nd Stage of Labor

20 Jul

Okay, so I totally just revealed that I was product of the 80s and cheese out on that era of music (she says, referring to the post title’s nod to the 1987 Salt n Pepa song)! We’re up to #9 on our 11 Ways to Prepare for Your Best Birth series:

#9 Avoid giving birth on your back, and follow your body’s urges to push

Today we’ll talk about the 2nd stage of labor, in which our uterus is pushing the baby down and out and we get to meet our sweet baby.

Avoid giving birth on your back

First: Avoid giving birth on your back (also known as “dorsal lithotomy”). I’ve never worked with nor heard of a laboring woman who, if left to follow her body’s instincts, would choose to lie down on her back. Isn’t it kind of bogus that we tell women in pregnancy to stay off their backs for so many weeks and then in labor we order them to get on their backs to push a baby out? A woman should be allowed to have full freedom of movement and choose whatever positions she finds most instinctive and least uncomfortable throughout her labor, including the pushing stage. This will virtually never mean lying on her back.

Here are a few reasons lithotomy (either flat on your back or semi-reclined) doesn’t feel right to a laboring woman at any point in labor—especially during pushing:

  • In labor, we often have discomfort in our backs, and lying on our back only increases that uncomfortable sensation
  • Lying on the back is the most closed position for the pelvis; our wise instincts lead us more often to sit, squat, or get on all fours — significantly more open positions for the pelvis.
  • The vast majority of us, at least in our adult lives, have never passed a bowel movement while lying on our backs in bed. A laboring woman often pushes with the contractions very effectively while upright or sitting on the toilet because that’s where she’s used to coordinating her abdominal muscles and releasing the pelvic floor ones. Then if a care provider comes in and disrupts that process by ordering her patient on the bed, suddenly when she’s out of the familiar territory she feels totally disoriented. This is normal and to be expected, so I’d say, “just say no!”

Actually, that’s a little late for the communication. I would recommend doing that if you must, but it would be better for you to have conversations with your care provider now, prenatally, about this point in labor and get a sense of how flexible your care provider is for the moments of baby’s head crowning and for baby’s birth. In a hospital setting, most OBs/midwives aren’t there with the laboring woman for the earlier stages of pushing until the baby is very close to crowning, at which time they’d come to stay with you until an hour or so after the baby’s birth. For the early stages of pushing, one or more nurses would be the continuous support, monitoring the descent of baby through the birth canal and getting your care provider when it’s time. So, in an unmedicated birth there’s usually a good deal of freedom of movement until the OB/midwife comes. This is assuming, of course, that you get a natural-friendly nurse (tip: request this if you’re hoping for an unmedicated birth upon arrival at the hospital in labor).

Follow your body’s urges to push

When a woman’s labor progresses to the degree that her cervix reaches 10 cm dilation (=openness of the cervix) and 100% effaced (no lip/edge of the cervix in the way of the baby’s head), which we also call “complete”, it signifies the end of Labor Stage 1 and entering Labor Stage 2 (Pushing).

For many unmedicated women, around the same time she’ll get an uncontrollable, overwhelmingly strong urge to bear down and push. This urge can be hugely helpful for women, particularly when it’s our first time to experience labor. It takes the insecure feeling of, “how in the world do I do this?” out of the equation entirely because the urge is SO strong and helpful.

It’s equally normal for other unmedicated women’s urge to take a while to be triggered. If you find yourself in this latter camp, here are my tips for you:

  1. If hospital staff are pressuring you to push immediately, ask if there’s any reason you can’t wait to actively push until the urge is triggered. (In the mean time, your uterus will continue to do lots of that work for you.) That is, there’s no rush to start actively pushing just because you are “complete”—contrary to what hospital staff might make you think due to their being stuck in their ways of regular all-too-impatient protocols.
  2. Change positions. Often the simple act of changing position can trigger the urge. (It’s a good general rule of thumb in labor, in fact: When in doubt, change positions to encourage progress.)

In a hospital setting, the nurses are accustomed to the majority of women getting the epidural and therefore not feeling this natural, instinctive urge to push. Therefore, they are trained to default to a highly coached, loud method of the “valsalva maneuver”, aka “purple pushing” because women are encouraged to bear down vigorously and hold their breaths for unnaturally long periods of time. With this method, nurses loudly and slowly count to 10 while yelling, “harder, harder!…that’s good!…go, go, go!” and often scold the laboring woman if she lets her breath go before they reach 10. For most women, this coached method will really only be needed if a) we’re rushing things and not waiting for the natural urge to push comes (as is standard in most hospital settings), or b) a woman has the epidural and most likely won’t feel the urge and therefore may welcome some guidance (particularly if it’s her first time to give birth). It is far from the most likely non-breath-holding method you’d use with the physiologically organic urge to push and tends to lead to greater likelihood of fetal distress due to oxygen deprivation.

I would add that, in the 2014 ACOG report on things hospitals can do to reduce the unnecessarily high cesarean rate in the U.S., they ask hospitals, “Why are you putting women on a deadline in this stage of labor?” — that is, most hospitals have set a fairly arbitrary time limit on the 2nd/pushing stage of labor. Usually it’s a generous 3-4 hours, but there’s really no reason to move to a c-section solely because “time’s up” if a mom and baby are doing fine and are up for pushing longer. With this, keep in mind here that studies have revealed that hospitals take 15-17 years to adopt new recommendations, no matter how evidence-based, wise, or urgent they are to incorporate.

Here is the BEST article I’ve ever read on the topic of instinctive pushing.

If you’ve given birth before, or if you are a birth professional, I invite you to chime in with your experiences and insights! What worked for you? What didn’t work?

Further reading

2014 ACOG report summary (Choices in Childbirth; full report link found on this page as well)
Second Stage of Labor: You Don’t Have to Push by Nancy Tatje-Broussard
Supporting Women’s Instinctive Pushing Behaviour During Birth (Midwife Thinking)
The Anterior Cervical Lip: How to Ruin a Perfectly Good Birth (Midwife Thinking)

Patience is key: On Spontaneous Labor & Avoiding Unnecessary Induction

10 Jul

Did you think I forgot to finish the “11 Ways to Prepare for Your Best Birth” series? I promise I didn’t! I just went on vacation and decided to take a pause and post some birth stories written by my students so I could truly vacation. Now I’m back from Lake George and feeling refreshed.

So, let’s finish these last few points on the list over the next few weeks!

#8 Allow labor to begin on its own & avoid interventions that are not medically necessary

I admit, the first part of this one is hard. It’s so incredibly common to have a sense of wanting the pregnancy to be over and meet your baby already—largely because baby is getting uncomfortably cozy in there as he grows and is kicking you in the ribs, making it hard to get enough rest and the like. It’s quite common for one of these things to happen around or soon after passing the (estimated) due date:

  • A pregnant woman requests induction
  • A care provider simply says, “it’s time” (insinuating there’s a need to synthetically initiate labor, even in the absence of an evidence-based reason to induce).
  • Or, a care provider uses the words “getting big” in referring to the baby’s size—which undoubtedly instills a good deal of fear in any woman who ever hears this!

Not good reasons to induce, my friend.

I encourage you to resist the temptation to request or agree to an induction (solely based on dates or size) as you approach or pass your due date.

Here’s why. Did you know that baby initiates labor when she is done “cooking”, so to speak? There is a protein that is sent out from baby’s lungs when they are finished developing and ready to breathe the ex-uterine air (throughout the pregnancy, baby gets her oxygen through the umbilical cord). This triggers an inflammatory response in the pregnant parent that triggers labor. Additionally, March of Dimes says babies aren’t fully developed until at least 39 weeks, and also points out that important in-utero brain development happens between 35-40 weeks. Therefore, in the absence of any unusual medical indication to start labor, it seems logical and optimal to wait for baby to trigger labor rather than getting unnecessarily involved in ways that could put baby at risk.

Keep in mind a couple of other things:

  • The estimated due date is just that—an estimate. There is a 5-week window (37 weeks-42+ weeks) that falls within the (large) range of normal for baby being ready to be born. Dating is often inaccurate, unless you know exactly when you conceived.
  • Even if you have the accurate date of conception, also remember that both baby and mom are organic, unique beings who weren’t created according to nor behave in line strictly with textbook-rigid timing. Therefore, everyone’s optimal timing is different.
  • We live in a litigious environment, so care providers will often intervene (induction + many other interventions) because that is their best defense in the event of lawsuit from a bad outcome. There’s also just an unfortunate general sense of impatience in a clinical/hospital setting. It is therefore up to us to move through the perinatal period as informed consumers so as to know the difference between this scenario and legitimately wise uses of interventions.

So, the bottom line in a healthy pregnancy is: it’s best to wait for baby to initiate labor.

A bit more on the “avoid interventions that are not medically necessary”. Your best strategic tools along these lines are:

  • Labor at home as long as possible
  • Buying yourself time as many times as needed if/when interventions are suggested (assuming the suggestions are not emergencies; and never assume an urgent tone in your care provider’s voice equals emergency as it rarely does. Probe, ask questions!). In case you could use some clarity on what your rights are in childbirth, check out the Rights of Childbearing Women from Childbirth Connection.
  • Take birth classes in order to learn about the good vs. questionable reasons for the many interventions as well as the current state of your local birth environment and facilities. This way, you’ll know the questions to ask and how to make informed decisions

A little bit of patience goes a long way. You can then use that time, while waiting for baby, to study up or simply rest and enjoy the quiet in your last few pre-newborn weeks and days.

Further Reading

March of Dimes

 

3 Ways you Can Learn to Follow Your Body in Labor

12 Jun

Continuing our series on “11 Ways to Prepare for Your Best Birth”, we’re up to #7:

Listen to & trust your body – it will guide you

A lot of learning to trust this process has been covered in #5 here, so this post will be relatively brief.

Interesting thought to ponder from the childbirth classic Childbirth Without Fear: Veteran OB back in the early 20th century observed that, when women didn’t expect birth to be painful and perceived birth as a natural process to be trusted, their sensations were significantly less uncomfortable and more manageable. We cannot underestimate the power of the mind-body connection!

I want to reiterate the power of exposure to positive birth stories in this journey toward exploring your instincts and trusting the process. Ways to do this:

  • Read Ina May’s Guide to Childbirth  — about half of the book details many positive birth stories. When I was pregnant for the first time and took birth class, my birth teacher’s emphasis was, “Follow your instincts.” That all sounded great in theory, but when it’s the first time to go through the process, I was totally at a loss for having any clue of what those instincts might look like. This book
  • Watch lots of positive birth videos, many of which are natural births. I show some in class. Here are a few to get you started:
  • Check out a range of instinctive labor positions and instinctive coping tools and maybe even print them to have for reference for labor day — find these in various places:

Further reading:

Prepare your Mind & Body: Take a birth class

1 Jun

This week on our “11 Ways to Prepare for Your Best Birth”, we arrive at:

#6 Prepare your Mind & Body: Take a comprehensive childbirth education class that includes newborn care and breastfeeding

Why In-Person Classes? Why don’t I just read a book or take an online class?

In-person classes are ideal for many because you benefit from:

  1. Getting to know other expectant parents, which is immensely valuable as you enter parenthood. You need to find your “tribe” to develop your support network for a healthy and happy parenting journey!
  2. Learning about specifically relevant, local information on care providers and hospital protocols.
  3. The combination of various teaching methods such as lecture, video, powerpoint, posters, activities, discussions, and physical bodywork provides a more comprehensive, valuable learning experience than any video or book can ever provide.
  4. A conversational atmosphere. Class is a great launching pad for important conversations between you and your support partner(s) to process feelings, express concerns, ask each other questions. For those whose labor support is your committed spouse/life partner, this helps both to more intentionally strategize toward both a better birth and also to deepen and strengthen your relationship.
  5. Hearing others’ questions  in class—ones that might not have otherwise occurred to you or that provide deeper insights.
  6. Physical activities & bodywork. This is absolutely most helpful with a live teacher to instruct, adjust and advise on labor positions, massage & counterpressure techniques, and other tactile comfort measures for labor.

Why group over private?

There’s certainly no right or wrong here but here are considerations:

  1. #1 above, round 2. This benefit cannot be overemphasized. Unless you already have multiple friends who are in a similar life stage, I promise you that you NEED this. You need to have the support, community, opportunity to compare notes, sharing the woes and joys along the way that will lead to a healthier you and more thriving new family unit.
  2. With group classes, you’re getting a MUCH more comprehensive education for a significantly lower per-hour cost.

I acknowledge that, particularly where I live in NYC, people lead busy lives, and sometimes the group class schedule just doesn’t work. Private is certainly the next best thing. It can also be a good option for certain very specific situations, such as someone who has given birth before and just wants a refresher or has other reasons that the group setting wouldn’t be quite the right fit.

But the Cost! Babies are so expensive. Isn’t class expendable?

A once-in-a-lifetime, sacred experience such a birth requires a good deal of preparation, and is worth the investment. It goes a long way for reducing fears and helping equip expectant parents with tools and strategies they need. I want to reiterate that a good birth class will also foster deep conversations and interactions between expectant parent couples, which will not only help them have a more optimal, healthier labor and birth, but also can enrich and strengthen their relationship—books or online classes cannot do this. Priceless!

Also, I think you’ll find that your perspective of the cost will change dramatically once you have a toddler and start paying for various classes for them. In hindsight we can realize what a good deal most birth classes are! In NYC, for example, a really affordable price for kids’ classes breaks down to about $20/hr. When I break down my birth classes to a per person/per hour cost, my classes cost way less than that, and are significantly cheaper than the hourly cost of most NYC babysitters. It’s a steal when you consider it from these perspectives.

Why Comprehensive?

I recommend seeking out a class series that is not only going to equip you with information on and strategies for a healthy labor and birth, but also will equip you with newborn care skills, breastfeeding and postpartum self-care knowledge. I recommend this series be a minimum of 12-15 hours. Ideally you want to have the class to be spread out among 3-6 weeks and 6 classes, although 2- to 3-day intensives are very popular for many who have busy schedules. Intensives are not as ideal because so much information is packed into a small amount of time, and you don’t get to know your classmates as well, either, both because most intensives are less conversational and are fewer days and break times together.

A common question I get is: Do childbirth classes include infant CPR? CPR classes are an a la carte, separate class in almost all cases (ie in NYC I don’t know of any childbirth educators who incorporate CPR training into their series). I do highly recommend that expectant parents take a separate CPR class. Some popular options in NYC are:

Options & Methods

Here are some of the most popular certifications, methods or class types (first one is local to NYC):

Not considered comprehensive childbirth ed, so please do not consider these substitutes, but could be nicely complementary and supplemental:

  • Dancing for Birth
  • Some prenatal yoga teachers may offer some one-off childbirth specific classes such as breathing techniques or bodywork for labor that can be valuable

I caution expectant parents to steer away from any teaching that would teach or even insinuate that a completely natural, drug-free birth is the only way to go. What this all too often does is to set up parents for guilt and sometimes even trauma when the organic process of birth, which is unknowable and uncontrollable to a large degree, doesn’t go exactly according to “plan”. Better to choose a balanced class that acknowledges that, even if labor/birth doesn’t go as planned, it can still be a positive and beautiful experience when we plan for it with strong intention and purpose.

Size Matters

Look for a class that is small (or small-ish). An ideal class size is around 5-7 couples; definitely no more than 16 people in a class in order to get individualized attention and to foster connecting with each other and developing your parenting “tribe”.

How to Find

  • Ask your friends! If you don’t have any friend who’ve given birth, maybe you have friends who have friends who have recommendations.
  • Yelp – read reviews
  • Google Search
  • Websites below or above for specific methods; some have a by-location search/finder

More Reading

American Pregnancy – Childbirth Education Classes: Types & Benefits
Bradley Method
Childbirth and Postpartum Professional Association (CAPPA)
Childbirth Education Association of Metropolitan New York
Choices in Childbirth on Childbirth Education
Dancing for Birth
Hypnobirthing
Hypnobirthing Video
International Childbirth Education Association (ICEA)
Lamaze International
WebMD: Types of Childbirth Classes

Is Birth Like in Movies & TV?

23 May

Short answer? For the most part, a resounding, “Heck no!”

Moving on to the #5 topic in our “Preparing for Your Best Birth” series:

#5 Prepare Your Mind: Get a realistic view of birth and understand it as a natural, healthy process

Think about any births you might have seen in movies or on tv. My group birth classes always need to start by dispelling these myths and reframing the way we think about birth.

Picture this, for example: A pregnant woman with a large bump wheeling along her grocery cart into line when suddenly you hear a loud “pop” and there’s a huge gush of fluid all over the floor, in a most embarrassing way. As soon as it happens, suddenly everyone thinks it’s a huge rush and emergency to get her to the hospital and someone calls 911, or her beloved nervously rushes her to the car.

The real deal:

  • Labor doesn’t usually start with the water breaking. It only starts this way 8-10% of the time.
  • Once the water does break, it can be an absolutely normal day or two before contractions even start. There’s no rush to go to the hospital or birthing center (with a few exceptions)

Give me another example, you ask? You betcha. After that rush to the hospital, the mother arrives at the hospital and they cut to her on her back, in a hospital bed, contorting her face in such an intense way that you’d think she’s pushing a baby out of that part of her body. You’d also think in this moment that a first time mother’s labor as well as pushing stage is incredibly fast (hence the rush to the hospital at the first sign of labor).

The real deal:

  • Labors for first time moms are usually long, lasting (on average) 12+ hours, and can easily last for a day or two. Before you panic at the idea of such length, it’s important for me to point out that the biggest variability in this wide range of normal is the time spent in “early labor”, when the sensations in the body can be ignored and managed quite easily — very gradually growing in intensity over time, allowing the laboring woman time to get acclimated to the sensations.
  • The pushing stage can last anywhere from 15 minutes (less common for 1st time moms) to an hour and sometimes more. To reframe this in a way that helps it feel more manageable and feasible, mom is only pushing/exerting herself during the urges and contractions, with breaks in between in which to recuperate, recharge, possibly even grab a catnap. Often for moms whose pushing stage takes longer, her contractions are spaced farther apart, so that she’s having fewer opportunities to push and more time to rest.

In my classes, I go through a few of the many miracles of our and baby’s anatomy that can also begin to consider birth in a different way that it seems so much more manageable and can reduce fear and tension. So much about our anatomy is miraculous and can help us understand why we (along with our active-participant babies) can totally DO this!

Further Mind & Spiritual Preparation

Beyond understanding birth in a (likely) new way, there are further steps that can be equally important and can help this reframing to take deeper root. Here are a few of those:

  • Prayer – this involves surrender to and trust in a greater power outside of us (if you are not a person of faith, perhaps spend time considering what it means for you to surrender and trust this natural process)
  • Meditation / Mindfulness – If you are Christian, I have a scriptures for labor reference sheet here; it also has some Orthodox Jewish scripture traditions detailed at the bottom of page 2
  • Affirmations – A client of mine liked these by Mama Natural—there are both secular and Christian/scripture-based options. Hypnobirthing can also be a powerful option, and centers a lot around affirmations. When I purchased the 3rd edition, it came with a birth affirmations CD; hopefully the current edition does as well. Some of my students have done the Hypnobirthing Home Study or the Hypnobabies Home Study.

The real deal:

Birth is a game of patience.

Birth is what a woman’s body is created to do.

Birth is healthy.

Birth is normal.

We can trust this process!

I highly recommend reading the positive, empowering birth stories and other great info in Ina May’s Guide to Childbirthit’s my top birth education recommendation for expectant mamas that can help us begin to think about birth in a different way. It did that very thing for me in my first pregnancy, thanks to my girlfriend’s encouraging me to read it.

Next up on the list, we’ll discuss preparing your mind and body further through childbirth ed classes.

Further reading:

Ina May’s Guide to Childbirth by Ina May Gaskin
Mindful Birthing by Nancy Bardacke
Birthing from Within
by Pam England
The Business of Being Born / More Business of Being Born (documentary)
Hypnobirthing (Mongan)
Hypnobirthing Home Study
Hypnobabies Home Study

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