Monday, April 14, 2014

Why the "Evidence" Sometimes Gets in the Way of Having a Natural Birth

This is a post I've been thinking about for weeks now. I am conflicted about writing it, which is probably why it's taken so long. Last week I wrote about reasons that women chose to have a natural birth and some of the reasons given were somewhat evidence-based. A couple of weeks ago I asked the following question on my BFBS Facebook page:

From your childbirth class, what helped you the MOST in having an unmediated birth?
1. The "evidence".
2. Labor rehearsals.
3. Relaxation practice.
4. Your doula.
5. Your cheerleaders (I did it, so can you!)
6. Finding the perfect care provider.
7. Getting your head in the game (sorry, I LOVE High School Musical).

The overwhelming majority answered #7 is what helped them the most, which is exactly what I expected. 

Being the founder and President of a childbirth education company, Birth Boot Camp, I am obviously a fan of evidence. It is super important in what we do as educators. We need to know our stuff and be able to back up much of what we talk about in class. The Birth Boot Camp Instructor training is intense for this very reason.

Many people come to class because they've done some research, enough to know that natural birth and midwifery care is a healthy alternative to having their labor medically managed with drugs and interventions. The evidence got them there -- and they will continue to learn more while in their class -- but now they need to learn how to have a natural birth. Well, some of that process includes following the evidence and asking the right questions of your care provider and birth place. Not just the right questions, but learning the translation of what they are actually saying when they give you "answers". 

Labor is not a left-brain act. The left side of the brain is analytical and logical. It reads/hears/analyzes the evidence. It is totally used during childbirth classes and making decisions about your care provider and interventions you would like to avoid. But when it comes to the actual act of labor and birth, the right side takes over. Birth is very primal. My midwife with my last baby, Barbara Pepper, always encouraged me to let go of things I knew, and just feel. The right side of the brain is known for being the creative side, but it's also the side where intuition and reading emotions happens. 

I believe the left side of the brain can seriously get in the way of labor. Take vaginal exams for example. You get a number -- now what? The left side of the brain often starts doing "labor math". For example, "It took me 15 hours to get to a 5... I can't do this for another 15 hours to get to a 10!" 

In Birth Boot Camp classes, we offer lots of ways to help mom (and dad) through labor, encouraging him to do the left-brain work and letting her do the right-brain work. At some point, letting go of "the evidence" needs to happen in labor. It's that moment where you are in the moment, listening to your body, moving the way you need to, and making sounds that keep you relaxed. It's truly "getting your head in the game" and sometimes that takes as much work during pregnancy as learning the evidence! Evidence in-and-of-itself isn't what gives someone a great birth experience. It's a tool, but preparation -- physical, mental, and emotional -- is essential for both partners. 

Monday, April 7, 2014

Top 10 Reasons Women Want a Natural Childbirth

I've been teaching natural childbirth classes since 2003 and have encountered all kinds of reasons people find themselves wanting a natural birth:

1. Because they have a friend/sister who did it.  This is why I had a natural birth. My friend, Alisa, did it and darn it, if she could do it, so could I!

This lady is the reason I had a natural birth!

2. They are afraid of the epidural.  I've had several people in class over the years that are just plain scared of the needle in their back. They are more afraid of that than they are the "pain" of natural childbirth. I've always been fascinated by this one. Occasionally, they can't have an epidural because of medical reasons so that's what lands them in my class.

3. They've had a bad experience with an epidural previously.  Every now-and-then someone has had a bad epidural where it didn't work right and they want to avoid not being prepared again. Often, these women feel like they didn't even have an epidural even when technically they did.

4. They've had a bad recovery when they had an epidural with another baby. This can coincide with #3, but sometimes their epidural worked fine but afterwards they were numb for hours. Or they had the spinal headache and couldn't care for their newborn or other children. It happens more often that you realize.

5. They've had a c-section and want to avoid another one. Inductions and interventions can often lead to c-sections. If a mom wants a VBAC (Vaginal Birth After Cesarean), her best odds are having a natural birth and not forcing the labor along.

6. They believe their body was created to do this. These are not in any particular order, although I'm leaving #1 where it is because it's quite common and it was my reason for wanting a natural birth. #6 is probably the second most common reason I hear women say they want a natural birth. They believe in the process and their bodies.

7. Their mom did it, so can they. I love it when women have the support and encouragement of their mothers. I hope I instill that in my daughters.

8. They want to breastfeed.  Sometimes I've had women in class that have said their reason for wanting a natural birth is because they want to breastfeed and they believe that the birth can affect how well breastfeeding works. This is true. That's not to say that women who have epidurals and/or c-sections can't breastfeed, but it is more likely to be less complicated without medications/interventions, etc. involved. Even though they may or may not say so, I think this one is somewhat equated with #6.

9. They want to challenge themselves. You know these people - they want to be on Survivor or the Amazing Race. Yes, people do actually want to have a natural childbirth to face their fears or challenge themselves. They are so fun to have in class. They are sponges and actually DO the homework. Love these couples!

10. They saw a water birth on Baby Story.  There's at least one in every class. They saw a water birth or homebirth on TV and thought it was pretty cool. Or maybe they wanted to be able to say "I did that." Whatever it is, we'll take positive media representation of natural birth wherever we can get it!

Notice: Evidence is not on this list. I am working on a post about this so I'm not going to dwell on it here. It's not to say that it doesn't play a role in choosing to have a natural birth, but honestly, I've never had someone say that "evidence" is the reason they want a natural birth. It's is almost always an emotional decision, not a factual one. We'll circle back to this later.

As a side note, occasionally it the dad who is excited about natural birth. I have to tell you, this rarely works out well. Every time I've encountered these couples in class, the moms have had an epidural or a c-section. I love that dads get excited about natural birth, but ultimately, mom needs to also be excited for her own reasons.

If you want an AMAZING birth -- for whatever reasons -- sign up for a Birth Boot Camp class today, either with an instructor or online.

Monday, March 31, 2014

Reveal This!

This gender reveal video, after being on YouTube for just a week, has nearly 1,500,000 views. While it's completely appalling (we'll get there), I am contributing to all the views by putting it on my blog. Forgive me. We'll tear it apart in a minute. Take a look if you haven't already.

Horrible, isn't it? I can't believe the parents did the cake thing, first of all. Second, they recorded it and put it on YouTube! Wow. Such disregard for their (only) son's feelings. It's like they are laughing at him and now letting the whole world laugh with them.

This video really hit home with me because I have one boy (the oldest) followed up with 3 girls. He was totally fine and excited to have the first sister. So excited! We had a 20-week ultrasound with baby #3 and found out she was also a girl. He was devastated and blamed me. His 4-year-old brain (and heart) couldn't understand how we had no control over the gender of the baby. Thirteen years later, he's just now gotten to the point where he is OK with this sister - who he desperately wanted to be a boy.

Fast forward to baby #4. We didn't have any ultrasounds with that baby, but we just knew it was a boy. We had tried for a boy and the pregnancy had been most like it had been with baby #1. Daymon was at the birth and found out alongside everyone else that the baby was a girl. Let me tell you, it was DEVASTATING. He cried the biggest silent teardrops ever. He was almost 9 years old and a little more mature than he had been with baby #3. We have given him full "permission" to cry over this whenever he's needed to. I will add that the morning after her birth, he was the first kid downstairs. He snuggled into our bed right next to her, looked up at me, and whispered "I love her more than anything in the world." I believe being at her birth and finding out with everyone in the room -- and being allowed to grieve -- helped him in this process. While I wasn't sad this last baby was a girl, I was very sad that my son would never have a brother.

The realization that he might never get a brother - that he so desperately wanted - was so crushing. Over the years, he's made similar statements as this boy in this video -- things like feeling so alone surrounded by all these girls. He's wanted to run away. He's spent more time out of the house, just so he could be around other boys. It's just not fair that they got sisters and a brother but he just got sisters -- and a lot of them!

The sisters in this video were so confused and visibly moved away from their brother. The dad says that he wanted it to be a boy too but doesn't really let his son grieve. The girls are crushed, and confused. To see your brother react this way to having another sister is also so sad. Both girls have got to be left feeling inferior by the brother and the dad.

I don't blame the brother at all though. We knew our son really wanted a brother, so I'm sure it was not a surprise that this boy would react the way he did. Honestly, pulling him aside, without his sisters, would have been the compassionate thing to do. No dumb cake and certainly no YouTube video.

To the boy who isn't getting a brother-
I'm so sorry your parents told you this way that you are getting sister #3. I know you are devastated to not be getting a brother. Some boys want a brother more than others. I have a boy like that and it's been sad for him. He's graduating from high school in a couple of months and is OK with it now. He's had lots of friends, boys and girls, but I sense that he is still sad about it every-now-and-then. Love your sisters. I know right now you have different interests but one day you'll have more in common. Teach them some baseball and they'll teach you some cool dance moves. I'm sorry you are in this pain. Give it time. You will grow to love your new sister. I promise. It's OK to be sad though. Make good friends. You can't choose your family but you can choose your friends.

One thing I love about Dr. William Sears, the Father of Attachment Parenting, is that he always talks about respect. Respect your children and they will respect you. I wish I was a better model of this behavior, and we do try, but it doesn't always work out. This gender reveal should never have been put out on YouTube. It was a blatant publicity stunt at the expense of their only son. Interestingly, my husband and I saw it separately (I didn't even know he had seen the video) and he was most fired up about the father talking about not wanting another girl in front of his two daughters. He commented on a post telling the dad that he's ruining his daughters' self-esteem, and even called him a jerk. Most people I've talked to about this video were totally offended by it and couldn't believe it was put on the internet. How about you?

* P.S. Dr. Sears is coming to Fort Worth April 25-27 for the Southwest Birth Roundup. There are other speakers as well, including Jill Arnold of The Unnecessarean and, Jennie Joseph, founder of The JJ Way, and Kathleen Kendall-Tacket, with several other awesome birth professionals from around Texas. Tickets are on sale now and there is limited seating. Last I heard there are still tickets left. Get yours today!

Monday, March 24, 2014

Failure to Progress and the Association with Sphincter Law

I've written a few posts on this topic over the years (The "F" Word, The Needs of a Laboring Woman Are More Easily Achieved at Home, and Welcome to the Olive Garden to name a few) but this week I received this video from Rachel Connolly Kwock, doula and filmmaker, and I just had to share it here with y'all. Check out Rachel's YouTube channel where she'll be adding more.

There are many reasons for Failure to Progress being the #1 reason for a woman having a primary c-section in the United States. "Sphincter law" is at the top of this list. Ina May Gaskin, as you know, is who coined the phrase "sphincter law" and talks about our sphincters being shy around "male surgeons". Ain't that the truth?

But, sometimes, just feeling watched in general -- even by people that have your best interests in mind -- can make it difficult to really let go and open up. Just some food for thought next time you are trying to dilate (or poop) while being watched.

Taken when TCBN hosted Ina May in July '12.

Monday, March 10, 2014

Healthy Mom/Healthy Baby - Is That Really All That Matters?

I recently heard of a hospital childbirth educator playing a birth plan game where each couple was given a set of cards with various things written on it that might be important to a couple (such as dim lighting and intermittent monitoring), including 2 cards that said "Healthy Baby" and "Healthy Mother".  The couples were told they could only keep 2 of the cards.

I find this game so offensive on so many levels.

First, what parent is going to keep anything other than these 2 cards at the end of the game? This goes without saying that all parents want their baby to be healthy. What mom wants to not be healthy? Seriously. The only lesson in a game like that is that ultimately birth doesn't matter. Birth is dangerous and you do whatever you have to to just get the baby out without either of you dying.

Second, the couple's wishes don't matter. We talk about the "dead baby card" being played by some OBs, but this is a different setup altogether. This sets the stage early on to teach the couple to be obedient patients. And really, who is going to write a birth plan after playing that game in the hospital class anyway? It's a form of brainwashing, in my opinion.

Natural birth advocates have been criticized for valuing the childbirth experience more than the life of their child. Give me a break. It's a sneaky - and rude - way of making women feel bad for wanting a good birth experience. Like they are being selfish for wanting that. I was recently talking to a mom who wanted to have a natural birth but her husband thought it was unsafe and wanted her to have the epidural.  Wha?! Where do people get these ideas?! I'll tell you where - from hospital classes like the one mentioned above.

Ladies, your birth matters and you have the right to be heard. Your wishes should be respected. Educate yourself so you know if your birth does become a "healthy mom/healthy baby" situation. Don't take their word for it - know for yourself!

You CAN have an amazing birth (and a healthy mom and healthy baby!)! Sign up for a live Birth Boot Camp class or our online class today.

Monday, February 24, 2014

Spoil Yourself -- Hold Your Baby

When you are pregnant you get so much (unsolicited) advice. And when you have the baby, you get even more! How many times have you been told that if you hold your baby too much, you'll spoil your baby? We have strong feelings on this subject over at Birth Boot Camp:

I remember a few days after my first child was born, I was on the phone with my dad and I made a comment about being able to put Daymon down for a little while to get something done!  I was excited about it and my dad was like "Duh, Donna. You shouldn't have to hold your baby the entire day. Don't you know you'll spoil him if you do that?"  Well, no Dad, I didn't know that.  It made me more than a little paranoid though.

I wasn't sure exactly what he meant by "spoiled" though. Did that mean he would be an absolute brat when he got older? Was he going to manipulate me into me doing whatever he wanted? Neither sounded great. Who wants a bratty kid, right?

The thing is, when I held him, he was pretty happy. We lived in married housing at BYU and while there were lots of babies, I didn't want my baby to be the one crying, annoying everyone. And so I held him. A lot.

A few things happened from holding by baby:
1.  He didn't cry.
2.  I didn't cry.
3.  He learned to trust me.
4.  I learned his cues and to trust myself.
5.  I learned how to be his mother.
6.  I had a great milk supply.

Like with so many things, it's important to trust and follow your instincts when it comes to mothering. Holding (or wearing) your new baby almost always feels right. Before birth, your baby was never separated from you. They want to be held. They are used to the way you smell, sound, walk, and talk. They want to be close to their food supply for crying out loud!

Know what's funny? My kids don't remember this at all. OK, that's not really funny. It's more sad than anything. I do believe it made them confident and trusting, and dare I say, independent? Even though they don't remember that time, I remember it. I treasure the time I spent doing nothing but holding my babies. Now that they are big people, they don't sit in my lap and I don't cradle them in my arms like I did when they were babies. 

So, when all those people tell you not to hold your baby because you might "spoil" them, you go right ahead!  You won't spoil your babies -- you're spoiling yourself with one of the greatest gifts you'll ever enjoy. 

Monday, February 10, 2014

"Baby-Friendly" is not a Substitute for MOTHER-FRIENDLY

If you read my blog, y'all know that I was involved in my local birth network chapter and on the Board of BirthNetwork National for a year.  The basis of the Birth Network chapters is the Mother-Friendly Childbirth Initiative written by CIMS and its ideas, research, and philosophy are at the root of the Birth Boot Camp childbirth curriculum.  If you are not familiar with the MFCI, you should be!  Read what I wrote about it here.

A good friend of mine is training to become a Birth Boot Camp Instructor and one of the requirements is that you have to attend 2 births, preferably that are in different locations from where you had your own babies.  It can be any kind of birth too, not just a natural birth.  In fact, we really like our instructors to have the opportunity to witness an induction/epidural/c-section. It's a great learning opportunity.

Back to the MFCI, my experience is that many people have heard of "baby friendly" care even though they don't really know what that means.  It sounds nice though, doesn't it?  In my opinion, "mother-friendly" care should be the starting point.  Most American hospitals have it backwards.  My friend was invited to an induction at a Baby-Friendly hospital, and her thoughts on this birth were so insightful. She gave me permission to share them here.

Mom and baby are fine. Everything went just the way she had planned. But I have been so emotional all evening about it. I keep telling myself she has the birth she wanted but she missed out!, I just keep crying. I feel like she missed out on the sacredness of it. There was hardly any emotion. Dr broke her water at 8:20 (she was at a 2) then she was started on pit. She was already in the bed with the monitor and blood pressure cuff. She stayed that way the WHOLE day except once when she went to the bathroom maybe around 10:00. 

They kept upping the pit but she wasn't having any kind of contractions that made her need to stop and relax. But she got an epidural @1:10 because they were worried that if she didn't do it then the doctor wouldn't have time because there has been several c-sections unplanned and there were already several scheduled. So at 1:30 they put in a catheter and she was at a 4. At 2:50 she was at a 6. She was frustrated that things hasn't moved any quicker. All along they kept upping the pit. 

At 3:15 she says I think I feel pressure but I don't know. (This was her 6th child and she says that once she pushes they come out quick) so the nurse comes and says you are 10! But you can't have the baby. The doctor is at another hospital with an emergency. So they find another doctor and start getting everything ready. 

I notice the nurse is getting a little panicky. The baby's heart rate slowed. She whispers "It's time to get the bay out now." And they just start pushing her. The doctor was tugging at the baby's head so hard his arms were shaking. 

There was no feeling in the room. Nobody is saying "way to go." Nobody is giving her any kind of excitement. Finally I spoke up and said something like "Its almost time to meet your baby!"
The baby was born at 3:43. Nobody wanted to cut the cord, so I did. The hospital has a "baby friendly" policy for the baby to be on mom for 1 hour so on to mom she went. But it just didn't seem like she was that into her baby. Neither was the dad. They had one of their kids there who was really excited to see the baby. Anyway long story. It took another 20 minutes for her to deliver the placenta and they didn't even look at it! I was a little stunned. They just tossed it.

As sad as it was, it was really good to witness the "un-emotional" side of birth. To witness someone experiencing it is so eye opening. She was so not attached to what was happening and missing out. It connected all the things I know, and have read and watched. I feel like the hospital putting in to place the "baby friendly" care is trying to make up for the moms being unattached. They have this in place to try and help, but if they would do mother friendly from the beginning they wouldn't have to force the baby friendly.

Birth does matter. How moms - and dads - get started with their baby is important.  It's important to be involved in your healthcare and I'll even go as far as to say to feel the baby be born.  All of these things will affect how well the mom (and dad) bond with their new baby.

I've said it for years and I'll say it again -- labor serves as a bridge between pregnancy and becoming your baby's parents.  If mothers care about how their babies get here, they'll be excited to hold their new babies and the oxytocin will be flowing.

If you know me at all, you know I'm famous for saying "time and place" in just about everything. There's a time and place for an epidural or a c-section, or an IV, or an induction.  That's not what I'm talking about in this post.  I feel like I've always got to have a disclaimer, so there it is.

Childbirth education is key to having an AMAZING birth!  Requesting Mother Friendly maternity care is a step in the right direction, but consumers have to speak up.  Don't just get an epidural and lie down and take it, not participating in one of the most important days of your life!