Monday, December 24, 2012

The Importance of the Natural Birth and Breastfeeding Requirements to be a Birth Boot Camp Instructor

As most of you probably know, I wrote a childbirth education curriculum in the last year and launched it as Birth Boot Camp®.  The classes can be taken online or you can take a live class in your area taught by a certified Birth Boot Camp Instructor.

In addition to an intense training program, an instructor-in-training must have given birth without the use of any pain medication.  She also must have breastfed at least one of her babies for at least one year.  Believe me when I tell you that this policy is in place for the benefit of the students in her class. It has very little to do with the instructor.  Let me explain.

Recently, I had a brief conversation with one of my daughter's teachers.  She saw the "Birth Boot Camp" vinyl on the back of my car and asked what that was all about.  I briefly told her and she said, "Wow!  You did that without drugs?!" in her sweet Southern drawl.  She went on to say, "I don't think I've ever known anyone who's done that!"  Imagine that she wanted to be in my class and I'm teaching her how to have a natural, unmedicated birth, but I've had an epidural.  Or a shot of Demerol , right at the end.  Now she still doesn't know anyone that's ever "done it" without the drugs.  How is she ever going to do it with everyone around her NOT doing it, even her instructor? It must be impossible to have a natural childbirth, right?

While the education is invaluable, I have often felt that the most important thing people walk away from class with is confidence.  They know they can give birth without medication.  Their instructor did it, and so can they! 

I've had so many women over the years tell me that they thought of me during their labor.  "If Donna could do it, so can I!"  Husbands cheer their wives on right at the end when she wants to give up, saying, "Donna said it would be like this at the end.  You are almost there.  We're going to meet our baby soon!"  If their instructor was teaching it, but didn't -- for whatever reason -- do it, that would break their confidence. 

The graphic designer for Birth Boot Camp's (awesome) materials was in my class last year.  Because of the shape of her uterus, her baby could not turn. He was stuck in a transverse (side-lying) position, despite her trying every single thing she could to get him to turn.  She was devastated to have a c-section, but she really didn't have a choice.  Thank goodness for modern medicine that could give her a healthy baby.  She is a total advocate for natural birth.  She knows the material.  She was completely ready for labor and I'm certain she would have "done it."  Unfortunately, she never got to experience a single "real" contraction.  She asked at one point about the possibility of teaching Birth Boot Camp and I had to tell her no.  I've had to tell a few people no.  It's not personal.  I love this girl, but it's not about her!

If a woman went all the way through labor without drugs and was even pushing and then had a c-section right at the end, how are the students going to truly trust birth in her class?  The same might happen to them.   And it might anyway.  The point is, learning how to give birth naturally is as much about what's going on in the head as with the body.  A woman can teach "prepared" childbirth education without having had an unmedicated birth, but in order to teach how to have a natural birth, we feel strongly that she should have done that herself.   There are other courses a couple can take if they want an epidural or c-section, but that is not what we do at Birth Boot Camp.

The role of the educator is unique.  It's not clinical, like a midwife or an OB.  It is not just supportive of "whatever choice they would like" - like a doula.  Birth Boot Camp is all about natural birth and we deliver a really good road map to get there.  A good teacher - no matter the setting or subject - teaches on a topic that she is not only passionate about but knowledgeable as well.

Sarah Clark, aka Mama Birth, helped write the Birth Boot Camp curriculum, and she tells of having 3 doctors in one of her classes.  She was quite intimidated - or so she says! - and they all said they knew the mechanics of birth (one had caught 200 babies), but they were coming to her class because she had DONE IT.  Boom.

The fact remains, unless you have done it, you can't know what it's like.  You cannot grasp the loss of modesty, the time warp, the inability to make a decision, or the fact that, in the thick of labor, you won't even remember this is all for a baby!  Talking about these things but not having had experienced them does not carry the same weight.  This carries over into so many areas of our lives:  Would you learn to play piano from someone who loved music but didn't play?  Would you go to a marriage counselor who had never been married?

I know things happen in labor.  I've had my fair share of epidurals and c-sections from class. They are usually necessary, sometimes even life-saving.  Couples that sat through my class were able to make informed decisions in their labor.  My heart goes out to those women who wanted a natural birth and didn't have one.  I know there are women who have not been able to have children, but if they did, they'd want a natural birth.

As for the breastfeeding requirement, we have actually accepted a few trainees who have not been able to breastfeed for the required one-year minimum.  We have a fabulous lactation consultant, Mellanie Sheppard, on our Advisory Board that we took these special cases to in order to help us understand what was possibly going on.   Again, my heart goes out to these women who tried and tried to breastfeed, but had true physical reasons that they were not able to.  With this requirement, we are trying to avoid are the "I had to go back to work" or "He just wasn't interested at 6 months anymore and we quit."  Sometimes breastfeeding, like birth, is hard.  It is so worth it to push through those challenges.  We want our instructors to be a support and example to the couples in their classes.  The recommended amount of time to breastfeed, according to the AAP, is at least one year, and according to the World Health Organization, 2 years and beyond is recommended.  We want to be the childbirth education program that is encouraging these standards not only on paper, but in practice and example.

Birth Boot Camp Advisory Board

Ultimately, Birth Boot Camp is about teaching couples to have a natural birth.  That is the Instructor's responsibility, and she goes through a thorough training process to be sure she is ready to do that.  Each couple that takes a Birth Boot Camp class - online or in-person - receives the Breastfeeding Class, The Ultimate MRE, on DVD.  They get a complete course taught by Mellanie, our lactation consultant, and the instructor will lead some discussion on breastfeeding in class, but they are not responsible for teaching the full breastfeeding course.  Thus, there is some leniency with this requirement.

We are not the "judge and jury" on a woman's birth or breastfeeding experience.  That is entirely up to her. We are not passing judgement or saying there is a right way or a wrong way.  These are simply our guidelines for our instructors and we feel they are important in order to help a couple achieve their desire for a natural birth.

Dani Long, BBCI
If you are interested in how the instructors feel about the requirements to become a Birth Boot Camp Instructor, you might enjoy this post from Dani Long, who recently completed her training all the way from Spokane, WA.  There is pride in completing an intense program and our instructors are ready to teach!

P.S.  I didn't write this post to start a fight.  I've had a couple of people sincerely ask for explanation and I thought others would probably like to hear it as well.  I'm a nice person.  This isn't personal. I love you guys. Peace out.


Allena said...

Greetings from Austin! I just stumbled across your blog a few days ago and have read EVERY post. This is going to be a long comment. :) I am 40 weeks pregnant today with my second child (our first daughter). Our son was (to quote you) a typical American birth. I was induced with pitocin and having my water broken. I had an epidural. He did not handle any of that well and we almost had a c-section. I had no clue all of that was MY fault at the time. I am now much smarter (thankfully). We are having this baby naturally with an amazing team. I am still delivering in a hospital but we switched doctors at 28 weeks because I honestly felt I couldn't trust the doctor who delivered our son. We now have an OB/midwife team who believe strongly in natural childbirth and have a reputation around town to match what they preach. We have hired a doula collective as well (who also love our OB/midwife). I am SO excited!! I just wanted to tell you your blog has been so amazing to read over the past few days as it just supports everything I've learned this pregnancy and provide such encouragement to me. I admit to being scared but am focusing on everything positive that I KNOW natural childbirth WILL BE! Thanks for everything you do!

Amy said...
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Samantha said...

Love it, you are rocking this!

Charlotte said...

I went through the same thing after having a preemie, when well-meaning doctors, nurses, and friends would give me advice without having had a preemie themselves. She was born at 32 weeks but has done great so far (babies always know when they are supposed to be born!! She was not a library book with a due date!!) but it was hard to take the doctors seriously when what they would tell me contradicted what natural mamas KNOW to be true, like that breastfeeding can nearly always work. It was so frustrating to be forced to feed her through a feeding tube just because they thought she might be too small and week to breastfeed and might expend more energy eating than the milk would give her, or that she would need an iron supplement due to being born before most iron stores are deposited. If breastmilk is the perfect food, that wouldn't be true. I don't care how many years you have been caring for preemies- unless you have had one yourself, your advice is worthless. Caring for a preemie is hard and scary, just like childbirth, and I know I wouldn't have had any confidence that my baby would survive the NICU unless the nurses caring for her had preemies too so I could look to their kids and think that if they made it through, mine will too. Telling me the stats and the stories of babies you've cared for over the years or how much you learned about their medical needs in school just isn't good enough. You can't possibly be a competent enough NICU nurse without having experienced prematurity firsthand. You can do nothing at all to help other preemie mamas and probably shouldn't be allowed to work there in the first place, because you will not be able to give other moms confidence.

Eminurse said...

To Charlotte - are you joking or just incredibly naive? You say someone can't be a competent NICU nurse without having had a premature baby? Well, most of the NICU nurses I know and have worked with, including myself, have not had preemies and we're all damn good! I would bet my life that not all your nurses had a preemie. Let's hope your child never has any chronic or acute serious disease, as most nurses would not have had those diseases, and thus would be incompetent....

TawnyNicole001 said...
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