Summer 2017 Group Prenatal Classes for Surrey Langley have now been scheduled!
These classes are for expecting moms due August or September. Groups are kept small to ensure parents get their unique questions and concerns addressed. Prenatal Journey’s prenatal classes are specially designed for people who would prefer to have as natural a birth as possible.
The classes will empower you to understand the physical and emotional journey of childbirth and what effective strategies real life women use to get through labour and have positive birth experience. You will also learn how to make informed decisions about your healthcare and that of your child.
Moms often start out feeling nervous about their ability to cope with labour, but end up feeling confident in themselves, their partners, and looking forward to meeting their babies and the journey that brings them.
Live in Surrey or Langley and Expecting a Baby Soon? Thinking about having Doula Support for your Birth?
Prenatal Journey currently has space for one more client due Jan 2017, and one more due Feb 2017. If you’re due in March or later, there is still space. I provide Birth Doula Support to moms-to-be in Surrey, Langley, Delta, Vancouver and Abbotsford.
Having a doula is a great idea if you would like to have more support through your pregnancy, birth and postpartum time. It’s especially helpful if you want to have your best chance at having a natural birth. Doulas provide non-medical physical, emotional and informational support so that moms can have an easier time in labour and have an empowering, positive birth experience. Evidence proves that having a Doula reduces the need for pain meds like epidurals or narcotics, and also reduces the need for inductions and cesareans. They also increase successful breastfeeding rates, reduce postpartum depression, and make sure moms and babies start their new phase of life feeling supported, positive and capable.
At births, I often help moms cope with labour with specific techniques and tools – counterpressure, hip squeezes, massage, position changes, TENS machine, encouragement and so on. I also am a great listener, supporting moms through any emotional challenges they are dealing with in pregnancy, birth, or after their babies are born. Being there with moms right in labour and being available 24 hours a day by phone in pregnancy and postpartum to answer any questions, helps moms get the information they need to power them to make informed decisions about their well-being. Dads also LOVE having a doula to help out in labour. Dads are so important at births, and I always make sure I show dads how to effectively support their partners. Dads and doulas usually work as a team. Moms can’t have too much support in labour.
Prenatal Classes, and Birth Photography
Besides doula support, I also teach prenatal classes and provide birth photography. I offer private prenatal classes in Surrey, Langley, and surrounding areas. They are on your schedule and in the comfort of your own home. Group prenatal classes are in small groups and consist of two full Saturdays, or once a week for 8 weeks. Many clients also love having birth photography done to capture special memories of their child’s brith and the first moments of life.
If you’d like to register, call 604 809 3288 or email firstname.lastname@example.org
Here’s what a doula and prenatal class client has said,
I was determined to give my daughter Valentina a natural birth at home without the use of any pain medication. Thanks to Kaurina, I was able to physically, emotionally and mentally prepare myself to make this happen. Kaurina was very thorough and motivating during those important months of preparation, helping my husband and I shape the kind of birth that we wanted for our baby. It was through her inspiring talks that we truly shaped our home-birth plan, as she helped guide our thinking as well as presenting many options that had not occurred to us. Thanks to her we were more than prepared for the arrival of our daughter. Not only did she provide me with the support I needed, she provided my husband with extremely helpful tools, helping him become an integral part of the birthing process.
During labour, I was so deeply thankful to have Kaurina with me as my doula. She was calming and reassuring, providing me with excellent coaching, calming my mind and body, giving me the focus and direction I needed to bring Valentina into this world as calmly and quickly as naturally possible.
After the birth of Valentina, the world came into sharp focus. No matter how many nieces, nephews, or children of friends, nothing prepared us for the intimate feeling of caring for our own child. With this also came the fears of proper care, the immediacy of her needs, and the emotional roller coaster of the post-partum period. Kaurina was there for us in every way. She answered every phone call and question, as well as coming by to check on our health, well being, and techniques; such as showing me useful breastfeeding techniques, how to care for the umbilical cord, and the best way to approach a bath for a newborn.
All of this care made for a truly beautiful birth experience, as well as ensuring a positive post-partum period; Kaurina can be thanked for it all.
A TENS machine, or TENS unit, is a simple device that you can use in labour to reduce the sensation of pain, and so it can help you have a natural birth. TENS stands for Transcutaneous Electrical Nerve Stimulation. You place these sticky electrical pads on your skin, and it delivers tiny electrical stimulation to the nerves. It is used by physiotherapists for pain relief of various kinds – muscle aches, migraines, back ache, injuries, and pretty much any pain, whether accute or chronic. For decades now, it has also been used for labour pain.
How is a TENS machine used in labour?
The sticky pads are place on the back in early labour, or near the start of active labour. It takes an hour or two to build up in effectiveness. It works for natural pain relief using the Gateway Theory of Pain – the stimulus to the sensation nerves blocks out some of the pain nerves because the brain can only process a certain amount of stimulation from the nerves before it starts to block out some out. About 80% of moms in labour who use a TENS machine say it helped them reduce and cope with the pain.
There are several brands of TENS machines. The most common one used for labour is the Elle TENS machine which has a Boost button to increase and change the pulse during contractions.
Are there risks or side-effects?
There are no risks or side effects except that you obviously can’t use it in the shower or bath. It is also not recommended if mom has a pacemaker. It should also not be used on the abdomen during pregnancy. It should be placed on the back.
Because it can be an effective method of pain coping in labour, with no side effects, it makes an excellent tool to have if you want a natural birth.
How to get one in Surrey or Langley?
If you want to have a TENS unit for labour, you have to get it before hand. Hospitals do not have TENS units available, although it would be great if they did. You can either buy one or rent one, or if you have me as your doula, you will have access to mine. To find out about how doula support can help you click on Doula Support.
If you are in Surrey, Langley or surrounding areas, you can rent a TENS unit from me for up to 5 weeks. The fee is $90 and includes 2 sets of electrical sticky pads. You can call me at 604 809 3288 or email me at email@example.com.
If you would like to purchase your own so you can have it for more uses than labour, they are available in Vancouver at Natural Creation or the Facebook page.
I am absolutely ecstatic to announce that I had my fourth kid, and 2nd daughter in January 2015. She was welcomed into the world by her older brothers and sister with so much love.
Of course as a doula and prenatal teacher, I was very interested in putting all the skills I teach in my classes to good use in my own labour.
First of all, right from the beginning of my pregnancy, I wanted to choose the best health care provider that would be a good fit with my birth preferences. This is one of the most important things I tell my clients that will affect the kind of birth you have. Don’t just choose any random maternity care provider. Find the ones who best fit with the kind of person you are, and the kind of birth you want.
Secondly, birth can be unpredictable, so when things don’t follow the textbook version of labour, you have to make informed decisions regarding what to do. There are ALWAYS options. When my water broke and my labour didn’t start for over 24 hours, it was stressful because, of course, as a mom, you naturally worry. But I kept reviewing my options and the potential risks of all the options available and kept discussing things with my midwives. Just to be clear, I felt totally fine with having any medical intervention that was clearly necessary and helpful, but I also know when interventions are not entirely necessary. There are always risks to both sides – having a medical intervention or declining it. In my situation I had the options of going to the hospital to start an induction, using non-medical ways of starting labour (herbs/ acupuncture etc which can be highly effective), or simply waiting it out. That’s another reason moms love having a doula with them in pregnancy and labour – if unexpected situations arrive, the doula can often talk moms through the decision making process, empowering them with a range of information on options so that moms can make an informed choice and feel good about it.
I knew the risks and possible outcomes of all scenarios and decided to take various herbs to get labour started. I also know that emotions and ’emotional blockages’ can have a huge impact on labour. So with the help of my doula friend, I worked through any deep seated emotions I was having that could have been blocking my labour from starting. That was EXTREMELY helpful because after I realized a huge emotional block I was holding, and then let it go, my labour started soon after.
Thirdly, of course, is all the pain coping strategies I teach. Once labour started, the first half was the easy part. The key for that is to keep focussing on staying completely relaxed. Holding on to any tension or resistance will cause pain. I was able to feel no pain at all for the first half of the labour by breathing out all the pressure waves and making a low toning sound. You can try it now, just let yourself sigh with a deep sound. You naturally let all your tension go and you feel more grounded. Remember fear in labour = adrenaline = pain = more fear = more pain. You have to keep the adrenaline out of the equation in labour and keep deep breathing away any tension or pressure you feel building up. Pay attention to your body.
As contractions intensified, I moved around, feeling for whatever positions felt more comfortable. Sitting, squating, standing, lunging, leaning forward on furniture, sitting backwards on the couch, swaying my hips etc. I was chatting with my doula, friend, mom, and midwives in between contractions. Eventually, I felt like leaving the living room and going up to my bedroom. In labour, women naturally experience a going within. They feel like they are going deeper and deeper inside themselves as labour progresses. A woman starts using more of her primitive, instinctual brain and less of the cerebral cortex. It is the instinctual part of the brain which controls the natural process of labour. Labour flows more smoothly when a woman is undisturbed so she can smoothly go deep within herself. Any distractions that pull a woman out of this state of mind will slow down the labour and also create unnecessary pain sensations. Bright lights, too much talking, asking questions, talking about time (which is a cerebral concept), telling a woman what to do so she can’t listen to her own body’s instincts, disturbances like frequent blood pressure checks, vaginal exams etc. will all take a woman away from her “labour land” state of mind. And to the labouring woman, this feels quite irritating.
I told my midwives that I wanted a very hands off approach to my birth. I didn’t want any unnecessary disturbances such as internal dilation checks or them telling me what to do. But having them there in the background helped me feel safe in the rare situation where medical help might be needed. It is important for birthing moms to feel safe and supported. That will lead to a smooth labour process. Anything that makes them feel worry, fear or anxiety will cause a slowing down of the labour process, or even complications.
Once I got to my bedroom, the lights were off with just a dim light on in the bathroom. My older daughter had woken up by this point and she lit some candles to add to the mood of the room. My mom made sure the music playlist I had put together for the birth was still playing. I had complied a series of songs that I found both inspiring and relaxing. I love music and I find it helps me set the tone for focusing on feeling good. In labour, you want to take your attention off the pain sensations and replace them with anything that makes you feel good. My doula was massaging my sacrum while holding a hot pack on my lower back. My husband rubbed my back and shoulders. That all felt really good. By this point, I was not feeling zero pain, like in the earlier part of the labour, but all these things helped take the edge off the intensity of contractions so they were completely manageable.
People often tell me that I’m brave to have a homebirth. Nothing could be further from the truth. The truth is, in terms of pain management, homebirth is often easier to manage because I feel more comfortable at home and there are so much fewer disturbances to my instinctual state of being. In terms of safety, solid evidence shows that homebirth is as safe, if not safer, than hospital birth, as long as it’s a healthy pregnancy, there are trained care providers in attendance, and a hospital is less than an hour’s drive away if there is a need to transfer. Here in the lower mainland, BC, Canada, we are so lucky to have a fantastic midwifery system that functions relatively smoothly at home or hospital. If you feel more comfortable having a homebirth, definitely go for it, or at least look into it. If you feel safer and more comfortable in a hospital, then hospital is the place for you. Birthing moms should be in the place that is more conducive to them feeling safe and supported. You have to know yourself, and know what you prefer. It doesn’t matter what anybody else does. It only matters what kind of experience you want and how you’re going to get it.
Eventually, my contractions got pretty strong and I wondered if getting in the bathtub with warm water would help. I wasn’t particularly planning a waterbirth, but I always keep my options open. The warm water does take the edge of, but of course, labour is still a pretty intense and powerful process. At one point I joked with my midwife, “So you brought an epidural with you, didn’t you?”
“Yeah, it’s just in my back pocket,” she smiled.
“Oh good. I wouldn’t want to be crazy enough to have a natural birth.” 🙂
(Just in case you didn’t know, you can’t have an epidural or any other drugs at a homebirth because of the risk those things entail.)
I remember, through one contraction I just swore the whole way. Then for the next one I struggled to remember what the purpose of all the pain was. Oh yeah, to open the cervix and let the baby out. So I started chanting “Open, open…” through the whole contraction, while visualizing my cervix opening fully, quickly and easily. Soon after that I started to feel worried. I had the presence of mind to remind myself that this was a normal emotion during transition (the last bit of the dilation phase before the pushing phase). I was worried that this would go on forever and the baby would never come out. It’s common to have this rush of irrational feelings in transition, and a doula often reassures a labouring mom that this is a natural part of the process and it’s good sign that means things are progressing. It is important for the mom to go back to her state of feeling safe and relaxed instead of letting the worry and the adrenaline intensify. Again, smooth, fast and instinctual pushing phase vs. prolonged and worried pushing.
I soon began to feel “pushy”, meaning I felt like pushing a little at the peak of each contraction. I let the midwives know so they could get ready and everyone else too. My younger two kids were woken up so they could be present for the birth. I tried different positions in the tub – on my back, side, hands and knees, until I found the most comfortable position for myself, which just happened to be squatting facing the width of the tub instead of lengthwise so my feet could push against the side while my back rested on the other side.
Pushing contractions feel different than dilation contractions because you’re not just trying to relax through each one. You’re actually actively pushing with each one. And in a drug free birth, you can feel the powerful force of your body pushing instinctively. It’s not something you can stop. It’s like one mom said, it feels like you’re body is just vomiting the baby out. It’s so strong and so involuntary. In a drug free birth, no one has to tell the mom how to push. Her body just does it. Pushing feels way more fun than the dilation phase before it. I felt very powerful.
Once the baby’s head was low enough in my pelvis, I could feel it. It was definitely a strange sensation and I exclaimed to all the 10 people who, by now had piled into my bathroom, “It feels like a bowling ball.” I put my finger in and felt the top of the baby’s head less than an inch away. A couple more pushes later and I could feel her head crowning. This feels like a burning sensation as the perineum stretches around the baby’s head. I expected this part to take a while, as it can take several pushes to slowly push the head out. But my body just kept going and in one push she went from completely inside to completely out. I had planned to catch her myself if possible, but she came so fast. No one was quite ready for that. Luckily my husband was speedy quick in catching her and lifting her out of the water and onto my tummy. She was happy and content sitting on my tummy, looking around.
We hadn’t found out the gender, so it was very exciting to look down and see it was a girl. My daughter finally got the sister she had been hoping for for so long. Here’s the picture that captures the sheer intensity of emotions of that moment right after birth – relief that it’s over, exuberance over the new person you are meeting, and for me the shock of how fast she came out and surprise that I got the girl I wanted.
It was a lovely family experience to have all my kids there, my mom, sister-in-law and friend. My husband caught the baby, my daughter took the photos, my older son cut the cord and my younger son helped the midwife weigh the baby. My kids will all grow up knowing that birth is just a normal, natural and safe part of life. Not something to fear. By the way, I wanted to wait till after the placenta was out to cut the cord, or at least until the blood in the placenta had finished pumping to the baby, instead of cutting the cord immediately. This is so that she can get her full blood volume and have a gentle transition to life on the outside.
Once I got out of the tub and walked back to my bed, I birthed the placenta and breastfed my baby before letting everyone else have her for some cuddles. My mom made me a nutritious, yummy smoothie with a tiny piece of placenta blended in. Having a bit of placenta reduces the risk of postpartum hemorrhage.
It was a lovely morning. I stayed in bed all day snuggling my new sweetheart. And the other kids were just over the moon excited with their tiny sister. Plus they got to take a day off school. 🙂
Birth Trauma is a topic that has been weighing on my mind quite heavily the last couple of days. There have been ongoing protests outside BC Women’s Hospital in the last few months, and more are planned for different locations and hospitals around the Lower Mainland and Fraser Valley. The protests certainly caught my attention with this video on you tube Birth Rally at BC Women’s Hospital.
I know Birth Trauma and Post Traumatic Stress Disorder as a result of a birth experience exists, but this was the first time I was seeing people openly speaking out with terms like “Obstetric Violence” and actually naming the doctors who imposed unnecessary medical procedures on women without their consent. Seeing the signs just gives a glimpse of the tip of the iceberg. It’s hard to understand exactly what they mean until you take a closer look at what happened, why and how it causes the actual experience of Trauma. Then after that, the important question of, “What do you want to do about it?” needs to be asked.
One of the organisers of the events, Kalina Christoff, has also provided a detailed explanation of what exactly happened that caused her distress, what she did after to start a dialogue with hospital staff, and why she eventually felt like holding rallies was the only way left to create change for other women. You can read her story here : Vancouver Birth Tauma.
Untangling the mess
The term ‘Birth Trauma’ can refer to two things – physical damage to babies during birth; and the psychological damage to mothers during birth. Of course, there is also psychological damage to babies that can happen during birth but since that is harder to study, research in the area is relatively new and scarce. The content of this article will be about birth trauma to mothers. (I believe that mother-baby are not separate and what causes stress and harm to mothers, causes that to babies as well. And when mothers are treated well, babies are treated well. You can’t stress the mom out and say you’re doing it to take care of the baby. The mom’s stress will stress the baby out too.)
The general public has a perception of what Birth Trauma means. They usually assume birth is pretty painful and can be so unbearable that it can be traumatizing. So an epidural seems like a pretty good solution. Or they may think that women may feel traumatized only when their babies are injured or die during the birth process. While these events may happen, there is a much more multi-layered dynamic.
First of all it helps to understand the process of Labour and Birth as made up of two distinct processes –
1. The natural course of events that would take place if there was no human intervention, and
2. The human intervention that takes place, usually in the form of medical procedures, some minor and some major, both of which can alter the course of the natural process itself.
What Causes Trauma?
While the natural process may be painful and difficult, that in itself does not cause the experience of trauma unless there is some cause for strong anxiety or fear. The more common cause for feeling traumatised is feeling the loss of power over your own body and situation when people do things to it that are outside your control. That is the cause of all trauma – Feeling Powerless over your own situation.
In other areas of life, you can see how certain types of situations can cause people to feel traumatised. Eg. Bullying, for example, where the victim feels like they have no power to prevent the bullying, War is another situation where people can feel traumatised, both the civilians who have no control over the events in their lives, and the soldiers who have to obey orders and do things that may not necessarily choose themselves.
So how can trauma happen in a birth situation?
Firstly, during labour and birth, the moms are in a vulnerable state. They are dependent on the care providers for helping them and their babies safely through the process to varying degrees. They also have some level of trust that their care providers will take care of them appropriately. Physically, they are vulnerable because they are in pain, half-dressed and may be exhausted and not thinking straight.
While most of the time, care providers are motivated by moms and babies best well-being, the fact is that they are also human. Just because we, as a society are trained to believe that we should always trust doctors, doesn’t mean that every doctor will never abuse his/her power. They are human. It would be ridiculous to think that everything a doctor does is always for the safety of moms and babies in birth. It’s not unreasonable to realise that there are other factors that effect decisions doctors, nurses and midwives make in labour. For example, scheduling, time, other patients, being tired, not wanting to do extra work, differing payment amounts for various procedures, peer pressure, lacking in experience or knowledge about certain situations, and as Kalina experienced, needing to train student doctors, nurses and midwives.
This leads to a heck of a lot of medical procedures done that kinda, maybe needed to be done, but probably not. Things are done to speed things up, make extra money, train students, get it over with so they can go home, go to sleep or go on to the next patient. The thing is, nobody is going to come right out and say that. They say things like, “The baby could be in danger,” “The baby’s heart rate is not looking good,” “It’s best for you and your baby,” and so on. Most mothers and fathers would not have the background knowledge to know the difference between a real problem, and a fudged one. They might happily agree to any procedure thinking it was saving their baby’s life. That probably won’t lead to feeling traumatised unless the procedure directly or indirectly causes some unexpected damage or pain, and the mom realises later on that the procedure may not have been necessary.
Many times, the risks to procedures are not explained before they are done. This can eventually lead to women feeling like they have no control over their situation because they don’t know what could happen or what they are agreeing to. Agreeing to a membrane sweep, induction, forceps, c-section and many other things has unwanted risks, but women are not told about them before they are agree to it. Worse still, it is common for membrane sweeps to be done by some doctors at 38 or 39 weeks without even informing or asking the woman’s permission. Forceps of vacuum can be great if the baby’s life is clearly truly in danger, but in those iffy cases where maybe, sorta the baby may be starting to show signs of distress, are the risks of forceps greater than the risk of waiting and trying other methods? Forceps can hurt the baby as well as cause permanent damage to the moms pelvic floor resulting in incontinence. If the mom is saying no, and the doctor does it anyway, can you start to see why some women say the way they were treated in labour was a violation just like rape?
That’s what causes the feeling of trauma and powerlessness. That’s what causes post-traumatic stress disorder after birth and some cases of post-partum depression. It is estimated that 4% of women have post-traumatic stress disorder after birth. But birth is a funny thing in human experience –
1. It is one of the few things that only women do. Probably if men did it too, it would be handled a totally different way.
2. It is a private event behind closed doors so the birth is not in public awareness.
3. You may learn how to fix basic things in your car, how to do your own accounting, how buildings are made even though you are not a mechanic, accountant or engineer. But, even though every single person on earth is born, shockingly very few people learn any basic knowledge about birth. Most of what they know is from the media, which is saturated in complete misinformation. Because of this fact, the decision making power over decisions about your own body and baby in birth is often handed over to health care professionals. This is a huge amount of power.
4. Unlike war, which is associated with death, birth is associated with being a happy time with a new baby. It is extremely confusing for both moms and other people when the joy and love is totally mixed up with trauma and horror over the way they were treated.
So because birth is quite different than most things in human experience, the general public cannot even comprehend why some moms could have birth trauma. This is quite clear when you start to mention Homebirth. The most common response is, “Why would anyone want to give birth at home?” “To avoid the risk of having my decision making power over my own body and baby completely violated, duh! What else, would it be?”
I have seen births with complications where the medical staff was awesome, focused and committed to honoring the mother’s wishes within the realm of safety. For example, there was a baby who was having a little trouble breathing and they figured it would be better to take her to the nursery. It was important to the mom to have a few precious moments to see and touch her daughter before she was taken away. The hospital staff totally respected the mom’s request and understood how important it was. They took a lot of care to explain and comfort the parents about everything that was happening with their baby in the nursery so that the parents would not be overcome with worry. It was very touching.
In other situations, however, I have seen medical staff get annoyed with moms’ reasonable requests and feel that they are unimportant. The attitude is that it doesn’t matter how moms feel. They should just be grateful to have a live baby.
The thing is this, there was a study done which showed women’s experience of birth was influenced most by the way they were treated by the people around them, not so much the length of labour, the amount of pain or even the outcome of the birth. Women can have extremely long, painful labours, and feel really good about them if their care providers and support people treated them with respect and dignity. Women can go through miscarriage and stillbirth, and even though that may be very upsetting, can feel soothed by care providers who treat them in a caring way and involve parents in making decisions. Women may have a short, straightforward labour and a healthy baby but feel terribly about their birth experience if care providers were brusque, demeaning or disrespectful to the moms.
As I am writing this, an article is published int he New England Journal of Medicine. Court-Ordered Care – A Complication of Pregnancy to Avoid. It highlights cases where mothers are forced by courts and doctors to undergo medical procedures supposedly for the health of their fetus. Now for the people who can’t see the stupidity and violation of that, I don’t know what else to say. But I know one thing, there is no one in the world who cares more about the safety of her baby than the mother herself. Mothers are not stupid. They are completely able to make decisions about what’s best for their babies and would do whatever they felt was necessary. The doctor doesn’t always know what’s best.
If you or someone you know feels like they have birth trauma, please read Kalina’s page Recovery from Birth Tauma. If you would like to talk to someone, you can call me at 604 809 3288, or email kaurina @ prenataljourney.ca.
Kaurina Danu is a Birth Doula and Prenatal Class teacher is the Surrey / Langley area. She works to empower mothers who want to make informed decisions about their pregnancies, births and parenthood.
Ok, this is probably the most comprehensive explanation of why someone might want to hire a doula I have ever read, and it comes complete with a concept diagram of the whole thing!
Rebecca Dekker starts out by saying,
When I was pregnant with my first child, I briefly considered hiring a doula. I saw the doula flyers at Baby Moon, where I did prenatal yoga, and I thought it sounded kind of cool. But when I talked to my husband about it, he felt a little squeamish about the idea. We are both pretty private people (although you wouldn’t think it now that I blog about birth), and he didn’t want anybody else there. He just wanted it to be him and me. And he felt like he would do a good job of supporting me. At the time, it made sense. But hindsight, as they say, is 20-20.
Now all I can say is what were we thinking? How could it possibly be just him and me at the birth, anyways? We were planning to birth in a hospital! A teaching hospital, no less! Where there would be strange residents and students coming and going, and where we had no control over who we got as a labor and delivery nurse. And this was my first birth! It is so important to avoid a C-section in your first birth, because that sets the tone and risk level for all of the rest of your births (and we wanted to have at least 4 children, too). I knew on some mental level that doulas lower the risk of C-section, but I guess I just didn’t realize how important doulas are. Well, I do now. So today, I am going to talk to you about the evidence for having a doula present at your birth.
So true! I can relate because during my first pregnancy, I couldn’t imagine what I would need a doula for too. All that changed once I was in labour. To read my story you can go to Birth Stories.
Rebecca goes on to explain the randomized controlled trials that prove how effective doulas can be for improving labour and baby outcomes. To read the rest of the article, click read the article here.
The absolute craziest thing is how after so much research, the medical profession isn’t like totally promoting doulas to every pregnant woman. The fact is, if doulas were a drug, it would be unethical not to recommend them. But they’re not a drug. They’re people. And so, right now, only the people who already get it, are choosing to have a doula. I hope by the time my daughter is having kids, every pregnant woman is informed about doulas and exactly how they can help, so she can make an informed choice, instead of of what I usually hear, which is, “I wish I had known about doulas BEFORE I gave birth!”
When I had my second kid, who was 9 pounds at birth, I thought that was pretty big. In fact, most of the doctors and nurses at the hospital were also surprised at his size. But then I started meeting tons of women who said to me, “9 pounds! That’s nothing my baby was 10 and a half.” One woman even said, “I had my 11 pound baby naturally no problem.” My midwife told me about a 5 foot woman she had as a client who had a 12 pound baby at home with no tears on her perineum.” Recently I read about the woman who gave birth naturally to a 13 pound baby. I started to think that 9 pounds wasn’t so big after all.
After talking to hundreds of pregnant women, however, I can safely say that most expecting moms, and their doctors have a paranoid fear of “The Big Baby“. They are afraid the baby will be too big to come out get stuck. I’ve even heard some women and one doctor say that they are afraid a large baby will make contractions more painful. This makes no logical sense whatsoever. But what about the worry that the baby might be too large to fit through the pelvis? Is this fear justified? It may be, in certain situations, but I would like to point out how there are other factors that are even more important than simply the baby’s size. In this video I explain how the baby’s position, or the way it is facing is more important than it’s size.
The position the baby is in is greatly influenced by the position the mom is in during labour. So moms can help baby to get into a good position by being upright, forward leaning or lying on their left, instead of lying back. This can be a challenge if mom has an epidural or morphine. This is why avoiding epidurals or narcotic analgesia as much as possible during labour, can help speed up labour and avoid cesareans.
Some other factors that affect the baby’s ability to easily fit through the pelvis have to do with the pelvis itself. If a mom has a big pelvis, there may be no problem. If she doesn’t have a large pelvis, or if the baby is not in an optimal position, then again, mom can get into upright positions that open the pelvis more to expand the pelvic outlet and help baby pass through.
You know how you start to feel your joints getting looser and falling apart in pregnancy? That’s due to the hormone relaxin. Relaxin softens the ligaments holding joints together, so that the pelvis can move and expand a little bit during labour. For example, squatting can expand the pelvic outlet by 33%. So squatting or other pelvic opening positions can be excellent in labour of baby is coming very slowly. Please not that if things are going really fast, do not get into a squatting position, cos then things are going to go too fast.
Hope this information help! If you would like to get more useful info or to take prenatal classes in Surrey, Langley or the Lower Mainland, email firstname.lastname@example.org or call 604 809 3288.
I’m awake at 3 in the morning writing improvements to the lesson plans for my upcoming prenatal classes in May. I’m so excited I can’t sleep. These are going to be the best prenatal classes EVER! Muah hahahah!
In my page on Birth Stories, I talk about the experience that led me to becoming a doula – a positive experience. But what led me to becoming a Prenatal Teacher was the negative experience I had as a first time pregnant mum in the health unit’s prenatal class series. The teacher was nice enough – a retired nurse who cracked lots of jokes. The other parents-to-be in the class were nice enough, although we didn’t get much time to really interact or bond, as I had hoped. And I guess the teacher covered all the topics she was supposed to. Yet, when all the classes were over, I had a clear and distinct feeling that they were a total waste of time. And that we were left pretty much as unprepared for labour as when we had started.
The fact is, I had already read everything the teacher had said in pregnancy books, which incidentally, also did not leave me feeling prepared for labour. I managed to find a few books, at the time mostly by Sheila Kitzinger, that included several birth stories written by actual mothers. That I found infinitely more useful than the regular pregnancy textbooks. I really can’t understand how textbooks can be of any use to people about to give birth since labour is not a written test you’re going to take.
Anyway back to the classes. I asked a few other moms to be what they thought of their prenatal classes, to which they replied, “Well, it wasn’t that useful to me. But I wanted my husband to take it so he could learn.” Then I asked the husbands what they thought of the classes, and they said, “I didn’t learn anything useful.”
Great. So why the heck would people take prenatal classes if they were totally useless?!
I wondered for a long time about what would make classes more relevant to real mums in real birth. And the journey has been fascinating. Ok, truth be told, I find everything about birth fascinating cos I’m a birth junkie, that’s why I do what I do. But it brought me to questions of, who decides what is taught in prenatal classes, the history childbirth education, and the history of pregnancy books as well.
There is a range of types of prenatal classes available out there. On the one side is the “hospital-type class” which teaches people what to expect when expecting and what to expect when in labour and so on. That’s the kind of class I took in my first pregnancy, not cos I actively chose it, but because it was the cheapest kind and all I could manage at the time. These classes are typically taught by nurses based on their years of experience as a nurse.
Then there are the classes which try to promote theories on what helps women have a more natural birth. Childbirth preparation classes were first introduced by Grantley Dick-Read, author of the Book Childbirth Without Fear. He was so surprised when he witnessed a painless birth while attending a homebirth as an obstetrician, that he pioneered the “groundbreaking” concept that birth is a normal event. This was during the 1940’s when women in labour were routinely given general anesthesia and had their babies removed by forceps and other pleasant things. Then in the 50’s, Dr Fernand Lamaze, a French obstetrician, developed the Lamaze method based on what he had witnessed in Russia. It was Elisabeth Bing who then popularized it in America. At around the same time, Robert Bradley developed the Bradley Method “husband-coached childbirth”. Wow! husbands in the delivery room? Shocking!
I don’t know about you, but most of these founders of childbirth education classes seem suspiciously like men. I would hazard a guess that maybe they’ve never actually given birth before. Just saying. But they’ve seen birth, right? That counts. And yes, they’ve done a great service to improving the field of birth. But what about these women who were actually doing the birthing that the “experts” observed. I wonder what kind of classes they’d come up with if we got them into a room together and asked them to brainstorm up some classes. Would they be similar to the types of classes we currently have, or dramatically different?
I’m sure you can figure that one out.
Of course, over time, those techniques, those very old techniques, have been modified and improved upon. And there have also been some significantly new models of childbirth education such as Hypnobirthing and Birthing From Within. Birthing From Within was actually developed by a woman, Pam England, who actually gave birth. Unbelievable!
I quite like the little write up about the paradigm of prenatal classes that is developed out of the experience from the perspective of mothers themselves – Birthing From Within. Now we’re getting somewhere!
Hypnobirthing was also developed by a woman, Michelle Leclaire. Ok, by now you probably have a lot more information about childbirth classes than you’d care to have. So let’s get to the point.
Basically, birth is not a cognitive process. It is an instinctive process. And anything that involves learning a bunch of new information and trying to remember it in labour, is probably not going to be of much use. What is useful, however, is reconnecting with the instinctual part of ourselves and deepening an understanding of the experience of the natural process of birth as well as how to avoid factors that make it go awry. Of course all that is what I cover in my classes, duh.
I’ve developed the content of my classes over several years and included useful elements of many of the above schools of thought, as well as the knowledge I’ve gleaned from talking to hundreds of mums and dads and of course, from my own experiences of giving birth and supporting women in labour. So far the feedback has been great. Even people taking the refresher class who had already taken prenatal classes elsewhere before are so thrilled with my classes.
So that’s been encouraging for me to keep making more improvements in the direction of what works for real women in real life birth.
I have a deep hope to make classes a life-changing event, and to improve the world one birth at a time. So back to work on my class plans, and Have an Awesome Day!
ps. If you don’t live in Surrey or Langley and can’t make it to the group classes, I offer private classes anywhere in the Lower Mainland, BC, Canada. See Prenatal Class Schedules. And if you live somewhere else entirely, do your research and find a class that suits your birth preferences. I also do birth plan consultations over the phone for far away people. For more info check out Birth Plan Consultations.
The simple answer is, “NO, but for most women it is.”
No one actually knows why labor feels painful. There are many theories. It’s sort of like what causes period cramps and why do some women feel period cramps and others not?
The part of labor that is mostly “painful” is the contractions of the uterus which pull back on the cervix to dilate it. The uterus is the strongest muscle in the human body so when it gets going, it’s pretty powerful. The brain interprets these intense sensations as pain.
Some women either naturally don’t feel pain at all or deliberately work to mentally and physically relieve the pressure and interpret the sensations positively instead of as pain. I’m not saying it’s an easy thing to do. You can’t just say ‘mind over matter’. It’s a lot deeper than that. Some women feel so overwhelmed with positive emotions and endorphins and love that they have an orgasmic birth.
The majority of women however, do feel pain, but let me separate the “good” pain from the “bad” pain. If you think of the natural process of birth ie. animals, tribal people, people who give birth in their home surroundings, the pain is never more than they can handle. A bit of pain can be useful. “Pain with a purpose.”
A bit of pain sends a signal to the brain to produce corticosteroids, which is the hormone that stimulates the baby’s lungs to produce surfactant. Surfactant coats the lungs so that the baby can breathe air when it’s born. Babies born by scheduled cesarean without labor tend to have a slightly higher risk of respiratory problems because they don’t have enough surfactants. Also, a bit of pain can be useful in evolution for letting the mom know something big is happening so she needs to move to a safe place.
The other kind of pain is what I call “bad” pain. It is the kind of pain that is useful in letting us know that something is wrong, you need to do something about it. Think about when you have gotten a massage. The massage therapist presses on a sore point to relieve the pressure. It feels a bit painful, but it feels like a good pain. Then maybe she presses with her nails, or presses on a new injury. That feels like a something-is-wrong pain. You tell her to stop. Or like if you put your hand on a stove. The pain tells you to move. If you didn’t feel the pain, you wouldn’t know to move.
Labor is like that. There’s the normal intense sensation, and then there’s the something-is-wrong pain. The trouble is, as a culture, we have been programmed to believe that labor is supposed to be the most painful thing ever, so we don’t know what to do with that overwhelming intense pain. We just think, get an epidural.
There are a few factors which produce that kind of pain :
1. Being in a not so great position. Lying on your back is probably the most painful position to be in. It’s also the least optimal for the baby’s descent and rotation. In all tribal cultures studied, not a single woman labored on he back. The problem is, that’s the position we always see women giving birth in on TV. And hospitals tend to ask women to labor or birth lying back because the fetal heart monitor works best that way, and it is convenient for the hospital staff. If a woman is listening to the pain as information from her body, she would lie down, say, “oh that’s too painful,” then change to a different position. Some other more comfortable positions might be sitting, kneeling, standing or even lying on the side.
2. Another factor is having a labor that is induced or augmented with artificial oxytocin or prostaglandins. These can make contractions more intense than natural labor, and the uterus may not relax as much in between contractions. Other kinds of interventions can also restrict mom’s movement, disturb her from fully relaxing in between contractions and being able to go inside herself, breathe and focus while she is having contractions. These can cause a greater perception of pain.
3. Another huge factor is what is called the fear-pain cycle. When mothers feel safe, and supported, they’re bodies produce oxytocin effectively and when labor gets going, they produce endorphins. But when moms feel anxious, disturbed, unsafe, stressed or fearful, they produce adrenalins, which inhibit oxytocin, endorphins, and make the sensation of pain feel much more intense. This is telling the body that something is wrong. Mom doesn’t feel safe. This is when labor feels like unbearable pain. Knowing this, Mom and the people supporting her can help reduce her anxiety and help her feel safe and supported.
A lot of research has been done on having a Doula (professional, non-medical labor support) in childbirth. They found that doulas help reduce the need for epidurals, cesareans and instrumental deliveries by about half. The reason for this is that doulas are trained, and focused on reducing moms fear and stress as it comes up, and helping her feel safe, supported and confident in her own abilities. This doesn`t just make for a more pleasant experience. Moms`emotions in labor affect the hormones she produces, which affect the amount of pain she feels as well as whether labor will be smooth or complicated.
I teach a whole in-depth class on how to have less pain in labor, or even no pain, so It can`t be summarized effectively in a post. Let me know if you want to find out about pain-free birth. 604 809 3288.