Over the next several weeks, Team Preparing for Birth will be debunking some common myths surrounding childbirth education classes. Check back every Monday to see the newest post.

MYTH #1: “I’m having a homebirth, and my midwife will do all my education.”

Home birth families often see childbirth classes as an extra, rather than a valuable and necessary tool to help them have the birth they are hoping for. The most common objection they have is that they will be able to get all the education they need from their midwife. While midwives do educate their clients to some extent, this perception that they can (or should) cover everything is a myth, for several reasons.

1) Education is not a midwife’s job.

Just as obstetricians are not childbirth educators, neither are midwives. Just because midwives are more likely to do more education than an obstetrician, does not mean they give comprehensive education, and they should not be expected to. That is not their job.

Rather, a midwife’s primary job is to maintain the clinical safety and health of the mother-baby dyad. This will involve some education, yes, but only as a by-product of good midwifery care.

A good midwife will encourage her clients to be active participants in their care by reading, taking classes, and educating themselves proactively, instead of passively relying on the lack of intervention common to home birth. Midwives want clients who are thinking women, who take responsibility for their own care, and who can integrate what they learn in practical ways.

2) The reality of transport.

Another downside to relying solely on your midwife for childbirth education is the preparation for hospital transport. Realistically, around 10% of women and babies need something that cannot be offered at a homebirth, for whatever reason. It is not a midwife’s job to prepare you for the hospital.  Her job is to prepare you for birthing safely at home. Therefore, an expert on the hospital system is needed to prepare a birthing woman, in case of a transport. Most midwives spend very little time in the hospital, due to the low transport rate, so their expertise on local practices may be limited.

On the other hand, childbirth educators work very hard to stay up-to-date on all policy changes, protocols, and the general attitude of the staff in local hospitals. They often work (or have worked) as doulas, and have regular opportunities to interact with staff in the local hospitals that midwives simply don’t have. (This is not a criticism, merely a reality.)

While a midwife can go over what a typical transport looks like in her practice, a good childbirth education class will be able to prepare the client for what a hospital birth will look like. She can help the client to understand how to navigate the environment, and teach her how to communicate with the staff effectively.

3) The birth tool belt.

Midwives know that most women need a wide array of pain management techniques available to them, since an epidural is not an option at home. While a midwife will teach her clients the importance of stress management, emotional health, and relaxation, there is no substitute for a good independent childbirth course where you can actually practice tried and true techniques from all kinds of sources. This creates a solid foundation of knowledge, provides varying perspectives, and allows the birthing pair time and space to learn or review valuable tools for labor.

4) Prenatal appointments can only cover so much.

Even though midwifery appointments are much longer than typical obstetric appointments, it is still a very limited amount of time for a woman to learn all she needs to know about birth. Not to mention the birth partner, who may not be able to attend very many of the appointments. Childbirth education can fill in the gaps, empower a birthing pair, and provide opportunity to practice valid techniques in a real-world environment.

It is never wise to assume that your care provider will simply take care of everything, no matter who they are. Leaving the decision-making and responsibility solely in your midwife’s hands is not fair to her, to you, or to your baby. You owe it to yourself to take a proactive approach to childbirth education.

I wrote my first post for the blog at Preparing for Birth, and it’s up today! Go check it out, and come back for more when you can!

“Many men in our culture are fairly apprehensive about birth. Most have never seen a real birth, or talked about it outside of sex ed. They are often nervous about birth itself, seeing their partner in pain, the what-ifs, and all that may come after. They doubt their ability to support their partner in her journey, and wonder if they’ll be strong enough.”

CLICK HERE to read more at the Preparing for Birth blog.

Grace & Peace,
Tiffany

Many men in our culture are fairly apprehensive about birth. Most have never seen a real birth, or talked about it outside of sex ed. They are often nervous about birth itself, seeing their partner in pain, the what-ifs, and all that may come after. They doubt their ability to support their partner in her journey, and wonder if they’ll be strong enough.

In fact, they often doubt and fear and wonder just as much as their partners do, but are often not allowed to express it, because they’re not the ones giving birth, so they feel that they don’t really matter. They may feel like they don’t have much voice in the process, and are just expected to go along for the ride, smiling and nodding whenever the experts speak.

Yet, at the same time, they are expected to know everything about birth, protect their partner, communicate her wishes, and support her physically and emotionally without pausing for breath.

Many worry that they just can’t live up to all of that. It really is an awful lot to ask of one human being, after all. Especially since history shows us that there have always been many support people surrounding a mother during birth.

Still, many men don’t realize just how much they are capable of. They don’t realize that they matter, too, and that they can enter their partner’s birthing space with confidence, ability, and strength to meet the challenges of supporting a labor and birth.

So, how do we help fathers to step into the birthing space with confidence?

We free them to be who they are, that’s how. We let go of our expectations, and help them to form their own expectations and desires for supporting the birth of their child. We help them to see that they alone can define their role in the drama and sacredness of birth.

I would suggest two important things that may help a father gain confidence and acquire tools to help him fulfill the role he wants to play during birth: 1) Independent childbirth education classes, and 2) Hiring a doula.

The more a man knows, the less he will fear birth, and taking Childbirth Classes is one of the best ways to lower anyone’s fear level in anticipation of birth. Many men appreciate information given in practical, interactive ways, and independent childbirth classes are often right up his alley. He can join with like-minded dads, ask questions, and have his concerns addressed more readily.

Information is a great, big factor in helping couples manage their stresses and fears regarding birth—as much for the father as it is for the mother. As an educator, at the beginning of a series, I usually see high levels of apprehension, which quickly fade from week to week, to be replaced by realistic expectations and informed confidence in both parents.

This is just as powerful for the father as it is for the mother. When Dad has confidence in Mom’s ability, she believes in herself all the more, and Dad begins to see that he has power to influence her for the better! Dad is able to acclimate himself more readily to the realities of birth, and begins to realize that he is an important part of her support team. Perhaps the most important part.

He feels a little more ready to step into his support role, and probably has clarified what he wants that role to look like. He will feel more confident about what he can do, and more realistic about what he might not be able to do.

In which case, he may begin to consider…

…Hiring a Doula to help him fill in the gap in the support team he might not be able to fill himself. If he participates in choosing and hiring a doula, he is much more likely to have his own expectations met, as well as those of his partner. When Mom and Dad are both fully supported, Dad is far freer to just be and do what his partner needs him to be and do.

While he will likely remember a lot of what he has read and learned about, that information may become secondary to him during the birth, and take a backseat to more immediate concerns in his mind.

He may become simply focused on loving this woman who is birthing his child. And why shouldn’t he? Why should he have to remember every counter pressure technique? Every massage technique, position change, or even the water jug and bendy straw? Why shouldn’t he be the face close to hers, his eyes beaming his love, concern for, and confidence in her?

A doula allows Dad to be front and center in the support role he always wanted to fill for Mom, in whatever way makes the most sense for their individual relationship in this particular moment. If he wants to be the Expert – he ought to be equipped to do that. If he doesn’t, then he needs the space and freedom for that, too. Or anything in between.

When he is free, all his anxieties and apprehensions tend to fall away, and he finds that birth is a challenging, beautiful, amazing space to be in with his partner. He finds that he is strong to meet the challenge, just like she is. Together, they grow in strength and confidence, becoming truly ready to meet this tiny new person they have made.

Doulas help open wide the door, making the birthing space more navigable, understandable, and pleasant for fathers. This, in turn, can only benefit the mother as she is able to rest in the support of her birth team. She no longer feels concern for her partner, because he shows no reason for her to be concerned. She is able to just birth.

Then, we can just step back and watch, as he exceeds all the expectations we have laid on him, and as he steps into Fatherhood in the way that makes the most sense to him and his new family.

Tiffany Miller, CLD, CCCE

As a doula, I require all of my clients to put together a birth plan, discuss it with their care provider, and to provide me a hard copy. I make very few exceptions to this requirement. I believe firmly that a birth plan is a critical piece of the puzzle in good perinatal care.

As much as we want to believe that our prenatal care is individualized, it often is not. Even home birth midwives can get into a “this is how I always do it” habit, though that is far less likely. Still – I have learned to never take anything for granted when it comes to care providers.

I spend a good amount of time with each client in helping them form their own unique birth plan, and provide them with role-playing opportunities that teach them how to have open, honest, and clinical discussions with their provider about their individual needs. If I am hired late into the third trimester, that is almost all I end up doing prenatally – birth plan work.

It’s that important.

That said, I don’t particularly care for the term “Birth Plan,” and I use it only because that’s the common vernacular. I think the word “Plan” conjures up images of precise blueprints and/or legally binding documents. A birth plan is neither of those things, and the sooner we understand that, the better.

Instead, I believe that birth plans are tools designed to help you, your care provider, and any staff you encounter to communicate effectively about your individual needs and expectations regarding your care.

It provides a basic framework that helps your care provider and staff to better care for you, but it does not legally bind them to your every whim and wish.

Instead, a birth plan gives you and your care provider an opportunity to pursue individualized care together, and to be on the same page before you go into labor. It has the potential to build rapport, trust, and respect between you and your provider–a critical factor in enjoying a positive, healthy birth experience, no matter what the circumstances end up being.

For this reason, I really prefer the term “Birth Preferences,” “Birth Goals,” or even “Birth Desires.” Those make a lot more sense to me. When a birth plan is viewed this way, it is often much easier to mentally and emotionally process anything that derails those plans.

Birth is still unpredictable, and there are no guarantees, no matter how safe we have made it. The reality is that birth is like any major event we plan: There will always be at least one thing that does not go the way we expect it to, for good or ill.

Mommas get sick. Babies get sick. Babies get into funky positions. Mommas get exhausted. Heart rates get wonky. Side effects of drugs happen. Things stretch on longer than we thought, or go far faster than we anticipated.

Stuff happens.

Overall, birth is a safe and healthy process, but it has a lot of variables within a very wide range of Normal. Accepting that fact, and writing a birth plan with flexibility in mind is key to processing those funky things that happen during our births.

I find that the most flexibly written birth plans get the most respect from staff. They see clearly that my client has done her research, and has realistic expectations. Frankly, I find that my clients are more likely to get exactly what they want when their language is open and flexible.

I also find that when things get weird in a birth, staff and providers tend to bend over backwards to keep the spirit of the plan intact. They seem to view themselves as being on my client’s side, and try very hard to make it work within the parameters this particular labor has laid out for them.

My clients come out of these births processing all of it in a very healthy way. They understand that they don’t have to like what happened, but if they felt respected, understood, and as though their choices mattered, they are often okay in the long run. They understand that it’s okay not to be okay for awhile. They grieve the stuff they didn’t like, but are grateful for the support and good care they received within the circumstances their birth chose for them.

Care they might not have received had they not communicated clearly what they hoped for, ahead of time, via their birth plan.

So, when writing your birth plan, be careful about the language you use. Really examine how it comes across, and how you view your relationship with your care provider. Some basic tips:

• Open with a sentence like: “We understand that circumstances may arise that preclude the following desires, but we expect to be fully informed before consenting to any procedure that may be proposed, and we appreciate your help in achieving a healthy and pleasant birth.” This lets them know you understand that birth has a lot of variables, and that you are willing to work with the staff.
• Have a short introductory sentence or two explaining your overall desires. (Natural birth? Well-timed epidural?) The staff will automatically know what requests will go along with that, and you can eliminate a lot of specifics. For example: If you know you want an unmedicated birth, and state that fact right away, you won’t have to tell them you’ll want to move around, have dim lighting, etc…
• Keep it simple. It shouldn’t be more than one page long.
• Use bullet points and clinical language.
• Tailor it to your provider’s practices, as well as the protocols at your place of birth. If you know they do rooming-in, you don’t need to request it.
• Do your research. Take an independent childbirth class. Hire a doula.
• Take your first draft to your provider and ask specific questions. “Under what circumstances might you do an episiotomy?” This helps you know if something needs to be added or taken off the plan.
• Have a cesarean plan. Look up “Family-Centered Cesarean,” and choose your top 3-5 items you think might be important, and add those.

Be decisive and clear in your desires, but remember to stay open as well. Choose carefully your hills to die on, and let everything else go if it becomes necessary. Ask questions. Even if all you can think is to keep asking “Why?” That one word can gain you a lot more information when a decision becomes critical. Open your eyes, and walk forward confident in your desires, your ability to birth, and your ability to make good decisions for you and your baby.

You are already a good mother. Go for it.

I could write mountains of information on this subject, but this post would get too long. Did you write a birth plan? Why or why not? Do you feel your desires were respected? Do you feel it created a sense of cooperation with the staff who cared for you? Why or why not?

Grace & Peace,
Tiffany

It’s been awhile, birthy world! Thank you for your patience. I’ve had quite the interesting summer so far, how about you? Anyway. Today’s post.

Go ahead and go read this short article before you proceed here: Fear Makes Labor Longer, Study Finds.

Image found at seamlessbrand.blogspot.com

This is something women have known innately for thousands of years, and something that natural birth professionals have been preaching for decades.

We cannot make labor happen faster than it should. However, there are things we can do to slow it down – and harboring fear is one huge one. It’s called the Fear-Tension-Pain cycle. A phrase coined by Dr. Grantly Dick-Read, a pioneer in natural childbirth.

Essentially, it works like this: Mom feels the pains of her first contractions, and fear creeps in that she will not be able to cope when it gets harder. This raises her stress hormones, which ready her for flight, and she tenses up. At the peak of her contraction, her carried tension leads to a greater sensation of pain, and she again begins to fear what comes next. She fears she will not be able to cope, and the cycle begins all over again. Not much fun, I’m afraid.

How do we break that cycle?

1) Hire a doula.
I address a mother’s fears by listening to her, and helping her work through them verbally ahead of time if at all possible. This can even be done in labor. Even small fears have the potential to become big ones in the right environment, so never dismiss any fears you have as “silly.” Address it, work through it, and let it go as best you can.

2) Take an evidence-based childbirth class.
In class is where you can find all kinds of practical tips, tools, and techniques (hooray for alliteration!), for coping with any kind of pain or discomfort you may have during labor. It’s a chance for your support person to learn how to best help you, and you can prioritize ahead of time what techniques you would like to try first.

Also, the more you know about the basic anatomy and physiology of normal birth, the less likely you are to fear it. It kind of takes away all the mystery, and sheds light on an aspect of your womanhood you may never have really understood before. I know that very understanding was a huge help to me as I labored with each of my children.

3) Consider home birth.
No, really. Do it. Look into it. Especially if you have a strong aversion to hospitals and doctors normally. What better way to minimize fear than by being in your own space? Where everyone caters to your needs in labor. Where no one crosses personal boundaries “for your own/baby’s good.” Where you have the most control over the environment. Midwives almost always offer a free consultation, and it never hurts to ask questions! (Visit my home birth & midwifery link at the top of the page if you have more questions.)

4) Learn effective stress management techniques.
These don’t just work for labor – they work for life. They are practical things you can even teach your young children to do when they are feeling stressed. We all know that stress can make us sick, so learning to do this is paramount to all of us in the crazy-fast-paced world. Incidentally – many of the basic relaxation techniques taught in childbirth classes are great stress management tools!

Among many other tools, you can use prayer, physical relaxation techniques, massage, warm compresses, breathing, essential oils, and herbs.

Once the cycle is broken, and you are relaxed, your labor will progress much more quickly and bearably. You may even enjoy many parts of it! It’s not as overwhelming when you know that it is all perfectly orchestrated to bring your baby earthside as safely and effectively as possible. Eliminating fear from the equation allows a better cycle to work: Rhythm, Relaxation, & Ritual cycle (Penny Simkin).

Well, it’s not so much a cycle as it is a principle at work.When you are able to get into a groove of some kind, to find your rhythm, you are able to relax more effectively. You will create little rituals that mark time and space for you in a place where time and space mean almost nothing. It sends you to your primitive brain (a.k.a. “Labor Planet”), and helps you handle your labor as you were intended to handle it: one contraction, one rest period at a time.

When you are relaxed well, you are able to handle everything your labor brings forward. You can crest your contractions like waves, accepting them and holding realistic expectations of your own ability to continue working as long as you need to.

A woman relaxed in childbirth is a woman of power, strength, and faith.

A woman relaxed in childbirth allows her labor to work as quickly and efficiently as it was designed to. There is nothing to slow it down when fear is out of the way.

The beauty of it is that it also has a physiologic effect on your labor! Women, relaxed and uninhibited, will MOVE in labor. They will move a lot. And every movement of mother encourages the baby to move, which in turn encourages the cervix to move, which encourages mom to move, and on we go. The beautiful cycle of relaxation and courage!

Embrace it by educating yourself and taking nothing for granted.

If you have had children before, what was the one thing that helped you cope with each contraction the most? What led you to try that? What fears, if any, did you confront in your childbearing year?

Grace & Peace,
Tiffany Miller, CLD, CCCE

Join the #doulaparty on Twitter or follow along at DesirreAndrews.com, June 22nd 6pm PT/9pm ET to kick off summer birth work with something extra special!

I am very excited that Earth Mama Angel Baby is sponsoring this weeks live chat. EMAB has amazing products for all types of birth professionals and families.

A note from the EMAB Team:

Are you a midwife, doula, nurse or obstetrician looking for pure, safe products to comfort postpartum mamas and brand new babies? You’ve come to the right place! Earth Mama Angel Baby offers safe alternatives for your clients who are concerned with detergents, parabens, 1,4-Dioxane, artificial fragrance, dyes, preservatives, emulsifiers and other toxins. Earth Mama products are used in hospitals, even on the most fragile NICU babies, and they all rate a zero on the Skin Deep toxin database, the best rating a product can receive. Earth Mama only uses the highest-quality, certified-organic or organically grown herbs and oils for our teas, bath herbs, gentle handmade soaps, salves, lotions and massage oils.

Earth Mama now offers a Birth Pro Cart for wholesale pricing available for birth support professionals! Join Earth Mama Angel Baby on the #doulaparty chat Friday June 22 to talk about their new shopping cart plus answer any questions you may have. Earth Mama will be giving away Postpartum Bath Herbs and Monthly Comfort Tea, Mama Bottom Balm, Mama Bottom Spray, and a grand prize of their new Travel Birth & Baby Kit!