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Friday, July 25, 2008

There's A Big Difference

23 July, 2008

Is There A Difference Between Childbirth Information And Childbirth Skills?


When the author of this article had her first child in 1970 in the US, there was a huge societal expectation that expectant parents learn Lamaze breathing and relaxation techniques. By the 1980s this had declined. In the place of learning skills, there became a high social expectant that families be given information which would lead to informed consent and the creation of Birth Plans. This has persisted since then.

Although information, choice and plans are vitally important when planning for the birth of our children, we have intentionally led people to believe that birth is such a natural aspect of women’s lives that no skills are necessary. Often women are told ‘You’ll know what to do on the day’ or ‘cats don’t need to be taught to birth neither do you.’

Although birth advocates hoped that given families information about the medical assessment, monitoring and procedures that will often accompany birth that the choices they make will create a less medical approach to childbirth. Unfortunately this has not succeeded. We must now consider a new approach to birth that brings childbirth skills back into what makes common sense to the public and to birth providers. This becomes a ‘reframing’ of public opinion.

A man by the name of George Lakoff defines: ‘Reframing’ as changing the way the public sees the world. It is changing what counts as common sense.’

Gathering information is an entirely different process than developing skills. Information is collecting facts, data, statistics and knowledge. These can be used to make choices, learn about the process of childbirth and know more about care options. However, information is often a passive yet mental process. Learning and using childbirth skills is an activity. Skills must be learned as a how-to, practiced and then used.

Unfortunately but true, childbirth is surrounded by much political debate. Since the 1980s, there have been two sides to this conversation that has effectively required expectant families to place themselves in one or the other camps. It’s as though these two sides are constantly in conflict with one another: natural vs medical, home vs hospital and doctors vs midwives.

Part of gathering childbirth information and making choices revolves around choosing which side you are on or where you hope or plan your birth to be. By doing so there becomes a judgment surrounding birth, placing one type of birth as better than the other … and that depends on what side you take.

Childbirth skills swing both ways and can do much to heal the chasm that now exists. Every pregnant woman worldwide shares the same body no matter what birth they will have. This means we can all prepare our birthing body for the birth of our baby. Because we share the same body whether we’re tall, short, thin or fat; whether we smoke or eat organics or having our first baby or 10th we can all enjoy preparing our birthing body for birth. All of us have to let our baby our of our body whether this will be through labour and delivery or a cesarean birth.

Preparing for birth and learning birth skills should become what ‘the public sees as common sense.’ Pregnancy is such a unique part of life even though it’s natural and may be full of medical issues. We can thoroughly enjoy preparing our body for birth. In the process of preparing our body, we can learn birth and coaching skills. Men have the same body and if they are going to be with us during the birth they need to take an active role. An active role can best be achieved by learning a set of coaching skills.

Birth skills can range from learning ‘techniques’ to learning specific skills such as Directed Breathing, the Pelvic Clock or Deep Touch Relaxation, Kate’s Cat, Hip Lift and Sacral Manoeuvre. Techniques definitely have helped many of us work through labour however techniques often fail because we don’t really understand what they are meant to achieve.

Learning childbirth skills that are based on our human body and behaviors are much simpler to use. All of us breathe in a relaxed manner when we feel no pain, are not working hard nor in stress. However, when these things occur our breathing changes. We can learn which types of breathing create relaxation and then choose to use them whether we experience the pain of contractions or during surgery and recovery.

Every birth provider loves to work with a woman who is using her own set of skills because they do not interfere with assessments, monitoring or procedures. Fathers who know how to help and actively participate in birth are just adored by midwives, obstetricians and staff. When couples work together with their baby’s efforts to be born, everyone is exhilarated. Birth becomes a positive experience that is actively worked through.

So when you are thinking about birth just keep in mind that gathering childbirth information so you can make informed choices is only part of what makes common sense. Learning, practicing and using birth skills is what you will do on the ‘Big Day’ and are well worth it. You’ll forget much of the information and Birth Plans will either eventuate or change however, your skills can be used with each breath.

Using skills are what make any person feel empowered particularly when you have the right skills for the task at hand. Birth skills will give you the edge, the ability to work in the present time with what is actually happening. Skills are adaptable. Having birth skills also reducing any sense of shame, blame or guilt. Instead of focusing on what ‘they’ are doing to you or around you, you focus on what you are doing for yourself. This keeps you focused more on your management style than on being passive to events.

George Lakoff is correct we need a reframing of childbirth if more families are to have positive memories of their birth experiences. With birth skills all births can be thoroughly enjoyed and become the self-empowering experience they should be.

Wednesday, July 23, 2008

Today I Gave Birth

23 July 2008

Twenty-five years ago I gave birth to my son. My daughter was born 12 years earlier so I've been part of the enormous changes in childbirth.

I didn't know The Pink Kit skills when I gave birth to my daughter in 1970s. Between then and 1892 when I gave birth to my son, these skills developed.

I didn't plan for my son to be born 8 weeks early. I didn't plan to be far from home and in a strange town. I didn't plan on having to arrive at a strange hospital at 3:30 in the morning in labour.

However, I did have my skills!

This permitted me to work with staff and the doctor through their concerns that my child could be very premature in size. Because I behaved myself (terrible word but one that helps others see that you are coping and managing some event well) they were less concerned.

Basically, they watched as I birthed him myself. Every single moment of the labour I used one or more of my Pink Kit skills.

Between contractions (although they didn't want me to get off the bed) I went around my Pelvic Clock, softening every single place inside my pelvis. As a contraction started, I knelt at the end of the bed and kept my pelvis open and soft.

I used my Directed Breathing at each inhale and exhalation. I also went around my cervix using the Cervical Relaxation and made certain that my sacrum was mobile.

As each contraction ended, I then went back into my most relaxed position so I could once again go around my Pelvic Clock.

Whenever my contractions notched up a peg, I checked myself. The doctor then wanted to check me as well and that was fine. Yes, I had to lie on my back for those few moments but I didn't have any difficulty staying in control of myself and immediately got into the position I wanted to given that I had to remain on the bed. But it didn't matter whether I was on the bed or floor, it's all in the mind and body how we perceive of ourselves.

Anyway, within an hour and half I could feel I was almost dilated. They wanted to take me to theatre to birth so they moved me on a rolling table and put me in the middle of bright lights with everyone dressed in greens.

Although not my preference, none of that mattered. I was fine doing my work and frankly it didn't matter what was going on around me.

I needed some lubricant while I massaged my vagina between each contraction. During each pushing contraction, I kept my hand on my baby's head just to guide him. I had four contractions and he was born.

Actually he flew out ... and grew up to be a pilot! They whipped him off to the intensive care while I birthed the afterbirth.

No, I would have preferred something different but I had what I had and I wasn't going to waste one moment of MY experience!

The doctor asked me to remain in bed for 4 hours before I went to see him. He was fine. Five pounds and 8 weeks early. He needed a wee bit of oxygen but within 12 hours he was fine.

I took him home the next day. The doctor would have preferred he stay longer but we agreed that I would come back every few days and of course, if there were any problems I'd call.

This is the bottom line .... because I behaved myself, the doctor trusted me to not be stupid and ideological. Do you know what I mean?

Having Pink Kit skills keeps you focused on what's important ... doing your own work. It might not be the perfect birth ... but boy it sure was. I'm incredibly proud, 25 years later, about my personal experience in how I birthed my son.

Since I've traveled extensively in traditional communities, I know that I live in a privilege country where medical care is available, we're not a war, there is no disease threatening us, there's no drought, plenty of food, no flood or earthquake.

Birthing in hospital is a privilege to millions of women worldwide. But that didn't mean I couldn't do the birth I wanted. What I wanted was to do the birth where ever I gave birth AND I DID.

Now I share with millions of others the skills they need to know to do their birth. Take charge of yourself, get on with it and no matter what type of birth you have you can do just what I and hundreds of thousands of women and men have done since my son was born ... give birth!

Monday, July 21, 2008

Birth Is Guaranteed

21 July, 2008

One Hundred Percent Of Pregnant Women Will Give Birth … One Way Or Another.

Hope you agree with the title. You are never pregnant forever and aren’t you glad of that. Yes, unfortunately some pregnancies end with a miscarriage.

The operative part of the title is actually ‘one way or another.’ As a reader, you are unique. Your life is full of your life and the choices about birth centers around your life. No one is the same. Everyone is different. Is that accurate?

Don’t all humans blink, cough, have one head, breathe in our nose and put food in our mouth? In fact, we have much more in common than differences. During pregnancy, no woman stores her baby behind her shoulder blades.

There are only two ways to give birth: surgical delivery (a very new invention) and out from ‘down there’ (the historic way).

Whichever way you give birth, your body is preparing for birth from 24 weeks onward. Doesn’t it make incredible common sense that we prepare our pregnant body for birth and learn good birthing skills? Well this should make commonsense. There are two reasons. First, you can totally enjoy preparing for birth. It doesn’t happen frequently and it’s such a special time. Enjoy, enjoy and enjoy. This also brings you closer to your baby and partner and brings your partner closer to your pregnancy. What’s neat is that men have the same body so it’s easy for him to help you prepare your body for birth.

Secondly, birth is such an important and big event in life that you really should be working with your baby’s efforts during the birth whether it’s the new or historic way. Birth is birth.

Birth is full of excitement. Birth is a process for both the woman and the baby. At first the woman provides a space for the baby to grow and then the baby is working to come out of the woman’s body and the woman’s body is responding to the baby’s work.

This is a wonderful time to use birth skills such as Directed Breathing, the Pelvic Clock or Deep Touch Relaxation. When these skills are learned by you and your partner, you work together as a family which is about to become a larger family. Enjoy the time together. You can use your birth skills and side by side coaching skills at every moment of each contraction or during the surgery and recovery if you have a cesarean delivery.

By using your birth skills you get to impress in your memory what you have done for yourself in whatever birth you have. The birth memories you create have less to do with what happens to you than what you do for yourself. We can embrace what we share as human beings which is very neat. This means we can appreciate our uniqueness and yet feel connected to the backward and forward longevity of our species.

When you use your birth skills you will have a positive birth experience. You’ll feel competent, capable and confident about your role in the birth of your baby. That’s a wonderful, wonderful feeling no one can take away from you.

Sunday, July 20, 2008

Fathers ... and VBAC

July 19, 2008

The reason for a previous cesarean delivery unfortunately does not fall into the ‘one only reason’ category. There are so many reasons why a birth ends with a cesarean delivery. Now you are faced with your partner’s decision (which may or may not have been equally or decision) to attempt a vaginal birth after a cesarean or VBAC.

Now you are faced with having to take a role you probably feel totally unprepared for. That’s a natural feeling for fathers to feel. A vaginal birth after a cesarean delivery (vbac) is still a topic of political debate between the medical community and the consumer … or pregnant woman. Often fathers feel excluded fully from the discussion. Your partner has very emotional reasons why she wants to have a vaginal birth.

Often her feelings and emotions seem in conflict with the medical community’s opinion that birth is risky enough much less adding the risk of attempting a vaginal birth after major abdominal surgery. Your partner might find support from other women who have successfully had a vaginal birth, but rarely will you hear from a father who has had to support this experience.

Well things can change. You can’t go back and re-do the previous birth but you can do a great deal to have either a successful vbac or a successful repeat cesarean. Oh goodness, why should this article even include a successful repeat cesarean if the goal is to have a vaginal birth after a cesarean birth?

But it’s important to go down this path as well. There aren’t really any women who will insist on a vaginal birth when they really know their baby is at risk. Parents will lay their life down for their child and that includes women who desperately want a vaginal birth experience.

With the right birth skills, any birth can be a positive experience. Preparing for birth is something that should happen during pregnancy. In fact, pregnancy and giving birth need to be tied together through learning both birth and coaching skills. Your job is to learn coaching skills.

Certainly you’ll be faced with so many things to think about. And many fathers do not feel particularly consulted. Preparing for childbirth is about: the choices/or lack of choice your partner has, the health issues of both your baby and your partner and your doctors or midwives’ opinions about a vaginal birth after a cesarean.

Wrapped around all of these complex issues is your relationship to the mother of your child. Having a vbac is an emotional decision for most women. They feel they have missed out on a primal female experience. There’s not much logic often in the decision. This isn’t right or wrong. And you have the right to ask your partner if she wants a vbac no matter what the outcome.

You’ll learn that women will say ‘I’ll have a cesarean if I think it’s necessary’. What she wants from you is support to try to have a vaginal birth as long as she and your baby are fine. And this is reasonable.

If you want to help make this happen, you must get your head turned in the right direction. It’s important for you as a man to realize that all pregnant women (100%) will give birth one way or another. This is essential to really know. Once you totally ‘get this’, you can take the next step and realize that during pregnancy is the time to learn birth skills (for your partner) and coaching skills for you.

Enjoying preparing for the birth of your baby can take place whether the birth is vaginal or by surgery. Birth is birth. This means as a father, you absolutely must learn a good set of coaching skills. Coaching moves beyond ‘support’. To support a woman in labour is basically a rather passive role. Coaching is not telling women what to do. It means working with the woman at every moment of this dynamic process whether this is one contraction following another or whether it’s during the surgery.

As long as the woman is awake and not unconscious, she still will breathe and her body will be in some position. This means she can always use breathing and internal relaxation skills at every moment of the birth process. You can help her do that and be an equal participant to that process.

Birth is actually a verb rather than a noun. Birth is also a process rather than an outcome. That’s why taking time during the last 16 weeks in pregnancy to learn birth and coaching skills adds a wonderful component to your partnership and your closeness to your child.

Another thing about birth that men have to understand is that it’s a very physical experience to our body. This body is something that both women and men share in common. We all have the same bones, muscles, can blink, cough and relax when we pay attention to doing that.

This means there are a set of coaching skills that fathers can learn and practice during pregnancy that increase confidence, brings you closer to your partner and baby. This is all good.

Then you can take a natural leap into ‘The Birth’. There are women who labour and then have a cesarean delivery. There are women who labour and have a vaginal delivery. There are women who have a cesarean delivery without having contractions. But keep in mind, birth is birth and all pregnant women will give birth one way or another.

This means as a man, you can see birth as an equal opportunity experience. You can bring your coaching skills to whatever birth your partner has. By working together with a shared set of birth skills based on our human body means that both of you can have a positive and fulfilling birth experience.

Just remember to bring your coaching skills into whatever birth is happening. Bring breathing, relaxation and great communication skills to your birth. Your doctor or midwife will love to see you, as a man, really helping your partner give birth. Birth is an action and coaching is the action that helps the woman accomplish her task.

Is a vaginal birth after a cesarean possible? Of course it is. This is much easier to accomplish when you have great coaching skills such as Directed Breathing, The Pelvic Clock and Deep Touch Relaxation and have taken the time during pregnancy to learn them. However, your goal must be deeper. Your goal must be to learn coaching skills during pregnancy and use those coaching skills in whatever birth you have.

Birth is birth and every birth can be the most enjoyable experience as well as an experience that grows your closeness as a couple and family. No family should be left with shame, blame and guilt around the birth of their children.

When pregnancy becomes connected to learning how to birth for the woman and how to coach for the father, then birth will become something we do no matter what by working together. When a vbac has been achieved because of the childbirth preparation you have done during pregnancy, then you realize that there are very specific skills you do need to accomplish the task.

So, as a father supporting a vbac, get stuck into learning coaching skills from 24 weeks of pregnancy. Every day that you practice together breathing and relaxation, you both feel more confident.