Lessons in Childbirth Education
Thank you again to Milon Nagi – writer, blogger, workshop facilitator and overall awesome volunteer for Choices in Childbirth!
At our latest Healthy Birth Choices workshop, three sets of new parents shared their experience of Childbirth Education and spoke of how their classes prepared them for labor and birth. Shara Frederick, doula and childbirth educator, gave us an introduction to some of the main schools of childbirth education – Lamaze, Bradley, CEAMNY and Birthing From Within. While the various schools have individual approaches, all are grounded in the idea that birth is a normal physiological process. All aim to educate expectant parents about this process and help them prepare for their own experience of childbirth. We were also joined by Dr Charles Swencionis, psychologist and Hypnobirthing instructor, who led us through a sample self-hypnosis exercise. Hypnobirthing particularly emphasizes learning to relax and decondition from fear, he told us. Fear causes tension, which causes pain. If we can relax it can ease some of the physical sources of pain in childbirth.
Michelle was planning a home birth in Queens, but, on her midwife’s recommendation, she and her husband decided to take a Home Birth class based in Brooklyn. “It was good to be among others who were also preparing for home birth and who weren’t weirded out by it”, she said. They found their classmates had interesting perspectives and questions they themselves may not have thought of. The class gave her husband “the bullet points” of what to expect and helped him feel more comfortable with them. He felt the class brought him a kind of confidence about birth that he did not get from reading books. Once the time arrived, he said, “I just felt like we kind of had this.”
Their class was spread out over four weeks, which they found very helpful as it gave them time between sessions to discuss and digest what they had learned. Michelle felt there was no way she would be able to remember everything. “But it stuck in the back of my head,” she said. “It just came out during labor.”
They learned a great deal in the class about what to expect of labor and also about what might happen should they need to transfer to hospital. One of the most striking things she remembers is the story of a couple who timed every single contraction over a 24 hour labor and found they added up to a total of 3 hours. That didn’t sound so bad, she thought – especially in 90 second bursts. “I knew if I could get through 6 breaths, I was golden.”
She hung on to this thought in labor, counting off 6 breaths through each contraction. Eventually she found herself in the birth pool set up by their window, her midwife, husband, doula and midwife’s assistant nearby. Mozart was playing, the lights dim, the water the perfect temperature, when her daughter emerged into the world. “It was just an amazing experience”, said Michelle. “For me, it was the perfect place to be – and I got to sleep in my own bed.”
Heather was familiar with the idea of Hypnobirthing from conversations with a friend who used it for her own birth with a midwife. From her reading and from conversations with her friend she felt confident in her ability to give birth naturally: “Women for thousands of years have had babies without drugs,” she told us. “Our bodies are made to do this… It’s important to visualize what you want the experience to be and stick with that.”
Heather chose an OB who was a friend from college and decided to hire a doula – which her husband later described as “the best money we ever spent.” They decided to take private Hypnobirthing classes, for which their instructor came to their home and, she says, basically taught them to meditate. “The one thing I practiced all the time was the breathing”, she told us, recalling one time she almost fell asleep on the subway and missed her stop while listening to her birth affirmations on her headphones.
Heather’s labor started slowly overnight. She was already 3cm dilated and feeling confident that her body was doing “exactly what it was supposed to.” Her contractions woke her overnight, but she felt able to carry on with normal life, even talking to people on the phone and working during in the morning. Then, at 11.30am, her water broke and things suddenly got more intense. She continued to labor calmly through her contractions: “I would breathe and breathe and breathe, and they would pass. And in between, I literally could have fallen asleep.”
It was only when their doula arrived that they realized it hadn’t occurred to them to call their doctor. Feeling an urge to push with each contraction, Heather got dressed and they made their way to the hospital. Things went fast: “We got there, I pushed and 45 minutes later the baby came!”
While Michelle and Heather both chose to have a doula on their birth team, Kimberly didn’t feel this would be the right choice for her. She felt completely comfortable with her partner, Ian, and wanted him to be her primary labor support person. They chose Bradley Childbirth Education classes, in part because of their emphasis on the partner’s role (Bradley traditionally focuses on “Husband-Coached Childbirth”).
Kimberly and Ian felt their classes gave them a chance to really focus together on their plans for birth. “It was really nice to have a study group, in effect,” said Ian. Different people had different ideas and expectations about things like how they would get comfortable in the hospital or at home. For Ian, this process helped lower his level of anxiety about the birth. “You may not know what the right answer is,” he said, “but having thought about it and asked the questions helps you be able to say, ‘Okay, I can do this.’”
They also appreciated the opportunity to talk about different approaches to pain management and to practice different exercises and coping techniques. One involved holding a piece of ice for 90 second bursts first in a hand, then on a wrist, then on their necks. “It really hurt!” said Kimberly. “For me, knowing it hurt but it was going to be over was really helpful,” she told us. It also helped to understand that the sensations of childbirth are pain with a purpose. “It’s pain – not danger,” as Ian noted.
When Kimberly woke to her water breaking with a gush, they walked the 20 blocks to their hospital to be checked as per their OB’s policy, expecting to be in early labor for some time and to be sent home. After some uncomfortable time spent in triage and some confusion at the hospital, she and Ian began to realize she was further in her labor than the staff understood. They decided to admit Kimberly to Labor and Delivery – and less than 2 hours later their son, Miles, was born. “If we’d gone home it would have been a home birth by default!” Ian told us.
The knowledge and understanding of the physiology of birth that Ian had gained through their classes helped him to recognize some of the signs and understand how far in her labor Kimberly really was. What’s more, he told us, the classes helped him internalize the importance of learning how to comfort his wife and gave him the tools to do it. After all, in his own words: “It’s all about comforting the woman in labor.”