I get this question quite often working with first-time moms. They want the easy labor without the epidural but they sometimes lack the confidence that they truly can achieve a medication-free birth. I’m not sure that “easy” is the best word to use in combination with the word “labor”. After all, labor is work! That said, if you prepare for labor and birth well in advance of your guess date, you’ll set yourself up for an easier transition into labor than if you didn’t prepare. And if you do the preparation in advance you’ll feel less stressed when you’re considering the question: “When should I go to the hospital for labor?”
So, how do you get realistic about the work of labor and birthing without shattering your vision for the perfect natural birth? If you’re wondering how to have an easy labor you’ve got to consider all the things that matter in your birthing experience. Basically, you need a birth plan.
What can a birth plan do for you? What I love about having a birth plan is that it helps you get really clear on how you want to give birth.
Here are some questions to consider: What do you want your labor to look like? How do you want your partner to support you? If you really want to know how to have an easy labor, you’ve got to know what “easy” means to you? Does it mean laboring in whatever position feels right, intuitively? Does it mean laboring in the water? Does it mean having lots of tools like a birth ball or a sling or a rebozo to help you labor in positions that will help to bring your baby down into the birth canal? Does an “easy” labor mean laboring at home as long as possible until you’re nearly 10 cm dilated so you can focus on pushing at the hospital or birth center?
It’s really important to know what your desires are, what your non-negotiables are, and how you want your partner to support you. When you know these three things, then you can really start to figure out what an “easy” supported labor looks like for you. For example: Do you want to hire a birth doula to support you through the labor and birth? Would it make sense to find online childbirth classes that would be a good fit for you and your partner so you could learn the information on your own schedule?
Maybe you need more tips for natural birth. When you’ve never given birth before, it’s hard to imagine sometimes what natural birth might look like. I really encourage my clients to focus on learning the positive stories about natural birth. One of the books I recommend to my clients is Ina May’s Guide to Childbirth. I love this book because it is filled with positive, empowering birth stories.
Maybe a “natural” birth isn’t what you’re looking for and that’s fine too. That said, it’s important to remember that no matter what your plan is for dealing with the contractions or the “pain”, there will inevitably be some time during labor that you’re at home. And that is worth thinking about!
Thinking about how to have an easy labor really has to do with thinking about your values and considering what “easy” means to you. How are you going to feel the most relaxed in labor? Does the idea of out-of-hospital birth make you too nervous? Or vice versa: Does the idea of hospital birth make you feel stressed and anxious? There is no right answer other than what’s right for you personally and as a birthing couple.
In working with my clients I find that the most important element is transparent discussion between you and your partner about your expectations for labor and birth. I cover this topic in my online childbirth classes so that you can discover as a couple how you’re going to work as a team when Labor Day arrives.
How do you know which online childbirth classes to take? I’m biased of course, but honestly it depends what you’re looking for. There are several different methods of preparation for birthing out there, including HypnoBirthing, Lamaze, and the Bradley Method to name a few.
What I love about what I teach is that I teach couples how to make decisions as a team. If your life partner is going to be your main labor support, then before you jump into a class you’ve got to be in alignment with your vision for your labor and birth.
In a nutshell, I teach couples how to get really clear on the “how”, “where”, and with “who” they want to labor. In my online childbirth classes, we basically create a roadmap that makes it easier to bypass bumps in the road. The clients I work with have a solid birth plan and the best part is they know how to pivot when the bumps show up (sorry, couldn’t help saying “bump”). 😉
Want more information about the online childbirth classes I offer? You can get more information here: https://peaceful-pregnancy-joyful-birth.teachable.com/p/birthplanningcoursesummer/
Thinking about taking a HypnoBirthing course? If you’re local to Minnesota, I highly recommend the hands-on courses offered by Flutterby. You can learn more here: https://www.flutterbybirth.com/
It’s amazing how many times I get asked this question: What’s the difference between a doula and a midwife? I love this question because it opens the door for women to learn more about how to have an empowering, supported birth experience.
When I answer this question, I simply say: Doulas are trained to offer emotional and physical support to moms in labor. Midwives catch babies.
Of course the answer above is the VERY abbreviated version, but it’s true. Then I go on to say that doulas are not medically trained. Instead of attending medical training, doulas complete a doula training course. Sometimes doulas also complete a doula internship like the one offered by the Minnesota Birth Center, https://theminnesotabirthcenter.com/doula-interns/.
Doulas begin their practice connecting with expecting moms that desire extra support throughout their pregnancy. Doulas focus on providing evidence-based information and helping moms advocate for themselves in labor so that they can experience their best birth. Many doulas pursue additional certifications like the IBCLC certification, which stands for International Board Certified Lactation Consultant.
Your doula can also be a wonderful support for your birth partner. Sometimes my clients worry that hiring a doula to support them in labor will make their husband feel obsolete. Quite the opposite!!! When you hire a doula you’re giving your husband or birth partner a safety net. Doulas can help lower the level of stress that birth partners experience when they see their loved one in pain or working hard to push their baby out.
Many dads have never seen a birth before. They’re not sure what to expect. So expecting your partner to be an amazing labor support person when they have no experience and no exposure to labor and birth just isn’t fair. I always reassure my clients that I’m there to support them and their partner. In fact, the majority of my “dad” clients report that having a doula during the birth was amazing and made their experience of meeting their newborn more enjoyable.
What about midwives?
There are three types of midwives. However, for the purpose of this blog post I’ll focus on Certified Nurse Midwives or CNMs for short. Certified Nurse Midwives are Registered Nurses that have pursued advanced medical training in a Masters or Doctorate level program. Typically they have 6 – 7 years of training in their field (if you include the years of study to achieve the Bachelor or Science in Nursing degree).
CNMs have all of the training required to provide care for moms during pregnancy, labor and birth, and postpartum. CNMs also provide care for newborns. When you birth in a birth center, for example, your CNM will do the newborn exam.
CNMs also provide well woman care! So even if your baby is a year old, you can still get care from your midwife. You can schedule your annual exam or be seen for family planning.
Finally, it’s important to note that doulas and midwives work together to support laboring moms in birth centers and hospitals.
Having a doula at your birth means that you and your birthing partner get support that is tailored to you. Having a doula at your birth means that you have a better chance of having a vaginal birth.
I also believe that having a birth doula keeps your medical team accountable. When you have another professional in the room like a doula, it encourages nurses, midwives, and physicians to provide excellent care. Doulas provide that extra layer of comprehensive care that is often missing in our health system.
Lastly, let’s not forget the amazing support that postpartum doulas provide! You’ll find doulas that offer pregnancy, birth, and postpartum support. You’ll also find doulas that specialize in postpartum support specifically. Specialized postpartum doulas can help with baby care, troubleshooting breastfeeding, preparing nutritious meals, and helping moms transition during the intense and beautiful postpartum journey. For a preview of what postpartum doula services look like, I recommend taking a look at the services offered by Midwest Doulas. You can find the website here: https://www.midwestdoulas.com/services/.
I’ll provide some resources below so that you can learn more about doulas and midwives.
In the meantime, you should know that most doulas are hired by the families they work with. So, if you’re planning to have doula support, start planning for that investment now. It will be so worth it! You can create a doula fund, for example. Consider opening a savings account and contributing to it during your pregnancy so that you have the funds to hire a doula when you’re ready.
To learn more about doulas, visit https://www.dona.org/.
To learn more about Certified Nurse Midwives, visit http://ourmomentoftruth.com/.
To learn more about how an IBCLC trained doula or RN can support you, visit https://www.ilca.org/main/why-ibclc/ibclc.
Rising Cesarean Birth Rate in the United States
The number of women delivering by Cesarean section in the United States has been increasing in recent years. The California Maternal Quality Care Collaborative (CMQCC) suggests that the Cesarean rate in the U.S. has risen by over 50% in the last 15 years! (CMQCC, 2016). In fact, in Louisiana in 2017, the Cesarean rate reached a high of 37.5% of all live births in that state.
Minnesota is still significantly above the recommended Cesarean rate of 10% to 15% as advised by the World Health Organization with a whopping 27.4% of all live births in 2017 being births by Cesarean section (CDC, 2017). Surprisingly, the Cesarean section statistic varies from institution to institution. Certain hospitals have higher Cesarean rates than others (CMQCC, 2016).
Higher Cesarean rates have been linked to reasons such as induction of labor, having a high-risk pregnancy, failure on the part of health care providers to allow adequate time for the normal course of labor, and fear of being sued. Although it is excellent that women in the U.S. have access to surgical care when required, women are also paying the price for delivering by Cesarean section.
Just one delivery by C-section can increase a woman’s risk of suffering from future pregnancy and birth complications. Moreover, many women are still discouraged from having VBAC (vaginal birth after Cesarean) deliveries due to the fear of uterine rupture, even though evidence supports offering women the option to attempt a VBAC (Motherly, 2018).
In summary, if women are not aware of the risks associated with birthing by Cesarean section, I expect that the rates of delivery by Cesarean section will continue to stay at an all time high and even potentially increase as women begin to accept this method of delivery as the new normal. Currently one in three moms in America gives birth by Cesarean section (StatNews, 2015). Giving birth by Cesarean section is becoming the new normal.
Rising Maternal Mortality and Morbidity Rates in the United States
A recent Minnesota Public News article points to the rising maternal mortality and morbidity rates in the U.S. (MPR News, 2018). Sadly, the U.S. ranks below many other developing nations in terms of maternal mortality and morbidity (Maternal Health Task Force, n.d.). This may seem surprising given all of the access to technology, medications, and surgical options in this country. However, one of the downfalls of access to all of these excellent tools and opportunities, is the risk of overuse especially in situations that are truly low-risk.
In fact, the failure to focus on this growing problem of maternal mortality can be seen in the fact that maternal deaths related to pregnancy, birth, and postpartum complications are not required to be reported as such in all states (The Pacific, 2017). Many maternal deaths are improperly recorded as caused by another event, even when the death was very likely caused by sequelae associated with pregnancy, birth, or postpartum complications.
Postpartum Depression Rates
Numerous magazine and nursing journal articles have pointed to the prevalence of postpartum depression in new mothers in the United States. It is estimated that rates of postpartum depression in new moms can be as high as 1 in 5 women (CDC, 2017). Unfortunately only a fraction of all women with clinical signs of postpartum depression ever receive adequate treatment. Some of the reasons postulated for why the rates are so high are: isolation, lack of community support, lack of sleep, difficulties with breastfeeding, and birth trauma.
The high numbers of women struggling with clinical signs of postpartum depression is not surprising given the limited support that women receive after delivery. Most women are not seen until 6 weeks postpartum after they are discharged from the hospital. Moreover, many women experience the reality of their partners returning to work after just one week of paternity leave.
European health systems have pointed to the fact that this significant gap in care delivery is unacceptable. It’s important to realize that there are many issues that can be identified and successfully intervened upon before the 6 week postpartum visit. Issues that, if left untreated, are likely to get worse.
How Can Virtual Doula Support Help?
Virtual Doula Support can help tackle this complicated array of issues in maternity care today by offering evidence-based educational information and materials that are delivered in a format that expecting moms are desiring, specifically via online courses, webinars, and videos. Moms today are busier than ever working at demanding jobs in their careers and managing their homes and families. I hear often from expecting moms that they struggle to find time in their calendar to fit in a prenatal education or birthing class. As a result, overscheduled moms are missing out on getting access to valuable information that can help them and their partners make healthcare decisions that are aligned with their values and potentially save their lives as well.
Another key point to consider is that the majority of women of childbearing age are not familiar with midwifery care as an option. In fact, many moms tell me that they do not know the difference between a midwife and a doula and there is a huge difference! This example shows the lack of information that is being passed on to women about their choices for healthcare providers, especially if they desire to have a vaginal, low-intervention birth.
The use of birth doulas in the U.S. is still not a mainstream practice and in many instances is reserved for those women that can afford to pay out of pocket for the service (Evidence Based Birth, 2017). Even though we know that having a doula present as a support for moms at a birth improves birth outcomes, many women are still not aware of or able to access this valuable service. Virtual Doula Support aims to connect moms and partners with critical information to help them have the best chance of avoiding a Cesarean section and recovering from childbirth with wraparound support.
Additionally, because Virtual Doula Support offers expecting moms the opportunity to participate in community via the private Facebook group, moms are less likely to feel isolated as they navigate pregnancy and the challenging postpartum time.
- California Maternal Quality Care Collaborative (CMQCC) (2016). Statewide initiative to promote vaginal birth and reduce primary cesareans. Retrieved from https://www.cmqcc.org/sites/default/files/CMQCC_CS%20Initiative_October%202016_Final.pdf
- Centers for Disease Control and Prevention (2017). Cesarean delivery rate by state. Retrieved from https://www.cdc.gov/nchs/pressroom/sosmap/cesarean_births/cesareans.htm
- Centers for Disease Control and Prevention (2017). Depression among women. Retrieved from https://www.cdc.gov/reproductivehealth/depression/index.htm
- Evidence Based Birth, Evidence that Empowers (2017). Article by Dekker, Rebecca. Evidence on: doulas. Retrieved from https://evidencebasedbirth.com/the-evidence-for-doulas/
- Maternal Health Task Force (n.d.) Maternal health in the United States. Retrieved from https://www.mhtf.org/topics/maternal-health-in-the-united-states/
- Minnesota Public Radio (2018, July 29). Article by Montagne, Renee. More women are dying in childbirth; California is leading charge to reverse that trend. Retrieved from https://www.mprnews.org/story/2018/07/29/npr-more-us-women-dying-childbirth-california-working-reverse-trend
- Motherly (2018). Article by Glover, Emily. VBACs can be as safe as second C-sections, according to a new study. Retrieved from https://www.mother.ly/news/vbacs-can-be-safer-than-second-c-sections-according-to-a-new-study
- Pacific Standard (2017, October 24). Article by Fields, Robin & Sexton, Joe. The embarrassing state of U.S. maternal health-care data. Retrieved from https://psmag.com/social-justice/the-embarassign-state-of-maternal-health-care-data
- StatNews (2015, Dec 15). Sky-high C-section rates in the U.S. don’t translate to better birth outcomes. Article by Thielking, Megan. Retrieved from https://www.statnews.com/2015/12/01/cesarean-section-childbirth/
Who controls your destiny?
One thing that surprises me about maternity care today is that sometimes women feel that they don’t have a choice in how they labor and give birth. The truth is, you almost always have a choice. Being well-informed in your decision-making is key. Do you take everything in healthcare at face value or do you view your relationship with your provider(s) as a conversation?
We often say that medicine is not an exact science. Practices in medicine, nursing, and healthcare are influenced and defined by guidelines, research studies, trial and error, habit, “expert” opinion, and ultimately personal preference or judgement on the part of the practitioner based on the available information. All of these elements influence the care that your receive when you enter into the traditional health care system. But remember, you are at the center of your care. Ultimately in today’s so-called “broken” healthcare system you are, quite honestly, the most consistent element in your care plan. The concept of choice is fascinating. I often hear women describe their current reality in a way that suggests that they don’t have a choice. One might argue that in some societies, women have less of choice. Certainly, there are cultural, geographic, and political influences that create this type of a paradigm for women and yet, as women, we have the power to control our thoughts. Consider the platform of Malala Yousafzai, Nobel Peace Prize winner and native of the Swat Valley in Afghanistan.
Malala lived in Swat Valley during the most intense and restrictive years of Taliban rule and yet, despite all odds, she exercised the power of choice by going to school with several of her girlfriends, even when girls her age were banned from attending school. Today she travels the world sharing her platform regarding the importance of education for girls in all corners of the world; despite the cultural setting in which she grew up, she exercised the power of choice, against all odds. And, most of us aren’t faced with the consideration that we might meet a bullet in our journeys to own our choices. She did. Exercise the power of choice now as you journey through each trimester. When labor begins, we tend to focus inwards and although we can still exercise the power of choice, our ability to express ourselves may be overshadowed by the intensity of labor and all of the other influences that present themselves at the time of labor and birth. The more you can exercises the power of choice, and especially the power of informed choice now, the easier it will be to convey your preferences in the heat of labor.
Regardless of your affiliation with the healthcare system and your level of comfort with accessing prenatal care, the choice is yours. You decide your thoughts, your course of action, where to birth, who to select for your healthcare team, and how you will approach your pregnancy journey. As a pregnancy coach, my mission is to support you in exercising the power of choice as you take ownership of your journey into motherhood, empower yourself with information and open your heart and mind to the benefits of a collaborative approach to maternity care. Ultimately my wish for you is that you have the opportunity to manifest your desires in growing and birthing a new being in the ambiance of love, light, and compassion.
Growing another human being requires transformation: mental, physical, and emotional transformation. The thing is, sometimes we get so wrapped up in the physical transformation, that we forget to focus on our emotional state. One of the things that fascinates me about the pregnancy journey is the subtle internal transformation that occurs. We go from looking outward to looking inward. All of a sudden the journey is not just about us and our exterior environment, but it is also about us and our interior environment.
The knowing that another human being is present and with you at all times, is both fascinating and eerie. Certainly, there is the excitement that one might experience in the last weeks of pregnancy, upon having the belly stretched so thin that your babe’s hands or feet might be seen. Your belly might take on odd shapes, you might begin to gather a sense of what position your baby is in based on where she kicks, or you might feel her head low in your pelvis, pressing on the pubic bone and reminding you, that she is on her own journey. Just as you journey inwards into the depths of your soul and your emotional being, she begins her journey outward into the climate that exists beyond the confines of a uterus.
I read a lot throughout my first pregnancy. It was my first, after all, and I had the time! But what I didn’t have was the wisdom of having crossed into labor land and having journeyed through birth. I didn’t have the traveler’s wisdom and I sought out all the gurus for answers: Ina May Gaskin, Pam England, and Gurmukh Kauer Khalsa. I even read “The Thinking Woman’s Guide to a Better Birth” by Henci Goer. I welcomed the stories of women birthing on the “Farm” as they were described by Ina May. I considered the emotional dissonance of women experiencing a Cesarean birth that did not plan for or desire one. I considered that I might feel out of control in labor, that I might succumb to suggestions that didn’t fit my birthing preferences. I had a lot to think about, but that was all that existed. Thoughts. I had no tangible experience and that fact in itself, was unnerving, raw, and liberating at the same time. My story was a mere whisper on the wings of a Monarch gathering momentum, passion, and direction.
There were so many possibilities. I envisioned my birth experience in a certain way, yet I knew that the story would not be mine alone. The story was also his. My son had a story to tell on his journey from the inner cocoon that involved transformation and my story was incomplete without his. Together we entered labor land. Together we entered the unknown, fueled only by snippets of wisdom, whispers of advice, and a vision that was in flux.
A Multitude of Hats ~ Embracing the Meditative State
“A woman’s life is like a juggling act. We’re constantly trying to balance different roles.”
~ Dr. Jannie Chan as cited in Think and Grow Rich for Women, by Sharon Lechter & the Napoleon Hill Foundation.
I love this quote. How many hats do you wear in a day? Perhaps you go from the role of wife or partner, to mom, to chauffeur, to volunteer, to employee, to chief problem solver. Perhaps you are a business woman-by-day & a homemaker-by-night. It can be exhausting and overwhelming. Unfortunately, operating on overwhelm and shuffling through task after task in exhaustion mode doesn’t translate into excellence. This is where mindset comes into play.
Mindset. A simple concept, right? Easy to master? Not really. I know what you’re thinking. No, I REALLY do. When I’m at the kitchen sink doing dishes, typically a thousand thoughts are running through my mind. Some of them neutral, most of them negative, and then of course, there are the lists. The THOUSANDS of lists that I make in my mind.
What does it take to really operate in your “zone of Genius” as Robin Sharma likes to say? It’s simple. It requires intense focus and being vulnerable to the meditative state. I’ve decided, in fact, that washing dishes is a form of meditation when, and ONLY when, I can silence the chatter of the ongoing lists and intermittent negative thoughts. Then, washing dishes actually becomes, dare I say it, RELAXING.
I notice the water flowing over cobalt blue Sushi dishes. I marvel at shrimp tails leftover from my husband’s midnight Sushi snack after a long day at clinic (I’m not sure how the cat didn’t get to those already). I notice how beautiful the texture of their paper thin crustacean propellers is in neon light illuminated above the kitchen sink. I notice my sweet German shepherd at my feet snoozing and running in her sleep, chasing rabbits, or eating them, for that matter (point taken, that last image was NOT meditative).
The point is, the act of simply washing dishes, allowing the cool or warm, or SCALDING hot water (if you are a germ-a-phobe) oddly enough, can be soothing, calming, and serene. Moments of Meditation, are possible, and tangible.
I recently purchased a book called “Meditation Secrets for Women” by Camille Maurine & Lorin Roche, PhD, at the suggestion of my Intuitive Life and Business coach. I have to be honest, I was reluctant to purchase the text. For whatever reason, meditation scares the sh*t out of me. Are you kidding? I can’t find a serene location, filled with soothing greenery, quiet (except for the sweet sounds of a trickling fountain) and the scent of cedar incense in the background, to meditate for 15 minutes to save my life?!? And, quite honestly, I hate to sit still. But I purchased the book anyway. And, so far I have managed to read a few pages, though not really meditate, yet, other than at the kitchen sink. But here’s the takeaway that I want to share with you…
There is no secret recipe for the perfect mediation. Meditation can feel simple, effortless, and doable. Three minutes of uninterrupted serenity at the kitchen sink, 5 minutes of glorious inner calm while basking under the shower head, 2 minutes of peace while brushing your teeth with the bathroom door shut, or locked! You put a pause on those nagging lists, you clear your mind, you begin to gather a sense of living, existing, being in the moment. And, best of all, you become open to clarity. Now you are on your way to your zone of Genius.
When do you meditate? For how long? How do you create space to operate in your zone of Genius?