Changing The Way We Birth, The Lamaze Way.

When we hear or think of birth, more often than not we are reminded of TV shows and movies where a pregnant woman is rushed down the hallway – huffing, puffing and screaming through contractions while being told to “push” laying on her back with her legs in stirrups! For many of us this is also how we view birth, as a rush, as a medical emergency full of bright lights, doctors, tests and exams, not moving or having very little movement and not having many choices – being disempowered.

Tv and Hollywood tend to portray Childbirth as an emergency, painful and unbearable.

(Image courtesy of “One born every Minute.)

What we don’t think of- is giving birth with confidence, being informed, having choices and knowing our options, having the freedom to move and change positions, having support and being empowered.

This is Lamaze.

Lamaze is about giving women the confidence to give birth, to trust in their bodies, and their innate ability to birth, to understand the process of birth and to be informed, Lamaze emphasizes knowing your options.

Lamaze classes provide women with opportunity to gain confidence in their ability to give birth simply and have the safest, healthiest birth possible. Classes are based around the Lamaze Six Healthy Birth Practices, which help to simplify the birth process, alleviate fears and instil confidence in expectant mothers.

Lamaze is not just about breathing techniques (many of us associate Lamaze with this). When Lamaze dropped the breathing method in the 1980s, it transformed from a birth method into a birth philosophy. Lamaze Classes provide women with the best and latest evidence based information about pregnancy, labour, birth and breastfeeding. Lamaze was established in 1960 and is the oldest childbirth education organization around, and is internationally recognised. Lamaze’s mission is to advance safe and healthy pregnancy, birth and early parenting through evidence-based education and advocacy.

I believe deeply that birth is a process you can trust, just as millions of women before have done, women natural know how to give birth and this is why I started Birthability.

Women NEED to believe and trust in their ability to give birth, but society also has to trust in a woman’s ability to give birth – It is vital that we support women in every way possible during pregnancy, labour and birth instead of intervening and turning birth into a medical procedure.

“Birth is an opportunity to transcend. To rise above what we are accustomed to, reach deeper inside ourselves than we are familiar with, and to see not only what we are truly made of, but the strength we can access in and through Birth” – Marci Macari

As a Lamaze Certified Childbirth Educator (LCCE), I feel that I have a crucial role to play in helping women understand how amazing birth really can be, and helping to empower and educate them to have the birth they want. Birthability course teach fundamentals to help women achieve this, and using the Lamaze Six Healthy Birth Practices – women can see how they can have a safe, healthy birth and the birth they want.

Classes are kept small, to ensure every question is answered and so parents to be dont feel overwhelmed.

The birth of your children are moments that stay with you for the rest of your life. It is the most incredible, overwhelming, emotional and inspiring time in a woman’s life. I am passionate about helping mothers regain their connection to their innate ability to give birth. I want to offer mothers a new way of looking at birth that will lead them from fear to freedom, that will give them knowledge to make informed decisions, help them feel empowered and understand that they have choices and most importantly that they feel confident giving birth.

I’m excited to be able to pass my passion on to expecting parents, to be able to show them how amazing and powerful their bodies are and how amazing and inspiring birth really can be, to help them remove the fear of birth and tap into their Birthability.

The Importance of Upright Positions In Labour and Birth.

Remember a few weeks ago when I told you all about a wonderful piece of birthing equipment called Comfortable Upright Birth Support - CUB. There are many reasons why I think every hospital should have one of these, why every birthing woman should have access to one.

Throughout history and around the world, women have used both upright and gravity- neutral positions to push their babies out. Objects like posts, rebozos and ropes have been used to gain better leverage, women have also used birth supports or stools.

If you have ever used a birth stool or seen one, you would have noticed that they are either made of wood or rigid plastic – they can be hard and uncomfortable for the mother to use and can’t be used for extended periods of time.

The CUB can be used as a comfortable support not only throughout labour and birth of the baby but can also be used during pregnancy to help encourage baby to adopt an ideal position for birth.

It’s innovative and versatile design means that it can be comfortably used to lean over-supporting an ‘all fours’ position, lean against in a kneeling position, relax and rest against when necessary or to sit on. Most women will instinctively find their own position during labour and birth.

Upright doesn’t mean standing only, and whilst this is a great position to labour and give birth in, it is not the only upright position. Other positions include sitting upright (as shown above), kneeling on all fours or squatting using a Comfortable Upright Birth (CUB) support, being held and supported by your birth partner and lying on your side.

The CUB allows mothers to adopt and maintain positions that are not only the most comfortable but physically the most helpful for them and their baby during labour, making giving birth easier, faster and most importantly, safer!

Comfortable Upright Birth support - CUB, can be used for various pregnacy, labour and birth positions.

Upright positions during birth (sitting, kneeling, squatting, and all fours) have been the topic of much research in recent years, and the results of the research are dramatically in favour, these are the advantages of upright positions:

• Being upright during labour and birth can increase the available space within your pelvis by 28-30% giving more room for baby to be born
• Your contractions are more effective. Some preliminary studies have shown that an upright position in labour is as effective as an Oxytocin (Pitocin) infusion in stimulating contractions
• Your baby is 54% less likely to become distressed during labour and birth if you are in an upright position
• The length of the first stage of labour, between 3-10 centimetres can be significantly less when you remain upright, active and mobile
• Upright positions reduce the duration of the second stage (pushing stage) of labour
• Being upright has been shown to result in a 23% reduction in medically assisted deliveries- more space, less distress and a shorter labour results in fewer necessary interventions
• A 21% reduction in rates of episiotomy (a cut made to the area between your vagina and  anus) in women who give birth in an upright position
• A 29% reduction in emergency caesarean sections
• Mothers have a reduced need for epidural pain relief when they are upright

The positions you use during your labour and the birth can have a huge impact on you, your baby and your labour. With lots of research supporting the benefits of upright positions, you can make your labour shorter, make giving birth easier whilst reducing the risks of complications during the birth.

You can also Find out more about CUB and the benefits via www.cub-support.com or their Facebook page www.facebook.com/CUBsupport

CUB also has section dedicated to evidence, research and information on upright positions, this can be found on the site www.cub-support.com/resources/ which I highly recommend taking a look at and learning more about.

I Dream Of CUB

When I first became a birth educator, I came across a wonderful product called CUB – Comfortable Upright Birth Support. As soon as I saw a CUB, I wanted one! I needed one I wanted one for my classes and for my doula clients to use, truth is I REALLY REALLY WANTED  them to have a one at their birth.

I have been happily dreaming and pining over one for a while – yes that right, I’ve dreamt about a CUB 😊, these dreams have been glorious. I’ve had dreams of using a CUB with clients, of having them feel the comfort and ease of using one. I have dreams of showing my birth education students how along with the knowledge and skills they learn in class, that they can also use upright right positions and the CUB to shorten labour, reduce interventions and help get baby into an optimal position, whilst helping to open up their pelvis to help their baby descend.

Yep – this is one dreamy tool that I’ve wanted to have for birth classes and for doula clients.

As a Birth Educator I teach the value of labouring and birthing in an upright position. It is also one of the key Healthy Birth Practices I teach in my Lamaze classes – Healthy Birth Practice #5: Avoid giving birth on your back and follow your body’s urges to push. Studies show that birthing in upright positions can shorten labour and decrease pain, as well as increase pelvic diameter and reduce the need for interventions. (Care Practice #5: Spontaneous Pushing)

As a doula I see the importance of birthing in an upright position and of using gravity neutral positions during birth, I see how positions can change and affect the length of labour and the comfort of birth as well as the position of the baby.

The fact that The CUB (Comfortable Upright Birth) support is a comfortable, versatile birthing support designed to help mothers adopt and maintain positions that are physically the most helpful for them and their babies during labor and birth, is a must for use at births. The CUB is designed with the mother in mind and birthing needs, being able to use the CUB throughout labor as a comfortable support, either to sit on, rest on or lean over as well as to give birth to her baby on – the fact that the mother can birth on a CUB and not have to move again really shows how the design has be thoughtfully thought of with the mothers needs in minds (let’s face it, it’s never fair to move a mother who is in a comfortable position for birth)

For me I know it’s going to be an invaluable tool for me and doula clients to use. I want to help mothers to adopt and maintain positions that are not only the most comfortable but physically the most helpful for them and their baby during labour, helping them give birth easier, faster and most importantly, safer! I’m looking forward to sharing CUB with my future clients and having them see and feel the benefits of upright positioning and using a CUB that is designed for this purpose and comfort.

Find out more about CUB and the benefits via www.cub-support.com or their Facebook page https://www.facebook.com/CUBsupport

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1948091/pdf/JPE160035.pdf

Why You NEED to take a Childbirth Class

Over the past 2 weeks, I have seen and had A LOT of expecting mums ask me “whats the difference between a hospital birth class and other birth classes?” and “why do I need to do a birth class?” So many of us question the need for it and many say “ it will happen how it happens” or “I don’t need to do a class – it’s a waste of money or time” or “I’ll just go with the flow”  or “ my body will know what to do”.

Today we are lucky we have many options to choose from when it comes to birth education, but did you know when it comes to pregnancy, birth, and labour that you have choices and options? Or that there is also a huge difference between a hospital class and an independent class. However Choosing the right birth course can make all the difference between a positive and empowering experience and one that leaves you feeling disappointed at best, traumatised at worst. It's important to think about what you want in your birth in order to pick a course that is right for you.

There is so much time and thought put into planning a pregnancy, planning a nursery and researching prams, bounces, rockers, cots…….but why do we not research and invest time into preparing for labour and birth, why is this not on the to do list?

Birth education IS an investment – why, Its simple! When you take a class, you are investing in yourself, your baby, your labour, your birth and your choices – you are investing in your birth experience.

There was a small study done on independent childbirth education and, the results were startling: a 65% lower epidural rate and a 44% lower c-section rate than women offered a standard hospital birth course. There was also a significant reduction in augmentation of labour (having artificial oxytocin to speed up labour) and a shorter second stage of labour, meaning less time pushing. The study demonstrated how being informed can significantly reduce medical interventions.

Medical interventions are so common today, sadly most women have come to see them as the norm and are often unaware they may not be necessary or best practice or even that they have choices and options.

Hospital birth classes are usually run by midwives who are experienced in hospital birth and the policies and standards which guide how they do their job. Most courses are held over a few days and cover a lot of information about pregnancy, birth and baby care. The birth information focus is generally on when medical interventions will be necessary rather than on what normal birth is and how to cope. They will tend to steer the choices towards what will be easiest for the hospital and not what will necessarily benefit you, your labour and birth.

" Excuse me, I want to invest in my birth experience" 

Many people think that out-of-hospital classes are only geared towards those desiring a natural birth. That they won't discuss or talk about pain medication at all when in reality they do discuss pain medication, as well as ways to decrease the likelihood of other interventions when getting medical pain relief. They also discuss ways to avoid the use of pain medications and choices and options for natural pain relief– Because they understand every woman is different! They also spend time on active involvement in labour and using natural comfort techniques, such as movement and a variety of positions and tools. Partners are also actively involved in classes because partners have a significant role in supporting and providing comfort to their labouring partner.

The stages of labour are taught and also highlight what your hormones are doing and the effects this will have on your body and why. Independent classes encourage the practice of positioning, counter-pressure, massage, the use of compresses, essential oils, relaxation and mindfulness techniques, and so much more.

Independent birth classes focus on far more than just how to cope with the discomforts of labour, independent birth classes will not only help you explore your options but also encourage you to find your voice for asserting your choices, and often empower birthing partners to be confident advocators in the decision-making that comes up along the way. birth classes provide expectant parents with the tools needed to be as in control of their birthing process as possible.

A good birth class will help you avoid “going with the flow” which really isn’t an option either, Think about that – who’s “flow” are you going with? Are you going with yours, or your Obstetrician, your partners, the midwife or nurse, the hospital, your mother in laws, sister or mum – the list is endless! An independent birth class with help you put a birth plan together and understand the importance of having one and putting it into action – so you don’t have to go with the flow!

Independent classes provide the birthing mother and partner with enough knowledge, confidence and power to positively approach their birth.

Choosing the right birth class is probably one of the most important choices you can make. What you learn about birth will help determine how your birth unfolds – not knowing your options means you have no options to choose from.

So look into doing a birth class, take the time to invest in education that can make a huge difference to how you give birth, I really believe that EVERY woman should take a birth class, and there are so many benefits to taking a class and it should be on your list of things to do before your baby arrives.

Hiding The Truth Of Third Stage

A few weeks ago I was chatting to an expecting mum and during this conversation she had told me that her obstetrician had told her in regard to third stage (placenta deliver) she would need a shot, to help birth the placenta and stop the bleeding. She was told everyone has it, she would have little choice – it was what was done and when she asked about it, the options given to her as a reason why it was done – where for pure convenience.

She went home and researched and asked her friends and what she found was that it was something most women had done, that it was common practice! I wanted to hold her hand as she went to discuss things with her obstetrician, I wanted to be there and support her when she told them “NO”.

The medical management of the third stage of labour- the time between the baby’s birth, and the emergence of the placenta it very common. We have injections, examinations, and clamping and pulling on the cord. Instead of skin-to-skin contact, bonding and body heat, we have separation, inspections and wrapping, and then we have haste to deliver the placenta and clean up for the next ‘case’.

As Sarah Buckley of Gentle Birth, Gentle Mothering has also written “Medical management of the third stage, which has been taken even further in the last decade, with the popularity of ‘active management of the third stage’ which has its own risks for mother and baby. While much of the activity is designed to reduce the risk of maternal bleeding, or postpartum haemorrhage (PPH), which can be a serious event, it seems that, as with the active management of labour, the medical approach to labour and birth may actually lead to many of the problems that active management is designed to address.”

The use of active management also creates specific problems for mother and baby. In particular, the use of active management leads to a newborn baby being deprived of up to half of his or her expected blood volume. This extra blood, which is intended to help the newly functioning lungs and other vital organs, is discarded along with the placenta when active management is used.

Synthetic oxytocin has also been linked to an increased risk of postpartum depression. In a recent study, it was found that women with a history of depression or anxiety disorder prior to pregnancy, exposure to peripartum oxytocin increased the risk of postpartum depression or anxiety disorder by 36%. Women with no history of prepregnancy depressive or anxiety disorder, exposure to peripartum oxytocin increased the risk of postpartum depressive or anxiety disorder by 32% compared to those not exposed.

Sarah also speaks of the hormones that occur during the third stage of labour, so when we inject a synthetic into the workings of our natural hormones those connections change and ultimately will affect mother and baby. What naturally occurs during the third stage of labour is strong uterine contractions continue at regular intervals, under the continuing influence of oxytocin. The uterine muscle fibres shorten, or retract, with each contraction, leading to a gradual decrease in the size of the uterus, which helps the placenta pull away from its attachment site on the mother’s uterine wall. Third stage is complete when the mother delivers her baby’s placenta.

During this time the Mothers has peak levels of oxytocin, the hormone of love, and endorphins, hormones of pleasure for both mother and baby. Skin-to-skin contact and the baby’s first attempts to breast-feed further augment maternal oxytocin levels, strengthening the uterine contractions that will help the placenta to separate, and the uterus to contract down. In this way, oxytocin acts to prevent haemorrhage, as well as to establish, in concert with the other hormones, the close bond that will ensure a mother’s care and protection, and thus her baby’s survival. (Buckley, 2005)

So why is this being ignored, knowing what we know about delayed cord clamping and the effects synthetic oxytocin can have on a mother postpartum, why are we not giving women a choice and a say in having a managed third stage and when do we say enough!

For me this is where childbirth education becomes highly important, where knowing the pros and cons of a managed third stage labour are taught, where being informed and being able to communicate with your care provider are vital – these are only just a few of the things expecting parents are taught in a Lamaze class.

Care professionals need to think about the birthing woman. Whilst most things are simply “routine” for them, they are not for a first time mother and full information and consent need to be given. Instead, most care professionals seem convinced that they know best, that mother’s do not know how to give birth and that birth is a medical emergency – when most births are not! They skim over information or just expect the mother to be a mind reader or get frustrated when she will not comply, when she will not do what they have told her.

All over the world, women are repeatedly forced to undergo procedures and interventions during labour and birth that they would not necessarily agree to. Had they been given all of the information and been able to make an informed decision, their choice would have been ‘no’. The decisions you make about your birth options can ultimately have long lasting effects on the health and wellbeing of yourself, your baby and your family.

Women who feel satisfied and in control of their birth experience are less likely to experience traumatic stress after birth. Ideally, women should be valued as the key decision maker in their own care by all caregivers.

In Birth, Gem.

References

Buckley, S., 2005. Leaving Well Alone: A Natural Approach to the Third Stage of labour. [Online]
Available at: http://sarahbuckley.com/leaving-well-alone-a-natural-approach-to-the-third-stage-of-labour

Kroll-Desrosiers A, N. B. B. J. G.-W. Y. M. S. T. D. K., 2017. Wiley Periodicals - Association of peripartum synthetic oxytocin administration and depressive and anxiety disorders within the first postpartum year.. [Online]
Available at: https://www.ncbi.nlm.nih.gov/pubmed/28133901

Rabe H, D. J. D. L. D. T., 2012. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes.- Cochrane Database of Systematic Reviews. [Online]
Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003248.pub3/abstract;jsessionid=3EE451A363B32133121955277B02EA9F.f02t01

Ruta Nonacs, M. P., 2017. Synthetic Oxytocin and Its Effect on Postpartum Mood and Anxiety - Womens Mental Health. [Online]
Available at: https://womensmentalhealth.org/posts/synthetic-oxytocin-effect-postpartum-mood-anxiety/