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BirthWorks with Birthpedia Conference – highlights

Our conferences are being described by attendees as, “The BirthWorks Experience” and this is different from other conferences they have attended.   Our program is based on the practice of human values along with integration of the mind, body, and spirit.  This is experienced in all of our conferences and workshops as well as in our training programs. The setting of the Lakeside Inn overlooking the lake was infused with peace itself, thus enhancing the theme of our conference, “Peace in Birth.”

All keynote speakers and presenters focused their talks on the theme of how birthing families and health care professionals can have more peace in birth.  They addressed this in a multitude of ways ranging from birthing vocabulary, to mother/baby skin-to-skin contact, to empowering high risk moms, to the importance of comprehensive childbirth education, to avoiding birth-worker burnout, to healing through birth stories and finding peace after experiencing birth trauma to name a few. I will touch on some of the keynote lectures here.

Nancy Wainer explored the world of birthing vocabulary and its effects on pregnancy, labor, and birth.  She made distinctions such as “We don’t catch babies, we receive them.”  The Bag of waters becomes the “amniotic release.”  The mucous plug becomes “Baby Gel.”  Is there such a thing as a “Natural Cesarean?” or a “Gentle Cesarean?”

Michel Odent MD discussed how the human placenta transfers antibodies to the mother so that the mother’s microbiota is friendly to the baby. Today most women give birth where there are unfriendly microbes, not colonized in the same way. Today we must ask, “How is our health to be organized?” He said, there are only two kinds of birth: birth at home, and birth elsewhere.  Today, we have dysregulation of the immune system comparing only with hospital birth.   We need to find new ways to adapt.   He went on to say that too often we associate stress as a negative way of thinking, but there are times when we need stress hormones. In a pre-labor cesarean section, babies are not being exposed to fetal stress hormones. For example, corticosteroids are needed for maturation of the baby’s lungs.  Also, understanding the birth process means understanding “Neocortical inhibition” which should become part of the birth vocabulary.  We need to wonder why birth is so difficult for some women and not for others.  It has to do with “Neocortical inhibition.”  The neocortex must stop working in labor.”  Women need to be protected against key inhibitory functions.

Michel made the trip across the Atlantic at the age of 88.  We gave him a tribute slide show of his work through the years, including pictures as a child, and also gave him a journal in which everyone at the conference wrote words of gratitude to him for his lifelong work in birth.  When asked the question, “What made you become interested in birth?”  he answered, “Oh, I’m not interested in birth – I’m interested in humans but of course birth is a part of human existence.”

Brad Bootstaylor MD:  Is one of three obstetricians in Georgia performing vaginal breeches in a hospital setting.  His Dads catch babies 90% of the time. He sees birth as a natural event that may or may not need managing. He emphasized the need to always have a conversation with birthing parents in shared decision making, hearing their needs and then discussing how they can work together. Even in an emergency cesarean, the process is important.  He said, “I help her to remember that her job is to bring her baby here to the earth.”  He shared seven pearls of care some of which were respecting a patient’s values, enhancing physical comfort, providing emotional support, involving the family and especially listening to the mother.

Dr. Bootstaylor said he enjoys his work and brings a positive attitude to women giving birth and their families. He doesn’t think, “Oh my, she’s still here!” He has assisted many women in vaginal breech births thus helping to avoid the major surgery of a cesarean.  Above all, he feels a trusting relationship is essential to any birth.

Lewis Mehl Madrona:  Being a board certified family physician and psychiatrist of the native Lakota American Indian background, Lewis brings storytelling as a form of healing in his culture and he has applied that to birth over much of his life. He acknowledged that there are both good and bad stories but they are the glue that hold people together.  Every story we hear affects our physiology whether we like it or not.  If we use it, it grows up; if not used, it fades away.  How do we make sense of story trauma?  Know that even in the worst trauma, good comes out of bad.  This transforms the victim into a hero.   What makes people feel better is giving meaning to what happened.    You can’t erase a story once it is told.  We can also strengthen good stories by retelling them over and over again. Lewis said story-based medicine may treat pain.  Listening without interruption and judgment is the greatest gift we can give anyone.

Mary Renfrew:  is a leading health researcher and midwife.  She has conducted research in maternity care and in infant feeding for over 30 years and her work has informed and helped to shape policy and practice in those fields both nationally and internationally.  Her work has a core focus on improving health and care for women, babies, and families and reducing the impact of inequalities.   Due to ankle surgery, her fascinating lecture was presented through skype.  She spoke about global challenges and developments in midwifery and how to tackle those through evidence and through education thereby moving evidence into policy and practice.

Amber Price: As the only CEO in the country who is also a midwife, Amber had much to share with us about how she is making changes to help pregnant women and women in labor at the Tristar Centennial Women’s and Children’s Hospital in Nashville TN. She said as a society, we dictate behavior for mothers and babies, but instead, we need to teach and not mandate. Below are just a few of the points she made in her talk.  View her entire fascinating talk by purchasing it at birthpedia.net/learn

  • 52% of pregnant women in the US are obese with BMIs over 50. Hospitals need equipment to meet their needs. If women don’t get what they need, they won’t come back.
  • Women think they are going to be treated like a queen in the hospital, but are often disappointed.
  • Both women and health care providers feel alone and largely unsupported.
  • There is mutual distrust between women and healthcare providers, exacerbated by word of mouth and the media.
  • Procedure rather than patient centered care is prioritized by healthcare providers. Women’s reports of care indicate that interventions are routinely imposed on them without meaningful informed consent.
  • The difference between home and hospital birth is that birthing women take on guest status. People are in control in their own homes,  however, when walking into the hospital, the minute they ask “May I use the bathroom?” or “May I have something to eat,” someone has power over them.

See our next E-news for the Professional Forums held at our conference.

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Janell’s Reflections

Intimate, Connecting and Peaceful, these are the words that come to mind when I reflect back on the 2019 BirthWorks Conference in Mt. Dora, Florida.  The speakers were inspiring and loving as they shared their knowledge and extensive experience with conference attendees.  The location was nostalgic and charming, worth the visit as well.

I personally was in awe of listening to Amber Price and the work she is doing to pave the way for better maternity care.  She shared many thought provoking facts that were spoken in truth and hope as she continues the momentum of a better and healthier maternity system.  She cares so deeply about her passion for improved maternity care and her professionalism in her administrative role is above and beyond “industry standards”.  I truly appreciated the information she shared regarding things that a hospital has control over in relation to addressing a concern or issue with a specific physician having privileges at a specific hospital.  Amber is like the first baby coming through the womb to pave the way for next generations to continue trusting the process of the journey of healthier and less interventions for better birth outcomes for all birthing families.

Another incredible session included Lori Barklage on Trauma Healing.  She emphasized how important it is to understand and to have tools to share with others that have experienced trauma in their childbirth journey.  She shared her heartbreaking stories of her past birth traumas and how she was able to heal those traumas and take those healing journey steps forward and help many others experiencing trauma in birth and other aspects of their lives.  The tool she provided in the workshop was so simple and easy to apply that I will be able to share and utilize its simplicity during the BirthWorks grieving and healing portion of the classes.  She is taking great strides in restoring the healing from trauma and does it in such a caring and loving way.

There were so many great guest speakers and keynote speakers that I just simply could not do them justice on a simple forum as this.  Having Nils Bergman, Michel Odent along with other local experienced and knowledgeable birth-field experts is always a unique quality that BirthWorks offers during the conferences. I highly recommend and encourage anyone thinking about attending a birth conference that is small, but mighty, to give thought to attending next year’s BirthWorks conference in southern California.

 

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Ultrasounds – Risks, Benefits, and Ethical Considerations

Submitted by Sally Dear-Healey, PhD, PPNE, CCE(BWI), Doula(BWI)

Years ago, X-ray was the diagnostic procedure of choice in pregnancy but today we understand more about the harmful effects of radiation so ultrasound is used as a safer alternative.  What we do know today is that every medical procedure has inherent risks known and unknown.  Therefore it is not wise to perform any procedure except if the known risks are higher than the risks of not doing anything.  However, instead of progressing cautiously and limiting exposure, more and more doctors/OB practices order repeated ultrasound scans for most of their patients/clients.

Ultrasounds are a form of electronic fetal monitoring that have become a normalized part of mainstream obstetric practice.  In fact, practically every pregnant woman in the U. S. will have at least one ultrasound scan during her pregnancy and most will have electronic fetal monitoring during their labor and delivery.  These women tend to be influenced by popular magazines, social media,  internet medical media, mainstream pregnancy books, news articles, and oftentimes friends and family members that purport that ultrasounds are necessary to ensure the safety and healthy development and birth of their baby. This article reviews a sampling of the issues, concerns, and benefits related to ultrasounds.

There are multiple issues and problems associated with the routine use of ultrasounds in pregnancy:

  • Most women today don’t question the procedure or educate themselves on its risks and benefits. Even if they have, few feel they have the right or ability to refuse the test(s).
  • Doctors may not have the time or knowledge to educate their patients about the risks and benefits of the procedure.  However, all women have a right to informed consent and should be encouraged to ask any questions they may have.
  • The number of scans is an issue. Instead of one ultrasound, many women have multiple ultrasounds over the course of their pregnancy in addition to “routine” scanning during labor and delivery (Electronic Fetal Monitoring and Dopplers are forms of ultrasound).
  • The integrity of the scanning machine, the length of the scan time, as well as interpretations of the results can be problematic.
  • “Gender reveal” parties based on the result of these scans are becoming more common and some parents have even purchased their own ultrasound machines so they can track the development of their unborn baby.
  • The financial cost of these scans is a significant concern for individuals and for the health care industry overall.  The average cost of an ultrasound in the U.S. is $250 – $300 without insurance.

Thirty years ago, there were concerns about ultrasound based on animal research, as in 1984, Doris Haire’s article in the Journal of Nurse-Midwifery titled “Fetal effects of ultrasound: A growing controversy,” which cited Dr. Melvin E. Stratmeyer, of the Center for Devices and Radiologic Health (CDRH), as saying “Increasing concern has arisen regarding the fetal safety of widely used diagnostic ultrasound in obstetrics,”  but to this day concerns about such things as neuromuscular development, anomalies, and genetic alterations have not been substantiated on animals or humans. In 1985, ACOG (The American College of Obstetrics and Gynecology) issued a technical bulletin that stated, “No well-controlled study has yet proved that routine scanning of all prenatal patients will improve the outcome of pregnancy.”

As a long-time birth worker, and having taught classes in human development and child and family studies for over two decades, I share their collective concerns and argue that, even though it has been thirty-five years since Haire’s article came out, we have yet to fully understand or appreciate the long-term impacts of prenatal ultrasound exposure.  Yet, there is research out that can be drawn upon to make an educated decision.

Nyborg (1987) writes, “Alterations to cell membrane structure have been reported by a number of investigators.  Some alterations include increased density of microvilli and ruffles in cell membrane following exposure that may alter growth characteristics” and “The persistence of a hereditable disturbances in cell motility after ultrasound exposure is especially important and investigations need to be conducted to determine if these effects occur in vitro” (256).

Sarah Buckley, MD, is also very clear about ultrasounds, stating that “Although ultrasound may sometimes be useful when specific problems are suspected, my conclusion is that it is at best ineffective and at worse dangerous when used as a ‘screening tool’ for every pregnant woman and her baby. […] Treating the baby as a separate being, ultrasound artificially splits mother from baby well before this is a physiological or psychic reality.  This further…sets the scene for possible but to my mind artificial conflicts of interest between mother and baby in pregnancy birth and parenting” (as quoted in West, 2015).

In 2000, Professor Ruo Feng, of the Institute of Acoustics, Nanjing University, who holds a PhD in physics and has published over 186 scientific papers summarized human studies of prenatal ultrasound and suggested five points of protection.  They are:

  • Ulltrasound should only be used for specific medical indications.
  • Ultrasound, if used, should strictly adhere to the smallest dose principle, that is, the ultrasonic dose should be limited to that which achieves the necessary diagnostic information under the principle of using intensity as small as possible and the irradiation time as short as possible.
  • Commercial or educational fetal ultrasound imaging should be strictly eliminated and ultrasound for the identification of fetal sex and fetal entertainment imaging should be strictly eliminated.
  • Avoid ultrasound in the first trimester of pregnancy. If unavoidable, minimize ultrasound.  Even later, during the 2nd or 3rd trimester, limit ultrasound to 3-5 minutes for sensitive areas, e.g. fetal brain, eyes, spinal cord, heart and other parts,
  • For every physician engaged in clinical ultrasound training, their training should include information on the biological effects of ultrasound and ultrasound diagnostic dose safety knowledge (West, 2015).

In terms of benefits, diagnostic ultrasound may be useful where there is a true medical need, although it is reasonable to conclude from the evidence that many of these conditions auto-correct themselves prior to the birth.  It could also be argued that for the mother who has experienced baby loss, either during a pregnancy or shortly after birth, seeing and hearing her unborn child may help to alleviate stress and anxiety in a subsequent pregnancy, which could also positively influence the well- being of the baby due to decreased cortisol levels.  On the other hand, scanning too much can actually create stress.  Jeffrey Ecker, M.D., chief of the department of obstetrics and gynecology at Massachusetts General Hospital, notes that “It’s important to have a specific question you are trying to address.  If by chance someone thinks they see something off, it can cause unnecessary worry” (Miller, 2016).  According to an article in the Journal of Ultrasound Medicine (2012), Miller et al. report that “Safety information can be scattered, confusing, or subject to commercial conflicts of interest.”

While some of the research presented is dated, it is widely acknowledged that very little has changed, and we still don’t have definitive answers.  If you do decide to have a prenatal ultrasound, it is wise to do the following:

  • Limit the number of scans
  • Have the procedure done by an operator with a high level of skill and competence
  • Have the shortest scan possible.
  • Be clear about what questions you have and be sure to ask them.
  • Most important, remember that it’s your baby and your choice.

 

References

  • American College of Obstetricians and Gynecologists (ACOG). (1985). Diagnostic Ultrasound in Obstetrics and Gynecology.  Technical Bulletin No. 63; October.
  • Haire, D. (1984). Fetal effects of ultrasound: A growing controversy. Journal of Nurse-Midwifery; Vol. 29, No. 4.
  • Mendelsohn, R. Dr. Robert Mendelsohn on Pregnancy and the Dangers of Ultrasound. https://www.youtube.com/watch?time_continue=208&v=YfaUQCp6L1s
  • Miller, D., Smith, N., Baily, M. Czarnota, G., Hynynen, K, Makin, I. (2012). Overview of therapeutic ultrasound applications and safety considerations. Journal of Ultrasound Medicine: 31(4):623-34.
  • Miller, K. (2016). This is How Many Ultrasounds You Actually Need During Pregnancy. Self.com https://www.self.com/story/this-is-how-many-ultrasounds-you-actually-need-during-pregnancy
  • Nyborg, W. L. (1987). Research Priorities in Ultrasound.  In: Repacholi, M.H.. Grandolfo, M., Rindi, A. (Eds.). Ultrasound. Springer: Boston.
  • West, J. (2015).  “50 Human Studies in Utero, Conducted in Modern China Indicate Extreme Risk for Prenatal Ultrasound A New Bibliography.”  Harvoa.org
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Ten Tips to Change the Course of Your Birth

By Brittany Sharpe McCollum, CCE(BWI), CD(DONA)

 

A positive laboring experience has the potential to increase satisfaction with the overall birth process, deepen parent and infant bonding in the first few weeks, and set the stage for a healthy transition into the postpartum experience (Simkin).  One’s outlook on their birth, however, has less to do with how the process happens or whether it goes “according to plan” and more to do with how involved the laboring person feels in the decision making process and supported they feel in using their voice (Elmir).  Although prenatal preparation, such as nourishment and hydration, movement, and conscious decision making regarding providers and birth support, is an incredibly important component of a healthy birth, it is also important to remember that circumstances and choices made during the process can also help to keep the labor on a positive course. Here are a few tried and true suggestions for preparing for an empowered and healthy childbirth experience.

 

Keep it to yourself.

As the saying goes, “A watched pot never boils.”  Texting friends and family or posting contractions on social media is a quick way to invite anxiety and fear into a birthing space.  Unfortunately, many people – even those whom have given birth before – are not aware of the normal physiological process of labor, the myriad fluids that the body excretes, and the wide range of normal in length of time of labor.  This means that a flood of questions will need to be fielded (or ignored) if the first contraction is shared with too many people whom have too little info about the variations in healthy birth.

 

Distract yourself…

until you can’t be distracted any longer.  Paying too much attention to the pattern of contractions or the variations from one wave to the next only wears the laboring person out mentally and physically.  Think of early labor as the end of pregnancy and conserve mental energy, relax the thinking brain, and get last minute loose ends tied up instead.

 

Call your doula. 

A doula can offer suggestions and guidance for coping with labor even before they arrive in person.  The reassurance of this professional birth support can help decrease fear and anxiety in partners, friends, and family members so that they are able to offer the best support possible to the laboring person and the hands-on comfort techniques, position change suggestions, and encouragement can help create an environment of serenity, confidence, and progress.

 

Make an evidence-based decision when/if your water breaks.

Yes – your water may not break!  Or it might, at any point in labor.  If the amniotic sac releases before consistent contractions and after 37 weeks of pregnancy, it is given the name “Term PROM” (premature rupture of membranes with a baby greater than 37 weeks gestation).  Although the majority of people have their water break at some point during consistent contractions, about eight to ten percent of people have their water release first.  Unlike the movies, where the water breaks and hard labor begins immediately, research shows that between 77 and 95% of people will begin labor within 24 hours.  Nope, not necessarily 24 minutes.  And studies also suggest that inducing labor with PROM is just as valid a choice for most people as is waiting up to 72 hours for labor to begin on its own.  To read more about the research and extenuating circumstances, check out this thorough article at Evidence Based Birth.

 

Get in the tub…and then out of the tub.

In the vein of Michel Odent, the tub will either get your labor moving or slow your labor down. When used early on, immersing oneself in water can be a great way to relax and allow for some rest before things get more intense.  However, used for too long of a time in active labor, water immersion may keep things from progressing and slow the pace of contractions at a time that is not ideal.  The use of the tub in transition?  Go for it!  The relaxation at such an intense point of labor may help move the birthing person right into pushing.  And evidence shows that water immersion can have a significant effect on decreasing one’s perception of pain.  Bottom Line: The tub may be best used at the beginning and towards the end of the first stage of labor and can be a great tool for managing discomfort.

 

Know your rights. 

Know your rights.  Know your rights.  Know your rights.  It can’t be said enough.  No matter how one chooses to give birth or what the circumstances leading up to the decisions are, it is crucial that the laboring person be aware of their rights during labor so that they can remain as in control of the decision making and as involved in the process as possible.  Research shows that it’s not how someone gives birth or whether things went “as planned,” but how someone feels about how they give birth which is tied to their feelings of control over decisions made in labor (Listening to Mothers).  And without a solid knowledge of what one’s rights are (and whether they in fact line up with birth place policy), it can be quite challenging to…

 

Use your voice.

Birth place policies are set up to serve the mode of birthing that is least liable for the birth place and most common among its clients.  If a laboring person is doing something differently than the norm in that space, they must understand that staff may not be familiar with the evidence-based way of supporting those choices and clients (or their personal birth support team – friend, partner, family, doula) may have to do a fair amount of assistance in advocating for the birthing person’s wishes.  Practicing asking questions and stating one’s choices is an excellent activity in preparing for birth.

 

Move your body.

Changing position and laboring and birthing upright have the potential not only to shorten the duration of labor but can also lead to more positive birth experiences (Dekker).  And here’s a not so little secret – upright birthing positions and movement in labor are possible even with pain medication!  Knowledgeable clinical staff and non-clinical support people can help, if assistance is needed, the laboring person into a variety of postures, both with and without pain medication, including but not limited to hands and knees, lunges, and seated positions.

 

Stay hydrated by mouth.  Although intravenous fluids have benefits when epidurals are given and when severe dehydration occurs, hydrating orally is an option supported by professional organizations worldwide.  “The American College of Nurse Midwives, World Health Organization, National Institute for Health and Care Excellence guidelines in the United Kingdom, and the Society of Obstetricians and Gynecologists guidelines in Canada all recommend that people be able to choose whether or not they want to eat and drink during labor” (Dekker).  Although IV fluids increase hydration, they also increase the birth weight of the baby which can lead to the appearance of excessive weight loss after birth and subsequent pressure to supplement human milk with formula.  Adequate fluid intake by mouth has been shown to be just as effective as IV fluids at shortening labor duration by about 30 minutes, while also helping to decrease tension in the throat and mouth and encourage feelings of normalcy in birth.

 

Understand the limitations of research.  Research is one part of the three components of evidence based decision making (the other two being client’s values and provider’s recommendation/experience).  Recently, a large study, called the ARRIVE study, looked at the effects of induction at 39 weeks on birth outcomes and called for the recommendation of induction at 39 weeks for healthy low risk pregnancies.  Henci Goer, medical analyst offers some fantastic insight into this research, discussing the limitations it has in regard to values and intentions of the laboring person in preparing for their birth.  Factors that may affect if this study applies to a specific person is whether they are planning for a medicalized birth, their desired use of pain medication, the prioritization of freedom of movement, and more.  An excellent infographic by Goer can be viewed at ARRIVE Study Infographic.

 

Let your intuition guide you.  No one knows the body and the baby better than the person experiencing the pregnancy and no one can speak for anyone else’s values or philosophies, which are a key component of true evidence based decision making.  Prenatal preparation and awareness of the importance of an active birth – as the laboring person defines it – offer a strong foundation for moving forward through labor and integrating the birth experience into a healthy and positive postpartum.

 

Sources:

Declercq, Eugene R. et al. Childbirth Connection. “Listening to Mothers III: Pregnancy and Birth.  Report of the Third National U.S. Survey of Women’s Childbearing Experiences.” May 2013. http://transform.childbirthconnection.org/wp-content/uploads/2013/06/LTM-III_Pregnancy-and-Birth.pdf.

 

Dekker, Rebecca.  “Evidence on: IV Fluids During Labor.” Evidence Based Birth. 24 May 2012; updated 31 May 2017, https://evidencebasedbirth.com/iv-fluids-during-labor/.

 

Dekker, Rebecca.  “Evidence on: Premature Rupture of Membranes.”  Evidence Based Birth. 20 November 2014; updated 10 July 2017, https://evidencebasedbirth.com/evidence-inducing-labor-water-breaks-term/.

 

Elmir, R. et. al. Women’s Perceptions and experiences of a traumatic birth: a meta-ethnography. Journal of Advanced Nursing, 2010 Oct; 66(10):2142-53.

Goer, Henci.  “Parsing the ARRIVE Trial: Should First-Time Parents Be Routinely Induced at 39 Weeks?” Lamaze. 14  Aug 2018,

https://www.lamaze.org/Connecting-the-Dots/parsing-the-arrive-trial-should-first-time-parents-be-routinely-induced-at-39-weeks

 

Odent, Michel. Childbirth and the Evolution of Homo Sapiens. Pinter & Martin Ltd; 2nd Revised ed. edition, 2014.

 

Simkin, P. Just another day in a woman’s life? Women’s long-term perceptions of their first birth experience. Part I. Birth, 1991 Dec; 18(4):203-10.

 

Simkin, Penny. Pain, Suffering, and Trauma in Labor and Prevention of Subsequent Posttraumatic Stress Disorder. Journal of Perinatal Education, 2011 Summer; 20(3): 166–176.

 

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By Cathy Daub, CD, CCE (BWI)

Laboring in birth is hard work but today we are making it harder than it needs to be. The secret is to find ways to create optimum space for the baby to move into and through the pelvis.  BirthWorks philosophy believes that “Birth is Instinctive” and that includes the baby knowing how to move through his mother to be born.  Remember that the baby was conceived in the uterus while low in the pelvis.  As he grows he moves up through the pelvis with the uterus into the abdomen where there is more room to grow.  So in an instinctive way, we can know that since the baby has already made that journey once, it is familiar to him.  What is familiar feels safe.

After moving up to his mother’s abdomen and reaching his birth weight, he is ready to move back down through the pelvis to be born.  But now there is one difference – he has grown.  At this time it is essential that a mother positions herself in ways to optimize the space in which he can move.

One position to avoid is the deep squatting position.  In this position, the pelvis is tipped backward as western women squat sitting on their heels which moves the pelvis into a posterior position.  This is a way to decrease space in which the baby can move.  Any position that tips the pelvis backward is a way to make descent of the baby through the pelvis more difficult.  It is desirable to have a forward pelvis in labor which offers more room for the baby.

There is another reason to avoid a deep squatting position in labor.  In labor, it is advantageous to increase the angle between the mother’s spine and the opening of the pelvis so the baby can position himself optimally. In order to do this, the woman in labor needs to keep her knees below her waist.  In a deep squatting position, the knees are above the waist. Keeping the knees below the waist is the BirthWorks Third Principle of Optimal Pelvic Positioning that all women of childbearing age need to understand.

There is a great position called “The Dangle Squat.” (see diagram)  In this position two people can sit on the bed or high chairs with a space in between.  The woman in labor stands between them and places her forearms on their thighs.  Then she drops down into a partial squat, keeping her knees below her waist.  She can feel the stretch in her upper body so that the forces going up are balancing the forces going down.  This is a position that opens the pelvis. She stays there for the duration of the contraction and then comes back up to a standing position and walks.  The Dangle Squat is an easy one to maintain for her helpers as well which is an important consideration in any birth.

Saying “No” to positions that decrease space in the pelvis and saying “Yes” to those that increase space in the pelvis makes a significant impact in the birth experience.   Mom, baby and family will be thankful.

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Birth Testimonial

by Erika Sanchez   Written January 4, 2019

My husband and I attended the Birth Works (birthing class) at Beach Cities this past October. It was taught by Janell Bartzatt.

This was our 3rd baby. The first two were healthy, hospital births. We had taken a birthing class at the hospital 7 years ago with our first child and almost didn’t sign up for this one. But because it was our first out-of-hospital birth, we decided it would probably be a good idea. I think we both felt pretty knowledgeable already on birth! But we both learned more from this class than we had through reading dozens of books and living through two deliveries!

Janell’s class not only covers a kind of what to expect, physically. But it also went through what to expect, emotionally. I left the class with such a clear understanding of what baby is going through during that labor, how I can help assist, and how to manage my pain. My husband felt more involved too. He had a better understanding of what he could do to help me through it.

We talked about fears and concerns we may have and how to move them to a place of control. Knowledge is power. So many of my fears were just from not knowing.

I left the class feeling empowered and that I could do this! It is so natural and not scary. Janell’s understanding on the topic made the class fun- it was a safe place to ask questions and to find real answers.

My daughter was born at Beach Cities 11 days ago on Christmas Eve morning. To say it was the perfect birth is an understatement. It was really everything I had wanted it to be. I really owe so much of that to Janell and this class. I was able to talk to myself to relax and breathe. My husband knew counter pressure points to help with the pain when it got really intense. Labor wasn’t happening to me- I was 100% in control. I was 100% present and it was amazing!