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Birthing Language

Words are powerful, so it is important to consider what words to use around a laboring mom. Her senses are already elevated and she is on high alert, and she is perhaps now in her “primal brain”. What is said to her or in her presence is sure to have an impact on her labor and possibly even her labor progression. Words are not always necessary at birth, and even kind and encouraging words may inhibit the mother from fully being in her labor state of mind which could possibly interrupt her labor. Not all women enjoy listening to others during their labor. It is important to know when to talk and when not to. When language is needed or wanted, how we talk is of great importance. Please allow me to explain this further.

The volume at which we speak should be considered. Is the mom vocal herself, perhaps moaning loudly? Is the room full of distractions? Are you trying to assist her in finding something to focus on? She may appreciate a loud, direct tone, but often, I think it is more so the case that a woman needs a soft voice spoken to her. A whisper in an ear can be received stronger than a yell. The loudest voice in the room isn’t always the most impactful. It is important to evaluate the situation, know the mother and follow your intuition when deciding on how to speak to the laboring mom.

Where we are when we are talking to mom is also important. Are we across the room or are we near her and close to her in her laboring space? Depending on where a woman is in her labor, she may only be aware of the bubble around her. To properly communicate with a laboring mom, you must be near her and in her space, while being respectful of that space as well. It is hard to whisper across a room to someone who may not even see or feel you.

Once respecting the importance of volume of our voice and location of ourselves in relation to the mom, we must carefully craft our words. As a doula, I am careful to not interrupt a mom’s labor as sometimes silence is needed and wanted. With that said, I also know when to use words to encourage, reassure, inspire and affirm. I would not want to mislead her by using arbitrary words. I must also be careful to not give subjective medical advice if she asks
questions on what she should do if given options by her provider. These words could easily derail a mom from her labor.

A carefully crafted sentence is important and how we phrase what we are trying to convey to mom should be considered before speaking.
Nurse: “You are 4cm dilated.”
Mom: “JUST 4cm?!”
(insert pause to think, consider her feelings and gently touch mom while looking at her)
Me: “You are making great progress! Your body is working to open so your baby can
come out.” (Refrain from analyzing numbers)

In that exchange of words, I wanted to be careful not to mislead her. I didn’t want her to feel as if she had so much more to progress, but I also didn’t want to convince her that the next part of her labor would be fast. I simply wanted to support her by giving her well-earned credit for her hard work and remind her that her cervix is not a crystal ball.

“This is hard!”, says the mom. My reply would be simple, “…and you are strong! You are doing good work to meet your baby.” I would be careful not to choose words that give herself doubt. I want her feel confident herself. Labor is of course hard work, but it would not be helpful to affirm that or remind her. What would be helpful is to remind her that she is strong enough to birth her baby.

What if mom says, “I can’t do this.” I can recall saying this when in labor with my first. I also remember hearing, “You have to, sweetheart.” Maybe the reply was said with empathy and some endearment, but it did not leave me feeling confident, positive or optimistic. I felt helpless. A better reply would have been, “…but you are already doing it. I am right here with here with you.” I think it would have been helpful to be reminded that I was doing it and that I
wasn’t going to be alone.

These are several examples of what can be said to a woman in labor, but ultimately it is important to remember the timeliness of our words, the volume at which we say those words and where we are communicating them from. If we remember to speak from our hearts, we are more likely to speak what is perfect at that moment in time.

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Together With Love at an Unassisted Birth

“She's coming, she's coming, she's coming!" exclaimed the birthing mother.
"Your body and your baby clearly know exactly what they are doing. We are here with
you," I responded as her doula.

My name is Jules. I live down here in Christchurch, New Zealand and have recently
attended my first two births as a Doula in training with Birthworks International. In my
first birth as a doula, I was welcomed and encompassed by the beautiful home birth
midwives and able to support my friend to have an empowering calm home birth.

My second birth was just a month or so later with a mother having her fourth baby and
with a history of fast births. Her second child was a planned home birth with a midwife
after a traumatic hospital first birth. The baby arrived on the bathroom floor before her
midwife arrived. Her mother in law was present and all were well but it was a scary
experience for this mother.

She was able to have a slower calm, attended water-birth with her third in her living
room. Now, her fourth pregnancy was a surprise and caught mother and father off
guard. For them, it took many months to come to terms with having a fourth unplanned
child. I met her late in her pregnancy when she had injured her ankle and was left
mostly immobile. We formed a strong connection over several visits and I noted her
main fears were to be alone during birth and to have an injury due to a fast labor.

The day came. I answered my phone at 2:50am to a very calm positive voice saying,

"I think the baby is coming."
“What’s happening?” I asked.
“I’ve been contracting for half an hour and my water just broke. Yes, come!”

Even though her tone was very calm and relaxed I took her call for me to come very
seriously and got to her house 15mins later (thankfully she lived very close).

Walking in, I heard the mum on the phone saying to her midwife,
"Ok,...I suppose I will call you back when I really, really need you here.”

She sounded slightly dejected. I greeted her husband who was busy in the kitchen
boiling water and beginning to fill the pool. I rounded the corner to greet mum with a
smile as she rolled onto her knees on the couch as a very strong contraction began.

"Wow this is very, very strong...this is the first one like this...maybe I do need to call my
midwife back," she says through some low primal groans.

Her body seemed to shift gear as soon as soon as I, her support person, arrived. I
applied back pressure through this contraction and when it has passed I asked,

“Would you like me to dial your midwife or shall we wait for one more contraction?”
“Wait for another contraction,” she decides.

Moments later, the next contraction came, even stronger than the last one. We move
through this contraction together and then she dials her midwife. As she does I look and
see the pool is a long way from full so I quickly take a hot water bottle, fill it and wrap it
in a clean towel to support her with heat ( a decision that turned into a small miracle
later on, from a carer’s perspective).

The next contraction was stronger again and with a panicked voice and low grunting this
beautiful mother moved to the ground on some clean towels her husband and I lay out
and said,

"She's coming, she's coming, she's coming!"

Mindful that too many words keep a mother in her higher cortex, I wanted to find a way
to validate her fears and calm her in the same moment. So choosing my words very
carefully I said in a soft warm tone,

"I know you don't want your baby to arrive before your midwife. Know that your body
and your baby clearly know exactly what they are doing. We are here with you."

With that, she seemed to calm slightly and go inward finally joining her baby on the
journey to her. Her baby was clearly moving very fast and mums breath was very quick.
Miindful that she was worried of tearing due to a quick labor, I then said in a calm voice.

"Let’s just slow things down a little by slowing our breath," and I breathed slowly with
her.

With that, she really slowed and became calm and present as her baby began to crown.
But just then, another moment of worry emerged from her,

"Who will catch my baby?" (as she was on all fours and didn't want to move).
"Dad is here ready to catch your baby," I said giving him a big “I’m here to support you
too nod" and showing where his hands needed to be.

He watched his daughter’s head be born and slowly rotate. I sensed a moment of worry
from him that he may not be able to catch his baby so I put my hands down well below
his to show him support and reassure him (although for me I had already made a
mental note to myself that I would do everything possible to not touch her baby as that
is not my role and furthermore wanting to protect the microbiome of this little one).

A moment later their beautiful little girl slid out into her father’s hands and I helped talk
mum through carefully lifting one leg so dad could pass baby under to her. I moved

closer to mum as she sat back and brought her baby up to her chest with the most
beautiful calm, empowered look on her face. I remember thinking with reverence,

“Wow, birth is just so normal." I was so caught up in the moment!

Then, suddenly feeling responsible to some degree, thoughts came to me,
“Check the baby’s color.”
“Check the baby’s breathing.”
“Keep the baby warm.” I quickly turned to my side seeing a clean towel wrapped in a
hottie. What a miracle!

We wrapped their new baby girl promptly in a beautiful warm towel and laid her on her
on mum’s chest. She was born ten minutes after I arrived and half an hour before the
midwife arrived.

The mother has since told me how empowering this birth experience was for her. She
said it could have easily been just as scary as her second unattended birth but simply
having someone with her that was calm and positive really allowed her to step into the
moment and be present with her baby girl as they began their next journey of life
together.

For me, this birth was one of the biggest divine gifts I will ever receive. It showed me
that both my knowledge of birth and my ability to calmly trust my instincts in the
moment, were enough to significantly support and help the mother, father, and baby to
have an empowering birth experience.

Later in the kitchen the father beamed saying to me,

"I can't believe I delivered my daughter!"

As this was my second experience with birth support to date, and a much more close up
one than my first beautiful experience, I did find myself thinking of all that could have
gone wrong later in the day... I have been able to settle on the reassurance for myself
that if anything untoward would have happened we would have worked through that
together in love. The key words that linger for me are “Together with Love.” The birth
was a gift my soul will always remember.

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The Importance of Why

One of the beauties of a strong and vibrant community of birth workers is that our conversations quickly delve into conceptual yet crucial topics such as human rights in birth, the effects of language and persona on confidence, power dynamics in the laboring room.  This talk brings us, as birth professionals, to a higher plane in understanding advocacy and the metaphysical aspects of labor.  However, when we share information with expecting clients, particularly in a group setting, it’s important that we are able to seamlessly shift from our hive minds, as birth workers, into the realm of creating a foundation of knowledge with our clients.

Offering too much all at once, although helpful for some who have researched a lot on their own, may feel overwhelming to expectant parents taking their first birth class.  When people experience information overload, they have a greater tendency to tune out, picking up and processing only bits and pieces, and ultimately feeling excluded from the greater conversation.  As childbirth educators, in order to successfully create a foundation of knowledge, we must understand the information our clients are bringing to the class space and we must assume nothing until we have reason to do so.  When we effectively and collectively have formed a knowledge baseline, we meet the parents where they are and have the ability to elevate them to a place of confidence and a space of safety in exploring their own priorities.  This will eventually help them utilize their rights to informed consent OR refusal, and communicate those preferences to their providers.

A simple online search for a birth plan will turn up all sorts of templates with prompts such as “I would like to…” and options including “walk and sit up during labor,” “avoid an epidural,” “have skin to skin right after birth,” and more.  Knowledge of these options are important and parents have the right to request these things.  However, what I have noticed in teaching birth classes, is that often parents are accepting that these are helpful things to do without having any understanding as to why.  Without knowing why, for example, movement in labor is important, clients are left without the confidence to back these preferences and without the ability to assert that these choices are honored.

As educators, we need to be ready to answer the question, from a research based standpoint as to why epidurals may not be the recommended first option against labor discomfort (and, on the flip side, why in some cases they may be beneficial), why movement and the use of gravity in labor is beneficial, why skin to skin has benefits for both the new parent(s) and the baby.  The greatest service we can provide our clients is in helping them understand why certain preferences have benefit so that they can make a conscious choice as to their priorities.  When we simply relay information and lay out techniques, we have merely bombarded expectant parents with more information – information they can often get from a simple google search.  By helping them understand the physiological process and how certain preferences may support or detract from that and how they can affect labor and birth, we are truly creating an environment of empowerment and learning.  The art of childbirth education is in the why.

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“The Baby Comes Out the Back” – Birth Story

by Krista Haggerty, BWI Trainee

I was 40 weeks and 6 days pregnant when I woke at 6am to my waters breaking.  It was a small trickle, but I knew today would be the day we would meet our third child.  I woke my husband, text my doula, and called my midwife.  Since this would be a VBAC, I had to deliver at a different hospital than where most women delivered at my practice, and it was almost a 40 minute drive.  My last labor was under 4 hours, so we wanted to be ready to go as soon as the contractions picked up.

I started having irregular contractions, but since they weren’t painful I figured we had some time.  We called my mother-in-law to come stay with our other two children.  Around 7am, I felt like contractions were becoming regular.  I called out when they began and ended and my husband timed them as I showered and got dressed, then helped my mother-in-law get settled with the kids.  When I asked him what the interval was, he said close to 3 minutes apart!  I called the midwife to let her know, and we left the house just after 8.

I played my birth playlist in the car to help me relax, and my husband and I smiled and chatted during the drive.  It was a beautiful morning, and we were happy to finally have our baby!  The contractions were getting more intense to the point that I was vocalizing through them.  They were coming closer together, but since they still were not too painful I thought we had plenty of time before things would “get serious”.

When we were about ten minutes from the hospital, I had a contraction that ended with me feeling the first twinges of pushing.  I text my doula quickly before another contraction hit me, telling her to leave ASAP.  I also told my husband, “it’s not an emergency yet, but maybe you should probably drive a little faster.”  He was very calm as he started passing cars, reminding me to breathe and telling me we were almost there.

We reached the hospital around 8:40.  By this time I was having contractions right on top of each other, and could barely move to get out of the car and into a wheelchair.  The urge to push was becoming much more intense.  My husband left the car right in front of the main entrance and jogged me through the front doors.  We flew through the hallways (with me yelling quite loudly most of the way!) until we reached the maternity door, and waited to be buzzed in.  I may have yelled “let me in!” in between contractions.  Once the doors opened, my midwife and nurses were rushing towards us, directing my husband to our delivery room.  As the birth team helped me get up from the chair, my husband jokingly said “she’s your problem now!”

I got on the bed and lay on my side, still vocalizing loudly and pushing with the contractions.  I asked for the lights to be turned off and welcomed the soothing dusk of the darkened room after our ride through the bright hallways.  My midwife checked me and told me I was only at 8 cm, so I needed to stop pushing.  I was annoyed, this made me 3 for 3 births where I was pushing too soon and risking a swollen cervix.  My doula wasn’t there yet, so the midwife and nurse talked me through the contractions, reminding me to slow my breathing and cheering me on.  My husband caught on and joined in, letting me know he was nearby.

After what felt like a long time (is there any time longer than trying not to push when everything inside you is screaming to push?), I suddenly felt the baby’s head drop down and I said “is that the head?  My midwife helped me get to a hands and knees position, and raised the top of the bed so I could be upright and lean against the bed.  My husband stood near me at the top of the bed and let me grip his hands, and I stabilized myself against him as I followed my body’s cues to push.  I wasn’t really hearing anyone in the room, but in my head I heard something I had learned last year:  “the baby comes out the back”.

Last August, I attended a BirthWorks Childbirth Educator Workshop.  The phrase “the baby comes out the back” was new to me, and was used several times over the weekend.  I had a difficult time understanding exactly what it meant.  It wasn’t until I saw a visual of a 9 month pregnant woman with a view into her womb; the baby was angled not straight down or slightly towards the front as I’d always imagined, but towards the back of her body.  It suddenly clicked!  The baby comes out the BACK!

Fast forward to a little more than a year later, and that was the mantra running through my head as I worked with my baby.  I rested in between contractions, knowing I was close to the end.  I pushed and breathed towards the back, and then felt baby’s head:  the ring of fire!  I slowed down and took a moment to breathe.  When I pushed in the next contraction, my baby was born!  It was only 30 minutes since we had arrived at the hospital, and I pushed for less than ten minutes.  It was my fastest birth, and my first that was intervention free.  I waited impatiently as they got ready to move me so I could hold my baby, and for my husband to tell me the gender since I was facing away.

It took a moment for my husband to announce in shock, “It’s a GIRL!”  There was a wonderful feeling of joy in the room, everyone was smiling and laughing.  It was a beautiful way to welcome our daughter to the world.

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A Mothering/Fertility Slavic Textile Doll

by Yulia Welk, CCE, BWI

Crafts can serve a role of ritual, strength and healing through working with mental images, fabric and old handmade Russian tradition of making charm dolls.

I have been making Russian traditional fabric dolls for five years now, they are very numerous and unique (check my Instagram at yulia_welk).  I currently have an exhibit of 25 dolls at the local library (Drummond Public Library, Wisconsin).

A couple of them historically are devoted to the subject of fertility, pregnancy and mothering.  In the dolls, besides making the head, body and dress, we also make breasts as an important symbol of nourishment for future babies and having enough gut, energy, strength, responsibility and health for tackling those tasks.

These dolls serve as visual guides for girls’ passage into womanhood.  The dress represents the ancient way of dressing for girls and women, as a collector of feminine energy that comes from the earth, being a creator, materializer, and having grounding aspects of femininity.

The second doll is called Pregnancy Doll.  She is made with colorful fabrics (red shades are important as being the charm, protective color that also represents life, blood, and energy needed for carrying the baby in the womb.   The doll has a belly with a real baby doll wrapped inside.  A woman would make a little girl or boy fabric baby, wrap it in the pink fabric, cover with the roll of birth bark and wrap in in the belly of the pregnant doll.

This doll serves as charm, protection and concentration of positive vibes for women.  Making it, women would talk about fears, concerns, birth and mothering.  The doll is publicly displayed until the baby is born.  If the outcome is a healthy happy baby this doll becomes a family, a clan female harm, that is inherited and used for future generations.  If anyone is interested in learning how to make these useful charms (we can do it online, $25 per person), please contact me through my website:  www.yulias.net or my home number 1-715-798-3175.

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Twin Victory

by Jane Beal, PhD, CCE (BWI)

When the waters were rising from January rains,

and the California hills were all green,

 

when the white-woolly sheep were wandering in pastures

and chewing the grass at their feet,

 

then the Victorious One went walking

across the expanse of her fruitful olive farm,

 

carrying twin babies in a belly grown as round

as the white moon when she is full.

 

She felt the little ones begin their journey in the morning,

her muscles tightening like they had with the first

 

eight years before, with her baby girl, who was now

playing in the trees, hiding and waiting,

 

for the new ones to come from the womb

into the world and change everything.

 

Victoria made her way to her home, a place

perfectly prepared and decorated in pink,

 

the prelude to wishes come true,

and within a few short hours, Suri was born

 

slipping gently into her father’s strong hands,

while her brother Noah waited inside,

 

wondering where his sister had gone,

until the midwives arrived

 

and then down he came, like he was invited,

a little blue and folded forward, but

 

he cried out and filled his lungs with air,

for the breath of life had gone into him.

 

When the placenta came, dark red and lovely,

fused on the maternal side, it showed how delicately

 

his life was connected to his life-house, for his cord

was only loosely connected to flesh,

 

but the strings did not tear, and he made his transition

from the water to the air in miraculous safety.

 

Then brother and sister lay closely together,

comforted in the presence of one another,

 

and their father and mother watched over them,

and their midwives praised God for their lives.

 

 

For everyone who has been born of God overcomes    

    the world. And this is the VICTORY 

that has overcome the world:  our faith. 

 

~ 1 John 5:4

 

Jane Beal, PhD is a childbirth educator, doula, and midwife. She has served with homebirth practices in the greater Chicago, Denver, and San Francisco metropolitan areas and in birth centers in the U.S., Uganda, and the Philippine Islands. Since 2012, she has been a contributing writer for Midwifery TodayShe also is the author of Epiphany: Birth Poems and Transfiguration: A Midwife’s Birth Poems. She currently serves as the Director of Education for BirthWorks International and teaches at the University of La Verne in southern California. To learn more, please visit sanctuarypoet.net, christiandoula.net and christianmidwife.wordpress.com.