The class topic last night was first stage labor.  This stage is characterized by a progressive intensification of the sensations in labor.  A mom will experience her contractions, or her “surges”, getting increasingly stronger and longer with less time between them, as she gets closer to the pushing phase of her labor.

Why do a "labor rehearsal" when labor is so unpredictable?? Mostly to train you and your partner into some "muscle memory".  By practicing different positions and reminding yourself when/why they are effective, that body of knowledge is more readily accessed when you are in labor.  Even if you forget your "playbook", you have some tools that you can use without referring back to a print-out of labor positions. (Although, HERE is one that I share with students.  I used it to prepare for our births and often use it as a reference in our classes.)

 

We had our couples do an active labor rehearsal.  As a reminder to them, and as a practice tool for anyone reading this who is striving for a natural labor, here are our tips on having a good labor rehearsal.

 

We have the advantage of a student workbook with illustrations to follow.  There are also resources out on the Internet with ideas for different positions to open the inlet of the pelvis to make room for baby.  The key is to try all the different positions.  Try to practice at least two simulated contractions every day, and you will find that you will have put your body in the different positions before you start labor. 

This is important for the following reasons: You will know if you can do them – if it hurts, maybe it’s time to do more stretching, or find other positions that have similar benefits without being uncomfortable.  You can also start making a list of the ones that feel really good, keeping in mind that this list may change as you are progressing through labor.

 

Again, the key is to simulate labor.  Once mom starts having stronger surges, she will be physically unwilling or unable to move while she is having a contraction.  So train your muscle memory the right way from the beginning. 

That’s not to say that you will stick to one position during the course of your labor.  It’s likely that there are several positions that you will try, and you may eventually gravitate to a few that seem to be the most effective.

 

In actual labor, a coach or one of the assistant coaches must always stay with mom.  She is in a vulnerable time, PLEASE stay by her side.  If mom is not comfortable having you in the bathroom, getting over the emotional hurdle will be better dealt with outside of labor.  It sounds weird, maybe?  It is possible that emotional barriers can keep labor from progressing.  Who would want bathroom issues to extend the amount of time you are having contractions?  Another thought: why delay meeting your baby?

                      

This is what we personally experienced: if you leave mom alone, she may fall – this could drastically alter the course of your labor.  Additionally, there is no guaranteed labor pattern – just because you have been having surges 5 minutes apart and you think she has five minutes before her next contraction doesn’t mean she should “go” alone.  If she starts having contractions on the commode, she isn’t going to be able to move.  It is possible, since the bladder is emptied, that the contractions will feel stronger after she has voided since it has made room for baby to descend, and she will want your help handling the stronger sensations.  From our own personal experience, I know we hit “transition” in the bathroom in 2 of our 3 labors.  It was a good thing to have someone with me to help me manage the mental gearshift and the sensations.

Coaches, you have a good job during labor.  You are the person that can make all the difference in mom’s confidence in herself and her ability to birth.  Prepare by working out your “athlete” at home and learning how to be the best coach for your team well before labor starts. 

Regarding such things as touch, music and environment: do you know her likes? Dislikes?  Do you know which relaxation techniques work for her?  Can you massage, talk, and time her contractions simultaneously? 

If you answered no to any of these questions, then we encourage you to start finding the answers!  And practice until you are doing several things at once without having to think too much about what you need to be doing to keep your partner completely relaxed through her labor.

 

The three main areas where mom will hold tension are her face (especially the jaw and brow areas), her hands and her feet.  Can you do the checkpoints in #4 and observe her for relaxation, too?  Most coaches need lots of help learning to do all these things at the same time.  You can find an assistant coach who is there to help support coach as he strives to do all these things.  Or, the assistant can help the coach to get mom as relaxed as possible so her body can get down to the business of having the baby.  The more efficient her labor, the sooner you will all be holding your baby in your arms.

 

A key thought is PRACTICE MAKES PREPARED.  As in all things where we seek to succeed, good practice leads to better results versus going in without any prior mental or physical preparation.  As labor has mental, physical and emotional aspects, we really encourage our students to allocate time every day to train their muscles and minds for the challenge of labor.

 

TRANSITION

No first stage labor rehearsal in class is complete without a discussion about "transition", the time between the active stage and the pushing stage of labor.  Although it might be an emotional time, transition is a good thing – it means your labor is almost over. 

Question directed at Bruss: Which one of your labors had the worst transition?

Answer:  There was not really a worst. You need to look for signs and prepare yourself ahead of time, prepare yourself now. Since transition occurs at the end of labor and you are caught up with the whole process of labor, know what to look for.  There will be distinct signs and they are different for everybody.  In our case, Krystyna got really abrupt.  Up to that point, she would communicate with “this feels”…or, “please try”… transition was marked with, “I told you not to do that!”

 

I also reminded our class of a birth story they had heard where the couple’s only sign was a physical sign: mom started burping out of the blue, and it lasted a little while.  When she calmly announced, “I think I have to push”, it turns out she really and truly was ready without having the self-doubt or the pendulum swing of emotions.  (For the whole story, go to http://www.youtube.com/watch?v=fDI61YWV5G0 )

 

HOSPITAL CARE

We were lucky enough to have two nurses join our class last night.  They were attending as assistant coaches-in-training for one of our moms.  I took advantage of the situation to ask the nurses who makes the best patient.  My goal was to illustrate the point that you are the labor you bring with you, especially in a hospital situation.  We encourage our students to write a birth plan to use as a communication tool, and to use positive communication (important at all birth venues).  The idea is that you are all on the same team and you wouldn’t be there if you didn’t feel some element of safety in the hospital.  As long as labor is progressing without complications, a couple is reasonable in their requests, and the care provider has signed off on the birth plan, it should not be difficult to have the hospital staff support your choice to have a natural labor.

Question:  Who makes the best patients, or who are the patients that are the easiest to work with?

Answer:  They are willing to work with patients who want to work with them.  They also appreciate patients who respect their medical training.  When it comes to requests, i.e. birth plans; patients who are nice get their way!

 

PRACTICE MAKES PREPARED

I want to encourage you to make the effort to practice what you want to happen on your baby’s birth-day.  We encourage our couples to do ten minutes in the morning before they get started on their day, and right before bed at night.  What better way to help mom feel safe, secure and stress-free?  She can go about her day knowing that she and baby are important enough to merit the time.  At night, she will sleep better after a good relaxation session.

We can attest to the fact that yes, it is hard to find the time.  In reality, you don’t find time – you have to make the time available.  It is worth it – even if you end up with interventions, the fact that you gave it your best effort makes for a labor that you can look back on with an element of pride.  The natural labor and birth you want is a reality – and the more you practice, the more likely you are to achieve the birth story you want for your family. 

There is another element to a successful labor beside preparation – and that is a well-rested team – and that is a post for another day.  Happy Practicing!!

 

 

Disclaimer:

The material included on this site is for informational purposes only.

It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

 

I had the opportunity to participate as a panelist this weekend at the Healthy Happy Baby Expo.  I realized that I have never articulated what The Bradley Method® is in a nutshell before.  I will spend the next few weeks trying to capture the essence of The Bradley Method® in these little slides...let me know if you have any questions that I should address!

     We had the privilege of starting two new Bradley Method® Class Series last week.  We are teaching a Friday night series with First-time parents, and on Sunday we are teaching our Bradley Method® "Next Class" with alumni families who are expecting baby number two. 

 

Date Night – Spend one night (or afternoon) a week with your beloved and do something together to honor the birth of your child.  Whether you spend a little time visiting in the car or breaking down the class on the way home, it’s class time + conversation that the two of you are dedicating to prepare for the birth of your baby.

 

Snack – I remember being hungry when I was pregnant and looking in the refrigerator, the freezer AND the pantry and finding that there was nothing in there that I wanted to eat.  Bah!  Then I got cranky.  Most Bradley™ classes take a snack break.  Whether it’s provided by your instructor or your peers, its one time that day that you will get a yummy snack without putting time or thought into it.

 

Camaraderie – Think you are alone experiencing the creaks, groans and squeaks of pregnancy?  Spend a little time talking to the couples on either side of you and you will find out that there are other people making sounds they never knew they would make, having heartburn that could fry an egg, and the concerns that have plagued pregnant women since time immemorial.

 

Community – Those people you see in class for twelve weeks?  It’s likely that they are going to be people you keep in touch with after class is over and you are holding your babies on the outside.  Even though they are complete strangers the first class session, like you, they are choosing to prepare for a birth with little to no interventions or anesthesia.  Maybe your friends and family are telling you, “Take the drugs – that’s what they are there for,” or, “You don’t get a medal for natural birth.”  The folks in class with you are a sign that you are not alone in your choice.  Together you will learn to say, “This is the choice that works for our family.”   You can gain confidence in your choice when you see how many other like-minded families are around you that understand and support your choice because that is a choice they are making for their families, too.

 

Communication – The foundation of any win-win relationship is the ability to communicate effectively.  Each week of class there is a different communication exercise to build skills between the couple, to help you clarify what you want and your priorities for your birth experience, and how to express that and evaluate what you are hearing from your care provider.

 

Healthy, whole food nutrition is a foundation for a healthy, low-risk pregnancyNutrition – Although it is seemingly basic, it is one of the easiest things that a couple can control in their efforts to have the birth that they want.  More and more studies are confirming what Dr. Bradley and Dr. Brewer knew – good nutrition is one of the foundations for a Healthy Mom, Healthy Baby outcome.  By making good, whole food choices that yield a daily protein count between 75-100g of protein, a family can lay a good foundation to have more options during a normal, low-risk birth.

 

Exercise – The next building block towards having lots of choices in labor is a mom that has the strength and stamina for her particular athletic event.  Some mamas have a “sprint”, some mamas have “marathons”, and most fall somewhere in between.  The Bradley Method® exercise program is designed so that a mama does some form of cardio to build her stamina and it incorporates exercises to strengthen her back, belly and bottom.  The mom who does these things increases the likelihood that she will be able to comfortably move through her labor to ease baby into position and still have the energy for her pushing phase. 

 

Comprehensive Education – Yes, we are definitely the “longest” childbirth class among the list of recognized “brands”.  By choosing our class series that is 12-weeks long, you are choosing a method that covers many different aspects of pregnancy, the process of labor, natural labor coping techniques, birth plans, variations and complications of labor (and knowing the difference between the two), postpartum care, breastfeeding and newborn care on top of the weekly focus on communication, exercise and nutrition.  While there are other “brands” that teach shorter sessions, we are confident that our approach allows couples the greatest opportunity to prepare for the birth that they want and life together as a new family.

 

Relaxation – Relaxation is the key to The Bradley Method®.  Dr. Bradley believed that a woman who could relax her body by focusing on abdominal breathing and nesting like other perspiring mammals was a woman that could labor and birth without drugs.  His theory proved out:  his natural birth rate was 94-96%, depending on the year.  Our classes not only remind mothers how to do their abdominal breathing, we also instruct couples on eleven different relaxation techniques that address physical, mental and emotional relaxation.  A couple that takes a Bradley™ series theoretically has a toolbox full of techniques to use during labor.

 

Practice Makes Prepared – Every couple has the opportunity to take the material home and make it their own.  By spending a minimum of five minutes a day practicing the weekly relaxation technique and practicing one of the many laboring positions we teach throughout the series, a Mom and her Coach are ready for a normal, low-risk labor.  If they take the communication lessons to heart, they have spent time outside of class preparing a birth plan that works for their family, and they have an idea of how they will choose to handle any variations of labor they may face so that if their labor follows a curvy path, they can handle the twists and turns with confidence.  Above all, a well-trained Bradley Method® couple trusts in the process of birth and they know to follow the Mom’s instincts + communication with the coach and the birth team towards a Healthy Mom, Healthy Baby outcome.

 

 

  One of my favorite sayings is, “Practice makes prepared”.  We had a wonderful confirmation in class this week of why it is so important to practice and prepare for the labor you want.   

 Our relaxation session in our last class was for both the mother and the coach to make a list of positive things the mother could think about during labor.  They were then to use these ideas during our relaxation practice/labor rehearsal portion of class.  Coach had a great list going that included what he called his “secret weapon”.  It was going to be his “go to” story to tell his wife when the going got tough in labor.   

 The time for relaxation practice/labor rehearsal arrived.  We dimmed the lights, put on our relaxation music, our students got into their first “practice position” from our diagrams of labor positions.  Then we did our first “practice”.  I timed the contraction by announcing how many seconds had elapsed (I call out 15, 30, 45 and 60 seconds).  Coach started with one of the ideas his list.  Mom did not like it – the story made her laugh instead of relaxing her.   

 We did our second practice, trying out a different labor position and the same scenario with music and lighting.  I timed again and Coach went back to the verbal coaching we have been using up to this point in classes, “words of encouragement”.  Mom reported feeling much more relaxed and Coach made an “uh-oh” face.   

 I asked him what was going on since he had just coached his wife through a great minute of relaxation.  He replied that his “secret-weapon” is a story that is along the same lines as the story that made her laugh, and she prefers words of encouragement…what was he going to do?   

 We reminded our couple that this is exactly why we practice in class and we encourage them to practice at home.  We are teaching them several ways that are effective at managing the discomforts of labor so that they can fill their toolbox with several different ways of relaxing mom.  If you don’t practice before you get into the hard parts, it’s unlikely you will be able to improvise since there are so many ways to manage labor.   

 By the same token, we tell couples every labor is unique, so it’s important for a coach to have a “Top Five” list of moms’ favorites so they know what to try first.  On top of that, we remind them that the most important factor for coaching is to be flexible.  Sometimes coaches find that the things that work in class do not work in labor.  Sometimes the list of “Top Five” turns into the one thing that works.  And it has happened that none of the coping techniques the couple liked in class helped, and they pulled from some of the other relaxation techniques we had covered and that they had practiced at home “just in case”.   

 It is exactly for those reasons that home practice is vital.  Mom can review techniques on her own and create her list of favorites.  Coach can review techniques and practice scenarios in his head while he is on his own.  The most important component is to practice together for the direct feedback.  Practicing together builds the coach’s confidence that he knows what he is doing and he will do well as a labor coach.  It builds the mom’s confidence that she will be able to rely on her coach.  Our personal experience is that this sense of safety and security, which leads to the ability to complete surrender during the labor experience, is the key to allowing labor to progress to the intensity that helps us meet our baby earthside.   

 We reassured Coach to keep those stories in his toolbox because laughter is actually a great coping technique.  It’s not comfortable during a contraction because it adds tension to an already tight body part – not ideal when a mom is trying to work with her body.  However, laughter is great tool to reduce adrenaline.  This is a huge plus because adrenaline inhibits oxytocin.  Receptors in the body can only accept one or the other, not both.  The other plus to laughter is that it releases endorphins, which can act as analgesia and promote a sense of well-being – both good things for a mom in labor to welcome their child.  We encouraged Coach to bring those stories out between contractions – they definitely deserve a place of honor in their personal toolbox.   

 I don’t liken labor to a final exam because sometimes the most prepared couples end up with a birth that doesn’t go according to their wish list and I don’t want to convey to them a sense of failure.  It is true that labor will test the couple in ways that they probably have not been tested before, and the more they practice at home, the better prepared they are for their experience.  Although the weekly assignment is for twenty minutes per day, even one minute of practice is better than none to build a couple’s confidence.   

 Being prepared for this experience will definitely improve the likelihood of having the labor they have practiced for.  Whether they have a “textbook” birth or a birth with variations, our happiest couples are the ones that feel they used their information from class and worked together to choose the birth of their child as a team for a Healthy Mom, Healthy Baby outcome.   

More about laughter and endorphins: http://stress.about.com/od/stresshealth/a/laughter.htm http://en.wikipedia.org/wiki/Endorphin   

More on labor positions:

Here are some of the ways we recommend our students manage their labor without analgesics or anesthetics.  Even when they are used in labor, we are so happy that our couples use them as tools to manage a long labor and their children are born nursing vigorously and with high APGAR scores.

Mom and Coach are informed. 

Through the course of The Bradley Method® class series, parents are taught about what to expect as “normal” in labor, what the variations on normal might be, the different options and interventions in labor, and how to recognize a complication that warrants a change in the plan for a Healthy Mom, Healthy Baby outcome.    

We also teach positive communication, something intended to strengthen the parental bond, as well as serve for positive interactions in the birth space with care providers and support personnel.  Our goal is that parents have the tools they need to evaluate labor, communicate their needs to care providers, and ask the questions they need to make informed decisions about the choices they may have to make in labor.   

Mom and Coach are athletes. 

An athlete with an eye on crossing the finish line does four things:  They train, they rest, they nourish and they hydrate.  Dr. Bradley called his patients “obstetrical athletes”.    

His nurse, Rhonda Hartman, designed a training program just for moms to prepare them for labor.  We are still teaching our couples this training program, starting with week one of class and continuing until the time of birth.  We also “train” relaxation.  Each couple is encouraged to take the weekly technique and practice at least 15 minutes per day so that there is muscle memory for relaxation when it is needed in labor.   

We continually harp on the importance of sleep in the weeks leading up to labor and once labor starts.  We learned this lesson the hard way, and as excited as we know our students are going to get as they anticipate the birth of their child, we want them to try to rest.  Getting to the magic number of “10 cm” is only the first part of labor – once they reach 10 cm, they also need energy for the second stage of labor to welcome their child into this world.   

We also echo Dr. Bradley’s advice to eat if you’re hungry, drink if you’re thirsty.  He makes the analogy that going through labor without eating or drinking is like playing a full game of football without any substitutions.  The body is working and burning energy to birth your baby, it makes sense to follow mom’s physical cues.  As long as mom is okay and baby is okay, we have found that mom’s appetite will naturally decrease as labor intensifies; and as with an actual marathon, that the need to hydrate is as important in early labor as it is when mom is close to crossing the finish line.   

As stated above, a hydrated mother makes for an optimal obstetrical athlete.  She is hydrated for energy and optimal hormone distribution throughout labor.   

 Water is also a excellent relaxation tool.  It works magic in labor: the warmth and the sensation move tension away from the body and adding a layer of relaxation as it works to soothe the mother’s body.  I have heard it called, “The Midwives Epidural”.    

Many hospital moms now have access to the birth tubs that are used very effectively at birth centers or at home births.  If  using a birthing tub or home bathtub is not an option, then the shower can also be an effective tool.  The sensation of water will still massage and soothe the body.  With a shower hose attachment, the water can also be directed at the body where it is the most soothing for the laboring mother. 

  

Abdominal breathing is taught in many settings to deepen relaxation – yoga, hypnosis, meditation, stress relief, and in The Bradley Method® of natural childbirth classes!  Abdominal breathing is also known as diaphragmatic breathing.  Basically, you are allowing your belly to rise and fall as you breath instead of your chest.  If you watch children breathe, or if you remember what it was like to breathe before someone told you that you needed to suck in your stomach, you will know what it means to breath with your abdomen.   

Abdominal breath is an important foundation for relaxation.  It slows down our mind and it allows or bodies to release tension.  We teach abdominal breathing in class 2 so we can build on it through the rest of the series.   

Coach is a relaxation expert. 

Coach needs to know what relaxes their partner.  Does mom respond to physical touch?  What kind of touch?  Does she like a strong counter-pressure or gentle effleurage?  Does she like a relaxation script, a prayer or a story read to her?  Does she feel safe in her birth space?     

By the end of The Bradley Method® class series, we have covered these, and many more questions, to help the Coach be a relaxation expert on their partner.  We also teach 11 different relaxation techniques for coaches to put into their “toolbox” to use as needed as labor progresses.   

Have a trusted assistant coach. 

Champion sports teams have a stellar assistant coaching staff.  The head coach doesn’t try to do it all – he delegates and finds the best person to train his team so that he can keep his eye on the big picture and continue leading and motivating his team.   

We have noticed that couples with an assistant coach generally end up with births that are closer to the birth wishes they made in preparation for their labor.  The extra set of hands, the extra energy in labor make a difference.  The couples that hire doulas also have an experienced birth professional to help them manage the map of labor.  A good birth doula doesn’t take over the birth, she will help the couple to recognize the signs of progress and make suggestions for coach to support the mom.   

Even if you feel like you want to be just Mom and Coach, you can benefit from an assistant coach coming in for a period in labor.  When we labored with Angelika, a dear friend of ours came in and labored with me when Bruss needed rest.  I had been laying down the first day, resting and napping since we know we have long labors.  Bruss had been checking in on me, taking care of our older children while we waited for family to arrive to tend to them, and he took care of feeding all of us.  He REALLY needed to sleep after dinner that night.  Andrea came, labored with me as long as she could, and when it was time for her to get back to her own family, Bruss was rested and ready to be head coach again.  I am forever grateful for her time that night – it allowed for Bruss to rest and restore for the long work we still had ahead of us.   

Break the Fear-Tension-Pain cycle. 

We break the Fear by teaching couples what to expect in a normal labor, along with the many variations on “normal”.  We also break the Fear by discussing the complications and sharing strategies and options for them to consider if they are among the small percentage of people that face complications in labor.   

We break the Tension by teaching Mom and Coach to be relaxation experts.  We break the Tension by teaching couples to communicate together, and how to communicate with their care team for effective and positive interactions.   

We break the Pain by reminding mothers that labor is an athletic event.  It isn’t always easy, however it is doable.  We invite couples from the previous class come share their stories with our current class.  I have seen the “light bulbs” click for both Moms and Coach when the other “first-timers” share their stories.  It makes it more realistic to hear that other newbies had Healthy Mom, Healthy Baby outcomes by using the information they learned in class.  It reassures them that the intensity is brief compared to the joy of holding their children.  The new parents confirm that the work is worth the effort, and that staying the course and/or making Healthy Mom, Healthy Baby choices are rewarded with a happy family outcome.    

We also encourage couples to find affirmations, prayers, scripts and/or music to draw energy from in labor.  Labor is an exercise in intensity that ebbs and flows.  Having something to focus on besides the intensity that is growing helps to focus mom on the work that she is doing.  They can also restore and encourage her when she wants to give into the pain.    

By having knowledge, training and tools, couples are well on their way to a Healthy Mom, Healthy Baby outcome.   

It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. 

An important part of The Bradley Method® (some say the most important) is relaxation.

The superficial view I had of relaxation going into our first Bradley class and subsequent birth was that of *physical* relaxation. Krystyna and I were/are regular Yoga practitioners and my mental picture of relaxation was the final Yoga posture where one lays prone on the floor after a hard workout where the only option is total physical relaxation. In my own mind I thought that getting Krystyna to the physical state of relaxation was the goal/benefit to her in pregnancy and labor.

The Bradley Method® instructs various methods of physical relaxation to the couples and encourages them to explore others that are meaningful to them. Among the methods are message, stroking, hot showers etc.

Combined with physical relaxation, The Bradley Method® teaches the importance of emotional and mental relaxation. Initially I considered these relaxation themes of less importance than physical relaxation. My thought process was if I can help get Krystyna to relax *physically* than the other relaxation components would take care of themselves. 

I have come to find out through our Birth experiences as well as the dozens of students that we have help teach/mentor that my initial approach to relaxation in pregnancy and birth was exactly backwards.

Physical relaxation is the *end* result and dependent on emotional and mental relaxation, Mom needs to be in a good emotional state, accepting of the baby and ready (as possible) to take on her labor, ready to be a Mother, has effectively dealt with any family dynamic issues *prior* to going into labor or any other *emotional* issues that may impact Mom's readiness for labor and beyond. 

As a strong compliment to emotional relaxation, Mom's ability to focus her mental energies effectively in pregnancy and labor can dramatically effect the outcomes for better or worse. I think of mental relaxation is the ability of Mom to affect her state of mind positively to overcome any externalities such as physical discomfort, emotional and environmental challenges.

What I have found through experience is that if Mom is not relaxed emotionally and is not able to focus her mental energies positively then *physical* relaxation is all but impossible. Conversely, by concentrating on emotional relaxation and positive mental focus then physical relaxation seemingly just happened and labor was able to progress more effectively.

.....

So what does all that mean?

For me as a husband and labor coach, what this means is that I have to (1) understand the importance/impact of emotional and mental relaxation to pregnancy and labor and (2) be ready, willing and able to effectively work/communicate with Krystyna on these components of relaxation during pregnancy, labor and beyond.

......

I'll end the post with a story from our first labor.

In our first labor Krystyna's water broke and labor contractions started soon thereafter. We went to the hospital after 6-8 hours and labored there for another dozen plus hours. While we were out walking the halls attempting to get labor to progress, Krystyna visibly became chilled and shaky. I reached up to her forehead and, sure enough, she was warm and very likely running a low grade fever. Krystyna told me, adamantly, 'do not tell the nurses/doctor that I have a fever or they're going to give us a C-section'.

OK, here I am as first time father, birth coach, with little or no experience, what to do?

Here's what went through my mind at the time.

1. Fever is sign of infection and potentially very dangerous to Krystyna and baby (we didn't know boy or girl yet)

2. Krystyna is *very* mentally strong and her mind is completely set on an intervention *free* labor and delivery.

3. Krystyna is *very* emotionally invested in this labor being natural and intervention free.

4. My last thought before coming up with a plan was I need to be careful how I handle this. Krystyna is very tired after 20+ hours of labor and on edge. If I don't handle this correctly there's a chance that she will just give up and then we're highly likely to be getting a C-section.

So here's what I did.

I told her that she was doing such a great job and was laboring really, really well. I also reminded her that she worked so hard in preparing for the birth with nutrition and education and I was *proud* of everything that she had done for our child. She was/is the absolutely the best and that I love her.

Next I looked at her and told her that she/we had done all these things to have the best outcome possible and the end goal of all this work was ultimately for her and the baby to be healthy and happy.

Then and only then did I tell her that the fever was dangerous. It was dangerous to her and the baby. And that we were not going to *hide* the fever from the birth team because that would go against our primary goal of having her and the baby be healthy.

Then I said that I was there for her and that we were going to do this *together* regardless of what labor interventions we might be faced with even if that meant we were looking at a C-section.

After that conversation we walked back to the room and told the nurse that we likely had a fever and started to discuss the options. The option we chose was to start a penicillin drip to take care of any infection. Several hours later (and 2 more interventions) Krystyna delivered Ysabella vaginally. Mom and Ysabella were healthy and Krystyna and I were *very* happy.

So my role as a coach in this birth was to help Krystyna deal with the emotional and mental challenges in being faced with medical interventions in labor despite her *very* strong emotional and mental investment in a natural, *intervention* free birth. In my opinion the emotional and mental aspects of this birth were the primary challenges that we had to get past *together* so that Krystyna could relax physically, let go and deliver Ysabella into this world. 

In the moment and in retrospect it was one of our very best days as husband/wife and new *parents*.

Bruss taught class last night and he is in the process of writing a blog post on mental relaxation beyond the script...in the meantime I am going to share some information about an event that the Arizona Bradley Method® instructors are planning.

The Bradley Method® has been helping women and their partners to have safe, satisfying birth experiences since the 1950s and it still works.  Area instructors affiliated with The Bradley Method® of Natural Childbirth will be hosting a Family Picnic on Saturday, May 5, 2012. The public event will be hosted on Amphitheater Island at Encanto Park in order to celebrate the Father of Fathers, Dr. Robert Bradley, the pioneer of allowing fathers into the hospital room to be at the birthing mother’s side.   

Robert A. Bradley, M.D. (1917–1998) developed what he called Husband-Coached Childbirth, now more commonly known as The Bradley Method® of natural childbirth. Dr. Bradley first articulated this method of natural childbirth in a 1947 clinical trial, and it was popularized by his book Husband-Coached Childbirth, first published in 1965.  Now in it's fifth edition, Dr. Bradley's method of natural childbirth had been used successfully by couples all over the world.

Dr. Bradley's idea that unmedicated childbirths were possible in a hospital setting was revolutionary in the era of anesthetized births. He was "allowed" to do his first clinical trial on unwed mothers. When they did not have adverse outcomes, he was next "allowed" to do a trial on hospital nurses that volunteered to be in his trial. After seeing the great results in the unwed mothers, he had no problems finding trial patients.

At the bedside of one of these married nurses, she was overcome with joy and  emotion after the natural delivery of her child. As her "thank you" to Dr. Bradley, she kissed him straight on the lips! It was at this moment that Dr. Bradley realized that husbands (now we say loving support person, or "coach"), not doctors, should be coaching these mothers through the labor and birth process.

It was from that day forward that Dr. Bradley started advocating for husbands to join natural birth mothers in the labor and delivery rooms. Now all birthing families in a hospital setting can benefit from Dr. Bradley's idea that coaches who are willing should be allowed to be at the laboring mother's bedside.

His method articulates the six needs of a laboring mother and the steps to take to provide a laboring mother with the help and support from a loving, trained coach.  His methods proved themselves through his patient practice. He likened his role as an obstetrician to serving as a lifeguard, stepping in only when his patients needed him.  Dr. Bradley had a 94% unmedicated birth rate throughout his years of obstetrical practice.  

We are excited to celebrate the life and work of Dr. Robert Bradley on May 5, the anniversary of his retirement.  The Bradley Day Family Picnic is open to the public. Past students, current students, and anyone interested in the many options available to birthing families in Arizona are welcome to join us. No matter what kind of birth experience you had or you want, we invite you to celebrate the man who normalized fathers being present at births in the hospital setting.

The Bradley® Day Family Picnic will feature child-friendly booths and games, as well as offer information on The Bradley Method® and other natural living options. The instructors will provide the fun; guests are invited to bring their blanket and a picnic lunch.

The Amphitheater Island at Encanto Park is located at 2605 North 15th Avenue, Phoenix, AZ, 85007. For more information on the picnic, please call Krystyna Bowman at 602-684-6567, or visit our Facebook Fan Page.  If you would like to RSVP, click here. For vendors interested in hosting a booth, please contact Krystyna Bowman at 602-684-6567, or via email [email protected]

We are regularly contacted by our Bradley® students as they go into labor.  For first time parents there is almost an universal excitement.  It is great to talk to the Dads and hear the excitement in their voices...the nervous, anxious energy as they start the wonderful experience of child-birth with their partner.

When I talk to the Dads as Mom's labor starts I like to give them a little pep-talk as follows:

OK.  You've been working very hard to prepare for this moment.  You have chosen a great medical team.  You've studied about labor and delivery, you've done the pregnancy and relaxation exercises, you've focused on a great diet.  You are ready.  Your job as labor coach is to pay very close attention to Mom.

- Energy level, mood, complexion color, pain level, ability to relax, ability to concentrate, hunger, thirst, fever, headache.

- Notice how Mom is doing in all these areas and note any changes.

- How close are the contractions?

- How intense are they?  

- Can Mom talk through them?  Or are they intense enough that she has to focus all her energy on them and can't talk or focus on anything else?

- Is there a pattern?

- Is the pattern changing?

Do the contractions (pattern, intensity...cadence) change with:

- change in position?

- walking?

- laying down?

- sitting down?

- shower?

- other?

Note all of these attributes and be aware of changes.

What stage of labor do you think you're in?  (Note: ask this question of yourself a lot)

Remember what you and your medical team decided ahead of time about when you would head to the hospital or when you would call in the midwives for a home birth.  Pay close attention to those thresholds.

Now while paying attention to all the little details about Mom's physical condition and how the contractions are progressing you have to focus on everything that you can do to support Mom as she labors.

- Keep Mom hydrated

- Make sure she has food (if she wants) for energy.

- In early first stage labor make sure Mom rests as much as possible so she has energy for later in labor.

- Help her relax through her contractions with your practiced methods.

- Don't ever leave her alone.

- Help her or be by her side whenever she's up and around.

- Take care of all the external things so that Mom can focus on the labor.

Enjoy the process.  The birthday of your child is one of the best days of your life.

So we have our sweet Angelika sitting in on classes with us since she is still nursing exclusively.  At eleven-weeks old she is a relatively easy baby who sleeps or coos quietly during class time.  For now, I can only hope it is a nice motivation for our students to see this sweet baby and look forward to the day when they will be holding their own sweet child.

 

We taught Class 3 and had our first “scenario” coaching exercise last night.  I can see that it is hard for the coaches and the moms in our class to imagine being in the midst of labor.  Most of our students start class between 20 – 26 weeks gestation.  They are enjoying their baby’s movements, having baby showers and wrapping their minds around parenthood.  The fact that this baby in mom’s uterus is coming out has yet to become a reality.  For now, they are only taking our word for it that they are going to need all the information they are learning about relaxation and motivation.

 

So, Coaches, how are you going to motivate mom to relax through the surges when their intensity keeps building and the frequency increases until they are back to back?  One of the reasons the Bradley Method® course is intentionally 12 weeks long so that Mom and Coach have enough time to fill their relaxation toolbox with strategies to manage labor and so that they have time to learn to work together as a team.

 

Here are some ideas shared about managing labor by other families who have recounted their birth stories:

 

Take one contraction at a time.  Mother Nature is very kind.  She gives us time between surges to catch our breath, change position if necessary and wait for the next wave of sensation to build.  These sensations build up over a period of time, and hardly ever do we have them on top of one another.  When we do have one surge on top of another, it’s probably because we are getting close to transition and we need to be reminded that we are so close to meeting our baby!

 

Remind Mom why she is doing this and why it’s important and worth it.  When you are still pregnant and comfortable, take the time to talk about the reasons why you are choosing to follow the course towards a natural birth.  Write them down if you think it will help you remember them during labor when things are starting to get more intense.  Keep your eye and mom’s focus on the “worth it”.  The effort and the work of labor will lead to a sweet baby in your arms and in your lives.  When you have a narcotic-free or at least low narcotic birth, you usually have a vigorous baby who is alert and who has a jumpstart on breastfeeding.

 

Some moms, I being one of them, put together a “play book” for coaches to refer to.  Some highlight their important pages in the student workbook, physical positions to use during different stages of labor, and maybe pull together prayers, meditations or relaxation scripts for Coach to read during labor when we need help to relax and let everything go so labor can progress.  In order to gain full benefit from this play book, make sure your coach knows where to find it and that you want him to use it.

 

Hold her hand, tell her that you love her.  This has always been the best “epidural” for me during our long labors.  Bruss’ constant support, his presence by my side in the fortieth hour that is just as loving and attentive as it was in the early hours of our labor when we were excited at the prospect of getting to meet our child; he is the reason why I have finished our “marathon” labors.  Even when I don’t want him to talk to me or touch me, his hand in mine reassures me that we are in this together and when I am ready to come out of my “zone” he is still there with me, working with me to meet our baby.

 

Praise, encourage and reassure her.  Don’t just give her a cursory pat on the back: pour on the praise – give her constant verbal support.  Praise her in front of your care team to build everyone’s confidence in her work.  Encourage us: read mom the letter she wrote to the baby about how she’s looking forward to meeting him or her.  Most of us have a hard time doing something for ourselves, but mention our children and we can do just about anything to ensure their well-being. 

 

Through the course of class we learn the signs and the progression pattern of a low-risk labor…as things progress and follow this low-risk yet challenging cycle, Coach can reassure mom that this is indeed, what they learned about and prepared for through the course of our classes.  Although labors must get intense in order to get to the contractions that produce a baby, it makes it do-able to relax through those contractions when your mind accepts that this is normal and many women before you have walked this path and had Healthy Mom, Healthy Baby outcomes.

 

If things deviate from the low-risk course and you have to make some decisions about how to manage your labor, we also teach our couples some tools to have a constructive and informative conversation with their care team.  The ultimate goal of any Bradley® birth is to have a Healthy Mom, Healthy Baby outcome.  When Moms and Coaches work together with their care team, you will always find yourselves making decisions that lead to this happy beginning to your new family.

 

 

 

 

 

My mom arrived from Chicago to relieve my aunt at around 4:00 pm on Friday afternoon.  She came in to see how I was doing.  She asked, “How are things going?” which of course started the tears again.  Being a woman of great faith, she said a beautiful prayer over us, then gave me a kiss and left the room to go take care of the kiddos.  I pulled myself together and decided I wanted to go see our children.  I missed them and one of the benefits of a homebirth is having those you love near to you.  We took a quick cruise around the house and saw the kiddos, and we decided it was cool enough to try walking outside again – maybe just one more time – to see what would happen.  

This walk confirmed our suspicions.  This baby wanted me on my side.  Nothing upright was working to progress the labor.  I lost it again – why was this happening to us?  Why couldn’t just once, my body work like a “normal” woman in labor??  

Up to this point, we had had student midwives checking vital signs on mom and baby.  I asked if we could have Wendi check me the next time just to be sure that we were both doing as well as they thought we were doing.  I wasn’t concerned about infection despite the fact that the membranes had ruptured going on 18 hours.  I had been good about taking Vitamin C every couple of hours, we hadn’t had one vaginal exam or external vaginal probing that was introducing germs “upstream” as we say in class.  My concern was simply that although I felt strong and the baby sounded good, we had been going at this since 5:00 am on Thursday morning and I wanted peace of mind that we could continue at whatever pace the baby needed.  

Bruss and I also talked about having the midwives go or stay, and we were not sure what to ask of them.  We conveyed this to Wendi when we talked to her.  I felt so bad having them stick around for “nothing”.  At the same time, I was wondering when we would call them back when our labor finally picked up.  Having spent so much time with us at our prenatal visits, they knew our birth history and knew that this had been our labor pattern in our previous births.  They assured us that they were comfortable, and happy to continue waiting patiently for baby to make her appearance.  

In the meantime, this birth also confirmed our choice to have a homebirth.  We had been in labor for 36+ hours now.  If we had been in the hospital, we would have been subjected to multiple vaginal exams by now.  If we had gone home and then returned after our water broke, we would have had a very hard time leaving again without signing a multitude of forms when it was clear that labor was not progressing.  I had declined the GBS test since we made an educated decision to take supplements that supported a healthy vaginal track, and I was confident that Dr. Ross’ KST check confirming that I was GBS negative was accurate.  Under medical care from an OB, I would have had to have the GBS test and had I tested positive, I would have been pumped with penicillin and IV fluids every four hours.  By now my hand would be swollen at the hep lock site, and my feet and face would be puffy and uncomfortable.  

At home, we were allowed to have the gentle birth we wanted for our child.  We listened to my body and followed the cues, however unbelieving that "this" was our labor.  We were able to sleep and eat to keep our energy up.  Our baby was monitored with a Doptone monitor every hour for a few seconds, which let us go back to the position we needed to be in for her more quickly.  Our midwives were supportive and encouraging that we were doing well and to keep going like we were going.  

Bruss kept in touch with Andrea and Dr. Ross via text throughout the day and night – they were our doulas by text!!  As they made suggestions he would try them if we hadn’t tried them already, as they gave us words of encouragement he would convey them.  

I would say I finally “accepted” the birth around 8:00 pm.  Bruss had given me wonderful assurances that this was the labor our baby and I needed every time I had started to cry.  He assured me that he was ready to labor just he and I – it had also become clear that having all the people around was starting to stress me out.   Despite the fact that a doula would be there to support us, he wasn’t willing to call in another person to add to the group of people in the house already.  

We decided to watch a movie and both proceeded to fall asleep.  The midwives continued to come in and monitor us through our sleep.  I was still getting up every 45 minutes to use the restroom.  One thing we did REALLY well is stay hydrated.  We found that we still had the contractions when we stood up and moved from the bed to the toilet.  As I accepted that this was our labor, I remember reading birth stories about women who slept through labor until they woke up in time to push.  I figured that we might as well give it a try – who knew – maybe this could be our birth story since short and sweet was definitely out!!  

It was my perception that the contractions were every half hour.  I could sense that I was moaning in my sleep, yet they didn’t feel so strong that they woke me up until it was time to use the restroom.  The midwives told me later that they had watched and felt my belly when I was sleeping, and I was having contractions about five minutes apart in my sleep.  

Somewhere between 10 and 11 pm, I could no longer sleep through contractions.  We decided to use the shower again.  We put a birth ball in there and let the water wash over me.  You know what happened – the contractions spread out again.  Since our baby was CLEARLY happier with labor when I was lying on my side, we set up a layer of towels in the shower and made a towel pillow.  I lay on my side, and sure enough, they contractions started getting hard again.  Although they were uncomfortable, I was happy to bear with them since I knew these were the type of contractions that were going to get us to the point of meeting our baby.  

Before we knew it, the shower stopped working as a relaxation tool, too.  I had a strong need to void, but I couldn’t do it anymore.  We decided to move back to the toilet to see if I could void in the toilet.  It didn’t take me two seconds before I declared that this baby was coming out *now*.  The birth stool that had been taunting me for 24 hours was finally going to be put into use!  

We got on the birth stool. I asked our midwife Wendi if this was really it.  She asked me to try pushing and if I didn’t feel any pinching, to go for it and work with my body.  The next contraction came and I could push without pinching – so we did.  This is the one time when we could have used an extra pair of hands.  Since we didn’t have them, Bruss got behind me and supported me in a dangle position off of the stool so I could bear down and also use more gravity behind the push.  Trying to be mindful that we were capturing this on video for possible use with future students and for our children to see, I made every effort not to yell out too strongly.  

We asked one of the student midwives to go wake up our children and my mom since it was clearly time to push.  Squatting didn’t feel as good as it had with our other children.  After a few pushes in the squatting position, I felt like it would be best to move to my hands and knees, so there we went.  Bruss ended up on the floor with me, and as a contraction came, I would lean all my weight on him and bear down.  This is the first time I have been clearly conscious of the baby moving through my vaginal canal – it was amazing.  I could feel her crowning, and I remember that Night Owl looked at my bottom and said, “I see the baby!”  I told him to talk to her and tell her to come out, which he did!  A couple more pushes and I could feel that we had delivered her head.  Before I knew it, I was holding our lovely little Angélica in our arms and overjoyed with the wonder of the work we had done together.  

We pushed a total of 20 minutes – the most amazing 20 minutes of our birth.  My mom and Night Owl got to watch the majority of the pushing phase.  Puma came in just as Wendi was passing Angélika ("Otter") up to my arms.  Our photographer who we have known for six years got to capture the birth of our new family.  Our midwives were there supporting and loving on the whole process, one of whom was able to capture the birth on film.  It was a room full of love and joy.  

We marveled at this new creation that was now part of the Bowman family.  We looked at her face, her belly, her fingers and toes.  We checked to make sure that we were indeed holding the newest little sister…and we were!  The senior student cleared out Otter’s stomach and nose with a little tube syringe.  She had taken in some fluid and was having a hard time getting her breathing started.  Within a few minutes of skin-to-skin contact with mom and some massage stimulation, her breathing assumed a normal pattern.  She got her full measure of blood – her cord stopped pulsing, we delivered the placenta, and then we cut the cord and got in bed.  It was probably an hour from the time we delivered to the time we all got settled in bed for the first time.  

The whole process was amazing.  It was beautiful to allow Otter the birth she needed.  The old mantra of “Trust Birth” was proven true once again.  Why had our labor started and stalled for two days?  Our little miss had the cord wrapped around her belly twice.  Although Wendi assured us it was not constricting anything vital, it is not something she has seen very often in her 11 years as a licensed midwife.  Our baby and my body knew that Otter needed to ease her way out so that her wrapped cord stretched as needed and supported her through the passage from her safe home inside my womb to her new home outside with us.  As a good friend said to me the day after, hindsight is always 20/20!!  

At our first postpartum visit Saturday afternoon, Wendi asked us if we had any favorite parts in our birth.  My first answer was holding the baby!!  We also liked the lack of time-driven pressure – we got what we wanted: the birth our baby needed.  It was amazing to have our children be part of the birth process.  They had gotten to come in and check on me, encourage me with kisses, and I hadn’t had to leave them to go to the hospital for three days.  Night Owl got to watch his sister's birth – and now we get to hear his version of events.  His godfather came to visit this weekend.  He asked NIght Owl to tell him about the birth, and this was his answer, “My mommy screamed and the baby popped out!”  Clearly, I wasn’t as low-key as I had hoped, yet it hadn’t scared him and he is delighted to tell people about his experience.  

So we are now *officially* home birth advocates.  We are incredulous that it took us four births to get here.  It has been a great way to close the chapter on our childbearing years.  We are forever grateful to the women at Freedom and the Seed who so lovingly tend to the families in their care.

Disclaimer:

The material included on this site is for informational purposes only.

It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.