Labour of Love Birth Dance

The new year begins. It's cold outside and the roads are treacherous. We have only a handful of families signed up for classes this month so it looks like we'll try combining the regular 6 week class and the seminar. It's just a reminder to me that birth is all about being flexible. A new year begins with flexibility, perfect.

I had to call all the families this week to confirm a date for our seminar and this gave me a chance to talk to the moms to be and introduce myself and our program. The introduction to a birth class is very important. Our classes at St. Joe's the Lamaze International program. I've been certified in Lamaze for almost 30 yrs. This program offers a scientifically comprehensive, research based, family centered philosophy that is committed to reaching out to all families in the most up to date formats. I love teaching about birth. Pretty simple introduction.

The Lamaze philosophy is just as simple: Birth is normal, natural and healthy. Birth profoundly affects women and their families. We'll be learning about the birth process and how a woman and her support team can fully respond to this amazing miracle. It is a miracle. It will transform you and your birth partners.

Most parents are excited about starting their birth class. They've most likely been reading about birth, asking questions, preparing for their baby in countless ways. Eating better, going to their Dr. or birth midwife. Preparing their home and family for the newborn baby.

I've invited the group to start reading the Lamaze website. The expecting parent section has many helpful articles, online videos to watch, The Giving Birth with Confidence blog, an online magazine and a newsletter to subscribe to, and several articles for fathers to be. I hope everyone will take some time to cruise this great site.

I'll try and post a few blogs before we meet to introduce more information. In fact lets start with this cute You tube video: labour of Love Birth Dance. We're

January 2011 Begins

Welcome 2011

The new year begins. It's cold outside and the roads are treacherous. We have only a handful of families signed up for classes this month so it looks like we'll try combining the regular 6 week class and the seminar. It's just a reminder to me that birth is all about being flexible. A new year begins with flexibility, perfect.

I had to call all the families this week to confirm a date for our seminar and this gave me a chance to talk to the moms to be and introduce myself and our program. The introduction to a birth class is very important. Our classes at St. Joe's are based on the Lamaze International program. I've been certified in Lamaze for almost 30 yrs. This program offers a scientifically comprehensive, research based, family centered philosophy that is committed to reaching out to all families in the most up to date formats. I love teaching about birth. Pretty simple introduction.

The Lamaze philosophy is just as simple: Birth is normal, natural and healthy. Birth profoundly affects women and their families. We'll be learning about the birth process and how a woman and her support team can fully respond to this amazing miracle. It is a miracle. It will transform you and your birth partners.

Most parents are excited about starting their birth class. They've most likely been reading about birth, asking questions, preparing for their baby in countless ways. Eating better, going to their Dr. or birth midwife. Preparing their home and family for the newborn baby.

I've invited the group to start reading the Lamaze website. The expecting parent section has many helpful articles, online videos to watch, The Giving Birth with Confidence blog, an online magazine and a newsletter to subscribe to, and several articles for fathers to be. I hope everyone will take some time to cruise this great site.

I'll try and post a few blogs before we meet to introduce more information. It's sunny and beautiful this New Years Eve day. Lets all great the year and new birth with flexibility and joy.

Becoming Baby Friendly

Our hospital has been exploring the Baby Friendly Hospital Initiative. In case you’ve never heard of Baby Friendly Hospital in a nut shell, it is a global “best practice” standard for supporting breastfeeding in the hospital setting. The initiative identifies 10 research based practices that will offer women and babies the best chance to be successful breastfeeding. The 10 steps look fairly simple to the casual observer, but in reality, many hospital struggle. Most of our common newborn care practices, such as formula discharge bags, and early separation of mothers and babies for weighing and baths are not supportive of breastfeeding, deeply entrenched and very difficult to change. There are only 90 hospitals in the US who have achieved the Baby Friendly status and this fact alone makes us ask why?

Breastfeeding is one of the most researched health practices you could find. Every professional organization associated with mothers/infants supports and encourages the 10 steps. The US government CDC (center for disease control) identifies breast feeding as the primary step in ensuring a healthy newborns start in life. What more could you want to answer the question why not. I’ve been aware of the Baby Friendly Hospital Initiative, the first mention of it in 1990 or so. I have only recently taken the process and decided it was doable. First of all I am just beginning to understand how much work is involved. As the lactation nurse in our facility the bulk of the planning and managing this process will be with me and my supporters. I am ready to take on the process. Most hospitals take at least 2 yrs. and as long as 7 yrs. to be ready for the Baby Friendly Hospital organizations examination visit. If you’ve ever been involved with the Joint Commission Certification visit you can expect a similar process, and if you’ve never been part of Joint Commission think of an Internal Revenue Service audit. I do not take this lightly.

The process needs support from all the hospitals staff. I am fine explaining the need for a quality support for a breastfeeding mother/infant to the OB staff I work with but what about the CEO or the head of Radiology or ER? Will I need to have support and help from them, yes. It is called the Baby Friendly Hospital Initiative, not the Baby Friendly OB dept. A mother needs support from all health professionals she might encounter, from the admission secretary who asks her about her admission to ER for mastitis, to the physician who will prescribe medications she can take while continuing to nurse her baby. We’re all needed in the process. Collaboration is essential to a new family’s success.

Moms and babies appreciate all our help

The science is clear. The perfect start for a human infant, is to nurse from it’s mother. This is not always how things work out for many reasons. We can’t solve all the problems but we can do our best to give families a good start. We need to have help from all of our partners in order to effectively incorporate the 10 steps I had a conversation recently with one of our Drs. about Baby Friendly and how MORE emphasis on breastfeeding would make his job even harder. He sees mothers in the very early post partum period and some of the mothers are miserable,; no sleep, difficulty getting the baby to feed, babies who have lost weight and the mothers feeling guilty. How can we possibly make it even harder for mothers and new families? I let him talk, mostly because I couldn’t get a word in, but he was talking about the problems they see at a critical moment . Our current breastfeeding initiation rate is almost 90%, but quickly drops in the first few months. The statistics also show that the Dr. has identified exactly where we have problems. We can start a family but the real problems come in the first few days and weeks home. Timely support for a mother will help the mothers and physicians too. Our OB department has talked about putting together a lactation clinic but the talk with this Dr. helped me see how important early help would be. If a mother could get help early her success would make the physicians job easier too. This discussion led to our clinic becoming a reality. We invite mothers to return to our clinic for hands on help and include this first visit in their hospital cost. Mothers are encouraged to come for an appointment if they experience difficulty.


In reality, the real cost expense is minimal. In an Economic Cost Analysis (U of Texas Health Sciences Center at San Antonio Janet Williams MD, 2009) This document estimates an increase cost per delivery in the range of 1-5% in the initial year but falling to less than 1.5% in 5 yrs. across all delivery types. The long run benefits to baby friendly includes better patient outcomes, higher patient satisfaction, higher staff satisfaction, and positive community support. Our own data collection can support the investment that we commit to this project.

A major reason hospitals avoid the Baby Friendly process is that it sounds expensive. Why should an institution, in this day of fiscal problems, take on a project like this.? Up front the process identifies a 4 Step process with a total of $6000 in fees. The final step also brings in a two person team of professionals who conduct the review over 2 -3 days. The team is paid for their travel, expenses and time. Generally and additional $2-3,000. In addition, the hospital funds education to staff, the cost of formula, nipples and bottles. The hospital administration must be supportive of this kind of capital expense. Our mother baby staff can easily explain the value of the mother baby bond but we need to explain this expense in a more concrete perspective. Recently, AAP came out with a cost analysis of suboptimal Breastfeeding in the US . They reveal that if 80-90% (our rate of initiation) exclusively nursed for 6 mo. The us could save $13 billion. Our partners in public health can acknowledge the value in increased breastfeeding in just the cost of supplying formula for low income families. The value in a healthier community, especially in low income infants and children is valuable for any community health system. The Baby Friendly Hospital Initiative program has research that shows increased initiation and duration with the initiation of the 10 steps. The value of working together to bring better health care to our community from the very beginning of life is worth our best efforts.



By seeking the Baby Friendly designation we commit ourselves to doing our very best that fits our hospital mission of a Christ centered organization, offering compassionate, quality care to all in our community. By becoming A Baby Friendly Hospital we tell our community that the health of our youngest citizens is important and worth our very best. If you want to learn more about the Baby Friendly Initiative go to www.babyfriendlyusa.org.

World Breastfeeding Week 2010

Amber, baby Amara dressed for a proper tea

Tabitha and baby having fun at:

A Traditional Tea with Baby and Me

One of my favorite day of the year is the day of our World Breastfeeding Week luncheon. The day is a chance to participate in a real breastfeeding community. All of our WIC chicks, La Leche League Leaders and any body else who happens to volunteer to help, start planning in early spring. The theme for World Breastfeeding Week is planned by WABA, an international group for breastfeeding advocacy to governments and UN agencies. This year the theme was Baby Friendly: 10 Easy Steps.

We love to party, where' s my hat mom?

Baby Friendly Hospital is a guide for any health agency to adopt the 10 evidence based policies that produce optimum support for breastfeeding mothers and babies. The process looks simple to the casual observer but when the process is started it doesn’t take long for the organizers to realize that changing corporate and hospital policies can be anything but.


Mommy, my dolly needs a hat too!

This year I volunteered to be the speaker and moderator, mostly because our hospital has begun the Baby Friendly process, and I just have way too much fun at this shin dig.

Great hat mom, but I love you best!

I suggested a traditional Tea this year. I got the idea from my dear mother. We went to a local tea room this spring and had a ball trying on the hats, having tea, fancy sandwiches and cookies. So, our planning began. Tea it would be. Each agency would decorate a table or two and our hospital would fix the lunch. What fun.

Mommy, can we wear our hats to church Sunday?

I had an inspiration and rented a dozen vintage hats from our local civic theatre and planned our table. We would be a Victorian theme. I had some antique china plates, cut glass and lacy table clothes. Asotin County WIC planned an American Girl doll themed table, North Central WIC would have quited table settings and depression glass. Niimii poo Tribal Wic would have a native people theme, and to top it off La Leche League would have a mad hatter table! Well, did we have fun or what!

Devonny, one of our La Leche Leaders

We probably had 40 moms and babies in all kinds of fancy duds. We played breastfeeding jeopardy, gave away tons of door prizes. Babies nursed to their hearts content, moms laughed and shared stories and wisdom. Grandmas and WIC counselors basked in pride. Breastfeeding mothers should always be totally comfortable and supported in our communities. This little effort shows us all how it’s suppose to be. Breastfeeding is normal.

Mommy and I are a team!

Beautiful baby and her mama


Lunch was great, thanks to everyone!

The first few minutes of life with baby

I've been privileged to spend my work with new parents and babies. I've been a nurse for 30 yrs. and I have never tired of working with the newborn. I have to say that the trend to skin to skin at birth has completely changed my care for families.

At birth the newborn is dried and placed directly on the mother. The baby is observed but not bothered by staff. The new family is allowed time to just get to know each other. I have always encouraged new parents to preserve this time. Ask staff to not bother you and your new baby for the first hour. The bath, weight, measuring etc. can all wait. Let your family know that you'll let them see,hold and visit after this first hour. Sometimes the baby may need care at birth and of course that will be the priority for the medical staff caring for your new baby. The magic of skin to skin is available to you anytime! The first few days of life is so important to you and your new baby but,anytime you can I would encourage skin to skin. It truly is magic. Mom, dad and baby will enjoy it.

This little video gives a nice account of the value of skin to skin contact:

Asking Questions: Find the answers

The Birth Survey

I opened class this week with an exercise in asking questions. I had the group take home copies of the 6 Healthy Birth Practices. I asked the group to pick one of the 6 papers and respond to what they read. We had a lively discussion of the information. These 6 handouts list the research on normal birth, such as; allow birth to begin on it's own which presents research that describes the risk of risk of cesarean if labor is induced for non medical reasons in first time moms. Why don't moms know this, they ask? We talked about the benefits of good labor support in labor and how to help mothers in birth. Asking questions of your partners, learning what she needs in labor, how can I help?

The research on common interventions in labor leads to questions for your Dr.; what is your cesarean rate? What is the plan if I go past my due date? Can I deliver without pain medication? Can I push in any position I choose? It's important to learn about your Drs. usual routines, but statistics will answer the real question. The Birth Survey is published by Childbirth Connection. A group that champions normal birth practices. This is a national survey from families who give birth and respond to the experience in hospitals. You can look up hospitals in your area. The survey has been available for only a year so there isn't many responses yet, but you can help by filling out the survey when you deliver.

We asked a lot of questions last week. Most of the questions will only be answered by the experience. The questions are important. Mostly, you will be starting the dialog with your labor supporters, your nurse, your Dr. When you give birth you will labor as you have to. Birth awaits; you should be free to respond and experience the miracle and all it's challenges. You and your baby will soon see each other and begin your life together. Your baby will love you without questions.


:

Moms need to ask questions if they want to get the birth experience they want. It helps if hospitals and birth centers publish their statistics, costs,and practices. Mothers and families can help answer these a questions by talking to their Drs., talk to their friends, and by responding to the National Birth Survey Birth Survey

/Baby Slings: are they safe?

Anytime I hear about baby equipment safety my ears perk up. I have been hearing a lot about sling safety on the news and this is an important thing for both mothers and educators to be aware of. There are safe slings and there are slings that pose hazards. There is also a way to wear slings....

In this blog Terry Shilling, Lamaze childbirth education trainer, has imbedded a video on the way to wear a baby in a sling.

I'm not trying to sell any specific wrap but I like the moby wrap.

Labor Stations

We're going to do labor stations this week in class. It's my favorite class. I love to watch the group.

Stations gives couples a chance to play with lots of different tools for labor support. They communicate, find out what they like, what they don't. How to help someone in labor and it's just fun. Kerry came and talked about having a doula in labor. Most of our moms can't afford the $350-500 for a doula but they do have the nurse and partners who love them... what more could you want.

I invited one of our local doulas Kerry.. she offered a nice help at the massage station and gave couples some idea of how a doula can help in labor.

During the activity the group moves around 8 different "stations". There is a station for massage, the birth ball, pushing positions, slow dancing and the rebozzo, back pain in labor strategies. I love how the partners get into it. I try to get all the couples to adapt as they need to. It makes a great class activity.

Prepare for birth in lots of different ways!

A Unique way to prepare for birth!
(this mom said it was OK to use her very cute picture!)

I'm off to a conference in Seattle this week, so I've asked one of our other teachers to fill in for me this week. Amber is one of our labor and delivery nurses. She is an awesome labor nurse and she recently had her third baby. When you come to the hospital in labor you'll find your nurses will be wonderfully supportive and helpful. To have someone you know, like Amber, you're stress will go down even more.

In this class you'll be learning about prenatal care topics such as; nutrition, hazards to avoid and warning signs of problems. You've probably already been paying attention to improving your diet, but it's one of the topics you need to really pay attention too, even in the last few months of pregnancy. We have so many food choices available to us and it takes a lot of control to choose the more healthy foods. If you want to have more energy, have an easier delivery (the recommended wt. gain during pregnancy is 25-35 lbs. It's really easy to let yourself go and eat, eat, eat! Keeping wt. gain down will help you have an easier birth)

Keep it simple, eat lots of fruit, vegetables, whole grains, protein and drink plenty of water each day. You can take a look at the food pyramid for pregnant women at www.mypyramid.gov.

Hopefully you've already heard many of the hazards to avoid. I always ask classes what they've read about hazards . I usually hear: staying away from paint fumes, cigarette smoke, uncooked meat, fish. Other warnings include; not handling cat droppings, drinking alcohol, street drugs and certain medications such as; ibuprofen, and aspirin. March of Dimes has an awesome site with lots of information on taking care of yourself and hazards to avoid and warning signs of problems during pregnancy. The March of Dimes foundation has identified preterm birth as there current focus. The foundation gives grants for research into the causes of preterm birth and has developed an educational campaign on preterm birth for pregnant women. Signs of preterm birth can be very subtle.

Every pregnant family should be aware of the signs (before 37 weeks):

1. Change or increase in vaginal discharge
2. Pelvic or lower abdominal pressure
3. Constant, low, backache
4. Mild abdominal cramping (with or without diarrhea)
5. Regular or frequent contractions... more then 4 times in one hour ( the tightening in your uterus that may be painful or painless.. you just notice frequent tightening)
6. Your water breaks in a trickle or a gush

The rest of your class will focus on labor. You'll learn the signs of labor, how to help your partner during early labor and finishing with massage.

Take a peek at this video on signs of labor, preterm labor:





And finally here's a good video on massage during labor at this site:

The First Class

I love the first night of class

We started a new Lamaze class last night. Couples began to come a few minutes early, which is always a good sign. We start as strangers eager to learn about each other.

We introduce ourselves. As nurse/childbirth educator and lactation consultant I have the obvious role of teacher but mostly a first night is about the couples and getting to know each other. I ask the group to turn to another couple and spend a few minutes trying to find 3 things they have in common... other then being pregnant. This is of course the obvious commonality. When you are pregnant you feel like the only one in the world going through this experience. In the real world though you have lots of company. Your first pregnancy is full of questions and new experiences. It's fun and scary as you watch your body grow and feel the new little person growing inside. You and your partner start preparing for the arrival.

We begin introductions and I always ask couples to tell their due date and one thing they've done to get ready for the baby.. but it has to be unique. If someone says they've put together the crib someone else can't say they did that. It's always fun to hear the answers, cleaning out the spare room for a new baby, reading a book about fathers and daughters, putting together the swing, preparing a family heirloom cradle for the soon to appear new baby, and all the traditional things couples do to prepare for a new baby. Since the beginning of time parents have prepared the very same way. Just as in the miracle of birth a family begins to form as it has throughout the generations. We find out that we have lots in common.

The class then turns to the obvious focus.. birth. The word alone has taken on a whole new meaning for the couples. We start by finding words that describe birth, "birth is... exciting, expensive, unpredictable, amazing, but then I ask for the four letter words that describe birth... hard, long, pain, messy, SCARY! As a group we come to realize that this normal process of birth has many unknowns. A woman and her partner need to take time to examine what birth means to them. What questions do you have, what fears are hidden inside, how will partners help? The nine months of pregnancy gives us time to prepare. In childbirth class we will begin tonight learning the ageless strategies that women pass on. We begin talking about "Healthy Birth Practices" that Lamaze has collected. Lamaze has looked at studies from all over the world to find simple practices that help a woman and her family work through labor and birth.

1. Labor begins on it's own
2. Find a loved one, support person or doula to help you through labor.
3. Move, walk, follow your need to move around during labor.
4. Avoid routine interventions, unless medically necessary.
5. Stay upright to give birth
6. Keep mother and baby after birth, preferably skin to skin, allowing baby to breastfeed as desired.

These simple practices give women and their care givers a guide for care. We will be learning more about the "Healthy Birth Practices" in the remainder of class. Be sure and spend some time exploring the Lamaze.org website and watch a video on what happens in a Lamaze class.
Prepare your home, your heart, and yourself to bring this new person into your family. Examine your feeling about giving birth. Name your strengths, your partners strengths, your questions. When you put all your questions on the table you can deal with them. Work toward increasing confidence. You will know how to give birth and take care of this baby, just as you are growing this baby. It comes from care, love and surrounding yourself with loving supportive people.

I love the first night of class. I get to share in the joy of the miracle of birth with a new collection of families. I meet new friends. We will share in this amazing experience. Each family will tell a different story, each baby will be a new and shiny person.

Keep Moving!

MOVE DURING LABOR

The most common question I hear in Lamaze class is; what will labor be like? It's hard to imagine this experience. It is a natural experience, but yet you have nothing to compare it to. You have learned to cope with all manner of signals from your body. Your body signals you to rest when you need too, when you need to eat, go to the bathroom, and when to move to find the best position. The simple fact of the matter is that moving in labor helps you give birth and keeps a woman more comfortable. Try to think of the pain you feel as a message. Find more comfort.

Move, move, nothing feels better. Inside your baby is moving too.. you are in synchrony with this little person. You both are working. Imagine the dance you are doing. Allow yourself to give into the messages.


I found this awesome video today and thought it would make an impression. This girl dances with the contractions of labor. Watch her expressions change:

http://www.youtube.com/watch?v=NxjABhLEJi0#


Your baby is part of this experience. Your baby is making a journey. Trust the process. The baby matures and grows stronger. His body sets the labor in process. The hormones of birth work together with the messages from the fetus to allow the baby to be born. As you progress through your pregnancy you have noticed many body sensations, aches or pains that you have managed. This is your bodies message. The baby gets bigger, your body allows your joints to relax. The hormone Relaxin is produced in increasing amounts during pregnancy. It allows your joints to "relax" more. Your baby also has increased relaxin produced during development. This hormone allows more movement during labor and birth.

Follow your body signals, find positions that are comfortable and helpful for birth. Movement helps.

Waiting for Baby

Waiting for Baby

When you find out you're pregnant one of the first things you'll want to know is when is my baby due? It's natural to want to know and part of the fun of pregnancy is imaging your baby growing. This is an important time.

Your Dr. will tell you an "Expected Date of Confinement" or EDC... you are given a specific date and you want to mark it in your date book. You tell your relatives and everyone starts planning. But what does this "date" really mean? Your baby will come sometime between the 38-42 week of your pregnancy. It's a guess with 2 weeks on either side of the date Dr. gives you. Does it matter. Nature offers your baby time to mature and each day gives your baby more strength and maturity. Each day the brain grows and matures. The entire body gets stronger. Your body also is getting ready for birth. You will notice that the baby gets heavy and your pelvic bones may feel achy, like everything is getting ready for birth, which it is! Plan for your baby but let the baby tell you when he/she is ready. Many scientists believe the baby has a major part in labor starting. It seems to be a combination of many factors. In nature a baby is born when it is ready. Interfering with the time of birth can cause problems. The baby may be sleepy, unable to nurse effectively, he may have trouble breathing. The baby born even a few week early may be less mature and less ready for life outside the womb.

There is no way to predict exactly when someone will go into labor. It's one of life little mysteries. Your body will give you some hints though. In the last weeks of pregnancy you'll find braxton hicks contractions may come more often, your hips hurt more, you're just more tired. The early signs of labor are usually subtle and mostly you won't notice much, but you're body is preparing for the wonderful work of birth.

When labor begins to get more noticeable; your contractions start getting closer together, they last longer then and hurt more. You start thinking this might be the real thing. Stay where you are most comfortable. Your own home is the perfect place to be in early labor. At home you can make yourself comfortable in your own surroundings. If you want to go for a walk, sleep, or have a snack you can.

During pregnancy the hormone oxytocin is produced. It rises naturally during your pregnancy and is responsible for the uterine contractions of labor. It is also called the love hormone. This hormone is responsible for many body responses including the strong contractions of labor but also the feelings and contractions you feel when you make love, or the warm loving connection you feel around family or dear friends. It is a complex system but simple in its responses.

When your labor is started artificially you are in the hospital. The nurse will start an IV . The medication used is often pitocin , an artificial oxytocin. It works on the uterine muscle and stimulates uterine contractions. You'll have to be on the fetal monitor continuously. You'll be in a strange environment. Both you and your partner will be spending a lot of your time just waiting. The contractions during an induction are noticeably more uncomfortable then normal labor. The nurses will be turning up the induction medication regularly in order to get strong contractions. Your more likely to need pain medication earlier which will mean being confined to bed and more monitoring.

Lamaze has written about letting labor begins on it's own.

There are times when an induction is needed. If a woman's blood pressure is dangerously high, or an infection or if you are too far past your due date. Talk to your Dr. during your pregnancy visits about his/her feelings about inductions. Educate yourself about the problems with inductions. Try not to focus on a specific date. Read some tips for avoiding an induction at the Lamaze website. Plan something special to do for the week of your due date. Being a parent is learning how to be patient. Relax and remain confident that your baby will be born when both he/she and your body are ready.


Great Resources while you wait:
Birth Stories to read

A video clip:

Avoid routine interventions; The Hospital Experience

Laboring with a support team: family and nurse

Birth is a natural bodily function that allows the delivery of the fetus. A medical intervention is a activity that intervenes with this normal process in an effort to help the mother deliver her baby. When you hire a Dr. and hospital to help you give birth it is important to remember it is a partnership. Your birth experience will depend on how the hospital and care giver (Dr.) approaches this partnership. By understanding the hospital experience you can become an educated partner as well.

Birth is a natural event that the body manages well. When you go into labor at home you can move and find comfort any way you want. The contractions will come and go. You'll find time is suspended, you get tired, you can nap, you get thirsty you get a drink, if you need to go for a walk you do. You and your helpers will move through labor in your own individual way. When you come to the hospital things will change. The hospital is an institution with routines for your comfort and safety as you labor and birth.

The medical system is complex and has at it's primary goal "safe" care for disease/illness. Our hospital culture in the US is driven by "risk"; reducing risk, fear of "risk", risk of litigation and risk or every potential problem.

If a woman is admitted to the hospital for a normal experience such as birth, she has now gone from a normal experience to a potential for disease, risk and danger. It will be hard for the medical personnel to see this birth as anything but a potential for problems. Every little change in the fetal heart monitor will be observed and evaluated in view of "risks". The Dr. and nurses are trained to manage disease.

A woman is admitted to the hospital in labor and her Dr. either has standing orders or gives orders for her care. There are also standards, that the hospital has in place for all labor admissions: the fetal monitor is started, urine and blood samples are taken to check for infection or other risks, an IV may be ordered to give fluids, just in case or to give pain medication. Standards for care may include; nothing solid by mouth, only clear liquids, she will be hooked up to the fetal monitor and discouraged from moving around; in order to get a good reading on the monitor, she will be told to change into a hospital gown. This strange environment can alter labor and make it more difficult to manage. In most hospitals, the mother is asked if she needs an epidural for pain and one thing leads to another, creating a cascade of interventions. She is given few options.

Keep in mind that the nursing staff is also there for you. Labor and delivery nurses should be trained in labor support. Ask the hospital staff if they are trained in hands on labor support.
At our local hospital our entire staff has been trained in labor support through Lamaze. We have established an atmosphere of support for normal labor. Our staff and physicians support the normal birth care practices and will offer both you and your support team personal hands on support.

We will encourage a birth plan as a way to encourage communication and partnership with you. In A birth plan you are communicating with your Dr. and the hospital about the way you want to give birth. We encourage families to bring their birth plan with them. At our hospital we have a pre-admission interview with the nursing staff. In the interview the nurse will discuss your plan with you. You can ask questions about hospital routines and how the nursing staff will help you accomplish your birth plan based on your physical needs and history.

Labor progresses best when a mother senses safety, comforting support and respect. The hormones are sensitive to atmosphere and fear interrupts the flow of oxytocin, the birth hormone. Endorphins, the bodies natural pain system, works best when a woman is free to explore her individual coping techniques for labor. In classes we will explore ways to find comfort and relieve pain. You will learn about the common interventions that occur during labor and birth. We will talk about how to write a birth plan. Information helps you and your family become an informed partner in your birth experience. Take time to ask questions about labor support in the hospital you choose.

Turn the hospital experience into the birth you want. Personalize the experience. Make your own interventions; bring your own music, blankets, games, birth doula or pizza! Get to know your nurse, talk to her about birth, take charge. This is your birth. You have a key role in the birth experience.

Read about avoiding routine interventions at the Lamaze website

Find good help for your labor

A Family Begins

As you start getting ready for the birth of your baby you'll wonder what labor will be like. In class we'll talk about the physical and emotional process. You'll also begin looking around to find people to help you. This is a very important decision. Who you have with you at birth will make a huge impact on how you experience labor and birth. You'll first look to your husband or partner. In our culture a woman's husband or the father of the baby is considered a logical helper in labor. But, keep in mind that most men have never been at a birth. Most male partners are as unsure of how to help as you are. The prospect of being a helper at the birth of a child is totally foreign most men. They do offer the most important element, he loves you and this is his baby too. As long as he is willing to offer encouragement, love you, offer help as you ask for it, he can easily be good support for you. I find most fathers are eager to learn how to help at the birth of their child and are surprised that they can offer the mother lots of support. In class we concentrate on the dads role at birth. Partners can check out this article on labor support on the Lamaze website. Tips for Labor Partners.

Most fathers-to-be are excited and willing to help in labor. Some partners are uncomfortable in a hospital or just not interested in helping. You might feel that this means they don't love you enough. Try and understand that this might be a very uncomfortable thing for him and realize that it doesn't mean he won't be a good father or partner in your life. If you feel like your partner may not offer you as much help in labor as you need you could ask a friend or female relative. Your team of helpers needs to be completely available to you during your labor. Be sure and ask your helpers to join you at childbirth class. They will learn a lot about labor support. You can also get a book on birth and labor support for either your partner or whoever you choose to help in labor. Some good choices are:

The Birth Partner, Third Edition: A Complet...
by Penny Simkin
The Official Lamaze Guide: Giving Birth wit...
by Judith Lothian
Pregnancy, Childbirth, and the Newborn: The...
by Penny Simkin
The Thinking Woman's Guide to a Better Birth
by Henci Goer
Ina May's Guide to Childbirth
by Ina May Gaskin

A doula is another helpful person for labor. A doula is a woman trained to offer professional labor support. Studies have shown that hiring a doula, can reduce the risk of interventions, cesareans and need for pain medication, and women report more satisfaction with their birth experience. To find out more about doulas go to the Lamaze website and magazine. In our community you can contact the Palouse Area Doulas. They offer a "meet the doula nights" every second Monday of the month at 7pm. You'll need to contact the organization to find out the location.

You will always remember the birth of your baby. Take time to search for the best support team you can find.

Beginnings

Ready or not here I come!

The birth of your first child is a miracle that is unfolding each day as your pregnancy advances. As a family awaits the coming of a baby they search for information from many places. Traditional classes are still an important step for many, but the numbers of people have decreased in recent years. As a childbirth educator I need to search out new ways to teach. I hope this blog will offer some new ways to reach families.

Many people do their own investigating and learning. I always encourage parents to check out:

1. The Lamaze website. You can get a daily pregnancy e newsletter, watch normal births, find out what happens at a Lamaze class and learn about pregnancy and birth from a reputable source.
2. We use this text in class: Prepared Childbirth; The Family Way by Debby Amis/Jeanne Green.
3. Check out this collection of videos and handouts for learning: www.mothersadvocate.org
Both of these sites offer information for expecting familys about preparing for birth.

In the first Class my goal is to: Have fun, introduce teacher and birth information and resources.

Birth is normal. This is the first topic I cover in classes. It's a simple statement but it implies much. What does it mean to you? You will have many thoughts, all are helpful to you. Each woman/family comes to birth with their own life story. It will be important for your new baby that you take time to appreciate all the elements you bring to his/her birth. You will be telling the story of this birth for a lifetime.

To me Normal means: a process that is expected to happen and the body manages without our thinking about it. The process is the same but different for each person. As normal as a sunrise. The miracle happens right in front of us. Relax and appreciate the moment.

A January sunrise

What do I want couples to learn in Lamaze class?

• They already know how to birth. Every woman will find her own coping techniques. You can learn new ways to manage. Each birth teaches a woman more.
  
• Listen to other women. Seek out positive birth stories. These stories can give you confidence and strength.
  
• Pick carefully the people you want to be with you in birth. Take time to find a Dr. you trust and can talk to. Talk to your partner about being your helper during labor. Most husbands will be unsure about what they are expected to do. In our classes we teach labor support. Some companians will be too uncomfortable to help, but are willing to team up wih someone else. Sometimes you can find friends or family members who have helped at births or would be willing to come to classes with you as an extra support person.
  
• Check out a Doula. This is a professional labor support person. A doula can support you during your labor and birth for a fee.
• Find people who give you comfort, confidence and love you.
  
• Make your own environment for birth.

I hope this introduction will give parents to be a start on their exploration on this amazing miracle of birth.