11.20.2014

Let It Go...

So, right about now, many of you have magically transformed into Elsa and are singing with gusto.


Yeah, that's kind of what I'm talking about. During labor and birth, your support team will be encouraging you to let it go... all of it. Physically, emotionally, and mentally. Labor and birth is an event unlike any other in your life - one which challenges you in all three of these areas, providing an intensity that brings you to a very primal place of reckoning within yourself.

For that reason, let's look at some practical and concise ways to encourage letting go during pregnancy, and in preparation for birth. 

First off, be sure to protect your bubble of peace during pregnancy by letting only positive and empowering stories and words into your heart and mind. Women love to give advice and tell 'big fish' birthing stories to each other. One simple thing you can say to stop negativity in it's tracks is, "please only share positivism with me, my baby is listening."

Read books that encourage education and preparation in a non-threatening and positive way. Books will give you education and tips/skills to help you through the labor and birth process. 

Practice physically letting go through conscious recognition of tension. An easy exercise for this is when you have to use the restroom, either #1 or #2.. .in fact, getting used to the sensations of both is actually helpful. When first sitting down on the toilet, remain in tension for a moment, notice how your pelvic floor is clenched. Then, take in a deep breath and, on the exhale, release the tension in your pelvic floor, allowing you to go to the bathroom... this exact sensation is what you need to accomplish during labor with every single contraction. You can do this as often as you like, and I recommend practicing this a ton in the last 6 weeks of pregnancy. 
Practicing progressive relaxation will condition you to physically release tension - which is a helpful tool for labor and birth. Find a good one, either through Hypnobabies, Hypnobirthing, or even YouTube, and practice it at least 3 times a week. 

And finally, practice being open and honest with your partner and birth team about any anxiety or worries that you have while preparing for birth. Two things are accomplished with this simple practice. One, you may be able to let go of some of these before your birthing time even begins. And two, if you can't, you are at least practicing honest self-evaluation - which will come in handy during your birthing time in the event any of these worries or anxieties come up during it. 

During labor and birth, there are some key tips and tricks to help you remember to let it all go...

First off, use words that help you let go. These words might be "limp and loose", "release and relax", "soft and open", or even "let go...". Your partner and birth team can help you by repeating these to you at the start of every contraction, and use reminders throughout the peak of each contraction as well. 

Now speaking of words (pun intended) let's touch on your own vocals. Prior posts have spoken extensively on the power of your labor sounds. More specifically, you can practice prenatally, and use in labor, the HA breath. Open your mouth and let your jaw hang throughout. Make what noises sound loose and limp, roll your head on your shoulders in broad sweeping circles. If you feel your jaw and neck muscles resisting, blow "horse lips". 

When you feel a contraction begin, shake out any tension in your hands, arms, hips, or knees before it climbs to it's peak. This will help you set your body into a state of 'no tension allowed' and wipe the slate clean during each contraction. 

Remember that toilet training from earlier? Practice that same 'letting go' during each and every contraction. Check in with your buttocks and pelvic floor and make sure it is in a state of looseness. If you pass gas or pee a little, that's fine. It means you are completely relaxed in the area it matters most. 

If you are in a position that you aren't using your hands to support you, place your hands palm up. This keeps you from referring tension to your hands. 

Remember to voice any negativity or anxiety/worry that comes into your mind and heart. Talking it out allows you to move over that hurdle instead of stepping onto a hamster wheel of negativity. Remember, your birth team can only help you as much as they know what you need. 

And that, my friends, is my list of practical ways to let go during labor! 


11.13.2014

Doulas Have Big Balls

There, I said it. Doulas have big balls. We do! I'm not talking about the scrotum, or even our ovaries... I'm talking about a birthing ball. Most doulas either have, or encourage the use of, birthing balls. Birth balls are just exercise balls that are put to use in various forms during labor and birth.

Some have round ones... 

http://birthingbeautifulideas.com
And some have peanutty ones.... 


And both have an excellent place in the birthing room.

But wait, let's rewind a bit... you know, that part of your life where you are mother-but-not-yet-birthed? The time between times when your body is busy growing a little human?  Ah yes, pregnancy.

PREGNANCY


Pregnancy is a great time to break out that exercise ball. It makes a doula just giddy with excitement when a mama will grab out her exercise ball and sit on that instead of allow herself to slouch into the couch (which is horrible for babies position). That's right, sitting upright on a ball during pregnancy is great for:

  • encouraging baby to be in a great position for labor and birth
  • decreasing backache by encouraging good posture
  • increasing elasticity and circulation to the perineum, which decreases the chances of tearing or an episiotomy
  • increasing circulation to your lower extremities, which decreases the risk for vericose veins and edema
  • opening up your pelvis to encourage baby to settle lower in your pelvis before your labor even begins. 
  • encouraging stronger abdominal walls and obliques, which helps support baby/uterus and decreases the risk of diastasis recti. 
Like I said, we doulas get downright giddy when we see you hanging out on top of big old bouncy balls. So, use them when you're watching TV, playing on the computer, sitting at your desk at work, sitting at the kitchen table during meals, or any other seated time. 

LABOR AND BIRTH


Oh now we're getting onto the better good stuff. Now remember all of those great benefits that sitting on a ball had for your pregnancy? Well, that carries over into birth.

Sitting on a ball during labor allows for mom to make all these broad sweeping and swirling, bouncing and rotating motions with her hips...

It's like doing the hula, while sitting on your bum and not tiring your legs out. This, in turn, allows baby ample room and movement to rotate themselves into the best position for an optimal exit strategy. It also allows for openness, very similar to the toilet, allowing for baby to descend into the pelvis in a chin-to-chest position.

Kneeling and leaning on the ball as well as standing and leaning on the ball can also be very helpful. It helps to open the pelvis and has all of the benefits of all fours and forward leaning positions, while allowing you to release and relax by not putting undue stress on your wrists, hands, and arms.

This allows for more complete relaxation. I think I hear some of you exclaiming right about now, "lots of mobility and stability, more relaxing and productive, and I get to look awesome with a birthing ball in tow? Where do I sign up?!"


In fact, it's so nifty that it helps reduce cesarean rates, pushing times, and the need for pitocin if a mama chooses to get an epidural.

AFTER BABY ARRIVES

Well, if you started ballin' in pregnancy, hopefully by the time baby comes you feel the same as we do: that exercise/birth ball was indispensable. It can continue to help you postpartum, fo' sho!

The first thing you can do is use it as it was originally intended to be used - for exercise. Using the ball for oblique and, later, abdominal exercises will help whip your trunk into strength and shape. In the long run, strong ab muscles will help decrease the incidence of long-term back problems that seem to plague mamas who are constantly carrying and holding, hipping and juggling little kiddos.

You can also use the ball to help stretch your body. This is great even immediately postpartum. Regular stretches will help minimize the chances of getting nursing back and allow your body a safe and aligned space to recover quickly from birth. In fact, speaking of breastfeeding/nursing, sitting on the floor and leaning back against the ball as it is supported against the wall will help mom with proper posture during breastfeeding.

Finally, you can use that gorgeous pregnancy lovin', birth rockin', exercise nabbin' ball to bounce-bounce-bounce your little peanut to comfort and sleep.


11.07.2014

Bathrooms or Birthrooms

It happens - mama is laboring along and someone, whether it's mom herself, her partner, her doula, or her provider, suggests she go to the bathroom for awhile. I get a little happy flutter in my belly, I love when mom labors in the bathroom... or, as many of us birth workers consider it, the birth room.

Yes bathrooms are where we relieve our bladders and our bottoms, or where we wash up... but, it's also where we have been conditioned to completely let go. We let go and urinate. We let go and pass gas and poo. We let go and sing in the shower. We let go and have a good cry when we need to be alone and find some solitude. Birthrooms, err, I mean BATHrooms, are a great place to let go.... and labor and birth is all about letting go.

The bathroom is full of great tools to use during labor and birth. It's no coincidence that women progress so well when they are in the bathroom. And here, in this post, we're going to break down all of these lovely tools, one by one.


THE TOILET, aka the magical birthing throne

The toilet is one of the most powerful labor and birthing tools in the bathroom. And no doubt the reason why: we have been conditioned to relax our pelvic floor when sitting on it! So if a mama needs to get her baby deeper in the pelvis, or  needs help relaxing and completely letting go, or getting a stronger or better labor pattern going, or simply emptying her bladder - this is the place to do it. It also allows mom to rest while allowing her physiology and natural law (gravity) work in her favor. 
"OK. So we have you on the toilet and now you’re pretty comfy. You can rest your upper body and head on the pillows. You can close your eyes and sleep (between contractions). We’ll get your partner on a stool or the birth ball behind you ready with a back massage during your rests and double hip squeeze or direct pressure during the contraction. And we’ll likely ask you to stay here 20-30 minutes. Maybe longer. Yep. Because it makes a difference. 
It’s probably clear that the toilet is a similar shape, size and height to a birth stool. So it makes sense that this is good place to hang out. But we’re here not because you are ready to push, we’re here to either get contractions longer, stronger, and closer together or baby to move down or both. And it seems to work. Here’s why: in addition to harnessing gravity, and getting you into a position that opens your pelvis while supporting you to rest, the open space in the toilet seat allows you freedom of movement to rock and sway your pelvis during your contractions. This movement makes a huge difference and can be just what is needed between lovely spells of resting to bring your baby down and progress your labor.  And let’s talk (for just a second) about how psycho-somatically, this the perfect place for your body to remember how to let your lower sphincters open. ‘Nuff said? Thought so."
- Baby Bump Services, Laboring on the Loo (an EXCELLENT article, go read the whole thing)



THE DRAIN, aka what happens in the bathroom stays in the bathroom


The drain is a great tool that is oftentimes overlooked... But let's not forget that birth oftentimes means that there is going to be a great amount of body fluids involved. And for this reason, the drain is so very helpful. 

Ok, so truth be told, some women have a really hard time going potty on the potty during labor. Sometimes, it's because there are other people around (performance anxiety), and for other women it's because sitting 'disallows' for her bladder to release, for positional reasons. In both of these cases, I'll sometimes encourage mom to stand over the bathroom drain, or in the shower/tub to urinate. Some moms find that standing, or standing and leaning, or even squatting, allows for her to completely release her bladder through swaying and swinging during contractions. 

Drains allow for that freedom and quick clean up. 

Likewise, if a mom is feeling very nauseous and has 'emesis basin retraction' (as soon as you offer her the place to vomit she swallows it back again, only to repeat with the next contraction), some women are given 'permission' if they are allowed to just 'let it go' (yeah, there are a number of you who started singing right then). 

It might not be pretty, but it gets the job done when other tools have failed; and for that, I am eternally grateful to the almighty drain!


THE SHOWER, aka the fount of oxytocin

Since we're still in the shower/tub and talking about the almighty drain, let's just stay here a moment and transition into our next tool, the shower. The shower is a helpful tool throughout all of labor. If your shower has a stationary head, the shower stream can provide excellent nipple stimulation if you place a washcloth over your breasts and aim the stream at your chest and belly. It can also provide a great distraction from back labor if it is directed at your back. 

If your shower has a removable shower head, you can focus the heat and rhythm of the shower stream to your aches. This can mean that you direct the shower stream to your lower back, your belly, or even against your perineum/inner thighs. 

Heat relaxes your muscles and melts away tension, while the invigorating rhythms of the shower get blood flowing and wake the body and mind up. Standing, or sitting on a stool or birth ball, while in the shower allows the woman to remain upright, giving gravity a chance to work in her favor throughout early and active labor. And finally, the shower itself provides enough distraction to the nerve endings that many women find showers to make contractions both stronger (because of the oxytocin produced from tactile stimulation) and easier.


THE TUB, aka the aquadural

Yes, it's been called the aquadural for good reason. The birth pool is oftentimes considered the best method of pain management during labor and birth.

Complete immersion in a tub or birthing pool is best reserved for when labor is active, unlike the shower, which can be used at nearly any time during labor. The reason for this is because the tub can sometimes space out contractions if used too early in labor - because mom isn't using gravity for progress and she relaxes a little too much for the uterus to be as effective as other positions.

That said, if the laboring mama is having a long early stage of labor, or if she is looking for a way to slow things down or stop them to get some rest during the early stage, the tub can help mom to achieve that.
"The warmth of the water on the mother's body can be very mentally and physically relaxing. The water pressure can help alleviate muscle tension and back pain. The effects of immersion in water may be summarized as the following: bathing provides buoyancy and warmth, both of which often bring immediate pain relief, relaxation, lowering of catecholamines, increases oxytocin, and more rapid active labor progress."
- The Labor Progress Handbook, by Penny Simkins and Ruth Ancheta

THE DOOR, aka the support that just won't stop

The door to the bathroom is a powerful thing. It gives mom power over whom is invited into a small and intimate space for her birthing journey. If she feels she has too many people watching her, or she feels the need to have some completely alone time, she simply invites those people she wants into her little cave of birthing energy and shuts out the rest.

So yes, the door is a tool when used how a door was actually intended to be used.

But, there are other ways that a door is tool for labor. One of these is for body work by using the door and door frame itself. If you happen to experience round ligament or hip tightness during labor, between contractions simply put your hip against the door frame and twist until the stretch releases that tension. Be sure to repeat on the other side so that you are balanced.

This stretching is great because, oftentimes, tension on one side of the pelvis/hip/thigh and not the other can be a sign that baby is coming down a little asynclitic. Stretching not only feels great, but can actually encourage baby to rotate and straighten out as it balances out the inner workings, tendons, and ligaments of the pelvis and pelvic floor.

http://eliteathletic.com/
Another exercise that can be done with the bathroom door frame is to do posterior pelvic tilts (aka, lift and tucks) against the door jamb. This exercise is perfect for posterior bubs, or any labor, in which mama is experiencing back discomfort. To do this, simply place a towel between mama's rump/lower back and the door frame. Then, at the start of a contraction, mama should press her lower back flat against the frame/towel, tucking her tailbone under, and lifting her belly to tuck it into her body.

Some women enjoy doing this as a continuous motion (tuck/tilt, release, tuck/tilt, release) whereas other women prefer to tuck/tilt and hold throughout the contraction. This can help get a baby lower in the pelvis, tuck their chin to their chest, or rotate. It can help mom by providing comfort and pain relief, along with give them a great tool that they can provide for themselves - which is a very powerful and positive thing to give mom.

And our final use for the bathroom door is to use the door itself as an addition to the rebozo. You can make a knot in the top of a rebozo, other long scarf (think baby wrap) or sheet, hang it over the top of the door, then shut the door to anchor it in place. Voila! You have an anchored laboring tool that mom can pull on, hang from, squat with, etc... This gives mom confidence and security to be able to get into many positions that she might feel a little wary of otherwise getting into.

If possible though, and unlike the picture linked, TRY to have the rebozo hanging down from the opposite direction that the door opens toward. This will ensure that someone on the outside of the door doesn't accidentally unlatch the door, loosening the anchor, and sending mama onto the floor!

IN CONCLUSION

I hope that our little trip into the bathroom has helped you see how a truly great birthroom the water closet can be! I didn't even touch on the acoustics of the tiled walls/floor and how it helps mama to open up her glottis. I didn't even get to talking about the usefulness of the sink. There are still so many more tools to be found in the bathroom that help make labor and birth a more fluid, efficient, and comfortable event.

But tell me, did you labor in the bathroom? If so, tell me your story (or link it) below!

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