Archive for the ‘Uncategorized’ Category

Why Are Birth Doulas So Darn Picky?

Tuesday, February 6th, 2018

It is my understanding that by being choosy about clients and committing to those who demonstrate the highest level of commitment to physiological and unmedicated childbirth, who are also most likely to choose a like minded caregiver, doulas try to protect themselves- their souls and their hearts.

 

During the holiday season, I attended a local birth community gathering in San Jose.  Our lovely host, a DONA trained and seasoned birth doula, invited us to introduce ourselves saying: “Tell us how you practice; what is unique about your practice, so we know which birth clients to refer to you.” The first doula to go shared that she is mainly practicing in one  particular hospital , because everyone knows and respects her there,  and she only supports birth clients who are strongly committed to a natural and unmedicated childbirth, and state that they are open to medical solutions if these are needed. Her introduction set the tone for our community freely share their preferences, and the trend became very clear: Doulas are picky about the clients they take on- and it has nothing to do with specializing.  

I began practicing 19 years ago as a pioneer doula in my country. At that time, I was struggling to convince expectant parents of the value of hiring a birth doula. Needless to say, I did not have the privilege of being picky about my clients. Did I enjoy supporting certain types of birth clients more than others? Of course! But it never occurred to me to choose clients in accordance with the OB practice or the hospital, nor with their level of commitment to avoid pain medications or other medical interventions. I was passionate, and still am, about supporting every potential client in hopes of leading them toward a healthy and satisfying birth experience. While I can’t say when the trend of filtering through clients began,  I have a some ideas about the reasons that brought it to the surface.

The practice of a birth doula is a hard one due to a vast array of aspects, including : practical or logistical, physical, emotional, social and financial aspects. Being a change agent, or an activist promoting natural childbirth, you already stand out in every social gathering outside of the birth workers community.  Your close friends are mostly birth workers who speak your language and share your passion and are the only ones who, like you, live their lives constantly on-call, practicing flexibility and willing to change plans in a blink of an eye, with no hard feelings. Your family and friends are always secondary to your devotion to attend your clients’ unpredictable births. As for your own mental state, commitment to as little as one birth a month means that you are not making big plans like birthday parties, or a romantic getaway, without stressing out about this one client.

Now let’s look at the emotional and physical hardship of being a doula. While modern society is committed to alleviating pain –  physical or emotional pain, doulas are the caregivers on Earth to accept pain, embrace it, and work through it.  Supporting our clients throughout labor contractions by containing their pains, doubts, fears and moments of crisis and despair takes its emotional toll. In addition, providing massages and physically supporting our clients’  bodies as they change positions, for an average of eight hours, is physically exhausting. On top of it all, we often deal with these challenges during night time, or at the end of an active day. And when medical complications arise, we coach our clients towards making an informed and mindful decision,empowering them to demand patient-centered care and not give up on their birth vision too fast.  

It is my understanding that by being choosy about clients and committing to those who demonstrate the highest level of commitment to physiological and unmedicated childbirth, who are also most likely to choose a like minded caregiver, doulas try to protect themselves- their souls and their hearts. Doulas want to guarantee their clients are committed to unmedicated physiological childbirth as much as they are committed to supporting and leading them throughout this kind of experience. They therefore refuse to support clients who say “I am attempting a natural childbirth, but I’m open to the option of taking epidural”. Doulas try to avoid the draining scenario of medicalized childbirth and being a witness to the frustrating cascade effect of medical interventions. By supporting only clients of caregivers we trust and with whom we are compatible, doulas avoid witnessing abuse in Labor and Delivery. Overall, this trend of carefully choosing one’s clients serves doulas’ need to decrease the hardship of their practice and get a sense of control over the birth experience they take part in.

As a seasoned birth doula and a doula trainer, I get it, I really do! And at the same time,  I still find myself being drawn to those clients who “try for a natural birth but are open to…epidural”. Perhaps it’s because I’m a dinosaur in the doula community, but for me, there is a special reward, a triumph, in leading that birthing client, who wants the natural childbirth because she sees the value in it, but is being honest about her doubt in her strength and abilities to be with pain. Leading this mother all the way to an unmedicated and healthy birth, looking into her wide open eyes and her joyous expression when she says: ”I DID IT!”  is so rewarding for me. It empowers me as a woman, a doula and a doula trainer.  

In order to increase my chances to avoid the draining scenarios of medicalized births and to make sure my clients demonstrate a high level of commitment to their healthy and vaginal birth experience – I practice prenatal coaching. Prenatal coaching is my leading technique, and it is how I make sure my clients and I are aligned in our belief system about birth, clear about their goals and what it takes to lead them towards achieving their desired birth experience, and we’re  equally accountable to what it takes to get there. While I understand doulas motivation to decrease the hardship of our practice, I see prenatal coaching as the pathway to achieving this goal, rather than filtering clients.  Serving only those who are mentally and emotionally prepared for a physiological birth means that we gave up on one the most important ambitions for doulas’ emergence – facilitating a cultural change in maternal care.  

To healthy births on Earth!

Our New Partnership Opportunity; Become a BCM trainer!

Tuesday, January 9th, 2018

At Birth Coach Method, our mission is to empower expectant parents and the professionals who provide them with care throughout their pregnancy and birth.  Now it’s time for us to team with providers with the same passions, so we can increase the percentage of healthy births and happy mothers worldwide!

We are teaming up with experienced birth support figures, doulas and childbirth educators, who support the Birth Coach Method (BCM) mission and want to use this opportunity to improve their birth coaching skills.  Trainers are hand-picked and specially trained by Birth Coach Method to lead continuing education classes to professionals and lead doula training programs.  Now is your chance to apply to join tour network! As a new Birth Coach Method Program Instructor, you will receive thorough training and all the online resources necessary to teach the BCM Training Programs.

Submit Your Application 

The First Virtual Class for Birth Coach Method Trainers Opens March 20th, 2018

 

BCM Supports our Program Instructors!

Instructors will receive the following:

  1. Access to the BCM online program with 30 hours of tele-class guidance on how to create and lead your own training programs.  
  2. All necessary class materials to share with your students, such as handouts and PowerPoints presentations, as well as educational materials needed to lead the workshop,  charts, and props lists. 
  3. Optional models of supervision and hands-on practice for the students, including the information needed to establish working relationships with local practitioners.
  4. Samples and instructions for creating a final exam.  
  5. Spreadsheets to follow up on student payment and requirements etc.
  6. Information about advertising and enrolling students in doula training workshops.

 

Are You Up for the Task?

We need instructors who demonstrate good communication and leadership skills in order to establish relationships with local practitioners and with your students.

We are teaming with birth support figures whose philosophy matches BCM and:

  • Are thoroughly familiar with BCM online training program(s).
  • Knowledgeable birth doulas with at least 8 years of experience as a birth support figure with attendance of at least 2 births a month throughout the years.
  • Teach at least one doula training workshop per year.
  • Attend minimum of 15 CEUs a year.
  • Possess the following educational materials and demo equipment: Childbirth Graphics Charts, pelvis, baby doll, placenta, cord and uterus, as well as practicing props like physio balls, peanut balls, and massage balls. We will be sure to provide you with the full list of educational props needed to enhance your students’ learning experience. 

Ready to Enroll?

Please submit an application and CV. If it is a good fit, we will contact you to conduct a phone interview. Once approved, you will be given a week of access to the program’s online lessons for a deposit fee of $179. The $179 which were already paid will be deducted from the student’s enrollment fee of $780.  

Submit Your Application

 

You’re a BCM Program Instructor! Now what?

    1. Share your workshop  dates, times, and location with BCM.  
    2. Create a website/landing page and advertise your training workshops locally.
    3. Collect tuition of $780 per student – BCM is open to adjustment of tuition in accordance with local fees.
    4. Pay BCM a percentage of 30% of each student’s tuition for the first 15 students per year. For every additional student you enroll per year, BCM will reduce the percentage to 20% per student.
    5. After you pay the BCM fee, our admin will send each enrolled student a personal link to create her username and password on the member’s website and begin the online portion of the training.

 

Integrating Group Coaching into Birth Education

Saturday, December 16th, 2017

Curing the Dramatic Drop in Childbirth Education Attendance 

We had some an amazing turnout for our first webinar tailored for childbirth educators !

This webinar is Approved for CE credit by ICEA and Lamaze International

                           Buy Here 

 

This Free Webinar Will Show You:

  • How to increase enrollment in your classes and make birth education an essential rite of passage again
  • How to transition from teaching and informing to coaching toward fulfilling parents’ desired birth experience
  • How to integrate group coaching into your childbirth classes
  • How to expand your practice to include in-person coaching sessions

 

Expand your leadership skills with new coaching strategies to lead groups and individual expectant parents towards their desired birth experience.  

                   

 

Coaching is Advocating for Patient-Centered Care

Saturday, December 16th, 2017

Resolving the Advocacy Dilemma in the Doula Practice

This webinar first aired as a New Year Resolution for birth doulas.

Join the growing community of doulas who already integrate coaching into their practice, and feel the difference; it will empower you and your clients! 

You can now purchase it Here for only $9.99, and we will email you the password.

Happy New Year!

 

“If we begin by asking expectant couples strong coaching questions, with the goal of clarifying their beliefs about childbirth and their goals for their birth, it will build the foundation for advocacy of a different kind. Advocacy that doesn’t represent expert’s authority but rather empathy and partnership. Advocacy that begins with the individual needs and beliefs.  We will then find ourselves introducing evidence-based resources that are aligned with our clients  personal needs and capacity, and eventually I believe it will bring more couples to take childbirth education classes and hire doulas.”

Who is the Birth Expert Here?

Thursday, July 6th, 2017

This New Method Will Make You Give-Up Your ‘Expert Position’ and Hand it to Your Birth Client.

 

Do you consider yourself an expert in ‘how to give birth’? If you are a childbirth educator, a birth doula, a midwife or a labor and delivery medical staff member, I’m almost certain that there is a confident voice inside your head saying, “Yes, I know all about giving birth, it’s my profession and what I do for a living”. However, I urge you to rethink your position: Can you be an expert about how any woman, other than yourself, is giving birth?

I recently finished reading the book “Childbirth and Authoritative Knowledge; Cross-Cultural Perspectives,” a collection of cross-cultural essays on reproduction and childbirth, edited by R. E. Davis-Floyd and C. F. Sargent, which extends the work of childbirth anthropologist Brigitte Jordan. I was deeply impressed by the authors’ understanding that since the establishment of Obstetric Gynecology in the middle of the nineteenth century, the experience of childbirth has been controlled and shaped by “those who know”; those who are considered an authority of knowledge, and whose ideas about childbirth shape and control our decisions and actions in maternal care, as opposed to the only expert in the room- the birthing mother.  “Authoritative knowledge is persuasive because it seems natural, reasonable, and consensually constructed. For the same reason it also carries the possibility of powerful sanctions, ranging from exclusions from the social group to physical coerciveness” (Jordan and Irwin 1989). who is the expert

After practicing from an authoritative position in L&D for so long, no wonder we ended up with a generation of birthing mothers who come into L&D unit and completely hand their lives over to the professionals, fully trusting them to make decisions for them. One would have assumed that birth activists and birth keepers, like childbirth educators and birth doulas, practice from a different position. However, I find that this is not the case. In nearly two decades of practice as both childbirth educator and doula, I admit that only after becoming a life coach, eight years ago, I finally stepped down from the “expert” position, and began seeing my students and birth clients as experts in their own lives, and therefore as experts in designing and achieving their desired birth experience.

I believe that for many decades now, even after the establishment of birth activism, women were caught between two types of “experts” – the “medical experts” and the “natural birth experts.Seeing the client as an expert in her own life, as well as the expert of the situation she is coached in, is a basic principle in coaching, and is manifested in The Art of Coaching for Childbirth, a guide I recently published introducing the Birth Coach Method motivating birth professionals of all kinds to integrate the coaching tools and strategies into their practice. This basic principle was first stated by two of the founding fathers of the coaching profession, Sir John Whitmore, who recently passed, and Robert Dilts. According to Dilts, coaching starts from the assumption that people have answers, and the coach’s role is to help them to overcome internal resistances and interference, give feedback on behavior and give tips and guidance (Dilts, 2003). So if the client is the expert and has all the answers, what is the coach’s expertise?  Here we can use Whitmore’s observation that : “The effect of coaching is not dependent on “an older, more experienced individual passing down his knowledge. Coaching requires expertise in coaching but not in the subject at hand. That is one of its great strengths” (Whitmore, 2002) 

front-cover

What does it mean to hold our client as an expert in the field of childbirth? How do we manifest this principle when leading birthing mothers towards a safe and physiological birth, and how do we trust the birthing mothers as experts when they don’t trust themselves at this point in human history?

Here are five steps I suggest we all take, and I mean all of us – physicians, midwives, nurses, doulas, and childbirth educators: 

 

  1. Work with questions: Instead of telling her or teaching her, ask the expectant mother more questions about herself. When she says: “I would like to give birth naturally”  do not assume you know what it means and you trust yourself to lead her there. Ask: “Can you clarify for me what is your vision for natural childbirth? How does it look? What happens in a natural childbirth? How does it feel? Strive for clarity. When she talks about her fear of pain, ask her: “What do you do when you are in pain? What do you know about labor pain? How do you usually overcome your fears? For more practical tools and a wealth of coaching questions for childbirth, I recommend reading The Art of Coaching for Childbirth.  
  2. Trust the mother as the expert even if she currently does not trust herself: As a coach, your most valuable asset is that you believe in her potential. This is true empowerment. When she says “I need to push”, reassure her “I’m here for you, follow your body, be with it for the next ten minutes while I’ll be here quietly, and just ask your body what it wants to do, I am right here.”  
  3. Encourage the mother to set-up a clear vision for herself and then ask: “how can I best support you in achieving this vision?”  Whether you are a doula holding your first coaching session with your client, or an L&D nurse who was just handed your patient’s birth plan, please initiate a conversation about it beginning with the same question.
  4. Coach the mother and support her towards her vision with no attachment to the manifestation of her vision. I know, this is a tough one! But hey, in childbirth, just like in any other area of life, there are no guarantees. What matters is the process. As long as you lead your client to be accountable for her birth experience, and have helped her to align her beliefs with her goals and her actions, it doesn’t matter if in reality there was a deviation from her vision due to medical impositions. Ideally, she will be satisfied with how she conducted herself through the process, and will own it as her journey. This change of perspective begins with you as her leader.  
  5. Be an authentic role model and practice observation without judgment: In order to lead, we have to be in touch with our personal truths. If you don’t trust your patient’s body and the process, and you practice from fear, please take the time to heal yourself and understand that your fear is in the way of your patient’s safe childbirth. Meanwhile, please step down from supporting a patient who envisions a physiological childbirth for herself. If you are a doula who lost faith in the good intentions of the medical system, please heal yourself, and meanwhile step down from assisting a hospital-based childbirth, as your lack of trust might sabotage your client’s childbirth experience. If you are disappointed by a woman who “tries for a natural childbirth but is open to the possibility of asking for pain meds”,  then you are practicing judgement and rigidity. Heal your wounds and work your way back to love and acceptance.

 

Resources:

  1. Dilts, R. (2003), From Coach to Awakener, Meta Publications, California.
  2. Irwin S. and Jordan B., (1989) “Cosmopolitan Obstetrics: Some Insights from the Training of Traditional Midwives, Social Science and Medicine,  28(9):925-944
  3. Whitmore, J. (1992) Coaching for Performance: Growing Human Potential and Purpose – The Principles and Practice of Coaching and Leadership, Nicholas Brealey Publishing, Boston

 

Are your clients hiring you to avoid a cesarean?

Tuesday, May 2nd, 2017

No, there is nothing wrong about it from their end, but how do you feel about it? Are you at risk for a professional burnout?

 

A couple of days ago I had a beautiful mentoring session with two local doulas; we will call them Iris and Lily.  We were going over some challenging cases they experienced recently, and exploring how the Birth Coach Method’s strategies and tools help.  Pretty early in our discussion, I learned that their typical birth clients represent some degree of polarity: Iris works only with clients who are strongly committed to an unmediated birth.  She feels that potential clients who are “willing to try [birthing] with no epidural, but leave themselves open to option of taking it” are not a good match for her.  Lily said that her clients are hiring her in order to “Check the box” of doula services; meaning that they read the statistics showing doulas reduce cesarean rates and they are hiring her to avoid a cesarean.  

benefits-of-a-doula

The reason I say that their typical clients represent a polarity is that Iris’s client, as described by her, is personally  committed to her own journey and to the choices she makes, and is hiring a doula to get the additional support needed in order to achieve her desired birth experience- unmediated physiological birth, whereas Lily’s typical client  is committing her doula to her wish to avoid a cesarean.

From the client’s perspective it totally makes sense to feel the doula is accountable for the birthing experience; after all for decades we have been using the doula statistics to promote our services, spreading the notion that the presence of a doula will reduce need for pain medications, inductions, and the chances of needing a cesarean. From the doula perspective, this promise stand the risk of professional burnout, because if medical interventions that you promise to reduce unfortunately take place in your client’s’ birth, you risk feeling that you didn’t fulfill your role.  You could feel that you failed in leading your client toward her desired birth and could even lose confidence in your professional validity. This is absolutely one of the areas in which I mostly appreciate the contribution of integrating the coaching principles and strategies into the field of birth support. This area is called client accountability, and it equally serves the client and the coach. 

As coaches we ask ourselves, who is holding who accountable in these relationships? Is she holding you accountable for her desired birth experience?who-is-accountable Is this arrangement truly working for you? Do you really want to be committed to your client’s journey more than she is? When you demonstrate a higher level of accountability to your client’s vision than hers, do you empower her or rescue her? Are you her support figure, her leader, or her savior; taking charge of her? Maybe you serve a ‘camouflage effect’ where she is convinced that she hired you in order to avoid a cesarean, and unconsciously avoids dealing with her birthing fears.  

Coaches in various fields lead their clients closer to fulfilling their potential and achieving their goals by holding their clients accountable; it is build-in in the coaching relationships.  When I asked Lily how does she know her clients are hiring her to “check the box of hiring a doula” she immediately pointed out the “inconsistencies” in her word: those gaps between what the clients say that they hire her for, or what they describe as their desired birth experiences, and the actions they take prenatally and during the birth to achieve their goal. That’s exactly it; coaches  evaluate a  low level of commitment when the clients resist taking the actions which will bring them closer to what they state as their desired goals

Prenatal coaching sessions conducted by a doula, or by a childbirth educator, can elicit the mother’s accountability for her desired birth experience and to her journey, and therefore has the potential not only to protect the birth professional from a  burnout, but to lead the expectant mother closer to fulfilling her birth vision.

 

More Resources:

To learn how doulas can elicit accountability

To learn more about client’s accountability vs. responsibility

To learn more about client’s accountability

To learn how to integrate coaching into birth support.

 

A New Guide from Birth Coach Method!

Sunday, November 6th, 2016

The Art of Coaching for Childbirth

Integrating the Principles of Coaching into the Field of Birth Support

Scroll down for the reviews  

The Art of Coaching for Childbirth is a practical guide inspiring and leading every professional in the front-coverfield of birth support to integrate the coaching tools and strategies into their practice. 

From one blog post to another and throughout my webinars, Birth Coach Method has become a paradigm shift in the field of childbirth support. It has drastically changed the conversation from teaching about childbirth to coaching the mother-to-be as an individual toward an optimal performance in childbirth. Birth Coach Method inspired birth doulas to shift from telling clients what they think is the best childbirth experience for them to asking questions, listening and exploring their belief system about childbirth, about themselves and their bodies, their strength and more.

While my book The Art of Coaching for Childbirth has been reviewed by top notch professionals and scholars in the field of birth support, I have come to the understanding that the Birth Coach Method is about to create a paradigm shift not only in the doula practice, but in the way childbirth educators approach their role. 

Buy Here

Scroll down for reviews 

The Art of  Coaching for Childbirth is more than a practical guide; it is an introduction to coaching. I dedicated the first part of the guide to establish the value of implementing the principles and strategies of life coaching into the field of birth support.  This part begins with a thorough introduction of the history and principal of the modern coaching professions, and continues with a presentation of the structure of the coaching process. While reading this part, you will get acquainted with the basic terminology of coaching like goals, inquiry, strong search questions, opening options, clarity, distinguishing truth from myth, accountability and more, as it being implemented into the field of birth support to lead birth clients to optimally perform at their birth.  To use the words of my friend and colleague Michal Klau-Stevens, The Birth Lady, this part will convince you of the value of incorporating coaching into birth support by healthcare workers, childbirth educators, doulas, and other birth workers.”(See below)

In the second part of my book I gathered all the coaching questions, which I presented at the theoretical part, and added hundreds of other questions and coaching exercises, which you can begin coaching with right away. This part will equip you with coaching strategies to tackle various scenarios and situations across the spectrum of birth support.

 

Read the Reviews:  back-cover-snip

“…The Art of Coaching for Childbirth, while compact at just over 70 pages, nonetheless packs in an incredible amount of practical information and useful tools.  She has skilfully transferred classic coaching strategies and made them totally applicable to birth educators and doulas. These strategies enable us to transfer the power back to the birthing woman, encouraging her to take responsibility for her own birthing journey. Empowerment, as we know, is not something we can give another person. It is something that originates from within….Neri’s book set off some real “light-bulb” moments for me and will definitely change the way I approach topics such as fear, pain and interventions in my Lamaze childbirth classes.”  Tanya Strusberg, LCCE, FACCE, Director, Birthwell birthright Childbirth Education, Lamaz-accredited and CAPEA, Australia.  http://www.capea.org.au/Resources/Reviews/ArtMID/589/ArticleID/62/The-Art-of-Coaching-for-Childbirth
 

 

 “…The coaching method, as applied to birth support, becomes a viable and vibrant path through the unwinnable culture wars that surround birth, which focuses on questions like, “Is birth safe?  Is it dangerous?  Where should it take place?  Who should attend births?”  One question that Life-Choma addresses head on, though, is “Whose birth experience is it?”  Because the answer to that question is the pregnant woman herself, then the coaching approach, as outlined in this wonderful book, is an optimal approach for those seeking to enhance women’s birth experience.  Coaching for Childbirth is an important contribution to childbirth preparation and support and this book, and the method, will be a valuable resource to childbirth educators, doulas and others seeking to support birthing women…”  Christine Morton,PhD, a former distinguished member of Lamaze International and current manager at the California Maternal Quality Care Collaborative

 

“Coaching for Childbirth is an innovative guide for professionals who serve pregnant women and want to integrate coaching techniques into their work. Neri has done a wonderful job of clarifying the coaching role and distinguishing it from therapeutic care and teaching. The exercises and scripts Life-Choma offers are excellent resources, and she constructs a convincing case for the value of incorporating coaching into birth support by healthcare workers, childbirth educators, doulas, and other birth workers…”  Michal Klau-Stevens, The Birth Lady

 

 “…The Art of Coaching for childbirth” provides nurses with the concrete coaching tools and approaches which can be quickly implemented  in labor and delivery. Teaching nurses to ask strong questions which help clients clarify their goals and priorities, while using pacing and leading strategy will make client-nurse interactions insightful…” Olga Libova, DNP, CNM, RN, Perinatal Nursing Faculty, De Anza College Nursing program, Silicon Valley, Ca

 

“Coaching for Childbirth; a Practical Guide for Integrating the Principles and Strategies of Coaching into the Field of Birth Support” is required reading for all individuals in the field of birth support… Doctors, nurses, midwives and doula’s, new mothers and fathers, will all discover a plethora of valuable information within these pages. Dr. Rosie Kuhn, The Paradigm Shifts Coaching Group

 

” It was a new approach concept to teaching childbirth education that many people could relate to as student athletes or being part of a team. This book also incorporated the popular reflective interviewing method many companies currently use during the hiring process to better understand the candidates thought process or personal intention.   Although the concepts in this book were not unique or ground-breaking, the author presented the subject through a fresh lens. For this reason, I would recommend this book.”  Tamela J. Hatcher, ICEA board member 

Coaching for Building the Best Support Group for the Birth

Saturday, November 5th, 2016

First published in Nov. 2016 as a free webinar celebrating the release of :

The Art of Coaching for Childbirth

Integrating the coaching principles into the field of birth support. 

To listen to this webinar please buy it here, and we will send you the password and the downloadable PPT.

 

 

Six Habits of Thinking that can Sabotage Your Client’s Birth

Tuesday, June 28th, 2016

For the past six years, I have practiced prenatal coaching with my birth clients. By incorporating between four to six prenatal coaching sessions into my doula practice I was able to identify six habits of thinking, or repeating themes, which could harm your clients’ birth experiences. Whether they are aware of these thinking habits or not, these themes run like an underground stream that will find any possible ‘crack’ to emerge and surface. This blog post is dedicated to these six habits of thinking and the coaching strategies you can apply to address them:

1. Perceiving childbirth as dangerous.   thinking habits
2. Confusing discomfort with pain and avoiding both these sensations.
3. Avoiding information that challenges her mentally and emotionally.
4. Adopting the cultural dichotomy of natural childbirth vs. medicated childbirth.
5. Perceiving childbirth as a project rather than a process.
6. Confusing the unpredictability childbirth with the inability to prepare for it.

Perceiving Childbirth as dangerous: Childbirth used to be a dangerous event in women’s lives and was associated with fear of death. Thanks to many developments in Modern Medicine, such as blood transfusion, antibiotics, sanitation and cesarean operations, and due to a healthier lifestyle, which includes better nutrition, plumbing, and family planning, this is no longer the case. A lot people die in car accidents each year, yet it seems that every day driving does not evoke fear in most women. However, the fear of dying in childbirth is still common and can be explained as a genetic memory, or in Carl Jung’s term as a “collective unconscious, a broader concept of inherited traits, intuitions, and collective wisdom of the past. If this fear is at the back of your client’s mind while she prepares for her childbirth and while she makes her decisions during her birth, it can explain the gap between what she says is her desired birth experience and the actions she takes toward achieving it. As her birth coach, your role is to help your client reveal this fear, get in touch with it, and then foster new habits of thinking which will replace it, like mantras, affirmations, or hypnosis suggestions. These new ways of thinking will have to be practiced on a regular basis in order to become her new habits of thinking about childbirth, and thus, will help reach alignment between her beliefs, her wishes and the actions she takes.

Confusing discomfort with pain and avoiding both these sensations: Our modern society associates birth with pain. homer From Homer’s poetry in 750 B.C, to Judaism and Christianity, birth is associated with horrific pain. In addition, modern culture is geared toward eliminating pain and discomfort. The expectant mothers of today were once little girls who were offered pain meds from a very young age. Being in pain during childbirth might be your client’s first time experiencing pain. As a birth coach, it is your role to recognize the openings in the coaching conversations in order to coach your clients through labor pain. You may conduct a discussion about the different concepts of discomfort and pain and explore labor pain with her using the PAIN acronym with the goal of distinguishing fears from realities. (PAIN; Purposeful, Anticipated, Intermittent, Normal.) You can assign your client the task of inviting mothers to describe labor contractions in as many words as possible other than ‘painful,’ in order for her to have a wider terminology to talk about labor contractions. It is important to establish the connection between all the labor support tools and coping with discomfort or pain.

Avoiding information that challenges her mentally and emotionally: The notion of avoiding health-related information has a long history in psychology. In the beginning of the 1900s, Freud’s theories about psychological defenses (repression, suppression, and denial) shed light on psychic mechanisms that people employ to censor uncomfortable thoughts. The questions of health information avoidance have also been studied from the viewpoint of ‘fear appeals.’ Studies conducted in the 1950s showed that extreme attempts to lead people to practice health habits by frightening them, with graphic pictures of mouth or lung cancer, were not very effective. On the contrary, such provoking images lead people to ignore the threat. Childbirth is depicted in all types of media as a threatening and dramatic event, involving a sense of medical emergency, tremendous pain, and a loss of control over one’s discharges and body in general. This scary depiction leads expectant couples to avoid acquiring information about evidence-based maternal care and to avoid all types of presentations of childbirth, including the healthy ones. As a birth coach, your role is to help your client form a positive and healthy concept of childbirth. This can be done by exposing her to different presentations of childbirth, as well as to statements of world health organizations that perceive childbirth as a healthy event. thinking is a habit

Adopting the cultural dichotomy of natural childbirth vs. medicated childbirth: I have discussed this topics in many of my previous blog posts and webinars. This dichotomy is strongly present in the way we talk about childbirth and is held by birth professionals and activists. I believe that it leads expectant mothers to think that they have to choose between these two very different experiences, and most often, the fear of pain will push them in the direction of choosing the medical experience. I urge you to drop the phrase ‘Natural Childbirth’ and use the concept of ‘Healthy Birth’ or ‘Physiologically Sound Birth’. In its essence, childbirth bears many characteristics which pose great challenges to modern women and prevent this experience from being ‘natural’ to them. Women need to prepare mentally and emotionally to these challenges, and that’s why your coaching is so needed. Our role is to help your client acknowledge the overall challenges, as well as the unique challenges childbirth poses on her, and to reassure her that with new strategies and tools, she can overcome them and achieve the goal of a healthy and physiologically sound childbirth.

Perceiving childbirth as a project rather than a process: To borrow from the world of business management, project management has emphasis process vs event

on getting the task done and achieving the end result. A project management has an objective or outcome to be accomplished, and the project ends when that objective is completed. Process management focuses on repeatability, efficiency (decreasing time needed and reducing cost), and increasing quality. A process management has an objective that is typically defined around the ongoing operation of the process. The unpredictability of childbirth makes it impossible to apply the project approach to it. There are so many variables involved in childbirth which we cannot control – the physiology and anatomy of the mother, the quality of contractions, the coping of the baby with the birth process, fetal position, and many more. When we apply the process management approach to childbirth, it becomes clear that we are coaching our client toward their optimal performance in childbirth with the goal of eliciting their accountability to the process of childbirth. Childbirth is then being perceived as a self-growth process rather than as an event.

Confusing the unpredictability childbirth with the inability to prepare for it: The unpredictability of the unfolding of childbirth and its outcome seems to oppose that idea of setting goals and preparing for childbirth. Many expectant mothers will avoid attending childbirth preparation class and acquiring knowledge based on the premise that the unfolding of their labor and the outcome of it is beyond their control. As coaches, we might be discouraged thinking that even if we coach the mother, empower her, and help her reprogram her mind, the unpredictability will remain in place. While this is true, it should not be confused with the inability of the mother to envision her desired birth experience and to work hard toward achieving it. When we perceive childbirth as a process, it becomes clear that there is no difference between coaching for childbirth or any other performance. Whether it is sports, acting, a career, an executive position, or a relationship, it is just an illusion to presume that we have the situation under control. Coaching for childbirth is a transformational process during which the client learns to be accountable only for what is possible for her, for the actions she takes in order to achieve her ideal birth, and not for the outcome. In this respect, it is a wonderful preparation not only for childbirth, but for what follows – parenting. In both childbirth and parenting we can only be accountable for the process. If you coach your client with this understanding in mind, there is a great chance that regardless of the unfolding of her birth experience, she will feel high levels of satisfaction toward the way she conducted herself all the way from conceiving to postpartum.

To Healthy Births on Earth!

Evidence in Support of Coaching for Childbirth; Reporting from the Field

Monday, April 25th, 2016

 

There is a buzz!!! “Coaching for childbirth is what everybody is talking about,” I was told a couple of weeks ago, when Betsy Schwartz invited me to co-host Birth Blab, and the Birth Lady,  Michal Klau-Stevens Joined us.  The raw and intuitive concept of coaching for childbirth, which I began developing two years ago, has evolved into a powerful method with solid theory and a substantial variety of techniques and exercises practiced by more and more doulas. The more doulas join the new paradigm of coaching for childbirth, the more evidence is being accumulated in support of the tremendous benefits of this practice.  This evidence shouldn’t be neglected, as it might just be the shift we have been waiting for, especially in light of the growing frustration of birth activists and birth professionals from the constant increase in medical interventions, such as inductions and cesarean operations. Therefore, I have decided it’s time for me share some of the evidence that comes from my own doula practice, as well as from the practice of a doula who attended my workshop – The Art of Coaching for Childbirth.

In this post I present three case studies which demonstrate the high level of leadership doulas and childbirth educators can practice, by integrating coaching principles and techniques into their work with expectant mothers.  In the first case study, one strong search question led an expectant mother to develop labor, fulfill her wish for a VBAC, and avoid a cesarean. In the second case study, a coaching question helped reveal and refute an old and harming myth regarding relationships in L&D, and in the last one a coaching conversation had turned the idea of losing control from a fearful experience to a possible pleasurable experience.

Case study no. 1: One strong coaching qucoaching couplesestion that led a mother into labor

Shelly, a member of my local community and an expectant mother in her 40th week, contacted me via Facebook messenger: “I posted my situation on our Facebook group, and everyone refers me to you, can you please help me?” Over a phone conversation she shared that she is hoping for a VBAC, and must give birth by the coming Friday (in three days), the day of her scheduled cesarean. She had already seen an acupuncturist, and her contractions kept coming and going. For the last ten days, she said, she was developing contractions and felt like she was going into labor, but they kept disappearing after few good hours.  We decided to meet that evening in order to explore what can be in the way of Shelly’s healthy labor.

Shelly came with her partner to the meeting, which confirmed her high level of commitment to her goal as well as a high level of support provided by her partner. I opened the meeting sharing that the situation can be explored from two angles: the physiology of childbirth and the anatomy of birth. By exploring the physiology of childbirth, I explained, I mean that Shelly’s hormonal system was releasing oxytocin to develop labor, but time and again there was something in the way, and her levels did not increase and even decreased. By exploring the anatomy, I mean that maybe the baby’s position is not optimal, and we might need to look into that and try to correct it with some exercises.

After about 40 minutes of demonstrating and practicing some positions, including the three sisters and the lunge pose, I instructed the couple to continue practicing these exercises daily until the birth. I then decided it was time to explore the physiological angel. I first talked about different methods to ‘ride the wave’ of the spontaneous contractions when they show up and help increase oxytocin levels and uterine cramps, such as nipple stimulation, sex and enema. Then I curiously asked: ”What is going to happen when your baby is finally here? Is there any concern or worry that can hold you back from releasing this baby to the world?”

Silence. The couple was looking into each other eyes and Shelly was in tears. Then both shared that they are only kids in their families, and they believe they are hurting their toddler by bringing another baby to the world. They both have careers and they felt sorry for their toddler for having to share the little and precious time with them with another baby. Then the dad added, addressing Shelly: “Remember last night your contractions were strong and steady and they disappeared immediately after he cried.”

So I set the couple down to make a list of all the benefits of having a sibling; from developing social skills to having a family when the parents are gone, and all the way to organ donors! There was laughing and crying, and then I shared my perspective that they are amazing parents giving the best gift to their toddler. I asked Shelly to read and recite this list to herself before bed time, first thing in the morning, and when she goes into labor again.

The morning after I was on my way to the airport, when I received the following Facebook message: “In hospital, fully dilated, baby is in +2, THANK YOU!”

 

Case study no.2: A coaching question leading to the annulment of an old myths  questions allow coaches

The following evidence was sent to me by doula Ellen LaVoie, from Redwood City, California: “ I asked my most talkative, well-researched client about what she was giving up in order to have an unmediated birth, and she was speechless! We explored her birth from a new angle. It was great! She soon went back to her big fear of battling with hospital staff. She believes she is giving up a smooth interaction with them. Then we worked on strategies for resolving that, many inspired by your workshop.”

 

Case study no. 3: Turning childbirth from a fearful experience of losing control to a pleasurable one

How many times did you hear expectant mothers sharing their fear of losing control during childbirth? There are so many different ways to explore this fear. You can ask “What do you mean by ‘Losing control’? Simply because it is not clear what they think about when the say ‘losing control’. Or “What happen when you lose control? How does it look like, or feels like?
A dear client shared this fear during prenatal session. I didn’t feel like exploring the fear will be beneficial for her, as I know her to be very prone to anxiety. Instead, I asked: “Is it possible that losing control over your body will be a pleasant and joyful experience? 
Silence in the room….and then “Yes, it happens in orgasm”. 
Me: Aha 
Together we came up with this list of wonderful experiences of losing control:

  • Falling in love
  • Free style dancing
  • Screaming on roller coaster ride
  • Feeling tipsy
  • Orgasm
  • and Childbirth

What have surfaced in the conversation as a fear ended up as a possible pleasant experience?

Interested in bringing ‘The Art of Coaching for Childbirth’ to your area? Contact me at: neri@birthcoachmethod.com