Setting a new trend: choice + birth skills
The present childbirth message in the world is to encourage families to make informed choices and create a birth plan. In our diverse modern societies, many people are not happy with how their pregnancies and births have gone. Parents’ personal experiences of birth and how birth services were provided show a fundamental need for a new conversation in childbirth. Is there a gap in the present childbirth conversation?
Since the 1980s, we’ve had a choice-based childbirth trend. Pregnant women do research to discover what type of birth and medical care they want and don’t want. With this research, they expect their birth providers to try and give them the birth they’ve chosen.
You may or may not know that in the United States, at least, there was an entirely different childbirth trend from the 1960s to the mid-1970s that was “skills-based.” Women had few to no choices back then, yet a whole generation of men and women birthed with skills amid the assessments, monitoring, and procedures done in the hospital-based system of that period. Lamaze and the Bradley Method were taught extensively in most hospitals. There was a very high societal expectation that we all attend the very first skills-based childbirth preparation classes. Fathers were equally involved and trained to be excellent birth coaches.
This skills-based trend was replaced in the 1980s with the choice-based trend we have today. Classes shifted and focused on information. Women began to birth again without skills, and fathers were implicitly led not to offer coaching support, but to support choices.
Today, birth plans are the gold standard for preparing for birth. However, for many reasons, most women do not end up having the birth they plan. In fact, most women say: “It was nothing like I imagined.”
For several reasons, skills were not joined together with the choice-based approach to birth, as they might have been. We can change that. In fact, you can help bring forth this common-sense change as expectant parents, and this article will explain how and why.
Women and men can bring forward a high societal expectation that all expectant families should learn birth skills in addition to making informed choices. If you are spending any amount of time doing research about what medical care you want and don’t want, you can spend an equal amount of time learning and practicing birth and coaching skills.
Now is the time to bring forth a childbirth revival combining skills and choices. When pregnant, it’s common sense and beneficial to learn birth and coaching skills, and then use your skills to work through the activity of birthing your baby in any circumstances.
Why? Because choices are what you want or don’t want, and skills are what you use to “do” the activity of giving birth. In fact, while choices may change, skills are the foundation for how you will cope, manage, work through, deal with, handle, stay on top of, and feel in control as your birth unfolds.
In other words, now is the time to bring forth a Childbirth Revival combining skills and choices. You are part of this exciting change, as it’s likely you have never heard of learning birth skills as a way to prepare for birth. But it’s your choice to learn birth and coaching skills that will propel this movement forward and fill the gap in the childbirth conversation.
Most of us discover that babies don’t “come to plan,” and too often choices are lacking, or end up changing. It’s frustrating, but true. However, all of us who have given birth know in the core of our being that we had to “do” the birth, no matter how it unfolded. We also know, upon reflection, whether we had skills to use or not.
The core of this new childbirth trend is a simple, easy-to-repeat message:
“It’s common sense and beneficial that all expectant mothers and fathers self-learn birth and coaching skills to work through the activity of birthing their baby in all births.”
This is the concept that can quickly lead to a childbirth revival.
Birth skills are a common-sense resource to have, and when combined with informed choices, they make for a well-balanced approach to birth. However, it will take many of us to keep repeating this concept over and over again to all who will listen to change societal norms.
In time, it will become common sense and beneficial for all expectant families to learn birth and coaching skills in addition to making informed choices.
Where do Webster chiropractors come into this new approach?
Your Webster chiropractor is a member of the ICPA, an organization dedicated to a philosophy called salutogenesis, which focuses on health and well-being and a sense of coherence, rather than pathology.
One way your Webster chiropractor adds a salutogenesis approach to birth is by providing a specific technique known as the Webster Technique. With this support, women are able to create and maintain pelvic balance and a well-functioning nervous system that can transform their birth experiences and safen their baby’s vital well-being. When parents self-learn birth skills, especially body-centric skills, they support the Webster Technique’s effectiveness for birth.
Webster chiropractors provide a service as auxiliary birth workers. They may also inspire you to use the philosophy of salutogenesis as you approach your coming birth, which often leads to increased resourcefulness including making excellent informed choices. The foundation for adding skills to choices—the basis of the Childbirth Revival—comes from how they benefit families in navigating some universal truths:
- 100 percent of pregnant women will give birth one way or another.
- Birth is an activity as well as an experience that happens to every birthing woman.
- When we lack skills, birth just “happens” to us and is largely dependent on circumstance.
- When we have skills and use them, birth still happens to us, but we can better participate in the activity by applying our skills, even when there is a great abun- dance of unexpected circumstances.
For any individual approaching birth, the salutogenesis approach is all about what you can do for yourself. In other words, when something happens to us and we lack resources, we tend to “react” in a state of disempowerment. When we have learned, practiced, and then use skills, we “respond” to what is happening to us, empowered to cope, manage, work through, deal with, handle, stay on top of, and feel in control.
Skills can always be used one way or another in 100 percent of births. With skills, fathers can work with their partners through this activity. Self-learning birth and coaching skills serves as a foundation for how you work through the activity of birth, regardless of all other factors.
Women and men can bring forward a high societal expectation that all expectant families should learn birth skills in addition to making informed choices.
Anyone who has given birth understands how challenging it can be to cope, manage, work through, deal with, handle, stay on top of or feel in control of the internal physical and emotional sensations, as well as what happens around us. Using birth skills is a conscious effort, and can be hard to do when internal and external sensations are intense, but they have a profound impact on feeling empowered and proud of our efforts. Lacking skills can leave us feeling disempowered, even when we get the exact birth outcome we want—and more so, when birth unfolds in unexpected ways.
Growing a skilled birthing population and elevating this Childbirth Revival requires a strong societal message that we hear and share often. Choices can be elastic, fickle, or even non-existent in some cases, but using skills is the bedrock of how we “do” this one-off, infrequent, life-transforming activity that we remember forever. Giving birth is an all-absorbing moment-to-moment experience we must navigate. The Childbirth Revival is about navigating the birth experience with resources by learning skills and by making informed choices.
Birth is an activity as well as an experience that happens to every birthing woman.
We’re all part of this exciting and meaningful change. While choices are very individual, birth and coaching skills are universal. Some are incredibly basic, like breathing, relaxation, and communication.
Below are various skills-based methods to choose from. Are these methods identical? No. Breathing skills can take many forms, as can relaxation and communication skills. But they are universally applicable, wherever you happen to be and whatever the circumstances. Pick the skills-based method that you resonate with, learn the skills offered, practice them, use them, and then reflect on how well they worked. We don’t get many times to do birth, so we can do birth as best we can each time.
Two vital trends for improving birth
Choice-based methods for childbirth preparation stress the importance of making informed “choices” and creating a birth plan. Choice-based informational classes cover many topics, such as what to expect in pregnancy, birth, and the newborn period.
Skills-based methods for childbirth emphasize the importance of learning skills to “do” the activity of giving birth. Skills can be self-learned by couples in the privacy of their homes, providing parents with greater body awareness and autonomy for an empowering birth experience.
Examples of skill-based methods
Birthing Better Childbirth Preparation
This online course is a skills-based method for all births, developed by moms and dads for other moms and dads.
“Start around 24 weeks onward to prepare your body for birth and learn birth and coaching skills that you adapt and adjust that are sustainable in all medical and natural births.” –BirthingBetter.org
“Calmbirth is a mind-body skills-based childbirth education program that prepares women and their support people to be active participants in their own labor and birth.” –Calmbirth.org
BOOK: Calm Birth/Prenatal Meditation for Conscious Childbirth, by Robert Bruce Newman
“Hypnobirthing is a comprehensive antenatal course that teaches parents practical and empowering techniques for achieving a satisfying, relaxing, and stress-free birth.” –Hypnobirthing.com
BOOK: Hypnobirthing: The Mongan Method: a Natural Approach to a Safe, Easier and More Comfortable Birth, by Marie F. Mongan
Birthing From Within
“Birthing From Within equips birth professionals with strategies to cultivate resourcefulness and resilience, both in themselves and the parents they work with.” –Birthingfromwithin.com
BOOK: Childbirth Without Fear: The Principles and Practice of Natural Childbirth, by Grantly Dick-Read
BOOK: Painless Childbirth: The Lamaze Method, by Fernand Lamaze
The Bradley Method
BOOK: Husband-Coached Childbirth: The Bradley Method of Natural Childbirth, by Robert A. Bradley
Since the introductions of Lamaze and the Bradley Method (the very first skills-based methods, primarily about breathing and relaxation), there has been an evolution of skills. There is one area of birth skills that has been lacking until skilled fathers and mothers focused their attention on it in the 1980s, around the time the cesarean rate was beginning to rise. This area has to do with how we prepare our pregnant body for birth and how we use those body-centric skills during birth. These skills became known as Birthing Better.
If you like a specific skills-based method but it lacks body-centric skills, then you can combine it with Birthing Better body skills, which have been honed and developed since the 1970s.
Let’s begin to look at the breadth of birth and coaching skills that can help birthing parents prepare for birth.
Here’s a specific list of skills that you can start learning (ideally beginning at 24 weeks).
- Preparing your body to open up
- Preparing your birth canal to become soft and flexible
- Finding positions that keep your labor progressing
The last three are examples of adaptable body skills.
Other birthing skills include:
- What to do when you don’t like the experience but want to manage it well
- What to do if you have a prodromal (late to start) labor
- What to do if you are afraid
- Forms of touch that help you relax internally
- How to use your skills in a planned/unplanned
Being skilled during your birth is an internal experience—you won’t be holding up a sign saying: “I’m now using breathing skills.” You have to use your mind to apply skills to your body, intimately. This is a very private experience. You want skills that adjust and adapt on a moment-to-moment basis, because the activity of birth can change moment-to-moment. The skills must also be sustainable. There should be no time during your birth when you can’t use some skill or other. When you keep using skills, you are less likely to lose control or feel overwhelmed.
Communication skills, especially nonverbal ones, help you and your partner work together effectively during birth. While you’re doing this private experience of birthing your baby, your birth providers and your birth coach always see and hear you externally and can tell how well you are coping. If your birth coach has learned skills with you, he or she might know what skill you’re using at any moment, because the two of you have learned as a team.
Your birth provider will only know that you’re using skills if you’ve created a skills-based birth plan and given it to them to add to your notes. Birth providers attend many births and can see and hear whether someone is coping or overwhelmed. They can observe that women who use skills birth with less overwhelm, just as they see skilled birth coaches or fathers to be more involved at birth. Birth providers love to work with skilled birthing families. They wish more families were skilled!
Webster chiropractors can be an auxiliary birth worker along with:
- Pregnancy yoga instructors
- Childbirth educators
- And anyone you want to add
Like some auxiliary birth workers, your ICPA chiropractor is unlikely to be at your birth. However, they play a huge role within the salutogenesis model of birth. Obviously, one thing they offer is a very specific technique to keep your pelvis aligned and your nervous system open so they are functioning ideally for your upcoming birth. Within the Childbirth Revival, chiropractors can also play a large role in advancing the concept that it’s normal and beneficial to learn birth skills, and they can offer insights into the value of learning body-centric skills for birth.
While your ICPA chiropractor may encourage you to become skilled, you can also take the initiative and approach your chiropractor and any others involved in your birth to tell them you are learning birth and coaching skills. Then, you can ask them to put all this information in your notes:
- What skills-based method you are using
- What skills you’ve learned between appointments
- And, after birth, how those skills worked during your birth
Salutogenesis “focuses on factors that support human health and wellness rather than pathological factors.” From this framework, there’s a real difference between midwives and obstetricians. For example, most people see that midwives look at birth from a positive viewpoint and believe that pregnancy and birth are normal and natural life events that rarely require medical care. In other words, midwives are part of the salutogenesis model of care.
In contrast, the medical maternity profession of obstetrics looks at pregnancy and birth from a potential problem point of view. Therefore, they use assessments, monitoring, and procedures more often. Obviously, modern medicine hopes to reduce or prevent pathology with these assessments, monitoring, and procedures.
Sadly, since the 1960s, when the first skills-based methods became available, an oppositional approach in childbirth led the conversation: medical versus natural, obstetricians versus midwives, etc. Yet every family’s birth is important to them. That is why the Childbirth Revival is so valuable. Your baby’s birth is important to you. You can become skilled to do it, wherever it occurs, however it unfolds.
The salutogenesis model focuses on you having resources. When you have resources for your own health and well-being, they can be applied even when your health and well-being meet challenges or unexpected external circum- stances. This is the power of the Childbirth Revival. It’s applicable to 100 percent of pregnant women, regardless of external conditions.
At the present time, it’s unlikely that your obstetrician will inform you or encourage you to become skilled. Like many other things, it’s up to you. If you are suffering during birth (without any other problems present) obstetricians will likely offer you pain relief. If you or your baby have risks, they will do assessments, monitoring, and perhaps procedures or interventions. Skills can prevent suffering, and they can be used even when you or your baby have potential risks.
Consider this reality. Risks are common. Risks are also normal and natural and were accepted prior to cesareans, which became more widely utilized in response to risk-aversion in the 1980s. Few risks become problems and even fewer problems become tragedies. Your skills, particularly if you’ve prepared your pregnant body beforehand, can perhaps reduce or prevent risks from becoming problems. And skills can help you move through a non-progressive labor.
At the present time, it’s unlikely that your obstetrician will inform you or encourage you to become skilled. Like many other things, it’s up to you.
Obstetricians may provide continuity of care. But even if you see different obstetricians at each appointment and don’t know which one will be at your birth, here is the reality: You have to do the activity of birthing your baby, no matter who is around you, or what they are doing. It’s that simple.
Inform your obstetrician that you are learning birth and coaching skills and that you have a skills-based birth plan in addition to your choice-based plan.
Inform your obstetrician:
- To put both birth plans in your notes so they can be referred to
- Inform your obstetrician and staff once you get to the hospital of the skills you will be using
- Then ask the staff and obstetrician to praise you and your partner when you are coping well
- Ask the staff and obstetrician to encourage you to use your skills if you look overwhelmed
- Remember to thank them for both of the above
If you are having a midwife attend your birth at home or at a birth center, you can give her the same information.
Inform your midwife:
- You are planning to make choices and to learn skills and will create two birth plans.
- Ask them to put both birth plans in your notes so they can be referred to
- Show your midwife at each appointment after 24 weeks what skills you’ve been learning
- Use your skills even before your midwives arrive to your home or before you go to the birth center
- Ask your midwife to praise you when you are coping well
- Ask your midwife to remind you to use your skills if you appear to be struggling
- Ask your midwife also to praise and encourage your birth coach
- Remember to thank them
No birth worker will stop you or your birth coach from using skills, even when they are doing their assessments, monitoring, and procedures. You can use your skills to work through the activity of birthing your baby, whether or not you like what’s happening to you or around you.
In reality, whether you have skills or how you use them ultimately has no relationship to how your birth provider functions. Read that sentence twice. Keep in mind always that you have to “do” this coming birth, no matter what. And since giving birth is a stressor, whether natural and at home or in a hospital, you can choose to do this activity with skills that will help you cope and manage.
Even if you or your baby have potential or identifiable health challenges, within the salutogenesis model you can and should have sufficient resources to cope and manage even when there are stressors.
Everyone acknowledges that pregnancy and birth are stressors. The resources at your disposal should help you navigate through the stress. Birth skills, informed choices, and chiropractic care are valuable resources.
Since babies often don’t come according to plan, and since there’s no way to know what your birth will be like beforehand, it is beneficial to include more than a choice-based resource such as a birth plan. Since you are the only one “doing” the birth with your baby, you can learn skills to prepare for and work through the activity instead of letting it just happen.
You are in partnership with everyone: your partner or birth coach, auxiliary birth workers, and your birth provider. You set the framework for those relationships, by whether you are coping or not, managing or not, over-whelmed and freaking out or feeling in control. (Note: This is not to suggest you shouldn’t behave however you feel or desire in birth. “Coping” is not the same as “behaving appropriately”.)
You are the one whom your partner or birth provider sees and hears. They don’t know what you’re thinking, but they see and hear how you are either reacting or respond- ing. Everyone wants you to have a positive experience. But you are the one who will have the lasting memories.
Often, skilled dads are asked: “how do you help your partner if she becomes freaked out during birth?” Their response, without exception: “don’t let her.”
Remember and apply these simple things that you can do
- Research what you want and don’t want for your birth
- Choose one or more skills-based methods and start learning at about 24 weeks. If you’re 40 weeks, still try to learn some skills. Any skill is better than none.
- Create two birth plans: First, what you want and don’t want. Second, what skills you’re learning and plan to use
- Have those two birth plans added to your notes so anyone can reference them
Why are we repeating this over and over again? We are giving you the practical steps and framework to implement this Childbirth Revival trend for yourselves. Once you understand the power it gives you as an individual, you can begin to tell others.
Ask those who will be with you to praise you when they see and hear you coping well. Ask them also to encourage you if they can see and hear you are having trouble. Giving birth is always big, phenomenal, dramatic, dynamic, life-transforming, monumental, all absorbing, moment-to-moment, and it launches you into parenthood.
Giving birth is so important that we should want to be highly skilled. You are the generation of women and men who we believe will claim your power in birth.
In many cultures, birth is women’s business. In some, women go off and birth on their own. In many other cultures, women birth wherever it occurs, including in one’s home.
Men are human beings. Men and women blink, cough, and can tighten/soften their pelvic muscles. All human beings thrive on a variety of skills—from parenting, to work, to cooking. Today, when women get pregnant, most men and women fall into an uncomfortable gap of not having skills. This continues as birth nears and during birth. Men and women often feel spit out into parenthood, having spent almost one year of their lives feeling a bit helpless in this very first activity of becoming parents. It doesn’t have to be that way.
In most modern countries, fathers are encouraged to attend the birth. If both mothers and fathers lack skills, this can be really challenging. Women will often feel the men didn’t help, while the men feel that they didn’t know how to help.
For a generation in the U.S., childbirth preparation focused on skills. Active women successfully pressured the maternity system to permit husbands to be at the birth because too many women suffered alone in birth.
In the 1960s and 1970s, labor and delivery nurses and obstetricians saw millions of birthing women and men work together. The result was that the maternity system began to change for the better.
Unfortunately, fathers as birth coaches became less observed. Fathers were told, directly or indirectly, that their new role was only to support and protect their partner’s informed choices. When we take a skills-based approach to birth, then birthing women and men have a renewed experience of birth. Everyone loves to be skilled. Learning skills together and using skills together means that you’ll work better during birth, and thereafter as a parent when your baby is born.
One very important birth coaching skill: to learn to see and hear when you need to help the birthing woman so she continues to cope, manage, and work through the birth, and to have the skill to do that right away. Often, skilled dads are asked: “How do you help your partner if she becomes freaked out during birth?” Their response, without exception: “Don’t let her.”
Birth is hard work. That’s why it’s called labor! And if you’re having a non-laboring cesarean, it’s still your baby’s birth, and it can still be empowering. Don’t let anything stop you from becoming skilled and using your skills.
Sometimes it’s strange to begin learning birth skills. Learning birth skills is different than many other kinds of skills we learn, since birth is a normal, physiological process of the body in addition to an activity we do. Still, it can still be likened to other kinds of skills, such as learning how to drive a car, how to cook good food, or how to have good sex.
For driving, you have to learn diverse and complex skills: how to use the steering wheel, brakes, mirror, and gas pedal, and how to appropriately respond to everything that’s happening around you. Moment-to-moment, you have to adjust your driving skills appropriately.
Giving birth is not like driving from one physical location to another, but it’s about learning to move through the birth experience, which traverses us into the realm of parenthood.
We drive frequently, but give birth infrequently. Each road trip we take is not stamped into our long-term memory like each birth. And since we know driving requires much more than knowing what car we want and which route we plan to take, similarly we must learn that in birth there’s more than knowing what we want, we must learn how to do the activity and how to move through the terrain of the experience itself.
Just as cooking skills help us satisfy the natural physiological urge of hunger, birth—a natural physiological experience—benefits with the addition of practical skills. If we gave birth as frequently as we dealt with hunger, then we would have as many skills-based resources for birth as we do for cooking!
Sense of Coherence
The more resources you have for birth, the greater your ability to experience a state of coherence during the process. Coherence has three ingredients:
We want birth to be comprehensible, manageable, and meaningful. We can comprehend birth as something that happens to us naturally, but also something we “do.” To make it manageable so that we are in control amid internal or external stimuli that bombard us with pain or other negative signals, we need resources. When we have the resources to navigate through the birth process, we are able to derive positive emotional meaning from our experience, because we are working through this experience actively engaged in it, even if it’s quite challenging.
There is far too much shame, blame, guilt, disappointment, anger, frustration, and trauma in birth. Implementing a Childbirth Revival that brings skills and choices together has profound potential to improve our relationships within the childbirth conversation, and to heal our societies at the root level of family wellness.
What is the purpose of this Childbirth Revival and growing this new trend?
- Greater engagement!
- Doing something for ourselves
- Improving our ability to cope (with pain or discomfort) and manage our moment-to-moment experiences, and not to lose the plot but to feel empowered and in control
- Building stronger families
- Reducing suffering
- More well-being around circumstances that have risks
- Fewer risks, and preventing risks from becoming problems
- A better approach to resolving problems without victimization
- Creating lasting change in society, regardless of its health care system, when all birthing women become skilled and empowered in birth.