Author: Neri Life-Choma

I am the founder of Birth Coach Method and am celebrating 20 years of leadership in the field of childbirth support. Throughout my career, I have been honored to provide doula support and teach childbirth ed. classes to hundreds of expectant couples, as well as to direct two birth resource centers. I am also a doula leader in my community in the South Bay area of Silicon Valley in California.

The Misleading Concept of ‘Natural Birth’; Let’s Talk About a Healthy Vaginal Birth

The dichotomy of Natural Birth vs. Medicalized Birth had been established in the discourse about birth for the past 30 years and was accepted by both birth professionals and moms. The most obvious and urging question expectant woman is concerned with is whether or not she will take epidural or will try for a ‘Natural Birth’,  and in accordance with what she feels inclined to, she will then educate herself and prepare for her birth. She will decide on a childbirth education class and make decisions regarding her caregivers and support group for the birth based on her decision for or against taking epidural. A woman who gave birth vaginally will almost always be asked whether or not she took epidural, or in other words “did you have a natural birth’? This situation is reflected also in birth stories we read online; where we can always find statements in this spirit:  “I decided not to take epidural and try for natural birth…and here is what has happened…or “So I decided it was time for my epidural…”. What I find even more concerning, is the shower of praises and cheers that the mother who went ‘naturally’ will perceive, vs. the mother who helped herself cope with an epidural.

I think that that the concept of Natural Birth is so misleading that while preparing for this experience, a woman might find herself giving birth in a way that cannot be farther away than what nature planned for women- a rather medicalized birth. Natural Birth’ is a proposition which describes the conceptual event of some sort of birth that the speaker or listener have in mind. But what type of birth is it?  What’s on our mind when we think ‘Natural Birth’? Which pictures come to mind? Which words are associated with it?  Which scenarios do we envision and are they really ‘Natural’ for the women we know and support?

 I argue that for modern women, there is nothing natural in the process of giving birth and therefore the concept ‘natural birth’ by itself presents women with a dilemma: Giving birth is part of our nature, this is how we procreate, and yet as an occurrence in the life of modern western women, there is nothing ‘natural’ about childbirth. 

To support my argument, I checked the dictionary for the definition of ‘natural’, and found the following definition:

nat·u·ral Natural, adjective 1. Existing in or caused by nature; not made or caused by humankind. 2. Or in agreement with the character or makeup of, or circumstances surrounding, someone or something. So now let’s take the propositions of ‘Natural birth’ and read these two definitions with it: Natural birth is: 1. Natural birth is caused by nature, not made or caused by humankind. 2. Natural birth is in agreement with the character or circumstances surrounding expectant moms.

My understanding is that when we oppose ‘Natural Birth’ to ‘Medicalized Birth’, we probably mean to say or imply that this kind of birth occurs and unfolds with no humankind intervention. Well, firstly we need to recognize that this concept tells us what Natural Birth is not, and not what it is. Secondly, I want to point out the misleading implication of this definition- that when we think about something that happens naturally, with no humankind intervention, the connotations that come to mind is of something ‘simple’ or ‘effortless’, which are not at all true when it comes to giving birth. Let’s take a look at the second definition and see how it resonates with us: “Natural Birth is in agreement with the character or circumstances surrounding expectant moms”. Really? Would you agree that in terms of ‘the character of life circumstances surrounding women’ nowadays, nothing about birth is natural for the modern western woman? Do you feel the tension? There is also a conflict between the two optional meanings of the concept ‘natural ‘. I think that healthy vaginal birth, which we refer to as ‘natural birth’, has become so rare because of the dilemma that the word ‘natural’ presents. Here is the dilemma of the modern in regards to childbirth:

   “It is in my nature to give birth, yet there is nothing about birth that is natural for me”

Here are some of the reasons why childbirth can’t be or feel natural for us:

  1. Birth is unpredictable and impossible to plan for. (How many of you already planned their summer vacation? Christmas vacation?)
  2. Birth requires us to agree to be in pain, and we live in a culture that is obsessed with alleviating pain. We also lost all our coping pain techniques and skills while being born in this culture.
  3. Healthy birth is a process that lasts an average of 18 hours for first-time moms, and we live in a fast pace culture; we use instant coffee and instant pudding and order food in drive through…We like our results fast! In movies and TV sitcoms birth takes five minutes max.
  4. Being a long process, birth demands physical and emotional performance, it demands strength and stamina which the modern woman who drives her car, uses elevators, sits in a perfectly air-conditioned office, uses washing machines and dishwashers, and does not squat down the river every day, absolutely lost.
  5. Our cultural inhibitions, which are the cultural circumstances surrounding expectant moms, are in conflict with our primal and intuitive response to birth.  The progress of labor depends on the release of hormones like Oxytocin and endorphin, that are being released by the part of our brain that is called ‘primitive brain’. The primitive brain activates primitive and uncontrolled reactions and behavior like moaning and groaning,  crying and screaming, throwing up, the spontaneous motion of the body like spiraling, and other types of behavior that are not considered to be attractive or feminine, and therefore are in conflict with our cultural inhibitions.

 To summarize my argument, talking about natural birth is misleading. In a subconscious matter, which women are unaware of, thinking about ‘natural birth’ lead women to either think about something as natural as a sneeze or a yawn, something that happens spontaneously with no investment or effort and therefore needs no preparation or intentional engagement. Ironically, expectant mothers must have a thorough and deep preparation in order to give birth spontaneously, in a healthy vaginal way. For the modern woman, giving birth in the way nature planned for her is quite a performance.  It requires her to perform physically, emotionally and mentally in a way that is much different from her everyday life circumstances. And just like no one says natural marathon or natural success, nor should we talk about natural birth. 

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Practicing for an Active Birth

   I have been a childbirth educator and a birth doula for the last 14 years. During the first year of my doula practice I realized there is a difference between Knowing about birth and Being in birth. With no exception, all of my birth clients took childbirth education classes and read pregnancy and birth guides. Most of them were also committed to have a natural birth, to avoid medical interventions as much as possible, and to design their birth experience according to their belief system and their emotional and physical needs. While supporting them in birth, their knowledge did not serve them well enough. The mothers whom I have worked with were missing tools for labor.

   So I have decided to begin my support earlier than the birth, and became a childbirth educator. As an instructor I teach the Active Birth philosophy, mostly affiliated with Janet Balaskas.  In my classes I always focus on practicing  labor tools. My perception is ,that in the Google era ,couples are exposed to so much information and knowledge, that my special contribution is in teaching them the hands-on practice of being with the birth.  I have created the Practicing for an Active Birth workshop especially for clients who wanted more hands-on practice. I taught this workshop for ten years in Palo Alto. My students were raving about this class, and the local midwives were continuously recommending it to their birth clients. On November 2012 I launched the DVD “Practicing for an Active Birth; The Most Comprehensive Hands-On Guide for a Healthy and Active Birth”. This DVD presents 2.5 hours of labor support tools and comfort measures for birth, and many coaching tips for both birthing mothers and their partners In accordance with different phases of the birth.

   Labor tools are in support of the progress of your birth as well as your ability to cope with labor pains.  Labor tools are relating to the physiology and anatomy of birth, and when you practice them, you have better chances of having a healthy birth which progresses in a timely manner (Off course it takes some collaboration from your baby too). It is hard for me to accept philosophies of childbirth education which deny the presence of pain in labor. Contractions are strong cramps of our uterus, and when a muscle cramps, pain is present. So how are you being with that pain and what are we doing when you are in pain? 

When we are in pain, our habitual instinct is to react with fear and tension.  We refer to these phenomena as the Fear-Tension-Pain syndrome. This is our survival mechanism.  Pain is a signal our brain translates as:  “Something is wrong; there might be a risk to the organism”. Neglecting the pain might lead to a serious threat on our survival.  Therefore, we emotionally react with fear and alert; we activate our Fight –Or – Flight syndrome, a remaining of early phase in our evolution and the number one cause of tension and stress. The Fight or Flight syndrome is a set of physiological symptoms, designed to enable us to fight a source of danger or flight when fighting is not optional.  Both these reactions will take: lots of adrenalin, shallow breathing, tightening of the muscles, fast heart rate, and an alert somatic system.

   Now going back to the birth experience, when we react to the pain of contraction with our habitual instincts described above, we are in the way of a good healthy birth.  The uterus works on two kinds of “fuels” –oxytocin and oxygen, both are in charge of effective contractions. In the presence of high levels of adrenalin, the release of oxytocin is inhibited, and our contractions are not becoming stronger and closer together, meaning- Failure to Progress.

We can summarize it this way:  FTP leads to FTP.  Meaning- The Fear –Tension- Pain reaction in birth leads to Failure To Progress.  Labor tools are related to the physiology and anatomy of birth since they allow the mother to de-activate the fight-or-flight syndrome, and by practicing them the mother is suppressing the release of adrenalin, increases the release of oxytocin and the flow of oxygen to her uterus, and reacting to her contractions with acceptance.  Here are some of the labor tools we practice: breathing techniques, massaging, positioning, several visualization techniques, positive affirmations, relaxation, and hydrotherapy.

About four years ago I studied to become a life coach. The coaching practice brought up a new understanding in the way I think about labor tools these days, and led to the development of the Labor Practice.  In coaching we are supporting potent clients in making a change in their lives.  The change can be in the way they act or in the way they are being with something.  A very central term in coaching is the change of the habit. As a life coach I encourage my clients to explore and distinguish habitual ways of doing and being, which do not serve them any more.  These old habits are in the way of getting what we say we want and doing what we say we are committed to.

With this understanding, I was able to see that acquiring the labor tools as part of the childbirth education class is not enough. That if our reaction to pain is indeed a habitual instinct, then it takes a lot more practice for the mother in order to break the habit and rely on a different set of tools. With that thought in mind I developed the Practicing for an Active birth  DVD. This is the most comprehensive Hands-On Visual Guide you can find !  Now couples can watch this DVD at the comfort of their home,  and practice labor tools as many times as they want, until the mother really fells she owns this set of tools.

   The DVD presents a wealth of labor tools – Positions for birth, Breathing techniques, different techniques of visualization – like spiraling of the body and expansion of the belly, Massaging techniques, hydrotherapy and more.  You will learn these tools in accordance with the different phases of the birth. In each phase of the birth, a different progress needs to take place, and I introduce the right tools to invite this progress. Whether it is a release of oxytocin in Early Phase or the engagement of the baby in Active Phase, you will understand the logic behind the tools and how they can best support you in achieving a healthy and empoweirng birth.

Here is a clip you can watch

Birth Coach Method – A Paradigm Shift in Birth Support

What happened the first time I introduced my  coaching method

Last week I had my very first public speaking introducing the Birth Coach Method to a local audience of birth professionals at the South Bay Area California. It was a moment of truth, and I have to confess – I was crazy stressed. It is one thing working diligently on my laptop in the comfort of my home, being fully convinced that integrating coaching strategies into birth support practice is the right direction and another thing to stand and talk in front of birth professionals. An hour before the talk there was no sign to my strong convictions.

My local community is the warmest, most engaged and fun audience I could have asked for. In just a few moments,  I was able to connect to my motivation and strong found conviction, and confidently introduce Birth Coach Method philosophy using the PowerPoint presentation I made.

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Practicing for an Active Birth; Learn a New Set of Responses to Labor and birth.

I have been teaching a childbirth education workshop called “Practicing for an Active Birth ” for ten years in Palo Alto. My students were raving about this class, and the local midwives were continuously recommending it to their birth clients. On November 2012 I launched the DVD “Practicing for an Active Birth; The Most Comprehensive Hands-On Guide for a Healthy and Active Birth”. This DVD presents 2.5 hours of labor support tools and comfort measures for birth, and many coaching tips for both birthing mothers and their partners In accordance with different phases of birth.

After becoming a Life Coach I could reflect on my work in the field of birth from the coaching perspective, and  I realized I want to find a way to encourage my birth clients to practice their labor support tools more than just a couple of times in childbirth education class. I wanted clients to understand that their habitual reaction to pain is in their way to a good healthy birth. Our habit is to respond to pain with rejection and contraction, tightening the muscles. Labor support tools were designed to help birthing moms cope with labor sensations and pain and to invite progress at their birth. But they need to own them, to make a new habit out of them so that in labor they will respond with them to labor contractions and strains. This apparent need for changing the habitual response to pain motivated me to publish this DVD  which allows couples to practice labor support tools at the comfort of their home until they own them. Since its launch, the DVD has been sold on Amazon and getting great reviews.

As a student of the  Birth Coach Training program, you will watch clips from this DVD in accordance with the phases of the birth. This will enable you to practice all the breathing techniques, positions, massage techniques, visualizations and other coaching tools that you want to implement when your client goes through this phase.  The same is true if you are registered to the “Hands-On Series” membership level.

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