Evidence in Support of Coaching for Childbirth; Reporting from the Field
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 possible pleasurable experience.
Case study no. 1: One strong coaching question 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 a 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 bedtime, 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 the hospital, fully dilated, baby, is in +2, THANK YOU!”
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 unmedicated 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 happens when you lose control? How does it look like, or feels like?
A dear client shared this fear during the 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”.
Together we came up with this list of wonderful experiences of losing control:
- Falling in love
- Freestyle dancing
- Screaming on a roller coaster ride
- Feeling tipsy
- and Childbirth
What have surfaced in the conversation as a fear ended up as a possible pleasant experience?
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