Doulas have heard this a hundred times: “I want a natural childbirth but I’m open to the possibility of getting an epidural”. Labor and Delivery nurses read it on birth plans thousand of times.
I leave myself open to… the possibility…
This opening can go both ways – it can lead your clients to triumph in moments of doubt and crisis or it can lead them to surrender to the fear and ask for an epidural.
This opening is where the coaching conversation begins. Coaches in many different fields, such as executive coaching, career coaching, relationships coaching, or lifestyle coaching are searching for this opening. And yet we, birth support professionals, are handed the opening so explicitly. This is our cue to begin to coach.
How do you engage the client in a powerful, life-changing, and results-oriented conversation, and not miss this amazing opportunity, this opening? How are you going to lead a coaching conversation with this expectant person or birthing individual who ‘leaves themselves open?’ Aren’t you curious to learn about the source of their hesitation – what is interfering with their ability to fully commit to their desired birth experience? Wouldn’t this be valuable to your support process if you understood what is the nature of the circumstances that will make them turn their back to plan A – having a natural childbirth, and choose plan B- asking for pain medication?
Do you know your birth clients? Does your philosophy of care resonate with them? Do you employ the best strategies to support them? Rather than the optimal pathway to maternal care, Transformational Birth Coaching puts the birth client at the center of the support process. In doing so, we find that there is a generational gap that might be interrupting us in supporting millennials throughout pregnancy and birth. Halt! Take a deep breath…I’m not calling out on millennials. I raised two millennials myself and I love and admire them. I’m simply drawing attention to the generational gap between those who established the field of birth support – their attitudes, philosophy, lifestyle, and collective concepts of pregnancy and birth, and current birth givers. Can this generational gap mean that the philosophy, desired outcomes, and birth support strategies we practice do not resonate with current birth givers, or might not be a good fit? It might be the time to pivot.
Does an ‘Expert Position’ benefit professionals in the field of birth support?
Do you consider yourself an expert in ‘How to have a healthy birth’? Whether you are a childbirth educator, a birth doula, a midwife, or an L&D team member, I’m almost certain that you believe your practice cracked the formula of the right way or even the best way to a healthy childbirth.
But do we all agree on what the phrase healthy birth stands for? And how would you feel if I threw in just one more word – experience. How confident are you now that you have mastered the best way, or the right way, to achieving a healthy birth experience? Perhaps it’s time to rethink our position. Can we give up the expert position and hand it over to our birth clients?
I have shifted the focus of my birth support toward prenatal coaching and led many birth practitioners to implement this transformational coaching approach into their birth support practice. I’ve noticed five common negative mindsets that expectant individuals may hold throughout my teaching and as I coached my own birth clients. These repeating themes can sabotage birth givers’ birth experiences, even when there is no physiological or anatomical problem. In coaching, we call these negative mindsets limiting beliefs or success blockers. Regardless of individuals’ awareness of their thought processes or beliefs, those run subconsciously like a program you downloaded and installed on your computer unintentionally. And just like a computer program, these negative mindsets may change clients’ attitudes, behavior, and the decisions they make.
Are your birth clients overwhelmed by the overload of information?
Being overwhelmed by the overload of information is a state of consciousness that many expectant couples struggle with. It disempowers and damages their ability to make mindful decisions and perform well. Beating it requires a shift in our practice rather than providing more information. You can help your birth clients beat this overwhelm by coaching them.
In my practice, I often encounter the overwhelm that my clients
experience being overloaded with information. Seriously, it feels like it enters the room when they do. How often are you being called to resolve this overwhelm as a childbirth educator or a doula? There are conflicting opinions and expectant parents don’t know what advice to take or what to believe while all along trying to do the right thing; they want to find what is best for the mother and the baby. The overload of information creates a ‘noise’ that interrupts our internal conversations with ourselves. Feeling overwhelmed is not only disempowering, but it’s also exhausting.
Are there any studies about the benefits of coaching for health improvement?
While working on my new certification course, Coaching for Pregnancy and Birth, I researched studies that will provide the scientific data to support what I already knew – coaching provides the most beneficial strategies to lead expectant couples toward a healthy and satisfying journey of pregnancy, birth and early postpartum. I assumed that the best research strategy would be found in the field of health and wellness coaching, which has been growing rapidly over the years as more people have become conscious of their health and well-being, and guess what – I was right!
Recently I watched the movie ‘Trial of Labor’, and listened to the stories of three women who wished for a VBAC (Vaginal Birth After Cesarean). It made doubt the approach we, birth activists, take in our efforts to improve maternal care. Especially our continuous attempts to educate and empower expectant individuals by pointing out the flaws of the medical system and its representatives.
What did birth activism look like in the 90s?
I gave birth to my oldest child in 1995. I often say that she was my muse since my first pregnancy and birth experience led me to pursue a career in the field of birth support. I was lucky to go through this journey in the 1990s, as it seems that these years offered women a wealth of information about natural childbirth: Barbara Harper first published Gentle Birth Choices in 1994, the same exact year that Michel Odent published his book – Birth Reborn. Janet Balaskas published Active Birth in 1992, and Marshal H. Klaus published Mothering the Mother in 1993. Henci Goer closed the 1990s by publishing The Thinking Woman’s Guide to a Better Birth in 1999. All of these authors were, and still, are my teachers and mentors, not to mention idols.
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:
- Birth is unpredictable and impossible to plan for. (How many of you already planned their summer vacation? Christmas vacation?)
- 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.
- 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.
- 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.
- 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.