Thursday, January 22, 2009

Doula Digest - Bradley Birth Education

Posted by Kim:

As part of my doula training I had to take a childbirth education class (not pregnant). It seems like I am always meeting Bradley birth educators and a lot of people are talking about it so I thought I would check it out, plus I really loved the idea of the Husband Coached Childbirth. It sounded like a method that my husband would have liked and appreciated. If only I was as educated then as I am now. I almost feel like I know so much more now that it is a shame that I am not having another baby. This is not to say that I haven't been lobbying for baby #3 for the last year! Back on track......

For convenience sake and the fact that I already knew her I decided to enroll in Michelle Mueller's Natural Childbirth Education class. There were four pregnant couples in the class and as the weeks passed we became a pretty close group. Unlike the birth education class we took. In our class there were about 50 people in our class and there was absolutely no intimacy or sharing of information between the students. WE simply learned what the teacher wanted us to know. Not that she was a bad teacher, we definitely learned the facts, but we didn't get the different perspectives from the students because no one really felt open to share in front of 50 people! Again I digress, back to Bradley.

Our class met for 11 weeks beginning in September and we covered the following topics:
  • Exercise
  • Nutrition
  • Pregnancy/Gestation
  • Variations and Options
  • Intro to First Stage
  • Intro to Second Stage
  • Birth Plans
  • Coaching
  • Postpartum
  • Advanced First Stage (Labor Rehearsal)
  • Advanced Second Stage
Each class started with Michelle asking each couple how their week went, how their nutrition was for week and if they have any concerns (including concerns about their care provider). In addition Michelle would ask each couple if they had been practicing their Taylor sitting, kegels and relaxation techniques. What struck me the most about this class was how fun it was to see each couple grow and develop during their last trimester. There was definitely quite a difference between the first class and the last, boy could I relate to how they all felt as they grew closer and closer to their due date.

The primary theme throughout the class was nutrition, labor management and the intervention spiral. We discussed the common interventions, why they are done, benefits, risks and alternatives. Some common interventions and their alternatives that we discussed were:
  • Vaginal Exams - request that they do not do the exams unless there is a compelling medical reasons.
  • Non-Stress Test - fetal movement counting
  • Induced Labor - Waiting, nipple stimulation, sex, accupressure, herbs, acupuncture, or Castor oil
  • Membrane Stripping - Nipple stimulation
  • Vaginal exams in labor - Limit exams prior to pushing,
  • Gowning - Wear own clothes
  • Separation of mom from support during admission - Do all admission work ahead of time
  • IV - Stay hydrated
  • Restricting food & drink - eat lightly, drink sips of water, eat ice chips or popsicles. Energy gels or honey.
  • Electronic Fetal Monitoring - Use fetoscope or doppler or intermittent EFM
  • Doptone - Use fetoscope if someone is trained to use it.
  • Restricted movement during labor - walk around, change positions often, take a shower or bath
  • Amniotomy - Use natural ways to speed up labor like walking, suck thumb, nipple stimulation, acupressure or acupuncture
  • Narcotics/Analgesics - Natural methods of pain relief
  • Epidural - Natural pain coping techniques: relazation, changing positions, movement, birth ball, visualization, bath or shower
  • Augmentation - Use natural methods of speeding up labor
  • Episiotomy - Choose a caregiver who does not perform them. Do pre-natal perineal massage. Do not lay on his back to push, practice kegels
  • Forceps or Vacuum Extraction - Prevention: good pushing positions and techniques, avoiding epidural
The Cascade Effect of Interventions:
  1. Break water to advance labor
  2. Gel
  3. Pitocin
  4. Drugs/Epidural
  5. C-Section
Common side effects of the Epidural are:
  1. Drop in mom's blood pressure
  2. They only work 85% of the time
  3. It may only work on one side
  4. Epidural headache 25% of the time
  5. Pain at the injection site
  6. Need for the use of forceps ro vacuum extraction
  7. C-Section
  8. Episiotomy
Overall I really enjoyed this class. I thought Michelle presented a great point of view and each couple could cater the information they learned to their own wants and needs. However, learning about Bradley made me more curious about the other methods of childbirth education. I think I may need to take the other methods so I can learn about them and then be knowledgeable about the different methods my different doula clients may choose to follow. Now I just need to find the time!

To learn more about the Bradley Method of childbirth please visit their website

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