When the Director of Common Knowledge Trust had her first child in 1970 in the US, there was a huge societal expectation that all expectant parents learn Lamaze or Bradley breathing and relaxation techniques. By the 1980s this childbirth trend had sharply declined. In place of learning skills, there became a high social expectant that families be given information which would lead to informed consent and the creation of Birth Plans. The US moved from a skills-based to a choice-based childbirth trend. This choice-based trend has persisted to the present time. What was happening in your country between the 1950s to present time? Did your country have a skills-based approach and are there now choices available for pregnant women?
Information (pros and cons of medical care), choice (what medical care you want and don’t want) and plans (how you’d like your birth to unfold) are vitally important when thinking about the birth of our children. Since the early 1980s, we have unfortunately and intentionally led people to believe that childbirth is such a natural aspect of women’s lives that no skills are necessary. Often women are told ‘You’ll know what to do on the day’ or ‘cats don’t need to be taught to birth neither do you.’ Many women don’t have a clue how to ‘behave’ or cope, manage or deal with birth as it unfolds and women are not cats. Humans are highly skilled by INTENTION and not by instinct. While pregnancy and childbirth are normal and natural Life events that does not mean either are simple, easy, straightforward, healthy, positive or leaves great memories.
Why did we lose birth skills?
You might not know this but all the early childbirth skills methods were developed by male obstetricians. This is NOT bad. What it means is that they were exposed to the medical system after WW2. These caring male obstetricians realized that the modern development in maternity care was becoming increasingly medical. Let’s explain this. As more pregnant women birthed in hospital rather than home, obstetricians wanted to prevent the ‘suffering’ (read this word to mean that women had no skills to cope with the natural occurring pain of contractions) associated with birth throughout Time. They also wanted to reduce or prevent some of the trauma and poor outcomes also associated with childbirth throughout Time. In order to achieve these two goals obstetricians developed ‘evidence based practice’, ‘standards of care’ and ‘guidelines of practice’. This meant every single birthing woman experienced the same maternity assessments, monitoring and procedures no matter what.
From WW2 to the present time maternity care has changed tremendously so don’t think that what your grandmother experienced or your mother is the same as each other or what you’ll experience. There are still medical assessments, monitoring and procedures (AMPs …. now called ‘interventions’).
We’ve set the stage. Every birthing woman had a set of AMPs done as a modern effort to reduce or prevent ‘problems’. These caring male obstetricians didn’t think every birthing woman needed all of those things. Each of them (Grantly Dick-Reid, Lamaze, Bradley) developed birth skills methods with the goal to:
- Achieve natural birth
- Achieve a painless labor
That seems like a good idea, doesn’t it? But in hindsight there was a huge problem. When you direct skills to achieve those two goals this happens:
- Too many women are left out and that’s just plan nuts. Giving birth is always an activity and every birthing woman should be have a great set of skills. Why should skills only be used by one group of birthing women?
- Too many women who were seeking a natural birth or a painless labor failed to achieve those goals using skills.
Frankly no one paid attention to the concept that all birthing women should have skills. But people did pay attention to the failure of birth skills to achieve natural birth or painless labor. Birth advocates came to believe that ‘skills are not necessary, don’t work and interfere with birth’ and what pregnant women need is childbirth information (pros and cons of medical care).
The long and short is simple. Birth advocates didn’t have a light-bulb go off in the collective Mind so that birth skills became advocated for all pregnant/birthing women so that everyone could work through their baby’s birth journey! Sad really. Instead birth advocates focused on whether pregnant women had ‘choices’ and to explain what they wanted and didn’t want should be put into a Birth Plan.
Here we are today … no skills as a societal expectation and all the eggs are put into the one basket called Birth Plan. Well, birth choices aren’t working. However, birth skills should have been expanded not reduced.
Let’s talk about childbirth information
This is how birth advocates explained childbirth information to pregnant families … ‘If you know the pros and cons of every medical intervention then you will choose less medical care’. Unfortunately this has not succeeded for so many reasons.
- There’s no way to know what your birth will be like so therefore you can’t really choose the birth you’ll actually have.
- There are so many elements of medical care so which ones are ok and not ok?
- And what happens if things change? If you don’t want a medical intervention and have one how will you feel later?
- Obstetricians and midwives often don’t know what choices are really important to you?
- Sometimes you don’t have choices. Sometimes choices change. Sometimes you don’t like what you’ve chosen.
- Choices have absolutely NOTHING to do with how well you’ll cope, manage, deal with, work through, handle, stay on top of and in control of the sensations experienced in the activity of giving birth.
We must reframe childbirth
We must now consider a new approach to birth that brings childbirth skills back into what makes common sense to the public and to birth providers. This becomes a ‘reframing’ of public opinion.
A man by the name of George Lakoff: ‘Reframing’ is changing the way the public sees the world. It is changing what counts as common sense.’
Gathering information is an entirely different process than developing skills. Information is collecting facts, data, statistics and knowledge. These can be used to make choices, learn about the process of childbirth and know more about care options. However, information is often a passive mental process. Information is about thinking not about behaving, acting or doing. Learning and using childbirth skills is all about what you’ll ‘do’ during the activity of giving birth. Skills must be learned as how-to then practiced and eventually used.
Politics of childbirth
Unfortunately but true, childbirth is surrounded by much political debate. Since the 1980s, there have been two sides to this conversation that has effectively required expectant families to place themselves in one or the other camps. It’s as though these two sides are constantly in conflict with one another: natural vs medical, home vs hospital and doctors vs midwives.
Part of gathering childbirth information and making choices revolves around choosing which side you are on or where you hope or plan your birth to be. By doing so there becomes a judgment surrounding birth, placing one type of birth as better than the other … and that depends on what side you take.
Swinging both ways
Childbirth skills swing both ways and can do much to heal the chasm that now exists. Every pregnant woman worldwide shares the same body no matter what birth they will have. This means we can all prepare our birthing body for the birth of our baby. Because we share the same body whether we’re tall, short, thin or fat; whether we smoke or eat organics or having our first baby or 10th we can all enjoy preparing our birthing body for birth. All of us have to let our baby our of our body whether this will be through labour and delivery or a cesarean birth.
Preparing for birth and learning birth skills should become what ‘the public sees as common sense.’ Pregnancy is such a unique part of life even though it’s natural and may be full of medical issues. We can thoroughly enjoy preparing our body for birth. In the process of preparing our body, we can learn birth and coaching skills. Men have the same body and if they are going to be with us during the birth they need to take an active role. An active role can best be achieved by learning a set of coaching skills.
Birth skills can range from learning ‘techniques’ to learning specific skills such as Birthing Better Childbirth Preparation skills: Directed Breathing, the Pelvic Clock or Deep Touch Relaxation, Kate’s Cat, Hip Lift and Sacral Manoeuvre.
Techniques definitely have helped many of us work through labour however techniques often fail because we don’t really understand what they are meant to achieve.
Learning childbirth skills that are based on our human body and behaviors are much simpler to use. All of us breathe in a relaxed manner when we feel no pain, are not working hard nor in stress. However, when these things occur our breathing changes. We can learn which types of breathing create relaxation and then choose to use them whether we experience the pain of contractions or during surgery and recovery.
Impress your obstetrician or midwife
Every birth provider loves to work with a woman who is using her own set of skills because they do not interfere with assessments, monitoring or procedures. Fathers who know how to help and actively participate in birth are just adored by midwives, obstetricians and staff. When couples work together with their baby’s efforts to be born, everyone is exhilarated. Birth becomes a positive experience that is actively worked through.
So when you are thinking about birth just keep in mind that gathering childbirth information so you can make informed choices is only part of what makes common sense. Learning, practicing and using birth skills is what you will do on the ‘Big Day’ and are well worth it. You’ll forget much of the information and Birth Plans will either eventuate or change however, your skills can be used with each breath.
Using skills are what make any person feel empowered particularly when you have the right skills for the task at hand. Birth skills will give you the edge, the ability to work in the present time with what is actually happening. Skills are adaptable. Having birth skills also reducing any sense of shame, blame or guilt. Instead of focusing on what ‘they’ are doing to you or around you, you focus on what you are doing for yourself. This keeps you focused more on your management style than on being passive to events.
George Lakoff is correct we need a reframing of childbirth if more families are to have positive memories of their birth experiences. With birth skills all births can be thoroughly enjoyed and become the self-empowering experience they should be.
Birthing Better was previously known as Birthing Better with The Pink Kit Method®. It’s now presented in online lessons. Look inside