New Zealand Nursing Journal Kai Tiaki Nov. 2002
“‘I have been inspired and compelled to share the knowledge of the Pink Kit that I have personally used in preparation for the birth of my second baby.The Pink Kit has taught me that childbirth is a learned skill and by knowing and understanding our body we can take control and progress the birth of our baby. The Pink Kit is a self-educational package that is in simple language and is easy to use, it consists of a booklet, video and audiotape to facilitate and validate the learning process. Part of the Pink Kit is learning about our anatomy and includes mapping your pelvis outlet, this is important as you then learn what positions to use during childbirth that help to keep you open. Other exercises and positions are also detailed and can be performed to assist with such issues as labor not progressing or persistent pain in the same place. The directed breathing techniques help to keep you focused, relaxed and later on moving through those painful contractions. The Pink Kit also details how to perform internal massage pre-birth, this greatly reduces the risk of tearing. The Pink Kit does not claim to replace medical intervention, but does provide women and their partners and support people with common knowledge about birth that has been learned from women of different cultures, religions and socio-economic backgrounds. The Pink Kit is essential knowledge for women and men wanting to prepare for, progress and assist with childbirth. As health care professionals I believe it is important to share such knowledge so others may benefit. I quote Benjamin Franklin
Tell me and I forget, teach me and I remember, involve me and I learn”
- Mandy Pagan RCpN, BN
MIDIRS Midwifery Digest Sept 2002 v 12, n. 3 p 427
“‘This is what your mother never told you about birth (more’s the pity). The producers of this ‘multi media birth preparation kit’ want to make the information it contains ‘common knowledge’ and to give pregnant women, their partners and support people familiarity with their bodies and the birth process and a ‘toolkit’ of practical exercises to turn ‘textbook knowledge’ into ‘self-knowledge’. The aim is for pregnant women to feel confident with their bodies, to know what they are feeling and where, and so to be able to express their feelings and needs. Those supporting them are encouraged to develop a similar degree of body awareness so that they can assist more effectively in labor. The pack covers the topics of breathing in labor; the pelvis and soft tissues; positions for labor and birth; pain, tension and relaxation; massage (including directions for doing perineal massage); and the stages of labor. Moving between the booklet, video, and audio tape, those using it are taken through a succession of exercises such as breathing into tense muscles to relax them, strengthening the pelvic floor, and creating more room in the pelvic outlet. Like all such guides, the pack only works if you actually do the exercises. But for those who have sufficient motivation, the result will be an embodied sense of the anatomy of labor and a deep relaxation and trust in the birthing process. On the whole, I liked this kit. One of its charms is that, while perfectly competent, it is not a lavish production with slick graphics and smooth presenters. The women shown learning the exercises had never done them before appearing on the video. The explanations are at times a little halting. However, for me, its homespun charms receded somewhat with repeated references to the ‘Minnie Mouse muscles’ (I think they are talking about the ischiococcygeus muscles) and the rather self-congratulatory renaming of the pouch of Douglas as the ‘pouch of Ms Douglas’. I would have liked the illustrations in the booklet to have been larger so that I could see what I was looking at, and I think the booklet could be improved by a clearer acknowledgement of the fact that not all birthing women are able-bodied and a fuller discussion of how the exercises and labor and birth positions might be adapted by women with physical disabilities. While there is a good section of the video showing the use of furniture for support in labor, some reference to the way in which laboring in water can facilitate changes of position would also have been helpful. But, having said all that, I would use the exercises myself and I would recommend the pack to motivated women, couples, doulas and other people who are planning to support someone through labor and birth. It is not cheap, but it would be a useful resource for midwives and NCT (National Childbirth Trust) groups, for example, to have to lend or hire out to pregnant women. The information and exercises could be taught in classes or workshops, but only after the necessary physical ‘self-knowledge’ has been acquired through doing the exercises. The kit itself is more appropriately used at home at an individual pace’.”
- Seren Wildwood, midwife, editor.
Midwifery Today review by Dr. Sarah Buckley Spring 2004
“‘Have you even wondered why some women have an easy time in labor…even in difficult circumstances…but others do it hard despite a supportive environment? Have you even wished that your fist-time mothers could ‘know’ what your experienced clients know about birth? Have you even wondered if women can actually learn to give birth more easily? If you answered yes to any of these, then the Pink Kit will be invaluable in your practice. What is the Pink Kit? Practically speaking, it is a kit comprising a video, tape and book. The instructional video, which links to information in the book, features eight main lessons: working with your breath,; exploring the bony anatomy; experimenting with different positions to keep the pelvis open; working with different movements in the bony pelvis; exploring the soft tissues of the pelvis; managing pain and tension; relaxation, rest and body care ; and putting the information together in labor. The audio tape describes what is called ‘the internal work’. After doing the internal work, women are encouraged to use this in late pregnancy and in labor to help them asses where they are and to know whether they are progressing. The information … the ‘common knowledge’… that women can gain from this kit is revolutionary. Through simple and accessible instructions, we can learn about our won specific anatomy and how to work with it to enhance the natural processes of labour and birth. Our partners can also be involved, doing exercise with us and learning how to assist and encourage us. The Pink Kit also teaches us to tune into our bodies, using massage, touch and directed breath for example. Using these simple techniques we regain our right and proper places as the experts of our own bodies. Midwives have much to learn personally from the Pink Kit, just as I have by reviewing it. We can learn more about the workings of our won bodies and how ‘universal’ (and superb) is our female design. We also gain a language with which to communicate about our bodies and the ways we use them, both inside and outside the birth room. For example, a midwife ( or a partner) can remind a woman that a hip lift may help her when her baby feels stuck in labor, and a woman can tell her care provider, in specific language, what is happening for her during labor. The information in the Pink Kit is both simple and precise and is based on many years of observation and experience with pregnant and birthing women. The Pink Kit recognizes that each woman’s body is unique and that a ‘one size fits all’ approach to birth preparation can be unhelpful. For example, although squatting is said to be the most open position for birth, the Pink Kit explains, that for some women, squatting actually narrows the pelvic outlet. Women are encouraged to experiment during pregnancy to discover which is the most effective position for them, which includes consideration of the soft tissues. Through doing the ‘sit bone spread’ with a partner, for example, a woman can learn how to create more room in her ‘soft’ pelvis’ for her baby’s descent. I could describe the Pink Kit as a sort of ‘optimal maternal positioning’ but it is much more. I recommend it to midwives, birthing women and anyone who wants to know more about their female body and the common Knowledge that we all share’. http://www.midwiferytoday.com/reviews/pinkkit.asp”
- Dr. Sarah Buckley
The pink kit is great
“‘I learned about The Pink Kit in 1990 when I saw the founder of Common Knowledge give a presentation at The 2nd International Home birth conference. Since I was a rostered midwife, at first I didn’t see how I could take this information into labors when I had never met the woman, though I could see the benefit for birth preparation. Years later and 2 kids later, I’ll tell you, I take it into every birth, and it works! The difference is that I educate women and their partners right then and there.
Anyway, at first I learned some of the techniques and went into labors and DID ‘hip lifts’ etc. They worked, but I soon realized that I was ‘doing to’ women, rather than working with them. I also had understood from my own first birth, that I had to rely on MY knowledge and my support people, rather than on the care provider, to get me through or help me stay focused or even remind me of the skills I knew and wasn’t accessing because it hurt and for a time, I lost focus. I prepared using The Pink Kit and chose care providers who had taken workshops of the information; yet they didn’t come forward to help and I realized that I had expected them to do so, rather than me have to ask when I needed help.
My whole practice changed. I used every opportunity to teach women and their men in labor. If the woman was having trouble with her breath, I taught that. If she was holding her bum, I taught her to let go. Everything works. We still have c-sections and forceps, but fewer, and the women and men just love the work. I wish every rostered colleague knew this stuff, so that any couple would have and will have a midwife on shift who knows this. Since I’ve been teaching women and men in labor, their ability to help me help them has exponentially benefited. They are so grateful. There has never been one woman in labor who says ‘no’ when I walk in and say. ‘I know something about our birthing body, want me to teach you?’ Even women having good births, love how they can use this knowledge.
At my second birth, I taught my sister. She was amazing. Now at births, I feel more like a companionable companion to the couple. I still do my professional things, but I now have a common language with which to talk to everyone. I extensively work with very ultra orthodox religious women. Over the past few years as more women have learned about The Pink Kit, more have done the Internal Work, which isn’t anything like ‘perineal massage’. After the birth, you often hear a woman remark ‘I did my homework.’”
- Australian rostered midwife
““Just an update on how The Pink Kit is working out for me this year. I have had many more primips and women with previous cesarean section or forceps births, and have not had a transfer all year!!! (apart from a vaginal breech and elective cesarean section for placenta praevia). This week I have really needed to use the body work stuff to get babies out. Three babes have been 4.5kg, and I have used lots of sit bone spreads. All have had intact perineums or tears that did not require suturing!!! Other couples have been buying the kit and I am ‘strongly’ saying that the work done now may feel like ‘Homework’ but it will help get your baby out.””
- Independent midwife
Midwifery team in New Zealand
“‘We aren’t going back to the way we used to practice. Getting clients to self-learn skills changes our Partnership to the positive. Families are less dependent and more self-motivated’”
- Midwifery team in New Zealand
“‘I have a dream. I can see more expectant couples working together at home. Then when they come into the hospital, we can ask them if they have done The Pink Kit. We can help them work together throughout labor and that takes heaps of pressure off us. I have a dream and I’m going to make it happen!’”
- Hospital midwife
New Zealand midwife
“‘Frankly, I struggled with the concepts put forth by Common Knowledge Trust. For many years, I used small bits of the information as part of my practice and sometimes it worked and sometimes it didn’t. However, there were couples who really took the kit to heart. They weren’t always educated, definitely not usually alternative and many did so because it gave them something to do for themselves. Those births were ALWAYS special. Finally, I put two and two together. What changed in my practice was that I began insisting couples do the work. This took time. Over the past 5 years, more couples come to me because they have learned that I’m a midwife who expects them to use these skills. What a difference this has made in my practice.’”
- New Zealand midwife
Lead Maternity Carer
“‘I was first introduced to the Pink Kit, in my role as a Midwife, 3 years ago now. I have since offered, highly encouraged, then insisted couples in my care utilize this wonderful kit. Most have embraced this new found knowledge of their body and their ability to work together at their birth. Most have also commented on how this kind of information, that helped them so much, was not available in any of the other books or antenatal classes they utilized. I am a Lead Maternity Caregiver Midwife in Nelson New Zealand. I have a caseload of 30 to 40 couples a year. I own 6 Pink Kits and circulate these around all the couples I care for. I do not self-select who I give this information to. In their second trimester I loan the Kit to everyone for at least a month and do a very hard sell on how much value it will be. I warn them that it is not light Friday night entertainment but very much a work video. Then throughout the rest of their care I make time at each visit to practice with the couple various skills. The couples that have embraced the Pink Kit have been diverse therefore as a caregiver I can not presume to know who will value this information and who will not. By not offering this to some I would be denying them the opportunity to know their bodies that much more and to work as a couple like they may have never thought possible. The diversity includes 18yr olds to 40yr olds; low socio-economic to high socio-economic; various spiritual beliefs; first time couples to fourth time Mums/couples; harmonious couples to struggling relationships to single mums; those having Homebirths to those who will require Obstetrical input [for example twins] This information crosses all barriers. As a midwife, I initially fell into the following traps of thought; “well they’ve already had a relatively easy birth”; “they’ve got too much stress going on in their lives”; “There are to many other health issues going on here to find time to educate on the Pink Kit”. The latter I still battle with because I really am very busy with the other aspects of their care sometimes. However I still loan them The Pink Kit and get through practicing most of the following directed breathing ; pelvic clock; hip lift; sacral tilt; sitbone spread; Pelvic mapping; and birthing positions. I now encourage all couples/ women to do the Internal Work. I would like to share with you some of the wonderful experiences I have had with couples, there are too many to include them all but this will give an overview of the value. My most recent experience involved a woman who had pre labor rupture of membranes. By the time her labor established 32hrs had gone by and although she had tried to rest as much as possible she was starting to get tired. However we had worked through the pink kit information antenatally so throughout her active labor she used the pelvic clock, a position that she knew was open for her, and the sacral tilt. When it came to second stage she really only pushed once otherwise she just breathed her baby out over her 20minute second stage. Pretty good for a first time Mum. I put this efficient 6hr labor and quick but controlled second stage down to her vigilance towards doing the internal work. This made easy work for a Mum who had an accumulated tiredness. The internal work that the Pink Kit teaches is not just massaging the skin of the perineum. It involves massaging the muscles in the vagina. This allows these muscles to relax and stretch at the time of birth. Enabling a faster second stage, less stress to the baby at this vulnerable stage of labor and decreasing the likelihood of tears or requirement of episiotomy for the Mum. In this case apgar scores were perfect at 10 and 10, you don’t often get a perfect score at 1 minute. One Homebirth I attended the couple worked together so beautifully I acted more as the back-up midwife. She again had an efficient and peaceful second stage where she calmly breathed her baby out. Her second stage had all appearances of a woman who’d had many babe’s but actually was having her first. Another Mum without a tear. One woman in my early days with the Pink Kit had convinced me she didn’t need to look at the Pink Kit because of her relatively easy first birth. However with her second birth she experienced a lot of supra-pubic pain (very lower abdomen) and she was having no progress in labor. I discussed the sacral tilt with her and convinced her to give it a go whilst lying on her left side. As soon as we did it the intolerable supra-pubic pain went and she felt her baby move into her pelvis. Ten minutes later her baby was born. What was happening was the baby was pushing down onto her pubic bone instead of going behind the pubic bone and into her pelvis. By moving the sacrum back this created a new space for the baby to move into and allow it to move deeper into the pelvis. I have looked after numerous very fit women who have had very tight lower abdomen and perineum muscles. Through working with the Pink Kit they have learned to identify where tension in the muscles exist and how to let these go. One first time Mum told me how she felt her baby move down into her pelvis whilst doing an exercise to release her lower abdominal muscles, she went into labor that night and had a very efficient labor. Antenatally I get every woman to identify which positions she feels most open in for birthing. If in labor, a baby is ever “held up” and there is slow progress, I have found that it is this position that gives the baby the space to move through and notable, sometimes dramatic, progress occurs. The Mum found this position whilst able to really focus and not dealing with tiredness and pain. She did not find it instinctively which is often a held belief but she remembered it because of the work she had done antenatally. In my experience often positions that women instinctively find in labor can be ones that help escape the pain but do not help the progress of labor. Leaning forward relieves back pain but does not direct the baby down into the pelvis and therefore slows progress. I have had numerous second time Mum’s look at the Pink Kit and say I wish I had seen this with my first pregnancy. A lot of these Mum’s had lent forward and had very long labors which for some ended with forceps. With the use of the Pink Kit in the subsequent pregnancy, where they adopted an appropriate position for them, they had very efficient second stages. The evaluation forms I receive, often make reference to the Pink Kit information and are very positive about it. Couples just love this information. Couples feel very empowered with this knowledge giving them a higher level of confidence in their new role as a parent. I have observed that couples then are more proactive about seeking more information about parenting and asking questions. This alone is a very valuable outcome of the Pink Kit but what is also valuable are the birth and labor outcomes that are reflected in my statistics below.”
- Lead Maternity Carer
Team midwife New Zealand
“‘I always feel really positive when caring for a couple in labor when I know they’ve put in a lot of work with The Pink Kit: essential preparations for your birthing body. It certainly seems to make a big difference to the labors and outcomes. The couples are so much more empowered- a very over used word- but seeing the women and her birthing partner work together, one can’t help thinking ‘wow, that’s empowerment!’ When labor is approached with confidence and a working knowledge, the atmosphere in the birthing room is more upbeat and somehow I always feel more relaxed ( as a midwife) as in it’s ( the labor) a shared responsibility and not something that I have to guide/direct. Seeing a woman in labor is always a moving experience, but seeing a couple working together to birth a baby is truly awesome.’”
- Team midwife New Zealand