A Crash Course in Childbirth Education

by Jennifer: mother, doula, future midwife, childbirth activist

I want to say by way of a disclaimer that I am under no illusion about the breadth and depth of this topic. My main purpose is to emphasize basic knowledge along with the things I have learned over the years that have been the most important to me, those that have helped me the most.

I am biased. I make no attempt to disguise this. I believe in natural birth, because it is the best for both mommy and baby. I have no qualms with the careful and judicial use of epidurals, but I believe they should be used sparingly. There is no substitute for the support of a doula at a birth. I also generally believe in attachment parenting, though I am not militant about it.

I am not a medical doctor, nor am I degreed in anything that would lend academic credence to what I'm writing. This is the product of my years of research and passion, since my first pregnancy, about what is best for mothers and babies. I have learned from books, childbirth groups, doctors, midwives, and doulas, as well as my own experience.

Prenatal Care

This is on my mind lately so I will start here. During pregnancy the baby is fed by the mother's blood supply through the placenta and unbilical cord. The placenta is an amazing organ: it is grown solely for the purpose of regulating the nutrients that reach the baby, but it cannot make up for bad nutrition or screen out all the toxins the mother ingests or breathes in. It cannot give to the baby anything that the mother does not have. Growing a baby takes a lot of extra vitamins and minerals, and good health begins with diet.

The best book I have read on this topic is Nutrition for a Healthy Pregnancy by Elizabeth Somer. She gives easy-to-follow charts about how much and what kinds of foods are best for gestating moms, and during pregnancy it sounds like a TON of food. The truth is that following this diet is not only extremely healthy, it also keeps you snacking (on good stuff) and eating regularly so that you never feel hungry and aren't likely to follow bad cravings - if you're not hungry you aren't likely to be craving french fries, for example.

I craved apple juice during my first pregnancy. Juice gets a lot of bad press, but I think that if you choose 100% juices, and get good nutrition elsewhere, it's probably fine. It's worlds better than caffeinated soda or coffee or alcohol (all those should absolutely be avoided during pregnancy).

One of my midwives said that the best emergency food for pregnancy is yogurt. It is high in protein, has all those active cultures, but it also has enough sugar that you aren't likely to suffer from low blood sugar problems if you haven't eaten in a while.

A little about cravings: Usually I think pregnant women should follow their cravings, because I have found that most cravings are driven by the biological need for something. During my first trimester I got by mostly on strawberry ice cream and rice cakes because that was all I could face without vomiting. But in the second trimester - the golden months of pregnancy - I started to crave proteins: eggs, steaks, hamburgers. I'm sure this was due to the high protein needs of my growing baby. Some days I wanted nothing but oranges all day long. It is these kinds of cravings, where the nutritional content is obvious, that I think pregnant women should feel confident about following.

The other big prenatal care element is exercise. I always got very sore and felt very heavy early on, so water exercise was the best thing I found. In my area I took Aqua Mom classes, and floating semi-weightless in the water was fabulous. Yoga of course is fantastic, but it must be of the prenatal variety, since during pregnancy the abdomen is not in its usual condition and not honoring that fact can be dangerous. Just be active, somehow. Many pregnant women go for frequent walks, and that by itself is probably enough.

During my second pregnancy I read and practiced the exercises detailed in Active Birth, a wonderful book by Janet Balaskas. I concentrated on strengthening my squatting muscles because I hoped to use that position during delivery. That birth was not as gentle as my first, and I didn't end up squatting, but the practice was beneficial. This, along with daily Kegels (you know, where you tighten and loosen your perineal muscles, as if you're stopping and starting urinating), helps to strengthen the pelvic floor muscles. With a strong pelvic floor, women have more control and flexibility during pushing, and they heal faster after the birth. Good food helps build strong tissues also, so with these elements, women increase their chance of birthing without injury or interference.

Pregnant women need to sleep as much as they can, to drink plenty of water all day long (yes, I know you're just going to pee it out in ten minutes, but you still need to stay hydrated), and to neither overeat nor undereat. Unless they're on bedrest, they need a little exercise. They need to do their Kegels.

That addresses the physical preparations for pregnancy.

Psychological Preparation

I feel very sad that this is mostly absent from our prenatal education. Everyone knows already that diet and exercise are the best things for just about everyone in every situation. But how do you prepare yourself mentally and emotionally to have a child?

There are some parts of parenthood that you simply cannot prepare for and need to learn by doing. But there are some things you can do that will be useful to you in many circumstances, from labor to birth and beyond.

Pregnant women have something that becomes shockingly rare once the baby is born: quiet time to themselves. This is perfect for learning relaxation techniques. There are so many of them; I will talk about what was helpful to me.

Yoga (and its related schools of exercise) emphasizes breathing, and with good reason: when we are tense, when we are scared, we sometimes forget about breathing in and out regularly. The act of taking slow, deep breaths, all by itself, is refreshing and calming. During labor it helps get oxygen to the baby, and can be used to help the mom to relax. After the birth, women can use the same techniques that they used during labor, to help them remain calm when they feel frazzled by motherhood (colic, anyone?).

Active relaxation (I may have made up that term myself - I can't think of where I've seen it before) is using a coach or one's own thoughts to relax parts of the body, starting at the head and working down the body to the feet, until the woman is completely relaxed. Women can carry tension in their cervixes, which is particularly unhelpful during labor, when the cervix is trying to open up. It might be helpful to learn now, during pregnancy, how to notice when the cervix is tense and how to relax it.

Underlying the need for exercises like this is the problem of fear. We tense up when we are afraid, and that is one of the things that most obstructs the birth pattern. Every woman has fears. Sometimes things come out during labor, unaddressed fears, that keep labor from progressing. I was able to look closely at and deal with my fears through Hypnobirthing classes, and that to me was the most useful part of the classes. I now firmly believe that pregnant women ought to search out and face their fears, during pregnancy rather than during labor or in the hectic postpartum time.

Fears can be anything. Some women fear that pushing a baby out is going to cause them to tear. Some women aren't sure if they can handle the pain of labor. Others are terrified of getting an episiotomy or having a c-section. Still others are worried about being a good mother, or of having future children, or a marital problem that might interfere with how the children are raised. All of these can and should be addressed as thoroughly as needed, prenatally.


More to come!