There’s more than one way to prepare for childbirth
When a woman becomes pregnant, she can count on hearing labor stories—from her mother, her sister, her friends, perfect strangers. Some of them she’ll ask to hear; some she won’t. Some of them will be of dream labors where a woman goes to dinner during her contractions, hops in a car to go to the hospital and has the baby 40 minutes later. Others will be heartbreaking, or just plain hard and complicated. Inevitably she’ll hear two phrases, usually tied together. “The worst pain I’ve ever felt in my life.” And, “It was worth it.”
That first phrase will be intimidating, scary even. It—and the growing, kicking fetus inside her—will likely propel the woman to prepare herself for giving birth. But how? Those same women who told her their stories will often have strong opinions: Get an epidural. Don’t get an epidural. Pitocin is fine. Pitocin is not fine. Go natural. Natural is for suckers. Breathe. Breathe. Breathe. She might hear the books and magazines she’s reading are wrong because they’re not pro-natural enough, or she’s reading things that are too pro-natural.
Though this sort of information can be confusing and overwhelming, it’s part of making an informed decision of how she’ll approach her own birthing process. I know this because I’m pregnant for the first time myself, with five months to go. But ultimately, every woman and every birth is different. There doesn’t have to be an absolute right or wrong way. It may be a combination of ways. In the end, “the baby makes the decision for everyone,” says Leslie Cowger, a certified childbirth educator at Renown Health.
Luckily, for each type of woman out there, there’s a method of childbirth preparation that will probably appeal to her and help her partner know what to do when the big day comes.
Mandy Colbert, a certified prenatal yoga and hypnobirthing instructor, says some people spend more time preparing for what car or TV they buy than they do for childbirth. “You need to prepare. Your baby will be stronger and healthier for it,” she says. “You don’t sign up for a marathon and then just wait for the day of the race.”
Most pregnant women and their partners who take a childbirth preparation class in Reno do it through either Renown Health or Saint Mary’s Regional Medical Center. They’re called “Prepared Childbirth” classes at both places, and parents-to-be can sign up for an all-day course or a six-week course that’s three hours each class. These courses cost $85 at both hospitals and are typically taken six to eight weeks before the woman’s due date.
On the third floor of Renown’s Sierra Tower, Leslie Cowger is demonstrating with a doll and a plastic pelvic skeleton how a baby is born. She squeezes the skeleton’s hips and shows how the baby’s body can cause back pain in certain positions. Then she asks me to bend over the table, which I do. She squeezes my hips to demonstrate how a woman’s birth partner could help relieve that pain. This is just one of the things pregnant women and their partners learn in her class. They’ll also learn about infant care and CPR, carseat safety, comfort methods from an epidural to natural methods, ways to use birthing balls and labor beds, and medication options. (The childbirth preparation instructor at Saint Mary’s could not be reached by press time for details on their classes.)
“We teach freedom of choice based on knowledge and options,” says Cowger. Amid lessons on the warning signs of labor, on breastfeeding and videos of births, participants also get a tour of the facility.
While both courses at Renown offer most of the same information, the six-week course allows for more breathing and relaxation time, which ends each session.
Cowger says women can have a natural birth at the hospital. Renown has a C-section rate of 30 percent, and an epidural rate of 45 percent. One way to increase the likelihood of a natural hospital birth is to draw up a birth plan, or “wish list,” which she covers in class. She says the birth plan should be regarded as a communication tool that needs to be flexible. She advises talking with your doctor beforehand about what’s on the list and what’s possible.
Another way to help increase the chances of a natural birth is to have a doula. There are two of them at Renown, including Cowger, and there are also midwives on staff. Saint Mary’s does not have midwives or doulas on staff. While a midwife can deliver the baby, a doula does not.
“A doula is just here for labor support for the mom and the family,” says Cowger. “She does nothing clinical.” She helps guide the woman into comfortable positions, acts as her advocate for the birth plan, gives massages—“I’m not pregnant, and I want a doula all the time,” jokes Cowger.
Doulas of North America carries a list of certified doulas at dona.org. Most aren’t covered by insurance and tend to cost around $600 per birth. You may be able to find one in training for free.
Denise Nelsen, administrator for Women and Children’s Services at Renown, says nearly every doctor is open to doulas, as they’ve been shown to decrease the cesearean rate by 50 percent.
Mind over matter
At Mandy Colbert’s Saturday morning prenatal yoga class at Yoga Loka, she’s telling me and the four other women there a phrase that’s been known to stick with her students: “A relaxed face means a relaxed cervix.” We’re doing poses found in nearly any yoga class—downward dog, warrior pose, child’s pose—but the poses are slightly gentler, with a heavy concentration on breathing. She’s tailoring them to pregnant women’s needs, such as increasing blood circulation to reduce swelling, decreasing back pain and building strength in the legs. Unlike most yoga classes, she reminds us to “bring baby with you” as we gently twist and bend. Also unlike other yoga classes, Colbert opens the session talking about her three kids’ antics at home, and she opens a discussion to share what we’re reading and how we’re feeling that week. She’s also provided a snack, ginger chews, pregnancy tea and an open invitation to use the bathroom anytime we need it. It’s a welcoming place for mamas-to-be.
“When you’re pregnant, the whole world starts telling you you’re crazy because of hormones,” says Colbert. “Here. We’re not crazy. We can be ourselves and listen.”
Kim Allcock is also a certified prenatal yoga instructor teaching at Yoga Loka, as well as the Yoga Center. “We like to teach so our breath and movements go together,” she says. “It becomes a relaxed and meditative thing for you and the baby.”
After a complicated first labor, Allcock started doing yoga training and had two subsequent natural births. She can’t pinpoint a cause-and-effect relationship to that exactly, but she thinks yoga had something to do with it. If she had been practicing yoga with her first child, she thinks she wouldn’t have been so overwhelmed by the birthing process.
“Yoga practice is all about mindfulness and accepting the change,” says Allcock. “It’s a tough line to walk. In the throes of labor, you don’t want to be making decisions, but if you have the tools, you can draw on your practice to help with that.”
Allcock and Colbert have three kids each, and they both suspect their yoga practice helped shape their children’s temperaments. In short, when they did yoga during their pregnancies, those children tended to be calmer than the others.
“Your baby is bathed in whatever is in your body, and if that’s stress hormones, that’s what you’re preparing your baby for,” says Allcock.” If they develop in a peaceful place, they become peaceful people.”
Colbert also believes that a peaceful place affects the baby’s brain growth. When she was stressed during one of her pregnancies, that child developed what she calls an “I’ve gotta survive mentality,” while the others “had more ability to devote to vocabulary and brain development.”
Once a month, Colbert screens a free film about childbirth topics after her prenatal yoga class. She also teaches a yoga class for moms and their babies (six weeks to pre-crawling), for prenatal couples, a hypnobirthing course (see below), a pelvic alignment class, and a Hot Fudge yoga class that combines cardio exercises with yoga.
Prenatal yoga classes aren’t meant to take the place of a comprehensive childbirth education class. They can, however, be a helpful tool for pregnant women to use throughout their pregnancy and into labor, whether they’re having a natural childbirth or not.
Under your spell
Hypnobirthing is a complete childbirth education class, and Colbert is one of two certified hypnobirthing instructors in town. (The other is Sheri Uhrig of Peaceful Arrivals. If there are others, we were unaware of them at press time.)
“Most childbirth classes give you techniques of how to get through the pain—‘the pain, the pain, the pain,’” says Colbert. “Hypnobirthing is, if you get rid of the fear, the tensions, if you surround yourself with people who love and support you, there’s not going to be pain. I’m not saying it’s going to be easy. Labor is hard and intense. But when there’s pain, it’s when you’re afraid and tense. You’re constricting your body, and it doesn’t work properly. If you’re constricting, with anything you do, there will be pain.”
Hypnobirthing is partly about finding where that fear comes from and how it inhibits the natural process of labor. “Then we give you techniques of deep relaxation and visualizations for you and your partner,” she says.
Some of what’s covered includes how to create a birth plan that lets doctors know what you want, such as holding the baby immediately after birth or having the father cut the cord. Also discussed are postpartum issues, getting your room ready, birth positions, and simply knowing you’re allowed to be in a different birthing position. The on-your-back-feet-in-stirrups-huffing-and-puffing model so prevalent in movies is not your only option or necessarily the best one. You’re also allowed to ask that doctors not use drugs like pitocin (or lesser amounts of it) to induce labor. Colbert has strong opinions about pitocin, and she discusses its pros and cons in her class and when may be good times to use it. However, she says hypnobirthing can also help women through a cesarean or an epidural birth; it’s not just reserved for the natural-birth bound.
“I don’t want my class to give more fear,” she says. “I want it to be more information-based. Make it your own. It’s an awakening of who you want to be as a parent. You walk away with a different understanding of yourself and what you want for your baby.”
Colbert’s hypnobirthing classes are offered monthly, in four, three-hour sessions. There are no more than six couples per class. It costs $235 per couple, though payment plans and a sliding scale can be available for the financially strapped.
As there are options when it comes to childbirth preparation classes, there are also alternatives to the doctor-and-hospital labor experience.
Diane Schaub of Sierra Midwifery has brought more than 1,000 babies into the world during her 27 years as a midwife. She only does home births. She doesn’t work in a hospital, though she will take women in labor to the hospital if they’re having complications. Otherwise, she can do nearly everything a doctor can do, but she also provides a lot of personal attention. She’s trained to care for women prenatally, attend the birth and check on the mom and baby for the first six weeks after the birth.
“People want midwives because most of them want less intervention in the birth, and they also want personal care,” she says.
That was the case with Keyonna McMillen, who was in Schaub’s office for her 4-week-old son’s checkup. McMillen had her first two children in the hospital and wasn’t pleased with the experience. She decided to have her now 2-year-old daughter and new son at home.
“I like being able to do things my way and more natural throughout,” she says as she prepares to nurse baby Joseph Scottorn, whom they call Scott. “The midwife will listen to your birth plan, whereas in the hospital they have to follow their policy. At home, it’s a lot more peaceful.”
Schaub says one of the first sentences she read in a medical obstetrical textbook was that 95 percent of births are normal. “But in this country we’re treating 95 percent like they’re abnormal.”
Schaub has a pretty good record, with a hospital transfer rate of only about 7 percent. However, she only sees low-risk people without medical problems. “Diabetes, heart disease, epilepsy—if they are having those symptoms or diseases, they aren’t considered.”
Schaub says she’s helped a lot of women have natural, vaginal births after they’ve had a C-section, which is something some women didn’t think was possible. Part of how she does that is by helping women in labor stay in the present moment.
“In our minds, we’re thinking, ‘It hurts now. How much will it hurt later on?’ But the way to do labor is to think, ‘I just need to breathe through this contraction.’ I know women are already equipped to do this. Even women who come in with their first baby, I tell them, ‘Your body already knows how to do this, and you just have to breathe.’ Sounds easy doesn’t it?” she says with a deep laugh.
So now that you’ve been presented with some options, you may be feeling more overwhelmed than when you began reading. There are equally strong pushes out there to go natural or to go with medical interventions. Many women aspire to a natural birth and then emotionally beat themselves up when they find themselves pleading for an epidural. Again, these are personal choices, but they can also be educated ones, as nearly everyone in this story related.
“My definition of prenatal care is what the woman does for herself every single day,” says Schaub. “That’s eating good food, drinking lots of water, exercising and thinking good, happy thoughts. I think what’s much more important than anything I will ever do is what that woman does every day for her baby.”
Prepared childbirth courses
For Renown Health classes, call 853-2229 (BABY), renown.org
For Saint Mary’s Regional Medical Center classes, call 770-7100, saintmarysreno.org.
Yoga Loka 6135 Lakeside Drive, No. 121, 337-2990, yogalokareno.com
The Yoga Center with Kim Allcock 720 Tahoe St., No. C, 972-1362 theyogacenterreno.com
Sierra Midwifery 323-4956, sierramidwifery.com
Doulas of North America dona.org