Thursday, December 9, 2010

4 hours of labor rehearsal and we lost a mom...

Weeeeeell, that was new! Read on and I'll tell you what happened.

During week 4 and week 5 of our Not Your Mama's Childbirth Class we do a labor dry run with ice. The first night we simulate labor as if it begins in the middle of the night when they're home (most common if labor goes on it's own, it seems!) and I holler out "your contraction starts!" The mamas hold baggies of ice in both hands until the "contraction" passes. After 45 seconds (average-ish time a contraction lasts in the early stage!) they let go of the baggies and their job, or rather their PARTNER'S job, is to get them to fall asleep by using relaxation techniques I taught them in the class 2 weeks before. As the class progresses the test begins for the partners. They have to remember EVERYTHING we talked about on how to comfort their mamas and help labor progress. I love it. They have their position cheat sheets lying next to them, pens and stopwatches on their phones in hand, and some have looks of pure concentration that is adorable to watch! Since we start the labor rehearsal with contractions coming about 8 minutes apart, the partners seem pretty darn confident and think this labor thing might be a breeze since 8 minutes feels like a lifetime to just lay around and figure out their next position.

Then, as it happens in REAL labor, the contractions get closer together, last for longer periods of time, and get more intense. As the hours pass, I have them switch from baggies of ice to submerging their hands in buckets of ice, to the pièce de résistance, the dreaded ice and water combo, or as I like to call it, the Black Finger Bitch. The moms begin to see the benefit of distraction and WHY those positions help to lower their perception of pain and the partners begin to see that they have a HUGE role in this labor...In fact I teach that the MOST IMPORTANT PERSON when Mom's labor begins is NOT mom...it's the partner!!

On the next week we continue the ice rehearsal and begin the class by having them "check in" to the hospital while contractions are coming 3 minutes apart (as I advise them to have them be when they head in!) And of course, epidural or not, they WILL feel that strong Black Finger Bitch level of intensity if they wait for the epidural until they've progressed into hard, active labor. (this helps to reduce the number of interventions and problems all the other educators teach you about) I have my doula friends acting as nurses and we go through typical hospital check in procedures from patient intake, IV insertion, and fetal monitoring, while mom is having those contractions. This is usually the REAL eye opener to the couples as they see how easy it is to become a medically managed patient instead of an informed laboring couple in charge of their own birth. It's a WHOLE new ballgame when the partners are in charge of nurturing their mamas while playing interference with the "nurses"...they see how quickly things can spin out of their control since mom is only able to focus on handling the pain of the "contractions."

Now, some of you might be thinking to yourselves, "Uh huh...I knew this was an all natural hippie bullshit class!" because I didn't mention anything about the epidural. BUT, my naysayers, the moms that have chosen to have an epidural as part of their birth plan get to dry off their hands, climb into the "beds," and resume positions that I've taught them to use when they're numb to get that baby moving down and out toward the end of this class.

During this second session of labor rehearsals we had a mom who had extreme nausea from the intensity of the ice contractions and had to take a break from the ice. Her face would flush and she'd feel sick to her stomach during the contractions...she told me the next week that although it sucked, she realized that this COMMON REACTION TO PAIN was an eye opener to what labor would be like. (and just so you know, barfing is VERY common in active labor and again in transition!)

I'm not stupid...and I don't act like my students are. Ice does NOT feel as intense as contractions. But I do feel that after this exercise they have a VERY good idea of how to handle labor when it comes. And they realize that they have all the ammunition in their brains (and their cheat sheets!) to help them have the birth they have envisioned...they just have to assert themselves and use it when the moment comes!

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