When Seconds Matter in Birth

Wednesday, August 26, 2020

When Seconds Matter in Birth

When folks think of birth, it is oftentimes scenes from movies, tv shows, or stories from friends that pop into our heads. Almost immediately, we also think of the pain, physical labor, and probably lots of drugs that we are accustomed to thinking are required to get through this process of birthing a child. As society has molded us to believe this, we have slowly handed over control--but to no fault of our own. Part of staying in control during situations is being able to have enough information that you can make an informed and educated next step. 

If you aren’t prepared to face the variables and normal variations of labor then thinking about your next move may make you realize that you’re not sure what your options are! This can strike a sudden and very uncomfortable fear. You worry something will go wrong and you won’t know what to do. But, you can know what to do and it all comes down to the way in which you prepare for your birth.

So... let’s dive into what to do! 

But first, let’s talk about what happens when there is monetary incentive and a very well-known ‘cascade of interventions.’ What happens when your nurse is tired and your doctor recommends a c-section after 4 hours of no cervical change because it’s 4:30am and the anesthesiologist is having a particularly busy night? This is when it comes down to a matter of one conversation. This is when it comes down to a matter of minutes of you digging deep into the preparation you did for this exact moment!

The reason that your preparation matters so much is because the preparation you do will give you tools for your birth toolbox. If you have been given biased or “watered-down” childbirth education, then you will not have been given all of the tools available to you--only what your source of childbirth education wants you to know. 

For example, imagine you are being given training on tools that you can use to build a box. You don’t know this, but the person teaching you doesn’t love to use nail guns and prefers to use good ole’ nails and hammers “because it’s safer.” During training, they will not share about the nail guns they have in the utility closet because they don’t want you using them. However, you know you are someone who knows how to be safe with a nail gun, sees the efficiency, and calculates how much more productive you’d be with a nail gun vs. nails and a hammer. Even still, you don’t have the option to use a nail gun because you were never even afforded the right of knowing a nail gun was available. It the time that it took you to bi8ld 2 boxes you could have built 5 and avoided the blisters on your hands! 

The same is true with childbirth education courses. If your childbirth education course only teaches you about unmedicated labor or epidural use, then they are robbing you of understanding the gamut of options you have along the spectrum of pain relief! With the proper intentional education, you can have your dream birth and avoid a c-section! 

This is where you will do one of three things: You will hand over the control, take the control, or you will keep the control. 

Identifying the control, taking the control, & remaining in control is key. 

Identifying control is asking what are my choices, what are my opinions about this, what do I think about this decision happening to my body? (To be clear your opinion is the only opinion that matters. You have the final say over your body and your baby. You should consider your provider’s professional opinion, but ultimately you are in control if you want to be). 

Taking the control simply looks like speaking up and making a decision. This is where your ability and confidence to advocate for yourself needs to be strong. Sometimes you have to advocate harder for yourself than other times, but in labor it is a must if you are going to stay in control. 

Remaining in control means understanding and “enforcing” (for lack of a better term??) informed consent and shared-decision making. You can remain in control by holding strong boundaries that you are the final say, you want to be involved in decisions and discussions, and you are only interested in evidence-based care (you are always free to ask your providers for research on things they are suggesting) regardless of hospital policy. Remember, there are many outdated policies in women’s health, for example, restricting food and liquids during labor or inducing for going past your due dates. It is up to you to know what your hospital’s policies are and to look into the policies to make sure they are based on the latest research. (To be clear: hospitals are not intentionally treating you poorly--many polices aren’t revisited often so the research has surpassed the policies and the policies haven’t caught up yet). 

Hand over: This is where so many people find themselves. I’m going to tell you how to get yourself out of this fearful handing over of control of your birth situation. When you realize that you prepared in all the wrong ways, it hands over control. When you realize that what your doctor is saying is super scary and you don’t know if it’s evidence-based or not, it hands over control. When you realize that you’re not sure if low amniotic fluid is something to be worried about or not, that hands over control. The fear sets in and you are willing to do whatever your provider suggests. This is not being in control of your labor. The remedy to this is preparing for the variables in birth. Birth comes in so many normal variations, but it’s up to you to know what those are so you can advocate for yourself (and your normal labor!). 

Take the control: This one is the action option! Once you find yourself scared and wondering if what they are saying is truly your only choice, you have a few options. You can reach out to your doula if you have one, ask for 20 minutes to think things over, or you can log into The Birth Lounge app and look up the research for whatever is being discussed. The lounge won’t give you the answer or suggest what to do, but it will give you the science behind the option so you can have an informed and confident discussion with your provider. The Birth Lounge will also give you the alternatives you have for that scenario so you can ask your provider about those, as well. 

Keep the control: This option is the product of intentional and comprehensive childbirth education. You know the definition of failure to progress is no cervical change in SIX hour but only after reaching 6cm. Anything before 6cm should not be considered failure to progress by definition. You also will have the confidence and the words to use to advocate for 2+ more hours so your labor can progress. You will also understand and know what you need to do next: hydrate, movement, don’t be on your back. This will all be second nature to you because you prepared intentionally for all the normal variations of labor with The Birth lounge. 

Control is everything in labor. You can be in control or you can let someone else be, the choice is yours. The way you prepare determines whether you are in control or someone else is during your labor. You should be preparing for all the variables and variations of birth so you know what is normal and what is not. You should also go into labor understanding how to 

One more thing before we go, let’s break down Informed Consent. The ‘informed’ piece of this phrase means you are informed of all of your options plus the risks and benefits of each option. The ‘consent’ piece requires that you have the freedom to choose any option without any influence, persuasion, or coercion. Both must be present for care to meet the requirements of ‘informed consent.’ 

The way you prepare for birth matters. If you don’t know what to expect, then you don’t know how to prepare. If you don’t know what’s normal, then you don’t know what’s concerning. I have always loved the comparison of preparing for a baby and preparing for a wedding. Folks prepare for weddings months in advance (sometimes more than 1 year!), yet for something so major and life changing as birth, we prepare for a 2 hour childbirth ed course sponsored by your hospital (be mindful who is teaching your curriculum and that it’s not biased). Even for marathons--folks prepare for months to run marathons, yet for something as physical as birth we prepare for maybe a 4 week series, 1 hour each week. 

Be intentional about the way you prepare for your baby. Understand your hospital policies and the research surrounding maternal health practices. Know the normal variables and variations of labor so you also know what is concerning. Explore your options so thoroughly that you are confident in the choices you have made for yourself and can have informed conversation with your provider about your choices. Deliberately put together a team of people and providers that support your individual birth goals and understand how you wish to be supported in this process. 

When seconds matter, you want to be able to remain in control and rely on your research-backed decisions to keep you and your baby safe.

The Birth Lounge will share The CONTROL Method. I will show you how you can control the most essential parts of labor and the choices made along the way to achieve your dream birth. No two birth plans are the same and we account for that individuality. Your birth goals are unique to you and The CONTROL Method will teach you how to identify, take and maintain the control throughout all variables and variations of birth. 

- HeHe

What is Early Intervention?

Wednesday, August 19, 2020

What is Early Intervention?

You’ve spent months preparing for your baby’s delivery and navigated the forever changing ups and downs of pregnancy and labor. Now baby is here. They are growing more each day, and you find yourself continuously questioning their development. Often comparing them to other similarly aged children and asking questions like “Should my baby be walking by now?” or “Should they be talking more?”. These questions don’t have a hard answer because every child will develop different skills on their own time and with practice. But this does not mean you have to navigate it alone. Early Intervention is an available program designed to help support families and their child’s development. 

What is Early Intervention?

Early Intervention is a publicly funded program meant to service children and their families from birth-3 years, who present with developmental delays or disabilities or are at risk for developmental delays due to a medical diagnosis or socioeconomic factors, for example. Early Intervention is free or low cost depending on the state you live in, and offers a wide range of services. These services are based on your child and family’s needs and can include services from a speech language pathologist, physical therapist, occupational therapist, developmental specialist, nurse, social worker, etc. Although Early Intervention is offered in every US state, services will differ slightly depending on where you live. If you feel you could benefit from Early Intervention services, check out your states specific EI program information with a quick google search. 

How do I get Early Intervention Services?

You may be interested in Early Intervention services for a number of reasons. Maybe a family member made a comment, or a daycare teacher expressed some concerns. It could be that although you are not worried, you would like some reassurance that their development is on track. In order to receive continuous support from Early Intervention, you must qualify for their services. You can self-refer by calling the program directly, or request that your doctor put in the referral for you. You DO NOT need a referral from a doctor to be evaluated by your state’s Early Intervention program. 

How do I qualify for Early Intervention Services?

Depending on the state you live in, your child will be evaluated using their version of a developmental assessment tool. Based on the assessment and a family intake meeting, your child will either be eligible or not eligible for EI services. Eligibility requirements and duration of services will also vary by state and may look different for each family. If you are eligible and accept services, you will then create an EI plan that is individually created to meet your family and child’s specific needs. Services are always optional and you never need to feel obligated to accept them. Early Intervention does not work for everyone. It is important the family is open and committed to services in order to make the difference.

When should I reach out to an Early Intervention program?

Early Intervention is available for families who qualify with a child age birth- 3 years old. This age range is specific because it captures them at that optimal age where their brains are continuously developing and shaping. Your infant or toddler is learning through play and social interactions and the earlier we can support these experiences, the most potential there is for success. There is no wrong time to refer to an Early Intervention program or to get help for your child. If your child is 3 years or older and you are concerned with their development, contact your Local Education Agency (LEA) for information and services! 

How should I go about finding out about Early Intervention services local to me?

The CDC lists out resources by state here. As well, Autism Speaks lists out similar contact information here, but if Autism is your specific concern may be a good resource to start from. 

Post written by Caitlin LeBeau, TBH Team Member, Developmental Specialist, & Doula

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