Mental Preparation for your VBAC: a doula’s perspective

Concentrated young man with his head melting in tangled lines

So you have decided to have a VBAC.  Lets assume you’ve found your supportive OB and maybe you’ve already hired your doula.  You’ve visited the amazing ICAN website and had lots of your questions answered.  With your birth team in tact and only your EDD between you and baby, you might wonder how else you need to prepare for this opportunity for a “Trial of Labor.”

I have already documented that I believe that unmedicated birth is more about mental preparation and mental determination than it is about some magical skill that you posses, but this post isn’t about deciding to go unmedicated.  Yet the same principal for mental preparation applies.  This post is for anyone out there wanting a VBAC. And I’d like to point out one of the biggest mental road blocks that may come up along the way.

As I’ve worked with many clients facing the exciting and sometimes unknown territory of their trial of labor, they begin to hit the “Wall of Comparison.”  Unknown-1

  • “This is exactly where I was with my last pregnancy when ____________”
  • “See, I remember doing this last time.”
  • “I just don’t think it’s going to be different since my body did this before.”

This wall of comparison can happen during your pregnancy and rear its ugly head while in labor.  Every time you reach a milestone in labor (dilation, station of baby, hours of pushing) you may be tempted to hit the wall.  And mentally when you hit that wall you have to break through or you may become defeated and possibly lose hope in your desire for a VBAC,  But I believe that a mental “flip the switch” is in order.  Adopt this simple phrase and philosophy: “Different day, different baby’

The one thing I would never want to do is assume I know the future.  I don’t know how your trial of labor is going to turn out.  But I am pretty confident in this: your body is not broken.  And each pregnancy is different from the last.  Each labor will be different from the last.  And mentally recognizing that whatever your pregnancy or birth looked like the last time does not mean it will automatically happen again this time: different day, different baby.

Think about that: Different day, different baby.

Different Day: Each and every birth comes with its own unique variations of normal.  Or even anomalies.  You are literally giving birth on a different day.  Hats off to you if it happens to be another Wednesday, sunny and a red car passed you on the way to the hospital “just like the last time.”  You need to buy a lottery ticket on your way back home.  But overall, you may have changed doctors, hospitals or even learned so much more about birth in between your last birth and this one.

Different baby:  Each and every baby comes with their own unique variations of normal and intricacies.  This time your baby could be in a completely different position, tolerate labor differently or even decide to show up faster or slower. And just as you will soon realize as you raise these babies, no two are exactly alike.  The same is true in birth.

My hope for you is that you will see the beauty in this pregnancy, even as you process the last one.  I hope that as you approach your guess day, you will be able to marvel in the variations of normal as you learn afresh how to trust the process of how your body is made to birth your baby.

When you hit the wall of comparison you can push through it (see what I did there)  as you focus and repeat to yourself:

Different day, different baby.

***Please understand that there are times where chronic health issues, as an issue of genetics, are what prevent a trial of labor and in those circumstances I would never glibly assume that it will just be completely different subsequently.***

Happy Birthing!

Rachel Garcia

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I love my job!

I went to a Postpartum follow up visit this morning.  There was a sweet moment when I looked at this picture and realized that I was a part of all three of these girls births.

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I don’t know that I have words to describe how honored I feel to be invited into a birth.  It makes me insanely thrilled to be invited back, as well!

Happy Birthing!

I don’t want to get to the hospital too soon.

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Getting to the hospital too soon is likely at the top of the concerns list for most moms. Obviously, not getting there in time is also worrisome for those not planning a home birth. The goal is to get there at just the right time where you aren’t completely uncomfortable in the car and certainly not walking in at 2cm’s.  

But yet, it happens. You start labor. Excitement is in the air. You feel every tightening and eventually the contractions turn from a tightening to a tinge of pain with it. Either the timing or the intensity of the contractions convinces you that you are, in fact, in labor. You’ve been told that contractions lasting five minutes apart for a minute or longer is worthy of heading toward the hospital so of course if your labor starts out with contractions 2 minutes apart that must mean this is gonna be intense!

You labor for a certain period of time (hours or half a day) convinced with each passing contraction that it is getting close to time to get in the car. You make the uncomfortable ride to the hospital. You are in control (or not) and breathing well (or not) and tell the staff “yeah, they are pretty intense.” And then they check.  2-3 cm’s. What? How is that even possible? I’ve been contracting for hours (or days).  

So what transpired that makes this a common occurrence? And can it be prevented, and if so, how?  

One of my birth mottos has long been “Natural Birth is 90% mental preparation and determination.” But what does that have to do with getting to the hospital too soon?  As you may know, labor has three emotional signposts: excitement, seriousness and then self-doubt.  Each marking a portion of your labor and cervical progress.  But because there are mental factors in play, I believe that what we expect  can greatly effect our perceived pain during each of those signposts. I’ll explain. 

1.  There is an expected time frame. We have often been told “call the doctor when you are five minutes apart lasting 60 seconds or longer for an hour apart.” Well, that’s all well and good, until you realize not every labor is the same.  Some labors start out with contractions 2 minutes apart and throws mom and dad for a loop because, while they are not lasting a minute or longer, they are sure 2 minutes apart is of extreme importance. We have to remember that there are many variations of normal. And starting with contractions that more frequent than expected is not the whole picture. 

2.  We really want for this to be ITLook, I get it. I’ve been there. I am so ready to be in labor that I am very aware of any small tightening going on and any slight discharge that is there (or not there).  We want so badly to believe that early labor signs are worth our focus. It’s only logical to assume the only way to know when they are “five minutes apart for an hour” or “5/60s/60m” is if we are timing contractions as soon as we notice them. But this is only contributing to the problem.  We mentally tell ourselves: “Labor is work. Therefore early labor is still labor. Thus early labor is work as well.” This means we feel the need to practice our relaxation as soon as those first contractions start.  While this is good in theory, it can cause our mind (the 90% mental I mentioned) to believe that these contractions are worth the focus.  And when focus combined with sheer desire for this to be IT combine, it can lead to believing something is more intense than it actually is.  

So what do I suggest? What have I suggested to mom’s before who are experiencing all of the above? I tell them It’s time to FLIP THE SWITCH!”

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 It is time to flip the mental switch. If you arrived at the hospital at 3cm’s in some intense pain, no one is going to tell you that it doesn’t hurt. It very well does. But it doesn’t have to. Flip the switch. Tell yourself these contractions are nothing to you. In fact, its not active labor. These are contractions that are easy for you. And no, they are not worth timing. Are they the beginning of labor? Yes, they likely are. But you do not have stay in that mental place that this is too much or too hard “even at 3cm’s?” No.  And your support team can help you get to that mental/emotional place.  

If you are ready to say some choice words to me, let me give an example.  How does a mom go from walking into the hospital at 2-3cm’s convinced that she “has got to be super close to pushing her baby out” to completely relaxed and looks like she’s sleeping 6 hours later at 6 cm’s? She has flipped the switch, found her rhythm and is mentally on top of her contractions.  Maybe she went home and decided that she would focus more on rest and relaxing than on timing her contractions, or “practicing breathing through them.” She determined that she could ignore the irregular contractions and trust that she would know when it was time to go the hospital.  That is why us doula’s will remind mom that early labor means still following the pattern of the day: if its daytime when early labor starts, continue your daytime routine and if it’s night time then go to sleep. Why in the world would we say that? So that you will know: these contractions are not worth your time.  When they get longer, consistently and make you focus (rather than you intentionally focusing) that is more like it! 

I understand, nobody wants to be told that what they are feeling should be ignored, but the mind is a very powerful thing.  And our pain receptors respond to messages from the brain.  It’s time to flip the switch on early labor and understand that early labor is the beginning . . . not (always) the culmination of it. 

Let me give you a personal example.  

I was getting a pedicure when my contractions (that had been off and on for 2 days) seemed to get longer and stronger.  I was refusing to time them but the trigger was when I noticed, during a contraction, how badly I wanted to “shush” the lady painting my toenails. So I went to the doc to get checked.  Turns out I was 8cm.  But this was me at 8cm’s: 

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Why am I talking on the phone chatting it up with my sister?  Was I not just wanting to shush a lady painting my toes? I got to the hospital at 8cm’s but when my doctor said “Well you are 8cm but he’s still really high, like -3 station.  I don’t want to send you home at 8cm, but you have a while to labor him down.”  That completely “flipped the switch” for me.  I have time.  I need to chill.  These contractions are not a problem.  Also, it’s important to note that my water was still in tact and the contractions subsided in intensity while in transit to the doctor and from the doctor to L&D.  

But here is my picture a couple of hours later.  Ruptured water, double peak contractions.  I am definitely in self-doubt.  Having to use every ounce of focus to not give up mentally.  While there was only the difference of 1cm from this picture and the one above, the contractions were completely different. The measurement of my cervix does not give the complete picture that helps to explain where we are in our labor.  

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At this time let me stress a very important message: if you end up at the hospital and are found to be at 2-3 cm’s there is NO SHAME in that. Take that as your mental cue to FLIP THE SWITCH and then sit back and watch how things change.  Rest, relax, find your rhythm and enjoy the birth day! 

Happy Birthing! 

I have a new website!

If you are reading this, you are already aware.  And it only took me 6 years!! I am so very excited to finally have all my info, blog and details all in one spot.  Sure you can still find me on Facebook, but this makes me “official,” right? 

Considering that I had to spend half a day setting this thing up, I am hoping it will motivate me to post more.  But I have a few reasons that it may not happen: 

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So yes. That’s a shameless plug to add some adorableness to this post.  

And thank you for stopping by!  Looking forward to some amazing births coming up to finish off 2014!! 

(Let me know about all of your 2015 bebes, so we can get you on the calendar!!) 

 

Happy Birthing! 

RG

A VBAC victory!

The emotion of the moment . . . when a mom who has been told her “pelvis is just too small to birth her babies,” finally proves them wrong . . . well there is simply no more empowering moment than victory! Great doctor and amazing nurses completed the “dream team” all knowing what this momma was capable of. Abby, you ARE strong. And your hips are beautifully made! 🙂 Congratulations on your unmedicated VBAC and on your precious baby girl, Anne Francise. She is a doll! 
 

 

Childbirth Class Outline

Here is an outline of my six week childbirth education class. It meets for six weeks, one day a week for two hours. Please email me at eljeep@yahoo.com if you are interested in signing up for an upcoming class. You can also find my facebook page here: Sweet Birth Doula Services.

Class 1:
*Lamaze approach to birth
*Anatomy/Physiology of pregnancy
*Emotional changes during pregnancy
*Nutrition during/after pregnancy, Comfort during pregnancy

Class 2:
*The importance of birth memories and satisfaction
*Addressing fears
*Confidence in your body, support, place of birth and care providors.

Class 3:
*Anatomy of labor: physical and emotional response.
*Six ways to progress in labor
*Hormonal orchestration during labor/postpartum and it’s importance.
*Pre-term labor

Class 4:
*1st stage of labor
*2nd stage of labor (pushing and birth)
*Physiological 3rd stage (anatomy and emotions)/ Delivery of Placenta
*First hour after birth and it’s critical role for mom and baby.

Class 5:
*Fear, tension, pain cycle.
*Medical pain management of labor
*The role of pain
*comfort measures to decrease pain
*Interventions

Class 6:

*Unexpected outcomes
*Birth plan: do I need/want one?
*Breastfeeding 101
*Postpartum: support and planning
*Newborn behavior and expectations

Blogging. What’s that?

It’s been a while since I’ve posted to either my personal blog or my birth blog. What started out as a personal sabbatical turned into life, and lots of it.

 
It wasn’t until I was at a birth two days ago and one of the sweet nurses passed me in the hall and said, “Hey. I just subscribed to your blog,” that really made me say, “wow. Someone is actually reading it still?” Then I felt sad. Because I really do enjoy blogging. I just hadn’t put it at the top of the list of priorities. But now that my sabbatical has helped me learn some balancing in my life.. I feel as though I may be able to pick it up again.
 
As you have seen, there hasn’t been a birth story in a while on here. Although, I can assure you that I have been so several births since the last birth story post.
 
I got very overwhelmed with three births back to back that I was unable to catch up. It would have put me in the grave (or much worse, neglect my duties with homeschooling and home) to be able to whip those out. So in the future.. you may not see as many birth stories. Or at least not in the way they were written in the past. I know, bummer.
 
Well, I hope everyone is well!
 
Happy Birthing!