Maternity Classes

My husband has been an ideal partner during pregnancy, caring, involved, and interested. He is like that in all facets of life, so it’s not really surprising. He was the driving force behind our decision to join our prenatal group, and this group has shown plenty of men who make stereotypes of how men behave in pregnancy outdated. At the risk of sounding mushy, I have a bit of a crush on my guy.

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We took three classes: (1) preparing for birth naturally seven class series, (2) safe start (infant care) one class, and (3) surviving the first month one class. I give a brief description of each class and then my favorite tip from each class below.

Preparing for Birth Naturally (Birthing Series)

A six-week class series, that ran for two and a half hours from 7-9:30 PM every Tuesday. The series included positive birthing positions, breathing, and relaxation techniques. This class explained all medications, interventions, tests, and cesarean options but focused ways to minimize or prevent the use of medications and intervention during childbirth. Only our birthing center holds this particular series.

Class 1: Introduction

After introductions (names, due dates, baby gender, cravings, our own birth story, and our partner’s birth story), it was instantly apparent how different this group was from my prenatal group in their perception of this life event and their empathy/sympathy towards other women experiencing this exact same event, literally alongside them. Let’s just put it this way…one woman in the group had mentioned she was craving vinegary items and really enjoys the taste of mustard, a second lady then leaned over to her partner and said loudly, “that’s the dumbest thing I’ve ever heard.” I was so appalled.

My husband and I ended up remaining silent during session while the others puffed over who was surviving the most unbearable pregnancy. Thankfully introductions ended, and the rest of the class was a brief introduction to labor, birthing positions, and pain management.

Most Useful Information from Class 1:

How one becomes dilated, and what a contraction is actually doing

Despite cursing my uterus pre-pregnancy for my menstrual cycles…I have to say, I am completely in awe by it. It is a powerful muscle that stretches to 20 times its original weight, and holds within it 1,000 times more than its original capacity…and at the end of all of that stretching and holding it does the most extensive work of its life.

Not only that, it’s the only muscle which exercises itself (abs…c’mon…look at uterus over here…you’re slackin’), and the only organ that creates and houses ANOTHER organ within it—the placenta (an impressive organ in itself), and then they tandem care for an entirely new life. The uterus is also completely goal-oriented, and it kicks everything out of it when it is no longer needed.  My kind of organ!

Besides, your uterus holds a doctorates degree, evidenced by the fact it’s in charge of dosing out the good stuff and signalling how much of what hormone to prescribe for each stage of pregnancy to prompt the next stage… plus, the rest of the body just makes way for the uterus when it decides to come to town. #respect

I know a lot of people think the placenta is amazing, and it is…sure…but I’m Team Uterus.

But, I digress…

Vickie (our instructor) showed us the standard diagram of the pregnant woman’s internal organs. She pointed out the cervix and the uterus. We all nodded. Yes, of course.07085_02X

Then she slowly ran her fingers from the cervix around the edge of the uterus, forming a fist at the top. She clenched her fist tightly in a display of tension, and then relaxed her fist. She then repeated this action while she explained that when the oxytocin reaches the uterus this signals the beginning of labor.

The uterus will begin to contract upward (her fingers glided up, away from the cervix) to form a point of tension that the uterus will hold (her fist tightened) and after a period of holding the tension the uterus will relax again (she relaxed her hand), giving the laboring mom a break before the next contraction begins.

Meanwhile, the cervix doesn’t really do much.

Instead, the cervix is being pulled and stretched by the uterus when it contracts (as they are connected). The successful pulling and stretching helps the babies head apply more pressure on the cervix, which has the uterus hollering, “more oxitocin!” The repeated contractions begins to stretch and thin out cervix (to “ripen” or “efface” the cervix) and the uterus builds itself towards the top in preparation to push.

The cervix eventually stretches and thins out enough that it opens (e.g. dilates) enough that some of the amniotic fluid will begin to release. As labor really begins, and the uterus is more consistent in it’s efforts, with contractions becoming more frequent.  This cycle of contracting and relaxing continues to pull open the cervix around the babies head until it can fit through. The ideal opening size is 10 cm (4 inches), which is why they say 10 cm dilated is when the second stage of labor (pushing) may begin.

I found this explanation so helpful, because I realized that I did not truly understand the terms, “ripening,” “contraction,” nor “dilation.” This lack of understanding had made me subconsciously anxious, and learning this made a big part of labor less of an unknown. I was relieved.

Class 2: Stages of Labor

Considering we talked about cravings in the first class, it was no surprise when the instructor brought up other things such as nesting during the first part of class. I had been annoyed when I dared to pine over baby items or research diaper usage to hear, “awww… you’re nesting~!” because I thought … “What? If you DON’T prepare for your kid then you’re irresponsible…and if you do…then you’re nesting?”

Marking “general responsibility” with the new term “nesting” just because one was pregnant is basically worthless. I would not have added it to a glossary.

The instructor went on to explain she didn’t get a “nesting instinct” for her first two pregnancies. However, on her last pregnancy, she became so obsessed with her kitchen floor that she cleaned it twice a day and blocked off the entrance so no one would walk on it. She would stare at the floor for extended periods of time just looking for imperfections to be cleaned.

Now… that is something worth creating its own glossary term for. Hot damn.

cleanallthings

After class, I asked my mom and my sister if they experienced the “nesting instinct,” and my sister said that near the end of her pregnancy she became so obsessed with organizing my niece’s crib that she would leave the door open while using the bathroom just so she could continuously monitor it, and was constantly cleaning or readjusting items around it. …wow #nesting

My mom said she didn’t, she just did general preparation and that she didn’t really understand why people called that nesting because who isn’t going to prepare in advance? Exactly!

Either way, I know my “planner instinct” came from my mom. 😉 A soon-to-be grandma in the class said she didn’t really clean obsessively, but felt instead this sudden surge of energy about a week or so before giving birth. This energy allowed her to accomplish the rest of her to do list.That’s the kind of nesting instinct I want!

Most Useful Information from Class 2:

Leaning forward can increase your odds your baby’s face will point towards your spine

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Apparently, 1 in 4 women have a baby that faces forward (posterior position) instead of facing mom’s spine (anterior position) when entering the world. This posterior position is not ideal as it causes more pain (“back labor”) and extends the length of labor in general. Then in the late 80’s and early 90’s the odds of this posterior position spiked to 1 in 3 women. Why?

According to our instructor, they found that this was correlated to an increase in pregnant women reclining backwards (such as reclining chair in their lazy boy) for most of their birth—especially the later stages when sleeping is harder to achieve. While a comfortable way to sit, this position utilized gravity to move the heavier back-side of the baby to lay against the woman’s spine. So as labor progressed and the available space and amniotic fluid declined, more babies tended to stay in this posterior position at the time of labor.

This can be corrected in labor by leaning forward during to use gravity to naturally twirl the baby around if found in that position during labor—but during labor this is a slow process due to contractions. Our instructor recommended a few forward-leaning positions to practice while we practiced our hip-opening stretches. Hopefully to increase our odds of an anterior positioned baby.

I’m scared of giving birth

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I have watched A LOT of birth videos, in every possible scenario and with every kind of pubic-fro. But, nothing quite hit me like watching a simple and short glimpse of a birth while I was sitting in a class preparing for my own birth. As the four-second image of the baby finally entering the world blipped across the screen, I inhaled in the sudden, shuddering way you do right before crying. It was then I became aware of my increased heart rate and the fact I was crushing my husband’s hand. I never had really comprehended before just how far away my mental preparation was from the reality of birth, despite all the videos, the books, and the self-assurance that I was really more concerned about postpartum than labor.

Massage is amazing

The birthing support person does a lot of work, which is nice to experience before actual labor overshadows this fact. Our instructor showed our support person how and where to apply counter-pressure to relieve certain pain points, how to massage and where… side note: the meaty part of someone’s palm simply applying pressure to your own hand…amazing. We’re saving that one for Valentine’s day. ❤

Considering the massage and relaxation portion of the class was a good 30-45 minutes, and my husband so gently dedicated his attention to really learning the correct moves, I felt a great deal of reassurance and trust towards him, which was a nice bonus.

Class 3: Medication and Intervention

I have spent much of my current pregnancy defending and doubting my birth vision. An exhausting endeavor. As many pregnant woman discover, your “it takes a village” group tends to be highly opinionated about pregnancy, birth, child rearing…and those assertive opinions, reactions, or attempts to convince you to change your mind, feel more like backlash.

As the anniversary of the first pregnancy ending looms and has a serendipitous alignment with the completion of Baby D’s 37th week of gestation… I realized that I no longer care about another person’s birth reality. I’m not going to spend my time trying to defend my birth vision because of someone else’s few [or no] experiences. Most people chose the best option available to them, in their facility. Birth visions are just that, visions, they change to accommodate the circumstances of reality.

It’s possible these naysayers simply didn’t have the choices available at their facility that I have at mine.

opinionsQuack, quack!

  • A tub birth? Hospitals DO NOT have tubs *audible scoff*
  • Have you’ve been lying about going to a hospital? Are you going to a real hospital?
  • Midwives are hippy thing [sad emote face].
  • Wait… are you giving birth at home?!
  • No epidurals in the tub?? You won’t survive!!

…and sitting in a drown-able amount of birth water with a tube sticking out of my spine and no ability to use my lower body sounds like a safe and sanitary thing for a hospital to allow?

  • Are you sure your hospital is a real hospital?

Y’all…

10818617_10152519902918517_1333044878_nThe banner my hospital posted which [finally] stopped the routine question of, “Are you going to a real hospital?”
I am just giddy with anticipation at all the thoughtful parenting advice I will get.

When I no longer felt the compulsion to defend my own choices (whether in birth or child rearing) it was a moment of relief to finally reach that point.

fuck-you

I do continue to dislike absolute statements about pregnancy, labor, or child rearing, because they all sound like this to me:

“I would NEVER or ONLY [talk in generalizations, because I lack the empathy/experience/knowledge to understand what I’m saying].”

No one gives you a ribbon for going epidural free, or wanting to go epidural free and realizing you would have a better birth experience with an epidural, or needing a c-section, or birthing in a corn field…everyone gets a helpless infant. An infant that took roughly 40 weeks until those laboring moms get to even touch the feet that have been kicking them for months. Seriously, we need a PSA to stop harassing moms over utilizing the tools available to them at the facilities they have chosen to give birth in.

Most Useful Information from Class 3:

Internal fetal monitors are kinda horrifying

Okay, that is not how she described them in class. She simply said, “the internal monitor is inserted into mom, and is then affixed to the baby. It provides better quality information about the baby compared to the external monitors.” She then passed it around the room.

internalmonitorcloseYes, that is a metal coil at the top.
Guess how they keep it affixed to the baby.

“Is this [flicks metal coil] how it attaches to the baby?”
“Yes, it is twirled to affix into the skin on the babies head so it doesn’t fall out during labor.”

Your water does not need to break in order to give birth

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For some reason, I just took it as standard birth procedure that your water must break or you are unable to give birth. Not true!

If the fluid has pooled in such a way that it is preventing the baby’s head from applying enough pressure on the cervix, then it may be beneficial to pop the bag of waters if it has not done so naturally. Our instructor said many births (at our birth center) go without the bag needing to be broken and it is very fascinating to see a baby born still floating inside its bag of waters.

She then passed around the amnihook, which looks a little like a long crochet hook.

I wish my birth center provided nitrous oxide (laughing gas)

painreleif-400x300Is this lady even pregnant? Doesn’t matter, I still want what she has…

About 80% of natural births in UK, Australia, and New Zealand include laughing gas to take the edge off labor pain. Unlike the narcotics and steriods available at most US facilities, it apparently doesn’t reach the fetus—just gives mom a nice high. My kind of hospital-booze!

Some facilities in the US (even a few near me) offer this. Apparently there has been some trouble controlling how the “continuous spray” aspect when mom drops the mouth piece away and others in the room enjoy the spray. Which kinda makes me laugh, but also makes me doubt the effort to implement this solution…as that seems like a very slight problem to overcome—and certainly those 80% of birth in the other countries figured it out. Or those are the happiest birth centers on the planet.

Oh well, the future of birth in the US. Ladies, enjoy it for me.

Class 4: Cesarean Birth & Tour (and Doulas, yay!)

This was actually our second birth center tour, it occurred 30 days prior to our due date–a kind of notice of eviction for our son-in-progress. There were even more rooms available this time (both tub rooms, and one shower room, plus one post-partum room vs one tub room). This made me feel even better about my chances of getting a tub.

The postpartum rooms were oppressively small, and I would recommend checking out a postpartum room in advance because I was thinking, “I couldn’t have my whole family in here.” But, we don’t have family in the area, so it doesn’t really matter for us.

carousel-ballfrom doulamatch

We also got to meet with the person in charge of the free doula program our hospital provides, and she got to explain what a doula is and what their role is during labor. I had already put “I want a doula” on my pre-registration so I am hoping a person will be available.

Doulas are a skilled, labor support person who can help you and your support person (my husband) through labor–particularly a medication-free one. She explained that even if you already know you want an epidural, a doula can help you through your laboring up to the point they when the hospitals allow you to have an epidural—which isn’t until you’re further into labor anyways.

Doulas also give my husband an opportunity to take a pee or eat without feeling like he would be leaving me alone. I really want a doula.

Then we watched a video on ceseareans and practiced some more relaxation techniques.

Most Useful Information from Class 4:

You cannot use the tub if you’re less than 37 weeks of gestation

I discovered that my hospital won’t let a laboring mom use the tub if she is less than 37 weeks (as you’re still in NICU range) so I crossed my legs to ensure baby D wouldn’t do anything crazy. 😉

Cesareans are scary

I am not against cesareans, but I think they are scary as hell. The sight of the operating room in the birth center makes me want to faint. I am choosing to give birth in a facility which offers cesareans, narcotics, and many other aspects of birth circa 2014.

However, the hospital I’m giving birth in also has a 1 in 5 cesarean rate, a rate total which includes high-risk pregnancy’s, previous cesarean pregnancy’s (who don’t want to do VBAC), and the legitimate unplanned cesareans that all combine together to total ~18% of all births in the center. There is no foreseeable reason I would need a cesarean, but it’s a potentiality that remains to scare the living baby out of me.

Our instructor talked about how at many hospital’s unplanned cesareans are done simply due to delay (ex: the standard length of pushing is X. “Mother has exceeded X, therefore we need to perform a cesarean as she isn’t making adequate progress”), and that while the cesarean rate in the US is 1 in 3, this statistic includes hospitals with a 70% cesarean rate. Hot damn.

The 1 in 3 statistics for cesareans excludes the free-standing birth centers (e.g. not in a hospital)—these facilities tend to have a 4% cesarean rate (e.g. they transfer to a hospital for a cesarean for 4% of birthing women)—however, these facilities deal with low-risk pregnancies. Despite this, I think 4% is a nice statistic because it shows that, realistically, only about 4% of low-risk pregnancies really should result in an unplanned cesarean.

Class 5: Positive Positioning

This is the “natural birth” part of course, and the part that makes it different from this series offered at the other branches.

Most Useful Information from Class 5:

I prefer the birth ball and the bean bags compared to a chair.

We tried around 12 different laboring positions while practicing relaxation and breath exercises. She also provided some easy-to-make relaxation tools for the support person to use, such as two tennis balls in a small sewed bag as a massage tool, and a cold small can of soda, and heating and cooling pads. Aside from loving the 2 hours of free massage, I got a good idea of what positions I just don’t like, and what items I think will be more successful.

A bag of flax seeds with essential oils in them… (1) smells awesome (2) stays warm for much longer than the bags of rice. Off to Winco’s bulk section I go…

This class also made me expand the list of items I wanted to include in my hospital bag.

She gave us a printout of the positive positions she taught us in class that day, and suggested we make a note of the ones we liked the most because it will help us quickly go to just the ones we liked vs. saying, “I think this is the one.”

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Class 6: Post Partum

This class went over the items our hospital was going to give us, and what they are used for, also some basic things to expect for post-delivery in terms of newborn care. The second half of class a pediatrician came in and offered more detail about newborn procedures, and we were able to ask her questions. Most questions centered around circumcision, breast feeding, and GBS.

We then played a postpartum jeopardy and I won a chux pad to protect my mattress from my water breaking (or my car seat if I happen to not have my water break in bed). I was thinking these would be nice disposable bed liners for the crib, but then decided to just use the washable ones to save the environment. My husband won us some chlorine-free disposable biodegradable infant diapers.

Most Useful Information from Class 6:

Breastfeeding is harder than it seems

Lactation consultants exist for a reason, and basically my biggest take away is that it’s worth me looking up information on this to have some names on hand. Also, they are not covered by insurance! What? Oh well. They are about 100$ according to our instructor, which would likely be our bill anyways after insurance.

Circumcision was poo-poo’d by the American Society of Pediatrics until just recently

I found this fascinating, because it seems like many people intend to get it. It was absolutely not recommended until very recently. Now it is simply not considered medically necessary, but they acknowledge that the benefits slightly outweigh the risk of surgery. Circumcision isn’t a common procedure in India unless medically necessary (paraphimosis) and the general stance being it is genital mutilation (which, if not medically necessary, would be). Also, if your child is over 1 month old, they must be put to sleep to have this done.

The obvious next question was how beneficial are the benefits. The pediatrician said the difference (statistically) is very minimal, because we teach kid’s good hygiene.  Circumcision came around as a way to prevent urinary tract infection for men, when showering and good hygiene wasn’t common–and the medically necessary reasons, are quite rare.

Surviving the First Month (Infant Care Class)

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A single two and a half hour evening class that shared information on normal newborn appearance and behaviors, crying, comforting skills and how to cope with little sleep. My husband didn’t show up until half-way through because he missed his commuter bus home and so one of his co-workers dropped him off at the class during the break. He missed the DVD which no one has flicked and pirated onto youtube…so you have to buy the damn thing! Grr! It was SO useful.

Think of it as the DVD you want to watch before you need to use The Happiest Baby of the Block techniques.

Most Useful Information from Survival class:

Baby’s eat for 9 hours every day

No typo.

Babies eat 10-12 times a day, and it takes them about 45 minutes to consume their food. This is 9 hours of just eating. This lasts for about the first 6 weeks of life as babies jaws and facial muscles gain strength and they can more efficiently eat food and then it goes down to around 30 minutes per feed.

Then they pee/poo about 10-12 times and new parents take about 10-15 minutes to complete this task (from realization of a needed diaper change to completion of said change), about 2-3 hours.

We’re now at 12 hours of just poo and boob. Good thing babies don’t need baths, clothes changes, comfort, or tummy time. Then you’d really feel pressed for time. I have a shower to take and a nap to enjoy.

Is “just nap when they nap” really an insult? I assume people say this to new parents over the top of their napping infant while said parent is out shopping or entertaining the advice-givers company. “Excellent advice, let me just push this lettuce out of my way and get right to it.”

At least I understand why new moms keep saying, “for the first six weeks I felt like all I did was keep the baby alive.” Because that sounds basically accurate.

Baby sleep cycles

It was AMAZING to see a baby in its light sleep pattern. It literally looked like it was about to wake up. Let the child sleep. This was on that H.U.G. DVD my husband missed…90% of what was useful in this class was on that DVD…and he missed it!!! Argh! 36$ for a DVD… why do they not have it on Amazon? I hate Paypal… *sob*

Baby’s crying pattern

newborn-crying

It was helpful to know it peaks around 6 weeks after the due date. Which is approximately when people say their kid has colic or purple crying

Don’t schedule feeding, track feeding

This may be a “duh” thing; but, many books and apps recommend scheduling this. They tell you how often to feed your baby. The instructor, a pediatrician, said she’ll often have patients come in complaining their child [infant] isn’t following the food schedule and screams all the time. Because if the child is hungry, the refuse to feed until a specific time.

She shows them how to notice when the baby is hungry, and encourages them to create a “custom schedule” by tracking when their baby is hungry and a natural pattern will emerge. Problem solved. The babies are no longer starving, and screamed less as a result.

I had downloaded three baby tracking apps, and one of them is the “It’s time to feed your child now, human” kind. This had made me confused as to whether or not I should schedule such things, I had heard about creating routines and schedules, so it seemed logical enough if there was an app for it. Despite it seeming like common sense to just feed a hungry baby. So I’m glad she touched on it in class.

Baby powder is bad

Baby-Powder

Did you know that baby powder is not recommended anymore?! The instructor shook some over the bum of the plastic baby and the fine little cloud came out as expected, a familiar scent in the air. Despite how far away I was sitting. I had some baby powder at home, and they still sold it in the baby aisle and in gift packs, so I was annoyed.

After class, I went home and grabbed my bottle, turning it over— and there was the warning, “do no allow baby to inhale…can cause breathing problems.” with a little X over the image of a baby head. I thought again how far away I was sitting and how I was still able to catch the odor . So I threw the powder into the trash. Johnson & Johnson… for shame.

A valuable question to now ask: how do you prevent diaper rash? Answer: You give “air time” to air dry the baby bum, and then ensure the baby’s skin is dry either due to their own urination or because you cleaned them.

Tummy time for play, back for sleeping

Babies seem like they are under constant threat of SIDS. So many statistics! For instance, there is a steep increase in SIDS among infants who are allowed to side or stomach sleep. When they are strong enough to roll over, they finally achieved the ability to save themselves, so you don’t have to move them onto their backs constantly.

The instructor, a pediatrician and grandmother, warned against allowing any child care provider (grandma’s included) to be wishy washy on this subject. She had seen enough SIDS cases due to this.

What I didn’t quite realize was that the longer the (awake) infant can stay on their stomach the better it was for their motor skill development in the long run. When awake, the baby should almost always be in a tummy position, as children who don’t get enough tummy time tend to be delayed with rolling over, crawling, and walking. Their entire life goal the first year is to basically wage war with gravity, and tummy time helps them accomplish this.

Safe Start (Infant Safety Class)

A single one and a half hour class that discussed how to provide a safe environment for an infant, infanct CPR (practice on infant mannequins), car seat and home safety

Most Useful Information from Safe Start class:

How to perform CPR and how to remove an obstruction

While I didn’t find much of this course useful, how to perform CPR on an infant was—even if I never ever use it. It’s very useful to go through the steps to know how much pressure to apply, how to breath, when to remove your mouth, the difference when their is an obstruction (choking), etc. and how to handle the emergency, etc.

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