Stacie Bingham: Birth Support in Kern, Tulare & Kings Counties
  • home
  • learn
  • birth
  • feed
  • meet stacie
  • blog
  • growing me

Cascade of Interventions AKA Magic Nesting Boxes

9/23/2014

3 Comments

 
Picture
The Cascade of Interventions is a typical topic covered in childbirth classes. I don't want to say it's like the Domino Theory of Communism,a logical fallacy known as "slippery slope," but it...it kind of is. As moms, doulas, educators, and birth workers, we often can recall someone's "cascade of interventions" story. The important thing when it comes to teaching is to help students understand that the use of an intervention doesn't mean a woman is fated to the "next" likely step -- with education and awareness, she and her partner can be work to avoid the common pitfalls a specific intervention might bring. Basics:

  • I like to use story-telling in many childbirth education activities. Roger C. Shank, a cognitive scientist, said: "Humans are not ideally set up to understand logic; they are ideally set up to understand stories." I feel this is an effective way to help participants relate and remember bits of information, versus throwing factoids at them. 
  • I have a set of 12 boxes, that when stacked reach over my head (and I am 5'5"). I bought them at Costco about 7 years ago with this activity in mind.
  • I have a 12-step story with each step written on its own slip of paper. The first part of the story is in the smallest box. Step two is in the next size up box, etc. I put these under students' chairs before class.
  • Parents offer their boxes as size/story dictates, read their part of the story, then stack their box. In reverse-size order we see how even though the small box was no big deal, as the stack increases, it starts to teeter, and it might even fall. I ask a partner to be in charge of holding the stack up while we finish the activity.
  • This story starts with the tiniest box in my nesting collection, and it is a benign "intervention," one we might not even consider when looking for offenders: external fetal monitoring. The story ends with breastfeeding being interrupted -- of course the worst thing we generally think of within the context of normal birth situations is cesarean birth; I felt that was an obvious choice. When it comes to cesarean birth, I feel it can be easy for participants to think, "That won't be me," whereas breastfeeding interference seems an idea we can open our ears to.


The story I use:
  1. EFM: Jamie arrives at the hospital at 3 cm woth contractions about 5 minutes apart. Jamie's coping method is bouncing/swaying on the ball. Once in her room the nurse wants to get a reading on her baby and requests 30 minutes of EFM to get a 'baseline" on baby.
  2. limited mobility; increased pain/anxiety Jamie's limited mobility means she is no longer able to sit on the ball through her contractions. Her contractions become more intense, and this starts the F/T/P cycle.
  3. pain medication request (Stadol) Jamie is scared about how she can cope with labor if it is going to get worse. She decides she wants to try an analgesic pain medication, which can be given as a shot.
  4. labor stalls Jamie finds although the medication takes away some of the pain, her labor has stalled.
  5. pitocin to speed things up; IV Jamie now needs pitocin to get into an active labor pattern. This means she will have an IV as well.
  6. epidural request As the pitocin increases the strength of her contractions, she experiences F/T/P cycle again. She requests an epidural.
  7. blood pressure drops Jamie's blood pressure drops in response to the epidural.  
  8. medication for blood pressure Jamie gets meds to counter low blood pressure.
  9. maternal fever Jamie has a fever, which could be from the epidural.
  10. OFP affected; baby born via vacuum Since Jamie was not able to be more active, her baby has not had help moving and rotating into an optimal position and needs the vacuum to be born.
  11. baby has fever; sent for observation, possible septic work-up Baby has a fever at birth and needs to be taken to the nursery for observation and possible tests. Jamie and her baby are separated for 6 hours.
  12. separation/breastfeeding affected Breastfeeding is affected.


The bolded statements are being recorded on a large sheet of paper as we read along. After the activity with the boxes, we go through the list and discuss what can be done to avoid or minimize the effects from a specific intervention. This is also the time I hand out basic info sheets about common interventions. 

I hope I included everything? If you have questions, ask! And please "like" my Facebook page to stay up-to-date on the teaching tips I share.

Picture
3 Comments

Make a Mini Pelvis/Baby Kit

9/15/2014

1 Comment

 
Picture
In celebration of getting my DONA recertification in the mail, I decided to challenge myself to see if I could make this creatively and frugally. 

This morning I went to Wal-Mart to peruse the Halloween decorations, thinking there had to be a usable pelvis from a skeleton I could use. I found one I thought would work -- and only one, really, out of all the decorations. I live in a small town, and Wal-Mart is just about all we have; I would have checked other places if I lived with more options, because although this one worked, I would have liked to see more samples. That was the only thing I purchased -- everything else I had around the house.


Materials List:
skeleton with a pelvis
embroidery floss
orthodontic rubber band
needle/thread
fabric
baggie
tape
baby that fits the pelvis
baby sock for uterus

I would use something else for the amnion, but I was grabbing things I had in my house -- nylons might work? Also I would use a newborn's sock, not an 18 months old's sock, for the uterus...you could also knit one. 

If you have questions, let me know! It took me about an hour from start to finish! And it could save you 70+ dollars! Sorry the order is off -- putting them in order this way on the computer makes the mobile version easier to view.

Picture
Picture
Picture
Picture
Picture
Picture
Picture
Picture
Picture
Picture
Picture
Picture

Picture
Picture
1 Comment

Pain is Like a Hot Wheels Car...

9/10/2014

2 Comments

 
Picture
I'm an educator that calls pain "pain." I think that is how most people perceive it. I used to feel the "p" word was bad, and I used all manner of euphemisms to avoid saying it. When you teach almost 2000 hours a year, you hear back from a lot of families. When more than one former student came back asking me why I didn't just call it "pain," I decided to adjust my viewpoint.

I do have an activity where I "break down the pain" into sensations, involving a bucket and water. The intent is to dissect each sensation, that when clustered together, we call "pain." I find it makes the physical sensations we experience more recognizable and less scary. But I digress!

I begin this activity before class, really, when I bring out the Hot Wheels track pieces absconded from my sons. When the first couple arrives, I ask them to put the track pieces together. Once finished, they are laid on the ground, the starting line by me, the finish line at the back of the classroom. 

You would be surprised how happy it makes people feel to see Hot Wheels tracks and cars on the floor of the classroom where they are learning about how to have baby! This is generally class 3 of our 6, when we discuss pain theories and comfort measures. This is how I share the Gate Theory of Pain, essentially, that we can make pain worse (turn it on) or make it less (tune it down) by what we think, feel, and do.

Picture
To start, I lift up the end of the track near me, the starting line, and I let a few cars loose. Unobstructed, they zip down the track like greased lightning (hello, Grease fans!). Then I ask, "What have you heard about, in books or from your friends or family, that helps with labor pain?" People start shouting things out. "Water!" Okay, get your Post-It notes out and write "water" down on one. Choose a partner to come and place his or her shoe under the track, and stick the note on the shoe. 

Ask again. "Massage!" Same thing. Have a partner come, place his or her shoe under the track at a different point, and slap that Post-It note on the shoe. How many people you have here depends on how long your track is. Pretty soon you have something that looks like this the top image, above (except I have them continue to stand while we do the next part -- I was home alone when I made the pictures here and I opted for empty shoes). 

Now repeat the exercise with the cars. Start sending them down (I use 5-6 cars). Some will make it all the way to the end, some will slow, and some will get knocked off the track. What you will see, though, is that the undulations made by the shoes (interference, right? Comfort measures) will compete with the "sensation's" ability to get to the end (the brain). We can make sure the road is clear for those sensations to fly straight up and tell us we are in pain, thereby triggering the fear-tension-pain cycle, or we can "congest" those nerve pathways by throwing in other sensations to confuse our brains about what we are really feeling...enter comfort measures and emotional support! Voila.
Picture
Picture
Picture
Picture
Picture
Stay 
connected 
to 
good 
ideas!

2 Comments

Stages of Labor: Visualizing Dilation

9/8/2014

1 Comment

 
Picture
If you know me in real life, you will know I have a giant shopping weakness (aside from thrift stores): IKEA. I love IKEA. I have a collection of past catalogs about 10 years in the making. Many don't understand the obsession, but there is just nothing finer than looking at cool furniture, being able to eat lunch, shopping for toys, kitchenwares, fabric, pillows -- even chocolate. Everything I like to shop for is there, in a giant, one-way only package with crazy-wheeled carts (and childcare!). 
One other thing about me: I love things that nest. Whether they are baby toys that stack together, measuring cups, boxes, or even Matryoshka dolls -- if it nests, it's the best. I have three different nesting toys that I actually don't let my kids play with...I keep them in the closet with all my childbirth education supplies. 

One shopping trip, probably 8 years ago (I could look in a catalog to see for certain!), I found these boxes. I was attracted to the nesting, of course. But as I looked closer, I wondered the measurements? Might they be in centimeters, oh maybe, 2ish to 10ish? I went to a handy pencil/map/paper-tape-measure station to check it out. The smallest box was about 2ish centimeters, the next box was 3, 4, 5, and so on, until finally the last box was 10ish. Woo-hoo! I bought about 6 sets!
Picture
How do I use them? I most often have them handy to show where each stage of labor kind of starts and kind of ends (I say kind of and -ish a lot, because I explain it is not an exact science, how open a woman may be). Also different sources say different things about dilation -- one book might say frst stage is 0-3ish, while another book says 0-4ish. With the new ACOG guidelines, there is even more to think about! But I like having the visual for all these numbers we talk about.

I also have strips of paper I put in each box, that tell what physical and emotional issues a mom may experience at that point in labor, ways to cope, etc. Sometimes as a group activity I pass them around and we share the stages of labor that way.
The bad news is, IKEA doesn't make these boxes anymore. The good news is, maybe you have an affinity for things that nest and there is a set in your possession? Maybe unlikely. But it gets the wheel turning, doesn't it? To be on the look out for what might work? If you are truly motivated, you could make your own, perhaps out of duct tape? I would love to hear your ideas -- let me know what you come up with! And don't forget to "Like" my Facebook page to keep getting ideas!
1 Comment

Dear Breastfeeding Mom...A Different Way to Teach About Breastfeeding

9/6/2014

0 Comments

 
Picture
I cannot even pretend this was my original idea. I got this from Linda J. Smith's book, Coach's Notebook: Games and Strategies for Lactation Education. In "Who's Glad You're Breastfeeding," Smith offers a list of family and community members who see the benefits of breastfeeding. 

I came across a pack of adorable thank-you cards at the Goodwill for $.99, so of course I picked them up with this activity in mind! I took 10 of Smith's suggestions and hand wrote thank-you notes for moms in the group to read out loud. As a modification, I had them withhold who the note was from and the rest of the group had to guess based on the information shared.

For example, the one I shared in the picture says: 


"Dear Breastfeeding Mom,

Thank you for breastfeeding. Your child's athletic ability gets a boost from better eye-hand coordination and motor development.

From,

Future Sport's Coach."

Smith has a list of 21 people "glad" a mom is breastfeeding, including her partner, her accountant, er dentist, her OB, her garbage collector, etc. After we read through the 10 I created, I asked what other benefits moms knew about that we hadn't covered. We also, tongue-in-cheek (but maybe not?) composed a letter from a mother-in-law to her breastfeeding daughter-in-law -- maybe as an attempt to  imagine what we might appreciate hearing? Nevertheless, it was a fun group activity!

0 Comments

Changes in the Pregnant Body: A Learning Activity

9/4/2014

2 Comments

 
Picture
I said before I am frugal. If I had all the money in the world, I am still not sure I would buy supplies if I could get away with making them. 

In my first class of six, we go over the different changes in the pregnant body. I found these paper ladies at an educational supply store, and immediately I knew how I was going to use them!

I am not an artist, but you don't have to be! I broke down the pregnant body into 9 different regions or topics. In my own interpretation, I drew. Then I glued or taped the baby doll form on the mom. On the back of each lady are the common issues associated with each topic. 

In class, each person or couple gets a lady (depending on class size), and I have an order I like to go in. One by one, participants read from the back of their paper ladies. I check in with the moms, asking if anyone has experienced certain ailments, how she has coped, etc. 

In my curriculum I have extensive back-up material for each of these changes, in case a family wants more information about something. An alternative to the paper ladies but still using the research information is one that always gets people giggling. Once I forgot my paper ladies at home and I wasn't sure how I could offer the information without just lecturing. I decided to have each couple draw their own pregnant lady, and label the issues themselves. Then they shared with the rest of the class. Hilarious -- I have kept some of those drawings. You wouldn't believe how much grown-ups can have drawing stretch marks or hemorrhoids!

The basis of this activity is finding the current information about the physical, emotional, and hormonal changes that happen in pregnancy, and going from there! Get out your markers, tape, and scissors, and start having fun!

Picture
Picture
Picture
2 Comments

Hey, Doll! Or, Where I Buy My "Babies"

9/3/2014

0 Comments

 
Picture
Pictured here are nine babies I use in my childbirth classes. I am cheap -- I mean, frugal. I could have purchased very expensive dolls from a company that specializes in education materials for this purpose. I could have eve gone to Toys R Us and bought them brand new. But being as I love saving money and find it a challenge to see how little of it I can spend and still have a useful item, I decided to scour my local thrift stores. It didn't happen in one day, it took time and persistence, but one by one I acquired these dolls. 

See the one on the top shelf, middle position, with the tattoos on his head? He's my favorite, and I bring him out every week to show a baby's position in the womb, or how a baby's head appears when crowning, or how to breastfeed in a laid-back position. The other dolls only come out in the breastfeeding class.I also purchased newborn clothes from thrift stores so they wouldn't be cold and naked. 

I bet I paid no more than $25 for the whole set. After the class when they are used, I clean their hard surfaces with a Clorox wipe and return them to their cupboard. Once every 6 months I wash their clothes. In "Coach's Notebook," by Linda J. Smith, she cautions about handling dolls as carefully as you would real babies, to model positive behavior for your participants. I have a habit of sitting my little model baby in my lap, facing outward, with his feet crossed at the ankles in a comfy, watching-TV-in-the-recliner position during class. It makes people smile, although a real baby wouldn't sit like that for long.

I have a fake uterus I use as well, also purchased at a thrift store -- but I will save that for another post (hint: it was repurposed from something else). There are some things you will just have to buy, like your favorite DVDs or copyrighted printed materials, so anything you can creatively recycle leaves you more in your budget for the things that just won't budge. 
0 Comments

What's in Your Head?

9/2/2014

4 Comments

 
Picture
One of the first activities I do in class to get to know people is always a big hit. Imagine entering a childbirth class, meeting an instructor for the first time, being in a room full of strangers, and knowing you are going to talk about how babies are born -- yeah, that can be a little bit stressful. Enter the Operation Brain Surgery Head! He looks silly, and he instantly brings us all back to pulling bread out of his basket and butterflies out of his stomach. Maybe it won't be so bad, say the collective grins and chuckles. 

This is the first opportunity participants have to just throw out their worries about pregnancy, birth, breastfeeding, or babies. Everyone gets a pencil and a slip of paper, and the instruction to WRITE! As the head gets passed around, papers get tucked inside the hole at the top. Once the head has made the circuit, each person pulls a strip out and shares -- this offers anonymity. The person who reads the strip offers what advice he or she can, and at this point in the game (being the first class), they often feel unsure of their answers. My Job:  I acknowledge the worry, often offer a brief, evidence-based counter to the worry, and share when in our schedule that topic will be covered in more depth.

There is a secret, though: most of these worries are repeats, meaning, people often have the same worries! This makes my job easier, as I get good at matching worry to class. It also makes the parents' jobs easier, as they see the normal part worry plays in the process of preparing for their babies. I have had students tell me, once they were able to have a place to write their worry down and get it out of their head, it lost much of its power.

Picture
Picture
Picture
How this looks: John pulls a slip and reads, "I'm worried about having a big baby and a long labor!!!" To his credit, he admits already he doesn't know how to answer and looks to me. 

"Labor length is often thought to be related to the size of a baby, but we know the position of a baby is more of a factor. After the break in a few minutes, we will learn about Optimal Fetal Positioning, and what can be done to help get these babies into better positions. Statistically, 
first labors are longer. There are ways to help shorten labor length, such as being active and upright. In next week's class we will get into the stages of labor and talk more about that." 

And so it goes for every worry. If I don't have any information to offer off the top of my head (meaning it was more unusual), I take the break to dig something up. I offer my findings, and I make a promise to find additional sources of information in the coming weeks. My biggest caution is to never leave anyone feeling more worried when they leave than they were before they came. In fact, I ask that at the end of the first class, and I make sure we have about 7 minutes to debrief and digest.

How do I address worries that aren't found in a biology textbook? A worry that comes up almost every time is "money." While I don't have any segment of class dedicated to how a family can afford their baby, I do offer many tips on saving money in almost all my classes. Whether it's finding a doula on a budget (class 3), or skipping the expensive breastfeeding gear (class 5) or unnecessary baby supplies (class 6), I like to think (because I am a cheapskate!), if they are along for the ride, they will get some ideas about reducing their expenses a bit.

This Operation head is likely hard to come by. I don't know, check eBay. But I have seen two at thrift stores -- I bought one to give to my mentor doula and trainer, and I left the other one on the shelf, not realizing probably somewhere out there, it could be a valuable resource. If I ever see another one, I will buy it! In the meantime, I have seen at least two options that would work for creative minds:
Picture
Wal Mart, not sure of price
Picture
Michael's, $4.99
I would cut a hole in the doll above's head, and probably carve out a hole in the wig forms's as well, and add a wig, of course! It's okay to be fun and silly -- it helps put people at ease and keeps them interested. If you have any questions or would like a more detailed outline of this activity, ask. 

Happy silly, effective, creative teaching!

I plan to offer creative tips for educators once or twice a week; "like" me on Facebook to stay in the loop! 

4 Comments

    My Life...

    ♥  four young boys and a boy dog (offspring)
    ♥  partner-in-crime (husband)
    ♥  
    families, mamas, and babies (many of whom are new to earth)

    Categories

    All
    31 Days
    31 Days 2014
    31 Days 2015
    31 Days 2016
    31 Days 2017
    31 Days 2018
    31 Days 2019
    ACOG
    Adoption
    Affordable Care Act
    Anatomy
    Animals
    Anxiety
    Appreciation
    Apprenticeship
    Art
    Babies
    Baby
    Bakersfied Doula
    Bakersfield
    Bakersfield Doulas
    Batman
    Bereavement
    BFHI
    Bias
    Birth
    Birth Center
    Birthplan
    Birth Plan
    Birth Story
    Birth Team
    Blogging
    Bob Marley
    Bonding
    Books
    Breastfeeding
    Breastfeeding Laws
    Breastfeeding Usa
    Breastmilk
    Breastpumps
    Business
    Carry The Future
    Cary York
    Cavities
    CBE DIY
    Certification
    Cesarean
    Chico
    Childbirth Education
    Choice
    Cholestasis
    Chronic Illness
    Cims
    Class
    Clients
    Coach
    Comfort
    Communication
    Competition
    Complications
    Confidence
    Consumer
    Coping
    Costco
    Counseling
    Cows
    Dad
    Dads
    Dancing
    David Bowie
    Death
    Dentist
    Depression
    Dermatologist
    Dilation
    Discovering Doulas
    Distortions
    Distraction
    Doctor
    Domperidone
    Dona
    Doula
    Doulas
    Doula Week
    Dr. Brian Palmer
    Drugs
    Due Date
    Early Labor Plan
    Ecstasy
    Embarrassing
    Empowerment
    Encapsulation
    Enloe
    Epidural
    Espanol
    Evidence
    Experience
    Facetime
    Failure To Thrive
    Failure-to-thrive
    Family
    Faq
    Faqs
    Fear
    Fear Tension Pain
    Fees
    Flu
    Frenectomy
    Frenotomy
    Gratitude
    Greece
    Green Baby Expo
    Handouts
    Hanford
    Healing
    Henci Goer
    High Risk
    HM4HB
    Holy
    Homebirth
    Hormones
    Hospital Birth
    Humor
    Hygeia
    Hyperemesis
    IBCLC
    Induction
    Infant Loss
    Infant Massage
    Insufficient Glandular Tissue
    Insurance
    Interventions
    Interview
    Jaundice
    Journal
    Kids
    Labor
    Labyrinth
    La Leche League
    Lamaze
    Language
    Late Term Preemie
    Laughing
    Leonard Cohen
    Lip Tie
    Liquid Trust
    Lithotomy
    Loss
    Love
    Low Milk
    Mammals
    Masks
    Media Resources
    Meeting
    Memes
    Mentor
    Midwife
    Midwives
    Military
    Milksharing
    Milk Supply
    Mini Cooper
    Miscarriage
    Mizuko Kuyo
    Moms
    Morning Sickness
    Motherhood
    Moving
    Multiples
    Music
    Networking
    New Doulas
    New England Journal Of Medicine
    Notebook
    Notes
    Nurses
    Ny Marathon
    Online Support
    Orgasm
    Origin Story
    Overdue
    Overpowerment
    Oxytocin
    Pain
    Partners
    Passion
    Passion For Birth
    Paula Radcliffe
    Peanut Ball
    Peers
    Photography
    Pitocin
    Placenta
    Placenta Pills
    Poem
    Popsicle Panniculitis
    Postpartum
    Postpartum Support International
    Premature
    Pushing
    Questions
    Rebirthing
    Rebozo
    Reflux
    Refugees
    Reimbursement
    Relaxation
    Resources
    Retained Placenta
    Rights
    Rockabye Baby
    Role
    Root Canal
    Rules
    Safety
    Scale
    Second Stage
    Self Care
    Sexual Trauma
    Shared Decision Making
    Sheep
    Skin Cancer
    Socks
    Solids
    South Africa
    Spiderman
    Sports
    Stages Of Labor
    Stillbirth
    Strong-ties
    Students
    Studies
    Superhero
    Support
    Surrogate
    Teaching
    Teaching Tips
    Teeth
    Temper Tantrums
    Thank You
    The Price Is Right
    Tiara
    Tongue Fu
    Tonguetie
    Tongue Tie
    Tongue-tie
    Touch
    Training
    Trauma
    Trust
    Tulare
    Ultrasound
    Understanding Research
    Vaccines
    Vbac
    Visalia
    Volunteer
    Waterbirth
    Weak-ties
    Weezer
    Weight
    WHO Code
    Writing
    Yoga

    Archives

    July 2020
    June 2020
    September 2019
    May 2019
    March 2019
    February 2019
    January 2019
    November 2018
    October 2018
    May 2018
    February 2018
    December 2017
    October 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    September 2013
    July 2013
    June 2013
    April 2013
    March 2013
    February 2013
    January 2013
    June 2012
    May 2012
    June 2011
    January 2011
    November 2009
    August 2009
    June 2009
    May 2009
    April 2009
    March 2009
    February 2009
    January 2009
    December 2008
    November 2008
    October 2008

    RSS Feed

Stacie Bingham, LCCE, CD(DONA), CBS(LER)

Calm, comfortable Lamaze education & experienced support for pregnancy, birth, & breastfeeding serving Bakersfield, Delano, Hanford, Porterville, Tehachapi, Tulare, Visalia + the World

​661.446.4532 stacie.bing@gmail.com
Picture
Picture
Picture
Photos used under Creative Commons from Renaud Camus, jmayer1129, jmayer1129, Rob Briscoe, jmayer1129, jmayer1129, jmayer1129, operation_janet, CJS*64 "Man with a camera", symphony of love, Aravindan Ganesan
  • home
  • learn
  • birth
  • feed
  • meet stacie
  • blog
  • growing me