 Recently for the Bakersfield BirthNetwork, I was presenting on comfort measures for birth. Expectant families, as well as doulas, come to these gatherings, and I love being able to offer information that is not only helpful to parents, but also information other professionals can take to their clients! As a Lamaze-certified Childbirth Educator, I am always putting together ideas in an unusual way to help make learning about birth fun! The inspiration for this started when I had a few ideas I wanted to squish together into an activity: 1. Update the stages of labor to reflect an additional pre-labor phase at the onset of the first stage 2. Scaffold the stages/phases of labor by choosing and practicing supports meant to intertwine with the key emotional and physical events occurring 3. Provide a handout which not only helps visualize the opening of first stage, but also serves as a cheat sheet to labor happenings, timing, and ways to cope What I came up with, I call the "Spinning Circles of Womb." Just kidding, I don't. But I think it works, and it's pretty simple, and that's all that counts -- no frilly title needed. Basically, here are the supplies:
 I can't remember a time when I sat participants at a table, but for this activity we did, indeed, sit at a table. Surrounded by Mr. Sketch Markers, paper circles, and stickers, I began to share the stages of labor by tacking three sheets of (laminated) paper onto the wall. There is relief when an expectant parent realizes there are only three stages of labor (I did have a dad once who suggested there were 14, but that was his lucky number, and I asked him to take a guess!). Three. That's not hard to remember, right? Then I tack up two more papers, which you can see below, right. I share how some genius decided to break the first stage of labor up into phases, which is another word for, let's just insert more stages into this stage and call it good.  On the front of the circles we write things like average length of that phase, approximate cervical dilation achieved, contraction action, and more (note: I don't show all of that in the picture). The pinnacle of this is affixing the face sticker to the appropriate phase, as a handy visual reminder of what a laboring person might be feeling in that moment. While we are moving through the phases with markers and stickers, we are also brainstorming what comfort measures might be beneficial at what time, and those are added to the back of that circle. We practice these comfort measures as we go. If we expect people to feel comfortable with different physical ways to counter the strong sensations of labor, we can't expect them to get there from a picture alone! Would you step into a ballroom, ready to dance in front of judges, simply from pictures you saw in a book? We need to actually show families what these positions and movements look like, how they feel, and when they help -- or they are of no help at all.
 I use marker to write on laminated sheets as needed; I also include a wheel of what helps in labor. At the close of this activity, families walk away with their concentric circles of information, a piece of pool noodle, and an information sheet which shows about 20 different physical positions of a laboring person and partner working together.
Not a bad way to merge my three goals! A handy takeaway that can be utilized easily during birth.
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!
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!
I finished another project I am so excited about! I wanted to put to pictures these 20 ACOG statements that came out in March with the goal to avoid a woman's first cesarean. Now some asked why the images didn't exactly match the recommendations. All I could reply back with was, some of these things, you wouldn't want to see in pictures, either because they would be boring, or because they would be graphic. But more to the truth is, I wanted the pictures to represent patience...we need to be more patient with labor. We need to give moms and babies more time to perform this task. I am so grateful to all the families, doulas, and photographers who shared pictures with me -- the response was overwhelming. Because the focus is on preventing the initial cesarean birth, I am pleased that some of these moms are shown laboring toward what ended up being successful VBACs! Patience is the key. Many of these are based on evidence that shows with more time, a woman can birth vaginally. And speaking of time -- research shows it can take 10-17 years before new evidence is implemented into practice. If we familiarize ourselves with these new recommendations, we can be the driving force behind ensuring the care we receive is current when our caregiver might still be doing things out of habit, comfort, or custom. Let's spread the word!  Pin these! Help raise awareness and get this information out there into the hands of the families that need it. The goal is to educate families, so they can enter into their providers' offices knowing what ACOG now recommends.  Stay tuned for August's adventures in celebrating World Breastfeeding Week and Breastfeeding Awareness Month. Like my Facebook page for resources that can be used by educators, doulas, and of course, breastfeeding mothers!
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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
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