 In 2014 I shared an opening activity, What's in Your Head? I use this as a way to help families share their concerns and fears about pregnancy, birth, babies, feeding babies, and becoming parents. It helps folks see they aren't alone in the things that might be keeping them awake at night.  Looking for variation, I recreated this idea with Legos -- little plastic building toys we have amassed numerous buckets of over the years. All of these were pulled from our private collection, although the compromise with my kids was to put them in tiny zippy bags so things wouldn't get lost. The first time I did this activity, I passed the Lego head around and had each person pull out a zippy bag and share what they thought the toys might represent. In my next series, I decided to include a card with a general worry that related to the item in the zippy bag. I had participants look at the item first and see if it reminded them of any concerns they had, and if they were stumped, they could read the card. Then we go around the group and share our items and what they might represent.
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 I recently had the opportunity to be part of a training for a local hospital's BFHI process. I wanted a tactile way for people to feel the differences in palate shapes. Needing the models to be comparable to a newborn's mouth-size, I had the idea of using plastic spoons.   I love Sharon and her creativity, and what an idea machine she is! She is great to brainstorm with -- I lay out all my half-baked imaginings, and Sharon helps plug the holes into a complete activity, or she offers an additional use of something I came up with. When I asked her to share in this year's 31 Days, I had a vague idea I tried to (poorly) convey: "...something about motivating yourself to write when it's the last thing you want to do. How do you come up with creative content, over and over and over?" Well Sharon has figured it out. She took that seed of an idea and grew this amazing, inspiring post, sure to help any new or blocked-blogger out there. As a birth or postpartum doula, writing blog posts may seem like a lot of extra work for no reward, but I would like to suggest just the opposite. Positioning yourself as an expert on topics that come up during the childbearing year is a great way to establish yourself as an up-to-date professional, attract more business and provide resources to your current clients. Many doulas are hesitant to blog or don’t know how to start or what to write about. I have collated 45 tips, resources and potential topics that you can use to get your professional blogging off the ground or maintain momentum if you already blog. 
Blogging can create new business opportunities for you and helps you share your expertise with other professionals, potential clients and the general public. It doesn’t have to take up lots of time or even be done every week. A regular and informative blog can help you to highlight your skills and can be fun to write. I challenge you to write a post and email me with a link, I will be sure to circle back to your blog and leave a comment! I look forward to reading what you have written.  Sharon Muza, BS, CD(DONA) BDT(DONA), LCCE, FACCE, CLE has been an active childbirth professional since 2004, teaching Lamaze classes to over a thousand families and providing doula services to more than 450 expectant families through her private practice in Seattle, Washington. She is an instructor at the Simkin Center, Bastyr University where she is a birth doula trainer. Sharon is also a trainer with Passion for Birth, a Lamaze-Accredited Childbirth Educator Program. In 2015, Sharon was awarded Lamaze International’s Media Award for promoting safe and healthy birth. Sharon has been an engaging speaker at international conferences on topics of interest to birth professionals and enjoys collaborating with others to share ideas and information that benefit birth professionals and families. You can find Sharon blogging on Lamaze International’s Science & Sensibility and DONA International’s DONA Doula Chronicles. To learn more about Sharon, you are invited to visit her website, SharonMuza.com.
 There is such emphasis on what to bring to the hospital -- you can find a hundred lists on Pinterest and other places. While we try to anticipate what a laboring person will need, inevitably, something may be forgotten. Here's a handy list of things you may already have access to simply because you are in the hospital.
Every doula learns her own tricks according to the laboring person's needs, the hospital's set up, and the nurses' suggestions. It's always a good idea to ask before you go searching in drawers and cupboards. But I have found, if you have a need or an idea, the staff is supportive of out-of-the-box ways to comfort someone in labor. What has worked for you?
 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.  I'm a doula. I love what I do, and I am really good at it. It is always an honor to help a family through birth by offering physical, informational, and emotional support unique to their situation. And I also recognize, as a certified Lamaze educator teaching families in the Bakersfield and Visalia areas, there are many reasons why a family might choose NOT to employ the services of a doula. These reasons might range from cost, to comfort, to hospital rules. In this situation, I want pregnant people to know how to shape their partner or other birth supporters into a doula. What are the advantages of a doula? How is she different than a partner, BFF, mom, etc.? She has no agenda or investment in this birth experience except to help a laboring person feel supported and know their options. What are the advantages of the partner, BFF, mom, etc.? You know this person better than anyone in the room. You know the likes and dislikes, the history and beliefs of this person, and you will be around after the baby is born. I often open this topic by asking each person to tell me something he or she knows about the person they have come with. I like this activity because it shows there will be professionals surrounding this birthing family, and while the professionals will know all the medical "stuff," the partners will know the pregnant person better than anyone in the hospital. Labor support is not rocket science. When you know what a pregnant person likes and dislikes, when you know what care this person would appreciate when sick or stressed, when you know what relaxes and what tenses -- this puts you in a prime position as a supporter, and suddenly you have something just as important as the professionals around you. By sharing things they know about each other ("She loves rocky road ice cream," "He hates his head touched") they see already they are armed and ready to doula their loved one.  I make goodie bags for all the families. They are filled with objects that symbolize a trait, activity, or way to support someone in labor.
When you love doulas, believe in their benefits, and are a professional doula yourself, it can be hard for class participants to feel you are unbiased on the subject (even if you are a professional childbirth educator, as well). I feel by offering an activity like this, you can show there are many different ways to create a birth support team -- and with anticipatory expectations of what a laboring person's needs are -- that doesn't have to include a doula.
 I have lots of fun goodies I use as an educator and doula. Sometimes these look like toys, and sometimes they are purchased in the toy section, but I promise, they are not toys, they are props. What's the difference? How do Hot Wheels track pieces change from toy to prop once absconded from my kid's room and placed in my childbirth ed supplies? What changes a kitchen utensil to an educational model? Dollar Tree junk to demonstration delight? One word: Here is a sampling of toys, and how I use them!
And my current favorite! This was an impulse buy when I stopped into a local store, Planet Bambini. I had to have it! I can't wait to use it! It would be great to help a sibling understand basics of how babies grow. Am I the only one who could imagine a contest between birth partners in a childbirth class -- maybe teams -- to see who can assemble all the layers the fastest?  One thing's for certain, it isn't going into the toybox at home! I let my little guy (21 months old) play with it, heavily supervised, for about 30 minutes, before I packed it up and put it back in its box. I know, I've got problems, you say -- it is, after all, a kid's puzzle! I own my issues. Just like we encourage when it comes to precious personal objects: it's my special toy and I don't want to share it. I added links to similar posts...
 As I compose this, my washer is going full-steam-ahead with a vomit-covered, king-size comforter in it, my 8 year old lies on a well-protected couch (his bowl on the towel-covered ottoman), and Kipper -- a long ago forgotten, feel-good kid show -- streams on the TV. My little guy is sick. Standing vigil with him last night, I was reminded we can make our pain worse or we can make it better, and a lot of that power lies in our brains. Like many of us, he doesn't enjoy being sick. He tried to rest, but when his stomach started to rumble, he grew restless, rocking his legs back and forth with anxiety and anticipation. Not wanting to wash any more linens, I encouraged him to move to the bathroom, where he would pace back and forth in front of the toilet in his attempts to avoid the inevitable. "I don't like to throw up," he said, tears sliding off his cheeks. "I know." I gently rubbed his back. I wasn't sure how much of his pain was from his stomach, and how much was from his brain. Sure, he was coping, yet he was also masterfully avoiding his body's natural impulses to move through this illness. Fear -- he was scared. "When you worry so much about being sick, it can make your body feel worse. I think if you can take deeper breaths and try to let your arms and legs be lazy and heavy, then you can really hear what your stomach is saying." We both sat on the edge of the bathtub as I mirrored the deeper breathing and lazy legs while continuing with my fingers on his back. We repeated this ritual many times in the night, and a shift occurred: knowing he could calm parts of his body and mind led him to feel more secure in what was actually happening in his tummy. He was able to better feel the illness, as it would come and then go, and this helped him rest in-between. See any similarities to labor here? Really what this describes is the fear-tension-pain cycle. In my classes we demonstrate this with a very long piece of elastic tied in a knot -- like a very, very long piece (10 yards?). I offer it to three different participants, so when held, it makes a giant triangle in the middle of our classroom. I then assign each of the three to be either "fear," "tension," or "pain," and have them relax their arms so the elastic falls to the ground, and we read over a few situations. As one trigger point becomes activated, that person pulls back on his or her piece of the triangle, then the next trigger is activated, and we see the result when the third person has to hold his elastic tightly to prevent it slipping from his hands. As we get to the problem-solving part, that person relaxes his or her part of the triangle, until it is loose and dragging the floor again.   "Mary is laboring at home. During her contractions she leans over her dresser and her partner applies pressure to her lower back. She would say her pain level during contractions is a 3-4, and she feels she is coping well. Soon she reaches the point where it is time to go to the hospital. She and her partner gather their things and head to the car."
What's going on here? And how can we short-circuit the fear-tension-pain cycle? The biggest difference is, Mary's coping strategy has changed -- she is no longer upright and mobile, being comforted by her partner's hands. Now she is sitting, strapped into the car, and on her way to the hospital.
A change in the level of PAIN, brought TENSION to her body, and FEAR about the future. Mary's partner can help her through this verbally -- reminders to relax and release tension, seatbelt caused hindered mobility, labor not necessarily picking up but changing sensation from changing position, etc. Relaxing can reduce the TENSION, while knowing this information can speak to the FEAR, thus helping to change the intensity of the PAIN, interrupting the cycle. Let's look at another situation (without the pictures -- as a side, I am currently reading Unfolding the Napkin, and I decided to follow the author's advice about processing visual information and creating my own pictures :)). Mary is now in the hospital. She is coping well by sitting on a birth ball and rocking through her contractions. She hears a scream down the hall and suddenly she has a FEAR response; consequently, she TENSES, and her PAIN increases. What can help here? Address the FEAR with words. Remind the woman, just as she has a birth team taking care of her, the lady down the hall also has professionals aware of her situation. The screaming might not actually have anything to do with a level of pain or danger -- it may just be how that lady chooses to cope, maybe she is just a screamer? Hands-on touch can offer physical reminders to relieve TENSION in areas of her body, and her PAIN level can go back to where it was before her scare. My little one is on the mend, the laundry is done, and I got a nap this afternoon. Watching him struggle was intense as a mom, just as it is when we are with laboring moms. It was an amazing tool to offer him, navigating through his own experience of the F-T-P cycle, by helping him recognize ways to make himself feel better in his body, by simply using his head.  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:
The story I use:
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.   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.
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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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