Monday, March 26, 2012

Childbirth preparation classes

With Littles
My hospital offered childbirth preparation classes, but in my early research, I came across references to classes focused specifically on medication-free birth. I asked Dr. S about them at a prenatal appointment at around 16 weeks. He brushed them off, saying it wasn't necessary, that all classes were pretty much the same.

In retrospect, this was the first of many red flags regarding Dr. S. (This was the same appointment where he told me, "That's fine if you don't want an epidural. I mean, 85% of my patients go into labor knowing they want an epidural, and most of the rest of them end up getting one anyway... but if you don't want one, that's fine.") But I just ignored the comment, and continued researching my class options.

I eventually settled on Bradley method classes. A couple of things appealed to me about Bradley, as compared to other childbirth methods. One is that it teaches the husband (or other birth partner) to play a key role in the birth. From the first time I brought up med-free birth, my husband was super supportive and involved, so we both really liked the idea of a class that would honor that. Also, Bradley seemed a little more "scientific." None of this woo-woo about hypnotizing yourself into a pain-free childbirth or creating a birth space to help you open, or other craziness like that.

We found a nearby instructor and started classes when I was about 23 weeks. We both found them incredibly helpful. My husband isn't the type to sit down and read a bunch of books about childbirth, but he was an enthusiastic participant in the classes. They gave him the knowledge and confidence he needed to be a great birth partner. I think that's so important. I might be the one giving birth, but it's my husband's baby, too. I want him to enjoy the childbirth experience, just as much as I do. Bradley classes helped him do that.

As for me, I am the type to sit down and read a bunch of books about childbirth :) But I still found the classes to be helpful. Probably the best part was being able to sit down with a real live woman who had been through a med-free birth experience. (Actually, two of them, plus a third birth that occurred midway through our class series.) She brought such a sense of normalcy to childbirth. This was so powerful, especially when combined with the positive way that my mother had always described my own birth. So many pregnant women get bombarded with horror stories about labor and delivery. I wasn't. In fact, I got the opposite: I was surrounded by positive stories and experiences.

I think that made a tremendous difference in my mindset going into labor.

With Noob
As much as I had enjoyed Bradley classes, I opted to make a change with Noob. One reason for this was that I felt the relaxation techniques I'd practiced in class were less than useful during labor. I'd always practiced relaxation lying on my left side, but when I got into labor, I found that lying on my left side was intensely painful. And then I felt a little lost -- like, what do I do now? It worked out OK anyway. I ended up finding other comfortable positions to labor in. And as one of my friends pointed out to me later, it's likely that all the practice did pay off in helping me stay relaxed throughout labor, even if I didn't do it in the same position I'd practiced. Still, with Noob, I wanted to find a method that gave me more flexibility in how I labored.

For this reason, I started looking at Hypnobabies -- one of those methods that I had dismissed as too "woo-woo" with Littles. The basic premise of Hypnobabies is that you can experience labor as being pain-free through self-hypnosis. I know... woo-woo :) But one of the things I really liked about it, compared to Bradley, was that it gives you a variety of self-hypnosis scripts to listen to in preparation for labor, as well as during labor itself. It also teaches "eyes open hypnosis," where you're able to move around and labor in different positions, while remaining under hypnosis. This appealed to me more than Bradley's left-side relaxation.

In addition, actually going through birth had changed my entire mindset on it. With Littles, I expected labor to be most painful experience of my life, because everyone told me it would be. It wasn't. As I've mentioned previously, I found labor to be more like my Ironman triathlon experience: It was intense, and challenging (both physically and mentally) -- but not "painful" in the same way that, say, getting whacked in the head with a lacrosse stick is painful. (Yep, I've had that happen, too, on more than one occasion...)

This put me somewhat at odds with Bradley, which teaches pain management techniques: Why would I need pain management for something that's not painful? Interestingly, this is right in line with Hypnobabies' philosophy. Really, Hypnobabies and Bradley are more alike than they are different, but there is one subtle distinction between the two: Instead of teaching pain management, Hypnobabies teaches that childbirth is pain-free. That sounds crazy to a lot of people, but it made perfect sense to me.

I'll give a quick example to better explain this distinction. In labor, there is a period called "transition," which is when your body switches from dilating your cervix to pushing your baby out. Most childbirth classes, Bradley included, talk about this being the most painful part of labor. So when I was laboring with Littles, I kept waiting for it to get really painful and difficult. I was hoping to feel that, because it would be an indication that I was almost done. As it turns out, transition didn't feel much different from the rest of labor for me -- but in my head, I was trying to make it feel worse than it actually did. Pretty counterintuitive.

Hypnobabies is different. For starters, it shies away from using childbirth-related words with negative connotations, so "transition" is called "transformation." And it teaches that transformation is pain-free, just like the rest of your "birthing time" (aka labor).

With Noob, I remember very clearly when I entered transformation. The house was full of people by that point, but somehow, I ended up alone in my bedroom. My husband came up behind me just as a contraction (or "birthing wave," in Hypnobabies terminology) hit, so I leaned back into him and swayed a bit while he supported me. The contraction ended and I opened my eyes and noted the time. As I did, the contraction started right back up again, so I leaned back into my husband and we swayed again. When it ended and I opened my eyes again, I saw that the second contraction had been a full 2 minutes. Long, back-to-back contractions like that are a hallmark of transformation, and I knew it. But they weren't "painful" in the normal sense of the word. This is hard to explain. I felt many things. I felt the power of my body, I felt my baby moving into position to come out, I felt the love of my husband supporting me -- but I didn't feel pain.

I can't say for sure why the two experiences were so different. Certainly, it could have been because I was expecting transition to be painful with Littles, and I was expecting transformation to be pain-free with Noob. But it also could have been that I was more relaxed in the comfortable surroundings of my own home, as compared to the hospital. It could have been that I was experiencing spontaneous birthing waves, rather than Pitocin-induced contractions. It could have been that Noob's labor was just easier.

But after that experience, I knew I'd use Hypnobabies for any future births.

With Q
I'm 25 weeks right now, and I've been doing my Hypnobabies scripts for the past two weeks now. With Noob and with Q, I've chosen to do the Hypnobabies home study course. This was another thing that appealed to me about Hypnobabies: We can study it on our own, rather than having to go somewhere to take classes. This is really convenient, especially since now we'd have to find child care if we wanted to take live classes!

Of course, by doing the home study course, I lose the benefit of having access to a live instructor, which I found so valuable during my Bradley classes. I'm OK with this now that I have my own childbirth experiences to draw on, but I think it would have been less than ideal for my first pregnancy. (There are live Hypnobabies classes available as well.)

Also, with Noob, I found that my husband was less involved in childbirth preparation than he had been with Littles. Hypnobabies does have a lot of information for the birth partner, but as I said before, my husband is not the type to sit down and read a bunch of stuff on childbirth. He did read a bit of the home study material, and he remembered a lot of the basics from our Bradley classes anyway, so it worked out fine and he was still a wonderful support to me during labor. But I'd love to get him a little more involved this time around.

So, is Hypnobabies better than Bradley?
No, I don't think it's necessarily "better." Just different.

When it comes to childbirth classes, whether a mom is planning to forego the epidural or not, I think it's incredibly important that she and her birth partner take childbirth preparation classes that are not affiliated with a hospital. The reason for taking non-hospital-affiliated classes is that they'll help you explore all your options, not just the ones that are available at your hospital. For example, childbirth preparation classes at a hospital without birthing tubs are unlikely to spend a lot of time talking about all the benefits of waterbirth. A non-hospital-affiliated class will likely discuss waterbirth, allow you to figure out whether or not that's something you're interested in doing, and possibly help you make the decision to change hospitals if having that option is important enough to you.

In fact, taking non-hospital-affiliated childbirth prep classes is the single biggest recommendation I make to expectant parents. There are tons of other things to consider, such as choosing a supportive OB or midwife, learning about all the options available to you during birth (eating and drinking in labor, different positions for laboring, relaxation techniques, waterbirth, episiotomies vs. tearing naturall, etc.), ensuring the birth partner knows as much about childbirth as the mom herself, considering whether a doula might be beneficial (I'll do another post on doulas in the future), etc... but a good childbirth prep class will cover all of that. Hence why it's the single biggest recommendation I make :)

As for Hypnobabies vs. Bradley and other "methods," I don't think the particular method is very important. Obviously, I've chosen Hypnobabies for myself, but I know it's not for everyone. Heck, it wasn't even the right method for me, during my first pregnancy! I always encourage women to choose a childbirth prep class that feels comfortable to them. Which may or may not be what feels comfortable to me.