I first met Lauren in 2010. Over the years, I've had the pleasure of getting to know this amazing woman on a personal and professional level. She has a wealth of knowledge and information about birth, in general, and breech presentation, in particular. She works hard to help women know their options in pregnancy and labor, and to make informed decisions for themselves. She offers Birth Boot Camp childbirth education classes in Bowie, Maryland, helps breech mamas worldwide on her website, and is the author of Breech Baby Handbook.
How did you get into the birth world?
After my breech baby, I went into hyper research mode to find out if I actually needed a cesarean or if there were intelligent, trustworthy, and wise providers who would have offered me a vaginal breech birth. I wanted to know if I made the right decision--to have a pre-labor cesarean for a footling breech baby who weighed 10 lbs. It started as a path to affirmation, to know if the story I told myself in order to lay on the operating table was true. I told myself that we needed the surgery; that the surgery saved one or both our lives. It's a common refrain in birth stories and in my case I wanted to know if it was true.
Was it true?
I don't know. I don't think so. I think she could have been born safely, but the truth is I really needed someone to tell me that. I had fallen into the belief that it wasn't safe. I believed it was possible but probably very dangerous and not a smart path--not a good choice. I would have been plagued with anxiety, my husband would have been worried, and there was no one who supported it. That may have made it unsafe or overly dramatic and intense.
If I had met Mary Cooper back then, I could have done it. She's an Ohio midwife who works primarily among the Amish and other plain people. She's done thousands of births and feels very confident about breech and women's birthing ability in general. If I ever have another breech after 35 weeks, I will drive to Ohio and stay at a hotel until I go into labor--if she'll have me!
So anyway, I realized how important full information is, and how important it is to have people around you that believe birth works. Birth is so much better when you believe it works, when you trust your body and your baby. I was way too ignorant and needed more support than I got. I decided to provide that where I could--to breech mamas online and with birth classes in person.
What spurred you on to write your Breech Baby Handbook?
I researched and wrote the website to help parents of breech babies make decisions about their care almost 5 years ago. It's helped a lot of people who are looking for answers. When I am in mega research mode myself, I'd really rather have the layout of a book. So I decided to put everything I know about breech in a book format, with headings and sections, and references, charts and graphs and all that good stuff. There's also better updating, more tips, slightly more information. It's the first thing to get added to when I get new information. Having the book serves two purposes. One is to make getting information and support for breech choices easier and faster and the other is that I get a little income and am forced to keep things current. I did it as a public service for long enough that it was starting to get slow...now I have a reason to keep it going. A whole lot of information is still available on the website for free, but the book adds another dimension.
Who do you hope will read this book?
Women with breech babies and their families, of course. Though it's good to know about breech options early in pregnancy. Mostly though the big free tip is that every woman should ask her provider to check the position of her baby by 34 weeks. A lot of the things we can do to help babies turn work better earlier. That said, I really hope more birth workers will read it and be certified as Friends of Breech Babies, so they can offer breech consultations and help all their clients have optimally positioned babies or feel confident about their choices with breech. There simply isn't much time when you find out your baby may be born breech. It's overwhelming.
How can care providers help breech moms?
Midwives and doctors can start fostering a community where vaginal breech birth is a safe and acceptable practice. This means attending training, talking about it, finding a provider to shadow for breech births, and working to bring the option back. People don't offer vaginal breech birth because women don't demand them. I know that one midwife or one doctor usually can't just do as she pleases and buck the system. That can be dangerous for their license and their job and sometimes their freedom. But if they always refer women with breeches to providers who do offer vaginal breech birth, at least for a consultation, the climate will start to change. There's a big difference between "No, a cesarean is your only option, it's not safe" and "I can't help you, but I know someone who can."
What can breech moms do to help themselves?
If you already have a breech baby (34 weeks +), decide if you want to have a vaginal breech birth. Look at the research and the professional opinions, and decide. Find someone who can attend you if you do want to and transfer your care. Then decide if you want to try to turn the baby. You're better off being with a supportive provider, even if your baby is head down. If you want to try to turn the baby, be serious but relaxed about it. Which is as hard as it sounds. You can't do a few breech tilts here and there and look at spinning babies once a week and expect anything to change. You have to be serious about it. Try the Vinaver Method, see a hypnotherapist, go to the chiropractor, etc. Not just one and done. But you also have to stay positive and stay relaxed, being OK with whatever happens. The oxytocin has to stay high for you to even go into labor, and there are more breech babies with stressed mothers. Good luck, right!
How do you feel the environment is changing for breech moms? Or do you think it is?
Vaginal breech birth is coming back. It is. There is great breech research coming out of Europe soon, and there has already been some. More trainings are being offered, there are conferences about it. The professional opinions are opening up. Institutional and system change is always slow, but it's coming. Pregnant women and their families are helping to drive it. People need to leave practices that don't offer what we want, and we need to tell them why. Change follows the money. It's still an economy.
Do you feel the environment is changing for birth in general?
For sure. Kind of like in the 70s, when our mothers were demanding they be able to labor without drugs and with their husbands present, more women now are asking for the freedom to move around, to make the decisions themselves, to have full information. Birth classes used to be more about birthing in such a way as to not bother or annoy the hospital. Here are ways to relax and breathe so that you can just lay there as if you are asleep or stay in the bed like they like you to do, and they won't push drugs. I'm not saying that relaxation and breathing aren't important. There are few things that are as important as being able to relax--body, mind, and soul, and getting oxygen to your muscles and baby. That's tantamount to safe birth. Not to mention pleasant birth. But modern birth classes help women advocate for themselves, move around in labor, practice upright birth, involve the partner. Moan if you want to, use these balls, this rebozo, etc. The options for pain relief are more varied and widely available. Doula practice is strong. It's much easier now to be part of the decisions, to advocate for yourself. Doctors and midwives know they have to make some accommodations. It's a work in progress.
How can care providers and other birth workers help birth be better?
Listen to women, and give them full information. Give them options. If you don't feel comfortable with what they want, send them elsewhere.
How have you been able to make birth better, for your students? For your community? For the world?
The best part about teaching is opening doors and saying, "Have a look in here." If I've helped anyone, it's because she looked behind one of those doors and explored it herself. Then she can make a decision about what feels right for her. Sometimes she will look for other doors to open on her own, now that she knows about the kinds of doors to look for. No matter what she decides, I can still be standing there with her. And I think that's how we make a difference. Just be.
Last week, I had the pleasure of meeting with other doulas for an amazing workshop hosted by an incredible woman, Penny Bussell Stansfield. The topic: using the TENS unit in labor. Ever heard of a TENS before? I hadn’t either until recently. So let me share with you what it is, what it feels like, and why it may help you in labor.
What is a TENS?
TENS stands for Transcutaneous Electrical Nerve Stimulation. What that means is that mild electrical impulses are transmitted from a handheld device to stimulation pads attached to the mother’s back. The impulses, through the pads, stimulate her nerve fibers. The device can be held by the mother so she can be in control of the power, intensity, and setting as she goes in and out of contractions. The unit itself is pretty small. The handheld device is smaller than a Wii remote and each pad is about 2” x 3” big. The lead wires that go from the pads to the device are about 3 feet long.
What does it feel like?
Jessica Koester and Dorothy Haines, two doulas from New Jersey describe it as a “shower massager without water,” which is a perfect description! The TENS feels like a pleasant vibration sensation on your back. As you up the levels, the vibration increases. You can read more in Jessica’s and Dorothy’s blogpost here: http://yourbestbirth.blogspot.com/2010/01/tens-anyone.html?m=1
Why may it help in labor?
In 1965, the Gate Control Theory was proposed by Ronald Melzack, a psychologist, and Patrick Wall, a neuroscientist. “The Gate Control Theory of Pain holds that the perception of physical pain is modulated by interaction between different neurons, both pain transmitting and non-pain-transmitting. Activation of nonnociceptive [non-pain-transmitting] fibers can interfere with signals from pain (nociceptive) fibers at the level of the dorsal horn in the spinal column, thereby inhibiting perception of pain. This is because activation of nonnociceptive fibers (through rubbing the area or through TENS) inhibits the firing of nociceptive fibers, which carry pain signals. Thus the brain can control the degree of pain that is perceived, based on which pain stimuli are to be ignored. In other words, the brain controls the perception of pain quite directly. This understanding led Melzack to assert that pain is ‘in the brain’. Pain awareness can be reduced by increasing innocuous stimuli, such as the tingling sensation from the TENS unit.” (Penny Bussell, www.pennydoula.com) Basically this theory states that if non-pain-transmitting neurons, which travel faster to the brain, are stimulated, they can override the pain-transmitting signals that travel more slowly, in essence, “closing the gate” to the brain.
With that in mind, using a TENS unit in labor can help 2 things: 1) when used on a low frequency, the tickling sensation stimulates the production of endorphins which are the body’s natural pain relieving hormones; and 2) when used on a high frequency, the non-pain-transmitting neurons are stimulated and override the pain-transmitting neurons (thus “closing the gate” on those pain messages).
The advantages to using a TENS unit in labor include:
However, there are some things to keep in mind when considering using a TENS:
How do I use a TENS?
Each TENS comes with instructions but here are the basic steps:
That’s it! It’s really quite simple! I’m so excited to be able to offer this tool to my clients in labor. If you have any questions, shoot me an email!
Birth Boot Camp Certified Doula (BBCD)