Instructor Training Highlights from April 2013
While Birth Boot Camp began with a mission to take childbirth education to more people through online classes, we have been honored to see incredible growth in our live classes. Women with a passion for birth, from all around the country, have signed up for our instructor training workshops. Now, just about a year into this business, we have instructors across the country and trainings beginning to span from coast to coast!
Let’s hear what these fabulous new instructors have to say about the comprehensive trainings that Birth Boot Camp organizes.
- “Awesome!”
- “It (the workshop) has been invaluable in giving me the hands on prep I needed. I love having a village to help us.” Maggie
Included in the price of your training are all the materials you will need to get started as a childbirth educator. Each new instructor receives an Instructor Manual, Instructor Handbook, Field Guide (student workbook), all of the Birth Boot Camp birth videos (you don’t have to find or buy your own) and supplemental videos for teaching specific subjects.
The only thing you will be required to buy when you start a class are workbook kits for your students. Not only that, Birth Boot Camp has developed detailed lesson plans and game ideas that you can use when teaching your own class.
- “The materials and all of the ideas given are so helpful and useful. I can’t wait to get started.”
One of the most important aspects of training is the opportunity that each instructor has to practice teaching to the entire group. Everyone is assigned a topic and we meet together to listen and learn from each other. Not only is this a wonderful time to practice and get used to teaching in a group setting, there are also some incredible ideas shared by these amazing instructors.
- “I thought the teaching part would be scary but I ended up loving it during training. It was fun and so helpful!”
- “I feel much more prepared to teach and more confident.” Beth
- “I loved practice teaching!” Beth
And with that, we would like to introduce you to our newest crop of trained, natural birth instructors! You can find all of our instructors, from coast to coast, on our Find a Live Class page.
How Birth Boot Camp Supports Midwives
One thing that is very important to us at Birth Boot Camp is supporting and encouraging the midwifery model of care. We are honored to have a very experienced and insightful midwife, Melody Morrow, CPM, as a member of our Advisory Board. Why is Melody so excited about Birth Boot Camp? She has seen the classes improve outcomes for her clients. Here are a few of her words. Thank you, Melody, for your support!
*****
Birth Boot Camp childbirth education has had an incredible impact on my midwifery practice. As a midwife, I have found that the midwifery clientele has shifted recently and become more mainstream. Women are now choosing midwifery care that haven’t necessarily researched and taken responsibility for their choices in birth. Some just want to try a waterbirth because it looked cool on television. What this means for me as a midwife is that if I take these clients, I have to make sure they are properly educated before the birth. If they don’t receive that education, I will likely be spending many, many more hours with them in pre-labor, labor and possibly a traumatic transport to the hospital.
I began to require that all my primips and women birthing outside the hospital for the first time take a childbirth class. While something was better than nothing, I didn’t necessarily notice a significant difference in outcomes for my clients who took a short class (4-6 weeks). However, I did notice that clients who took a longer Birth Boot Camp class did often have very different outcomes. Women were less fearful and more determined. They participated in their care and were making informed choices. Dads were providing excellent, confident support throughout pregnancy and, noticeably, in labor. Moms who would have otherwise had epidurals or C-sections, were having unmedicated births.
I believe Birth Boot Camp will enhance and support your work as a midwife because:
1. It promotes and affirms the midwifery model of care. The Birth Boot Camp curriculum is based on the Mother Friendly Childbirth Initiative. What they teach aligns perfectly with how I practice.
2. It gives parents 10 weeks of intentional education. This enables parents to make appropriate decisions for their care and increases their ownership of responsibility. In short, more families “own” their birth choices. Education lasts approximately 18-24 hours, so they simply have time to learn what they need.
3. The live classes promote peer support, encouragement and determination. Think of these couples meeting for 10 solid weeks to learn about birth with like-minded people and a dedicated teacher who has done it before. They are supported and positive about their birth and having more of their emotional needs met.
4. Someone else, besides you, is encouraging the same things you want them to hear. Good nutrition, exercise, positioning, and much more are all things they are learning about OUTSIDE of your visits, not just during them. My clients are more likely to be intentional in caring for themselves when they are given directed information, statistics, etc. and discussing these things with their partner and other birth workers.
5. Dads become more confident, involved and less fearful. A confident and involved dad really helps with mom’s well-being. Many clients will become even more passionate and appreciative of the choices they are making, even if they don’t have their desired outcome.
6. It is contemporary. The films are current and interesting. The topics concerning birth and interventions are up-to-date. In class, they discuss babywearing, cloth diapering, chiropractic care, doulas, Spinning Babies™, and other things that we want our clients to know about, but may not have time to fully teach them. Their class will connect them to resources that I might not be able to.
7. It forces couples to stop and focus on their pregnancy in this fast paced world. Couples connect with their pregnancy and with each other. They discuss issues and they come to an understanding. They appreciate their baby and the experience together. I wish every couple did this!
8. Knowledge is power. This means less confused, fearful phone calls and false labor runs for you.
In short, when my couples access the kind of quality childbirth education provided by Birth Boot Camp they have a better birth experience, my job is easier, and if things don’t go as they planned, they are comforted in knowing that they did all they could. This kind of childbirth education truly makes a difference.
Melody Morrow, CPM, LM, BBCI loves babies and birth. Since 1998 she has attended over 1,100 births and assisted in the training of over 70 midwifery students. She is passionate about preventative, respectful care for mothers, babies, and their families. Melody works in Texas at Edenway Birth Center as the administrator and senior consulting midwife. She is enthusiastic about her calling and loves to help empower families as they become informed and educated about their choices during their maternity and birth experiences.
Oxytocin
What is Oxytocin?
Oxytocin is an amazing little hormone.
Even if you don’t know what oxytocin is, you probably notice its effects each day. Oxytocin is sometimes referred to as the “love hormone” and it has a unique role in many of life’s important events. Oxytocin is released by activities such as cuddling, nursing, massage, and lovemaking. Even hair brushing and chocolate can encourage oxytocin release. However, the largest release of this hormone is usually at the moment of birth.
The emotional and physical importance of Oxytocin-
The impact of oxytocin is twofold. First- it has an incredible emotional impact. As you probably guessed, it is often present when we do things that have a special ability to bind us to others. Oxytocin release during nipple stimulation (such as while nursing a baby) serves to bond us powerfully to our children. The incredible oxytocin “high” that is experienced at the time of birth causes a fierce attachment to our child and an overwhelming desire to love and protect them. The emotional impact of oxytocin is powerful in romantic relationships as well as the parent/child dynamic.
Second – it has an important physical component. The surge of oxytocin causes contraction of the uterus both during labor and after the birth. This is not only beneficial, but can actually be lifesaving, as it prevents excessive blood loss.
Oxytocin and your labor-
Imagine the typical charts of labor that you may have seen. Labor is often depicted as coming in waves or hills. Each contraction lasts for around a minute and is followed by a longer break. As time goes on, the contractions get longer and the breaks get shorter.
But what causes these rushes of contractions? What stimulates them? The answer is fairly simple- oxytocin. Produced in your brain, oxytocin is rhythmically pulsed throughout the body. This is, in part, why contractions come in waves with a break between them. (Note that a labor stimulated or sped by an IV drip of Pitocin may not follow this pattern. Pitocin is what artificial oxytocin, often delivered via an IV, is called.)
It is important to understand what can stimulate oxytocin during labor (relaxation, massage, nipple stimulation), because you can use this knowledge to speed or encourage good, strong labor, if necessary. The same things that make you open to oxytocin reception and production (feeling loved, safe, and secure) can help encourage healthy labor.
Think of the uterus at the time of birth. This large, powerful, and muscular organ has been stretched to capacity to hold a full term baby. Suddenly, as the baby delivers, it is empty and must quickly shrink down to a much smaller size. Let’s not forget that the uterus, during pregnancy, has a large organ (the placenta) attached to it on the inside. Shortly after the birth of the baby, the placenta detaches and delivers. The spot of placental attachment within the uterus leaves, what really is, a large wound. This place (the spot where the placenta was attached) is where we see blood loss from at the time of birth.
Now, if you have a large, stretched out organ with a large wound within it, how do we reduce the size of that wound and thus reduce subsequent blood loss? The answer is simple- we must quickly shrink the organ (the uterus) and thus the wound (the place where the placenta was attached). Oxytocin serves this special purpose. The contractions it causes (remember how strong they are at the time of birth?) help to quickly shrink the uterus and limit blood loss.
As a new mom often notices, the days after birth are not without contractions. Every time a new mom nurses her baby, these post-baby contractions (often called “after-pains”) may be felt. While they may be uncomfortable, after-pains serve an important purpose – they help the uterus continue to shrink down so that mom’s blood loss is minimized.
You can see that oxytocin is important to our day to day life but particularly vital during childbearing and the years after. Oxytocin emotionally helps us feel bonded and attached to our children. It also serves to protect the life of mom by helping minimize her blood loss postpartum. There is a lot to love about the “love hormone.”
Mother’s Day Sale
Happy Mother’s Day! This sale runs Saturday, May 11th through Sunday, May 12th.
Cloth Diapers – Not What Your Mama Used
I am going to tell you a story about how I decided to cloth diaper. In 2002, I had a friend that was pregnant with her first. At the time she was also recently single and broke. She had said that she was going to cloth diaper to save money. When she went to Babies R Us the only thing that was available were prefolds and cruddy plastic pants. Ask any grandma, plastic pants suck. They always have, they always will. They are reminiscent of a shower cap with leg holes. Except this shower cap was designed to keep the moisture in. HA! Slightly disappointed in what was available at big box retailers, I turned to the internet. I quickly found Fuzzibunz. At the time I thought they were the coolest thing ever, but alas was not inspired enough to run out and have a baby.
Fast forward to 2010, I am pregnant and reminded of my find 8 years prior. Yes, Fuzzibunz have been around that long. So I jumped online and found that there was much more than just Fuzzibunz, there were Fuzzibunz, GroVia, AppleCheeks, bumGenius, and more. I was quickly overwhelmed with the options available. I was completely aware of prefolds (ref afore mention friend) but fitteds, pockets, and all in ones were a completely new ballgame.
When I told my husband that I wanted to cloth diaper, he quickly told me that I was a complete lunatic. My husband is the second out of five boys. He remembered cloth diapering with those sucky plastic pants, prefolds, and pins. The conversation went a little like this:
“I am not washing diapers out in the toilet,” he told me.
“But honey we can cloth diaper at home and disposable while we are out. We will save a ton of money.” I replied
“You are crazy. I don’t care how much money we save. I am not swirling anything in the toilet.”
“Ok fine, we can cloth diaper at home and disposable while we are out, and *I* will take care of the laundry. You just change the diaper.”
“Whatever, but I still think you are crazy”
So that is what we did. We started out in pockets, but I wasn’t thrilled with fit or absorbency. Still confused by the difference between a fitted and an all in one, I decided to attend a Cloth Diaper 101 at my Chiropractor’s office. We picked up a couple All in Ones, a GroVia and a Bottombumpers .
Within a few weeks, my husband was helping me stuff our stash of pocket diapers. He exclaimed, “Just be done with this and go with the All in Ones!” HE was hooked. From that point on, my son was in cloth 100% of the time.
Now when my husband hears somebody is having a new baby, the first thing he asks is if they will be cloth or conventional diapering. The average answer is similar to what his was in the beginning. Now his response to their objections is simple…”Cloth is awesome!”
Credit: Valerie Cannon Photography
Tiffany, owns and operates the Fort Worth Cloth Diaper store, Simple Baby. She is an advocate for natural birth, breastfeeding, and real diapers. She is a chapter leader for Tarrant County Birth Network, the largest chapter of Birth Network National in the nation. For more information about cloth diapers be sure to visit the Simple Baby Cloth Diaper Encyclopedia.
4 Simple Ways to Prepare for Natural Birth
Congratulations on your pregnancy! Many women desire a natural birth but preparing for one can seem overwhelming. Here are some wonderful tips for preparing yourself for the best natural birth possible. There is so much you can do to ready yourself and your family for birth. With these four simple things: education, nutrition, birth place, and birth team, you will be more able to make your goal a reality.
#1-Education- Probably the most important step in preparing for natural birth is to educate yourself as much as possible. Just as with breastfeeding, the more you know about the benefits of natural birth for you and your baby, the more motivated you will be to follow through and prepare accordingly.
Of course there is a plethora of information out there on birth. How do you trudge through it and find the diamonds among the coal? First, a comprehensive childbirth education program is a must. Look for one that is longer rather than shorter. A weekend “crash course” cannot possibly give you all the information that you need to navigate policies, stay low risk and prepare properly for the birth you want.
Look for natural childbirth classes that cover staying low risk, nutrition and exercise, relaxation techniques, choosing a care provider and birth place, the stages of labor, preparing your partner, common policies and procedures, breastfeeding and newborn care, and possible complications and how to avoid them.
Not only will a good birth class help prepare you, it should prepare your partner as well. In all honesty, your partner’s preparation is tantamount. If they are frightened or simply unaware of normality, it will inevitably impact the birth negatively.
In addition to preparing your partner, your natural birth instructor will be able to guide you to find the best books, websites, even care providers and doulas in your area. Think of a childbirth instructor as somebody on the “inside.” They have been there and done that and now they can help you accomplish the same thing. (Our instructors are well trained women who have had natural births, themselves. You can see a list of their requirements here.)
#2-Nutrition- As you will quickly learn, preparing your body for a natural birth is just as important as preparing your mind. Your body will go through some drastic changes as it grows first a placenta, then a baby, adds fluid, almost doubles its blood volume and prepares for future breastfeeding.
Eating properly means not just avoiding refined foods such as sugars, white flours, packaged foods and chemical sweeteners, it also means adding the right foods into your diet. Daily nutrition should include several servings of greens (broccoli, spinach, kale, asparagus, etc), citrus foods (oranges, tomatoes, kiwis, bell peppers), vegetables and fruits (celery, cucumbers, bananas and apples), whole grains (spelt, quinoa, oatmeal), eggs, complete protein sources (meats or other combined proteins such as beans and rice) and dairy (milk, Greek yogurt, keifer).
Women are amazed at how much better they feel when eating properly during pregnancy. Many common pregnancy ailments disappear. Great nutrition and adequate protein can even help eliminate morning sickness. Your childbirth instructor can provide you with a complete system to chart your nutritional intake and make corrections, if needed. You can also find many phone apps with which you can keep track of your daily nutrition throughout pregnancy.
Great nutrition will help your body and your baby be ready for a natural birth. Many care providers believe that common ailments that surface at the end of pregnancy and often lead to induction or C-section can actually be avoided with optimal nutrition.
#3-Choose Your Birth Place Carefully- One of the most important choices, as you prepare for a natural birth, is your choice of birth place. Many factors play into this decision from insurance coverage to proximity. Women often have three main choices available to them when it comes to birth place: hospital, birth center or home. The birth place that works best for you and your family will be influenced by many things, from cost to your own health to where you feel most emotionally comfortable.
Wherever you choose to birth, be sure that the policies are not so prohibitive that they make natural birth nearly impossible. Some important policies to look for are:
- Women are encouraged to eat and drink in early labor.
- Vaginal exams are kept to a minimum.
- Women are encouraged to move about in labor.
- IV’s are only given when necessary.
- Breastfeeding is supported.
- They have a low C-section rate.
In a birth center, you may want a hospital nearby in case of transfer and an environment in which you feel comfortable and supported. If choosing a home birth (as with any other birth place), you will want to carefully choose your midwife. Look specifically for someone with experience, skills or certification that you feel comfortable with.
While it may be tempting to choose a birth place simply because it is close, doing things because they seem “easy” is an often regretted decision for birthing women. A nearby hospital with a sky high induction and C-section rate will greatly increase your chances for the same. In the case of an unwanted and/or unneeded cesarean section, a shorter drive for a birth place can yield a much longer recovery. Choose your birth place carefully.
#4-Choose Your Team Well- You won’t win the Super Bowl with a football team made up of expert karaoke singers and you won’t get a natural birth with a team of care providers who specialize in surgical birth. Choosing your birth team carefully is one of the best ways to ensure you get a natural birth. Sometimes, even when a mother is knowledgeable and physically prepared, things can fall apart for her in labor if her team doesn’t support her decisions.
So how do you find this pro-natural birth team of supporters? Asking your childbirth instructor is a great way to start. As a woman experienced in birth and engaged in the local birth community, she should have a list of resources to provide you with.
There are many people who will make up your birth team. All of these people will influence your birth experience.
A great doula (a woman trained to support a birthing mother) can be a fabulous resource for both the laboring woman and her partner. She can provide emotional and physical support, an experts view on supportive care providers, and may act as a sounding board for advice.
Another good person to have on your team is a Webster Certified chiropractor. Chiropractic care during pregnancy (and even birth) can help ensure the pelvis is well aligned so that it can move for a faster and more comfortable birthing experience with a better positioned baby. This alone can help avoid many problems that prevent natural birth.
Probably most important of all is your choice of care provider. Your doctor or midwife will make decisions when you can’t and will be there for the final moments of birth. It is vitally important that this person be both trustworthy and skilled. If you are a low risk woman, you may want to consider midwifery care. Midwives often work in hospitals (thought many can be found working in a home birth or birth center environment) and their approach to birth tends to be more supportive of natural choices.
You CAN Have an Amazing Birth! Choosing a natural birth is a wonderful decision. With the right choices and preparation, we believe that most women can achieve this goal. (Check out our stats from our students!) Proper education, excellent nutrition, and careful choice of your birth team and your birth place are all things that can make your choice of a natural birth more attainable. When all is said and done, sometimes things don’t go exactly as planned. But, when we have done our best and chosen a care provider that we trust, we can rest assured that we did everything possible to accomplish our goal.
I’m pregnant! What’s happening here?
Photo credit: super-structure / Foter.com / CC BY-NC-SA
What Should I Expect During the First Trimester of Pregnancy?
You are pregnant! Congratulations!
Now you might be wondering, what happens next? If this is your first baby then you are in for some wonderful and amazing changes as your body starts to grow a new human being. Every moment might not be wonderful, but every change does inspire wonder.
Here is a list of some of the many changes that take place in your body during the first trimester of pregnancy. The symptoms you experience will vary, since every woman and every pregnancy are different. Consult your care provider with any questions you may have.
Nausea or Morning Sickness-
Morning sickness is probably the most talked about pregnancy symptom of all. For many women there are symptoms of nausea that start somewhere around five or six weeks into pregnancy. The length of time this lasts varies, from a few weeks to the entire pregnancy. Typically, nausea subsides after the first trimester, or around 12 weeks gestation. While it is called “morning sickness”, this pregnancy nausea can last all day, but is often worse in the morning or after going without food for a long stretch. For some women, they will experience no nausea whatsoever.
Morning sickness is thought to be caused by changing hormones and the slowing down of digestion that often occurs during pregnancy. Various things can help control pregnancy nausea so that it isn’t overwhelming. Eating protein rich foods frequently throughout the day is often the most helpful thing that can be done. Trying to consume about 80 grams of protein each day may provide relief, and starting each morning with a protein rich breakfast (eggs, oatmeal with fruit and nuts) can start the day off right and curb nausea.
Ginger is well known for it’s ability to help with nausea and can usually be safely consumed during pregnancy.
Breast tenderness-
While not as talked about as nausea, breast tenderness is often the first thing that tells a woman that she may be pregnant. Suddenly your breasts are tender to the touch, which may be especially noticeable while exercising. Usually a minor irritant, breast tenderness is one of the first signs that your body is growing a baby, your hormones are changing, and you will in a few short months be nursing your little one! Our bodies are amazing.
There is no known “cure” for this aspect of pregnancy and it will usually pass with time.
Headaches-
Some women experience headaches during pregnancy, often in the first trimester. While they can be disconcerting, especially to someone not used to them, there is often a simple solution. Often pregnancy headaches are simply caused by low blood sugar and the increased need for nourishment as the placenta is being formed. Pregnancy is not a pathology, but it is hard work for the body and requires healthy, whole foods, frequently throughout the day. (Sign up for our e-mail list to get a FREE download about optimal pregnancy nutrition with bonus recipes.)
Eating frequent small snacks or meals (about every two hours) always containing a protein source is probably the best way to not only curb pregnancy headaches and also feed your body the nourishment it so needs during the early days of pregnancy. The practice of eating healthy has the added bonus of helping with a variety of pregnancy symptoms considered unavoidable, from nausea to swelling. You and your baby are worth the effort.
Feeling emotional-
Though seldom talked about, feeling a variety of strong emotions during pregnancy (especially during the first trimester) is very common. Some women find they cry more easily, others find that they are glowing and deliriously happy. Even when a pregnancy was planned and much looked forward to, feelings of ambivalence are normal. The occurrence is so common it is documented in midwifery textbooks as a normal pregnancy symptom.
While the change in hormones may cause this emotional manifestation of the physical changes in the body, there are things that can help. Some women find that careful attention to their diet, paying especial attention to healthy B vitamin sources is beneficial. Brewers yeast, seafood (in moderation, according to your care provider’s recommendations), beef, cheese and eggs are all ways to increase B vitamin consumption through diet.
It is also important that the new mother be gentle with herself, accept that pregnancy can be emotional, and surround herself with supportive people like her partner, her birth doula, family and friends, and a knowledgeable childbirth educator. Pregnancy is a time where each women deserves extra care and support.
Exhaustion-
You are pregnant! Do you feel sleepy yet?!
It is very common for pregnant women to feel tired in both the first and the third trimester. During the first trimester of pregnancy (from conception to about 12 weeks gestation) it is perfectly normal to be tired. Your body is working hard to form a placenta and the very beginnings of your baby. Give your body time to rest and feed it well during this time when so much is developing.
Good diet, paying special attention to greens (you can supplement with a liquid chlorophyll if needed) and iron intake (meats are high in this and chlorophyl supplements will help your iron to absorb well as will vitamin C) can help with tiredness. Women get a renewed energy when the second trimester starts, around 13 weeks.
Frequent urination-
Even though the baby is very tiny during the first trimester, it is not uncommon to have a frequent urge to urinate. Hormonal changes cause the blood to flow through your kidneys more quickly thus causing more frequent urination. In addition, your blood volume increases dramatically during pregnancy (by about 50%) and this is a further stress on the kidneys and increases the need to urinate. Of course, as the baby grows, because it rests just above the bladder, the increased weight adds pressure causing frequent urges.
Though this is a normal and healthy part of pregnancy, avoiding things that are diuretic (like coffee, tea, caffeine, and alcohol) can ease the burden on your hard working body.
Birth Boot Camp encourages a proper Kegel program to strengthen the pelvic floor. The muscles in the pelvic floor support the bladder and other organs and having them strong and flexible allows for more control of elimination.
Growing a human is hard work -
Sometimes it is tempting to focus on the “symptoms” of pregnancy. We prefer however to focus on what a miracle it is. A human being (you) is able to grow another human being. It is truly amazing (and yes, hard) work. You will find that there are many nutritional and lifestyle changes that can improve overall health and happiness throughout pregnancy.
Enjoy! The best is yet to come.
Should You Kegel?
Introduced in 1948 to strengthen the pelvic floor, Kegel exercises have recently experienced a surge of controversy. The discussion on how and when Kegels (an exercise designed to improve core strength and support the internal organs) are appropriate for women requires examining how the pelvic floor functions and what keeps it in shape.
This article discusses the function of the pelvic floor, how to properly incorporate Kegels into your lifestyle and alternatives if Kegels are inappropriate for you.
The function and purpose of the pelvic floor.
The pelvic floor consists of a group of muscles that sit between your pubic bone in front and your coccyx, tailbone, in the back. Ideally, the pelvic floor acts like a trampoline – flexible to weight when needed, but strong enough to hold up what is placed on it. The pelvic floor has four main functions:
- It acts as a sphincter, which means it closes the openings of the urethra and the vagina.
- It is supportive. In particular, it supports the pelvic organs (uterus, bladder, etc.).
- It has a sexual function. An orgasm is a rhythmic contraction of the pelvic floor muscles.
- It is a stabilizer. The muscles of the pelvic floor stabilize the pelvis during movement. When functioning properly, the pelvic floor can help prevent or decrease pain in the low back, pelvic region, hip, and even the knees. Think of the pelvis as the foundation of a house and your spine as the house. If the foundation is weak, then the house won’t stand properly. Your pelvic strength is important to your spinal health and thus the health of the entire body.
The pelvic floor muscles do not exist alone. They work together with your transverse abdominals and multifidus (deep back) muscles to support your pelvis and spine. Your glutes are also very important to the stability of your body- specifically your gluteus medius.
In addition to the everyday necessity of a strong pelvic floor for prevention of problems like urine leakage, a strong pelvic floor is specifically important during pregnancy and childbirth. Most every pregnant woman has noticed increased pressure and, sometimes, trouble with leaking urine as the baby gets bigger and presses down more and more on the bladder. A strong pelvic floor can help with this and is important to proper positioning of the baby at the time of birth.
The ideal position for a baby to be born is with the face towards the mother’s tailbone with the chin tucked to the chest. This ensures that the smallest presenting part (that “cone head” sometimes noticeable in the hours after birth) is presenting. A strong pelvic floor applies appropriate pressure to the top of the baby’s head, causing the chin to tuck and encouraging this birthing position for the baby. A face or military presentation (where the face of the baby is the presenting part) is much bigger, can cause more pain, and can, in fact, be impossible to deliver vaginally.
A properly functioning pelvic floor will help prevent embarrassment, discomfort, and even difficult labors.
What are Kegels?
Arnold Kegel was a gynecologist in the 1940s who worked with women suffering from “genital relaxation” or a weak pelvic floor. He used an instrument that could measure the strength of the pelvic floor muscles to determine the severity of the condition. Dr. Kegel saw women of all ages who struggled with various problems (incontinence, sexual dysfunction, etc.) due to a weak pelvic floor. His intention was to find a way to help people who struggled with urinary incontinence without resorting to surgery. (You can read Arnold Kegel’s published paper on the pelvic floor here.) He sought to help women learn to identify and strengthen the pelvic floor through resistance exercise, ie, muscle contraction. His findings indicated that in all but the most severe cases of pelvic floor damage, women could return to a normal, functional lifestyle through these exercises. The strengthening of the pelvic floor muscles, pioneered by Dr. Arnold Kegel, are known today as Kegel exercises.
Researchers are still finding great benefits to women who are doing proper pelvic floor exercises. Today, rather than using the instrument used by Dr Kegel, physical therapists and others specializing in female pelvic floor health use biofeedback machines to measure the strength of the pelvic floor and to help women learn how to properly contract and relax these muscles.
Proper Kegeling
While Kegel exercises for the pelvic floor are currently very accepted and widely done, it is apparent that just doing Kegels, without proper instruction, is simply not enough. A Kegel exercise program should be done properly and should be individually geared for each woman and her needs. The Kegel program taught in Birth Boot Camp classes is based on the work of Pamela Jones, PT. This individualized program helps each woman assess her pelvic floor needs and adjust her exercise program.
It is important that women struggling with severe or specific problems or pelvic pain consult with their care provider or seek out a physical therapist specializing in women’s health. The following are general tips for properly strengthening the pelvic floor.
A proper Kegel requires FULL relaxation and then FULL contraction and then back to FULL relaxation. Remember, proper Kegels don’t just involve contractions. Relaxation is a very important component to your pelvic floor health. If a woman cannot achieve full pelvic floor relaxation then stretching and relaxation techniques should be used first.
To begin Kegeling, you must first recognize the muscle that you will be strengthening. This is often done by stopping the flow of urine mid-stream. The muscle that you tighten in order to do this will be the same one you strengthen doing Kegels. (Don’t do this frequently, only to initially identify the correct muscle.) Noting how easy this is for you and how quickly it can be done can give you some indication of your pelvic floor strength. Another way to identify strength of the pelvic floor is by tightening your pelvic floor during intercourse and getting feedback from your partner. Note how long you can hold this contraction and how many times you can repeat it. As you begin a pelvic floor strengthening program, continually ask for feedback from your partner.
Once your pelvic floor strength has been determined, you can tailor your Kegel program to fit your needs. A weaker pelvic floor will require just three to five repetitions five times per day in a position where gravity can assist you. For example, with your hips propped up with pillows. A woman with a stronger pelvic floor will be able to Kegel in an upright position, even while walking or running and will be capable of doing more contractions.
Remember to tighten and then FULLY relax the muscle. A proper Kegel will develop both strength and awareness of the muscle. We don’t just want a “tight” pelvic floor; we want a strong pelvic floor which we are able to fully relax. Also, be aware of the surrounding muscles. The point of a Kegel is not to tighten the gluts or bottom. Those should stay relaxed. Focus on muscles in the front. It will feel like you are tightening the vaginal opening rather than the rectum.
No more Kegels?
It seems clear that the scientific literature and popular opinion recognize the importance of both the strength of the pelvic floor and the importance of Kegels in this strength. Despite this, Kegels have fallen out of favor in some circles and this sentiment has made its way into the birthing world.
Often those who believe Kegels should not be done recommend squatting instead. Any comprehensive birthing class will encourage and focus on squats. They are a very important exercise for many reasons – flexibility, strength, and opening up the pelvic outlet. They are also effective in strengthening the pelvic floor without the use of Kegels. Our instructors encourage their students to appropriately squat AND Kegel as part of their comprehensive physical preparation for childbirth. Many other exercises are also encouraged which help strengthen the body for birth. Ideally, these two exercises (squats and Kegels) will both be employed by women for a fully functional, flexible, and strong pelvic floor.
Is there a time when Kegels are not appropriate? Some women will find that their pelvic floor is excessively tight. Tight is different than strong. In fact, a woman can have a weak pelvic floor that is very tight. This is usually accompanied by pelvic floor pain. Women describe this pain as feeling like a headache in the pelvis. For those women whose pelvic floor is very tight, doing excessive Kegels would not be appropriate and could make the problem worse. Diagnosis and treatment from a physical therapist specializing in pelvic floor problems may be appropriate. Your physical therapist would be able to prescribe an individualized program that could help.
In addition to exercise, we recommend that pregnant women seek chiropractic care from a Webster certified chiropractor. Chiropractic care during pregnancy can also help with some of the pain associated with pregnancy and, like a strong pelvic floor, can help ensure proper positioning of the baby. As mentioned earlier, the pelvic floor, spine and pelvis all work together for a functioning, healthy, and pain free body. If the pelvis is badly misaligned causing torque on the pelvic floor muscles and thus excessive tightness and an inability to fully relax, it can not only cause pain but make it nearly impossible to properly Kegel and strengthen the pelvic floor muscles. A chiropractic adjustment by a Webster certified chiropractor can remove the misalignment in the pelvic bones allowing full relaxation of the pelvic floor and relieving pain. Once the bones are properly positioned and the muscles are allowed to fully relax, a complete Kegel exercise program may be implemented to strengthen the muscles that were once weak and hypertonic (tight), allowing it to be both supple and strong.
In conclusion
Without a doubt, a strong and healthy pelvic floor is important to every pregnant woman. A comprehensive childbirth class should include various ways to strengthen the pelvic floor, including Kegels, squats, and other core strengthening exercises. It is important for women to evaluate their own individual needs and adapt, as necessary. Your childbirth educator will also go over many of the ways you can protect both the pelvic floor and the perineum (tissues between the rectum and the vagina) during birth.
Additional information and resources-
Dr Kegel’s Research: http://journals.lww.com/greenjournal/Citation/1956/11000/Early_Genital_Relaxation__New_technic_of_diagnosis.4.aspx Study finds Kegel exercises more effective than cone or electric treatment: http://www.bmj.com/content/318/7182/487.abstract Cochrane Library meta analysis finds that doing Kegel exercises improves lifestyle and in particular, stress incontinence: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005654.pub2/abstract;jsessionid=ECFB884EB2A0D1D252E134351F9B8AA4.d03t01 Website for Pamela Jones, Physical Therapist specializing in women’s issues: http://physicaltherapy-northtexas.com/ To find a chiropractor certified to work work with pregnant women, check out: http://icpa4kids.org/Find-a-Chiropractor/ Thanks to Sara Bogner, Physical Therapist and Nathan Clark, DC for lending their professional opinions on this subject.
Sarah Clark has been a birth instructor since 2008 and now helps train future birthing instructors for Birth Boot Camp. A mother of four, she also blogs about natural birth and motherhood at www.mamabirthblog.com.
