Jen, can you tell me about the Bradley method?

[ShannonandDel]

Please

[JenBerry]

Sorry, sorry, life's been hectic and I only saw this last night but didn't have time to reply.  Even this one is going to be pretty short.

Bradley Method (aka Huband-Coached Childbirth) - the basic stuff is handling pain with relaxation, surrendering to labor so your body can do what it has to do.  They emphasize deep abdominal breathing as the best/only way to truly get yourself to a deeply relaxed state, and the support of a loving husband/coach to support your efforts and be your advocate.  They also stress healthy eating and specific exercises (squats, pelvic rocks, kegels, etc.) as the main ways to get yourself ready for a healthy and low-intervention birth, and education as a huge factor in preparing for childbirth and parenting.  There is also basic breastfeeding info.

Like many such things, how good the class is depends on your teacher.  I totally agree with the basics of the method, though, and it certainly has gotten me through two natural childbirths and would get me through another if I'm so lucky.  Classes are usually 12 weeks long, although you'll find some teachers who do 10-11 weekers.  I payed $275 for mine in Dallas in 2002, teachers in Atlanta charge about $300 now (which is what we charge now since we absorbed an Atlanta teacher and all raised our rates to match), if that helps give you an idea of cost.  You can even get a receipt to send to your insurance co. and see if they'll reimburse you.

Okay, those are the basics I could do quickly.  Please let me know if you have further questions about Bradley, my classes, how it differs from Lamaze or Hypnobirthing, etc.

Jen

[ShannonandDel]

Thanks!
I would love to know the differences between the different methods when you have a chance. Delaney's birth was not so natural and I really want to do the next one natural. I think I am a lot more confident this time.

[JenBerry]

The impression I get of Lamaze is that it's very different from what it was in the 70s when Bill Cosby parodied it in his comedy routine.  The basic point of Lamaze as I understand it is distraction.  That you can trick the brain, by occupying with other things, into not feeling as much pain.  This is where the patterned breathing (an ex. of first stage breathing would be the "he-he-he-he-hooo") and focal point come in, as techniques to take you out of your body, so to speak.  Now, I will say that I have met some women, especially women who had their kids in the 70s-80s, for whom this all worked beautifully.  They credit the Lamaze breathing with keeping them off the drugs.  I have talked to more women, however, who said that the breathing was all well and good until the hard labor kicked in and then it didn't do shit for them.  They were too overwhelmed to do anything so focused.  There is also the possibility of hyperventilation if you do the patterns during labor without practicing enough beforehand to get your body used to it (have dh do the "he-he-he-he-hooo" breath about 4 times and see if he doesn't feel lightheaded), which is another reason that Lamaze has lost some favor.

Hypnobirthing, Hypnobabies, Hypbirth, are all self-hypnosis based programs, usually available for home study for a couple hundred dollars.  The idea here comes from Grantly Dick-Read, who believed that if you retrain the brain to think of labor as a painless event, then you can make it so.  His idea is that we're all so conditioned to think labor = pain that we never give it a chance NOT to be painful.  So you have to practice (that's a common thread with all methods, so get ready to work for it), usually with scripts or recordings, so that you get to the point where you can go to that hypnotic state very easily and even in the thick of labor.  As for how it works, I again get mixed reviews, but I feel better about this than about Lamaze.  Most women I've talked to say that Hypnobirthing got them feeling really confident and serene about their birth, very much in control of their reactions.  I like that they refer to contractions as "surges" or "waves" so that you can get that picture in your mind and think about labor in a different way.  And my one student who also did Hypnobirthing, although she ended up with a c-section for CPD, said "I couldn't even describe the labor as painful, just intense".  And didn't Megs use some form of hypnosis for Asha's birth?

Anyway, my big concern with hypnosis style classes is that the women for whom it doesn't work seem really, really miserable.  Although I must say that I have no idea how much those women practices, and I got a general vibe off of them that they were really looking for a quick fix, a "natural epidural" if you will, but didn't really believe in the hypnosis.  And I would think that it's the sort of thing that would work better the more you trust it, ya know?

The other thing is whether or not they have enough information on birth planning, common complications, ways the coach can help, informed consent, communicating with your birth team, etc. that Bradley does.  I've never taken or seen a full hypnosis course, so I don't know what all is included.  You won't really need so much of the newborn care stuff that's in the Bradley class, but I think that everyone can benefit from a class that covers some of the politics of birthing, not just mom's emotional and physical needs.

Eh, it's so up to you.  If I was recommending something, though, I'd say look to Bradley and hypnosis first, whichever you're more comfortable with and interested in.  I'm usually able to find at least one Bradley book (Husband Coached Childbirth or Natural Childbirth the Bradley Way) and usually a hypnosis book (usually Hypnobirthing by Mongan) at my local big bookstore, so you might browse through and see if one or the other strikes your fancy.

Jen

[ShannonandDel]

Thanks so much!  I will look into those books. I was totaly unprepared for Delaney's birth

[moogie]

Great Summary on Hypnobirthing Jen.  One of things i want to point oput is that Hypnobirthing is also about removing fear from birth.  Fear prolongs our labours and can therefore lead to interventions.  The education in /hypnobirthing classes is more about how our bodies function during labour, not about complications so it would be good to supplement the class with say /bradley or your own research. i did my own research and my hypno instructor was also a midwife so she gave me a lot of guidance about interventions.  Hypnobirthing is husband/partner assisted like Bradley.  Tristan had an awesome experience with Ashas birth, not a very good experience with Charlie as i didn't want him to touch me and i felt out of control. 

Jen, what you said about hypnobirthing and practice is true.  you really need to get it ingrained in you that it is possible. i had my doubts but my instructor helped me to snap out of it.  it really becomes such a rythmic trance once you get into it and you just know what your body is doing.  I knew that the time was coming close to pushing and my instincts were there the whole time.  the  midwife at the birth couldn't believe how in control i/we were.  Oh and my birth was so much shorter and they say thats a hypnobirthing thing too.

[jnezmama02]

Hey, I thought I'd throw my 2 cents in here, if you don't mind since we've been discussing this a lot in my NCB group on my birth board. Even though I've not used either, we've got a hypnobirthing instructor in our group as well as quite a few ladies doing Hypnobabies and it's been interesting readinig about the differences between the 2 main "brands" of childbirth hypnosis programs. (no one in our group is doing HypBirth b/c it's newer). Anyway,  here's what I've learned: 

--Hypnobirthing doesn't really offer home study courses here in the US, b/c they really encourage attending classes (though you might be able to find some used class materials on ebay); HypnoBabies offers either classes w/ additional home study materials or you can buy just the home study course materials. The home study seems to be a good pick for people who have already had a birth or who have already read a bunch on pg and birth.

--Both methods emphasize retooling women w/ different language to describe labor and birth in order to set up a more positive reflection of what's going on in their bodies rather than the negative image our society has given to labor and birth. Instead of contrax, they call them "surges" or "waves". Instead of pain, they call it "pressure", etc.

--Hypnobirthing teaches relaxation thru self-hypnosis by means of focusing away during surges; the method focuses on keeping calm and still during labor.  HypnoBabies teaches self-hypnosis by focusing inward during surges; also teaches how to stay in a hypnotic state while being more active in labor (walking, talking, squatting, etc).   

--Both methods seem supportive of having a partner assist, if you want, or going it alone. Though, I think from what I've read, the focusing inwards makes needing a partner to "help" less likely w/ HypnoBabies.

--Classes for both methods teach the physiology of pregnancy, labor, and birth; Hypnobirthing seems to include more postpartum info than HypnoBirthing.

--The few people who have done both methods seem to think that HypnoBabies is a more well-rounded, in-depth program and seemed to have better success w/ it.

HTH!

[jnezmama02]

Oh, I wanted to add that the book "Natural Childbirth the Bradley Way" was the single most useful book to me when I was prepping for Emily's birth.   Even if you decide not to go w/ Bradley Method, you should try to read thru it. I just got a copy from the library when I was prepping for that birth. I was going to check it out again for this birth, but it's always out. I wish I would have just bought my own copy last time...but I can't seem to bring myself to spend the money this time, lol.

The criticism I've read about Bradley method classes (please don't take this personally, Jen) is that it's a great information tool about pg & birth, but not so great at teaching actual pain coping skills (of course this depends a lot on the actual instructor). A lot of women know what's going on, but then kind of freeze up once they get into labor b/c they don't have something that's scripted. Also, so much of it relies on the partner to assist and a lot of guys get in there and freeze up and are useless to the laboring woman.

As far as techniques, I personally kind of blended Bradley and the self-hypnosis methods.  I can't get into scripted hypnosis..it just feels a little too "forced" for me. Instead, I rely on deep breathing thru contrax and focusing inward (while listening to music that does get me in a deep relaxed state). This is sort of like the focusing inward self-hypnosis, but just that I made up my things in my head that worked for me...it feels more "organic" to me. I also did A LOT of walking, squatting, using the shower, etc in birth to help w/ coping. Also, I didn't deny that birth would be painful, rather I decided to embrace it as having a purpose. So, I wasn't fearful of the pain...so that I could release the fear/tension cycle. DH just was kind of "there" for the beginning. When he become more of a coach was at the end of active labor and in transition when I no longer could focus inward....then I changed and became more focused outward on him...he kind of led me in deep breathing during that time. That really helped and I don't think I could have kept it together if he hadn't been there to help.  Anyway, my point in saying all this is that you can blend pieces of methods together to make something work for you, if you put in the time and energy to really focus on it and figure out what works for you.

[moogie]

Hope, I did Hypnobirthing and there was a strong emphasis on your partner participating, and in terms of the hypnosis i was taught to go within.  so it kind of sounds like how you described hypnobabies.  just wanted to clarify.  I was using different squatting and all fours positions for the birth too. with hypnobirthing there is a lot of focus on breathing to take advantage of contractions(surges) too.

[JenBerry]

I've discussed this with some doulas who've had clients use hypnosis and Bradley, and we all basically concluded that they're two sides of the same coin.  When you're really doing the Bradley thing, deep breathing, imagery (if that helps you relax), total relaxation of all the muscles you're not using, etc., then you can really "get in the zone" almost as if you were in that supercalm hypnosis state.  I sometimes refer to hypnosis as "Bradley, only more so" because the focus is really on the deep relaxation and the pain relief that comes with it.

Some Bradley classes do, I think, focus more on the book learning than the pain relief techniques.  I hesitate to say this, because I really do love the Bradley theory, but you'll probably find that younger teachers who are more concerned about covering the workbook and have less feedback from their students are the ones who don't do a good job really prepping you for labor.  It took me 2 years to get to the point where I felt like I was really teaching my students HOW to birth, not just ABOUT birth, kwim?  A hypnosis course might have that over Bradley b/c it's the main focus, am I right, Megs?  More practical in some ways.

I think it does bear repeating, though, how much Bradley does cover the politics of birthing today, as well as the common variations in labor and how to make choices about them.  If you are at all concerned about your birthplace's protocols, or your doctor's supportiveness of natural birth, you might want to factor that into your decision.

Jen

[jnezmama02]

Hmm...this is interesting Megs, b/c I went back to the birth board discussion of the two methods and pretty much copied what they said.  I'm not sure what they exactly mean by self-hypnosis by focusing in vs. out. Maybe it's the "method" of hypnosis used. Not sure.  There was also some discussion about Hypnobirthing only having one entry into hypnosis, where HypnoBabies had several entries...I'm not sure what that means, so I didn't include that.

I'm glad, though, that you were able to be very active in your labor...it sounds like either program is good. Perhaps the ladies on the board just had a personal bias for HypnoBabies over HypnoBirthing. Not sure.

Jen, I like your description of using Bradley Method relaxation methods to get "in the zone". That's definitely what I was able to do.  I think your right that it really has to do w/ the experience of the instructor. Also, I think it is also hard to tell someone how THEY can relax unless you use a very prescribed method like hypnosis. I think where Bradley really helps is if YOU can figure out how you best relax...your best music, best imagery for yourself, etc. It's not the same for everyone. But, that requires being really in tune w/ yourself and I think a lot of people don't figure this out themselves b/c they expect the method to do it for them.  Unfortunately, I think those are the type of people who freeze up.

Jen, can you describe what kind of things you cover when you teach them how to birth?

[moogie]

I sometimes refer to hypnosis as "Bradley, only more so" because the focus is really on the deep relaxation and the pain relief that comes with it.

That sounds about right to me.  And like you said, Hypnosis sounds like its lacking the important stuff like how to avoid intervention, when intervention may be needed etc. i think one of the reasons they don't teach this is because they feel that it may negatively affect the birthing woman by insinuating that birth has complications or can have issues.  With hypnobirting they actually don't want you to attend traditional birthing classes at all because of the negative impact it may have in terms of creating fear and doubt.  I think if they don't want you to attend traditional classes then they need to do more in terms of educating about interventions and complications in their own way.  I knew about interventions and complications from all the research i had done the first time around but also my hypnobirthing instructor helped me out to, though she probably shouldn't have according to hypnobirthing.  but she told me as a midwife not as an instructor.

oh and by the way even though those hypno women in videos look calm as cows, theres a lot going on in their heads and bodies and they know it.  I had a very calm exterior and i was focussed but it wasn't 'easy' like the videos make it out to be.iykwim

[JenBerry]

LOL, Megs, at the "calm as cows" comment.  I often dislike birth tapes from the Bradley organization b/c most of those women are so calm that my students don't buy it!    I end up showing some births from this great Discovery Health Channel show called House of Babies, located at a birth center in Miami.  You get all natural births, but some of them are harder than others.  I don't show the really loud, potentially scary women unless I still have students in class that need "permission" to act that way during their own births, but I like a few who at least make it look like work!

As for the ways I teach them to birth, there are such a variety.  I ride my students much harder now than I used to.  I used to spoon-feed them all the information without making them think much, if you want to know the truth about it.  I mean, yeah, I taught the relaxation practice, but that really just teaches you how to get to sleep when you're 9m pg and miserable.   I hit them with the reality check in Class 2, when I set up something I call the Intervention Buffet.  I place out little pieces of paper with various interventions on them (interventions for Energy & Hydration, like a routine IV, ice chips, clear juices, light foods; those for Pain Relief like epidural, IV narcotics, a doula, shower/bath, walking, self-hypnosis, massage, general anesthesia; you get the idea), and invite all my students to take a plate and pick up anything that they are at least 95% ok with having during their birth, as well as any pieces that they don't understand (b/c if you don't understand something it's easier to convince you it's okay).  We go through them and talk about what most hospitals have as their standard protocols and where you have some wiggle room.  I also remind them to think about what their doctor/midwife would choose for them, if they walked through the buffet instead, and how they feel about the outcome of that.

We do a lot of communication exercises, too.  Talking about what their fears and hopes are for the labor and birth.  What kind of support we think we might need.  I'm very open about my births and parenting a newborn, so  that basically anything they may be thinking that's shocking doesn't seem so bad next to what I've just said.   We practice pushing positions so that they get a feel for what they'll be doing, and what positions feel most comfortable to them, as well as what positions are good for particular situations (posterior baby, distressed baby, tired mom, etc.).  We practice a relaxation technique almost every week, from a progressive muscle relaxation, to sense memories, massage techniques for the coaches to use, and positive birth imagery.  We have a big 40-minute labor rehearsal in one of the last classes where I my students have "contractions" every 2 minutes, and the moms are the ones who decide how long they last so that the coaches are forced to watch her for cues.  They have to walk around my home or the store, moaning with the contractions or making horse lips, leaning on their coaches or the furniture, trying out hard labor.  The coaches are totally overwhelmed trying to rub the right spot, get water in between contrx, think of new positions to try out, new techniques to try, etc.  Seriously, they giggle for the first 5 contractions or so, but then they get down to business.  Oh yeah, Most Convincing Couple gets to pick a prize from my prize box, so that helps. 

Hmm, what else?  Back to the video topic, I try to use some really good ones.  There's one called Birth in the Squatting Position, it's a Brazilian video, and it shows about 6 different women all giving birth while squatting and the babies just slide out!  No doc pulling on them to manipulate the shoulders or anything, they just come out.  Most of my students have never looked at birth in that way.

A couple more useful tools:  I have a Priority Game that we play to discuss birth planning, where we have a bunch of flip cards with low-or-no intervention choices on one side, and high intervention choices on the other.  They start off with all cards low-side-up, then they have to flip over the ones they can stand to lose.  Then they have to flip over more.  And more.  Finally they're left with what are their highest birth priorities, the ones they should include on the birth plan.  This also presents the idea that, in all honesty, it's the very rare student who comes back in and tells me "yes, everything went exactly as we planned it to".  In fact I can only think of one who came close, and she was birthing with the same midwife I used for Nigel's birth so it was totally laid back and easy to do what she wanted.  Everyone else, choices had to be made. 

Okay, the other really great one that helps so much are the Trial Labors.  I have these cards that lay out a pretend birth, and all along the way there are questions about how to handle certain common situations.  A coach has to figure out what to make his wife to eat in early labor, or how to get the last-minute stuff in the car while she's in hard labor, or how to KNOW whether it's even time to leave yet (that's a biggie for most of my coaches, their big freakout-inducer).  If there's a question about how to support a mom in a certain situation I ask the coaches, but then we also turn it over to the moms and say "what would you like to see happen here?"  I encourage all the moms to write down anything they want their coaches to do, from what they plan to wear to what they want to hear, make freakin' index cards if it helps.  Coaches can't do their job if mom hasn't told them what that job is!  I really stress the partnership aspect of birth, whether the coach is a dh, cousin, mom, whatever.  The two of them are in this together, and how they work together affects the whole birth.  Even if things don't go as planned, even if there are complications, you can still get good feelings about the birth if the mom and coach are working together to make their best, informed decisions.  And you get those kinds of decisions when you've been thinking and talking about it together for a long time.

Okay, I've yacked forever.  Somebody put duct tape on my fingers.

Jen

[moogie]

the buffet sounds like an awesome idea. 

so if they choose an epidural do they get to pick out of one of 4 hats to see if they get forceps or suction too. lol. not sure what the true percentage is though. 

[JenBerry]

Well, we do talk about how if they choose the epidural they have to go back and get routine IV, continuous fetal monitoring, etc. since those are hard & fast additions.  I hadn't thought about having them pick other chance interventions based on that, thanks for the idea, Megs!

Jen