When couples attend Pink Kit classes, they often ask, “Why should we be preparing for birth? We’ve made our birth plan and chosen our care provider.” What is important is that the women is driving the car, not just taking a journey by car, which can imply she is the passenger. What we’re trying to get people to understand is that developing birthing skills is a necessity just like learning to drive a car. These couples include people planning homebirths with independent midwives and people planning hospital births with continuity of care team midwives or a GP or obstetrical specialist. Common Knowledge Trust (CKT) has discovered that analogies may help answer this question.
First, we tell them labour is like taking an unknown journey by car. Even if you’ve taken this road before, each journey is different and unknown. It can be very strenuous and demanding. It might be long. You might get tired. Someone or a few people might accompany you. Throughout this journey, others might try to help you out in order to safeguard you and make certain you reach the end safely. Some professionals might suggest that you skip the journey. Circumstances might actually require you to do that. Other professionals will encourage you to take the journey because it might become a highlight of your life.
Then we ask, what is the difference between that scenario and labour? After many responses, we tell them the real difference is that you have already learned to drive a car. If you had to take such a journey and didn’t know how to drive, would you be willing to spend eight to 12 weeks learning beforehand? Where is the birth professional in this analogy? Some are encouraging you to make the journey and others might think it’s too dangerous, or you might think you don’t need to do it, fly instead. The birth professional is usually the low or high tech mechanic.
Next, the couples talk about their relationships to the professional care provider. Their midwives are encouraging them to choose a birth plan. They have decided where to birth, and the doctors are often telling them what they need. So we present analogies to other common professional relationships. We are all passive when we go to the dentist, yet most of us take care of our teeth every day. If we took this approach to birth, we would prepare beforehand, but in the presence of the professional we would be passive. Not ideal.
Giving birth is more like learning to sing, dance, paint, throw pots or play an instrument. We probably seek a professional teacher. Yet we have to do the work to learn, as well as show the teacher our progress. If we took this approach to birth, then the birth professionals would be our musical instrument instructors, yet even midwives don’t often take that role. The Pink Kit is the driving lessons, so this analogy still doesn’t give us a clear understanding of what other similar professional relationship is like labour and being cared for.
By the time the class works through all the analogies, the couples begin to understand: only the woman is going to labour. The father, partner, friend or relative is there to help her on the journey, which will occur around and through whatever professional care they receive.
Since The Pink Kit information developed in the U.S. in the late 1970s and 1980s, thousands of couples have used the preparation and then laboured in hospital. Having done the preparation ahead of time, the couples work together with directed breathing; they use positions that keep the woman open. There is been a great deal of ‘best positions’ that have been theoretical and not worked for women, because they didn’t know enough about their bony structure or how the muscles reacted to positions. They do hip lifts and sit-bone spreads and carry out sacral rocking so their sacrum is mobile. This developed instead of the counter pressure on the sacrum that closes the space the baby needs, although it relieves the back pain. Learning to keep the sacrum mobile, gives the baby room and the woman relieved regardless of assessments, monitoring or other procedures going on around them. They just go on working through the process of labour. Staff and doctors often comment on what a “good labour” they had. “Weren’t they lucky? One woman responded: “I wanted to grab that person by the neck and shout, ‘You don’t know how hard We worked for that good birth!’”
When we ask couples what their mothers and fathers taught them about managing labour, most say: “Nothing,” “Not much,” or “It hurts, you’ll get through it.” If they haven’t been taught by their mothers and fathers how to manage labour, where are they getting the information, and how useful is it?
Whenever people need to accomplish a new task, it’s vitally important that they learn appropriate skills and then apply them. Because so few people have been at births, they have no idea what appropriate skills are. If a woman perceives her contractions as manageable, she will use her breath sustainably, create self-relaxation responses, get into” labour and accept the process. If she perceives them as painful or very, very painful, she will respond with ragged breathing, tensing her body and using other struggling behaviours. What CKT is teaching expectant couples (lessons they will eventually teach their own children) are the sustainable behaviours they can put into place regardless of the woman’s perception, particularly when she does feel her labour to be “painful
The fact is that these are the universal skills that any woman can use, not just another ‘theory’ or ‘technique’. People are continually saying that what they learned in ‘childbirth education’ classes went out the window, which means, to date, those skills aren’t universal enough or not useable. Why would a woman want to respond to labour with frantic behaviour? It’s the lack of appropriately learned skills.
As women learn these appropriate skills and apply them to the task, the
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