Teaching Music as a Comfort Technique

Many childbirth educators include background music within our classes – maybe we have energizing music playing as people arrive or over break, maybe we use relaxing music during relaxation techniques, maybe we use it as one of the tools during an ice exercise. Or we vaguely mention that you could have a birth playlist prepared. But I think it tends to be a background thing. How often do you explicitly talk about music in pregnancy, labor and postpartum and what the benefits are?

It turns out there is actually some good research into music in the perinatal period.

Music During Pregnancy

Several studies have shown that listening to music during a non-stress test reduces the parent’s anxiety and improves the results of the NST. (RCT by Catalgol, RCT by Oh, RCT by Soylu, trial by Dolker and RCT by Garcia-Gonzalez et al). With clearly proven benefits, and no risks, this seems like an easy thing to suggest. And while all these studies were in the context on an NST, one might be able to guess that listening to music during other stressful procedures or any time during pregnancy might also help reduce anxiety and improve baby’s responsiveness. Again, with no harm, is it worth sharing this idea?

One quasi-experiment found that when women in their third trimester listened to relaxing music with a tempo of 60 beats per minute for just 15 minutes, their anxiety level was significantly reduced. There were additional studies that looked at parents participating in music therapy sessions in their home and/or prenatal music classes. (cited in McCaffrey, et al)

Music During Labor

• Dance and music combined and music alone both reduced pain and fear during active labor. (RCT by Gonenc and Dikemen)
• Listening to music during labor led to lower levels of pain and anxiety, improved fetal heart rate and less postpartum analgesia. (RCT by Simavali, et al.)
• Listening to music reduced pain and anxiety during latent phase, but no difference during active labor. (RCT by Liu et al)
• Listening to music during labor reduced pain levels during active labor and at one hour postpartum, and decreased anxiety in active labor, second stage and one hour PP. (RCT by Buglione, et al)
• In a systematic review and meta-analysis by Santavinez-Acosta, (they use the term “music therapy” but I believe the included studies were all listening to music) they found: less pain during latent and active labor, less post-cesarean pain, less anxiety during labor and in the first 24 hours, less pain meds after cesarean.
• Another systematic review by Chen (note, there may be some overlap in the studies reviewed by this and the prior listing) showed lower anxiety, less depressive symptoms, lower pain and better blood pressure.
• An integrative review by McCaffrey, et al, showed 15 out of 20 studies showed statistically significant decrease in pain, and four showed a decrease. 8 of 11 studies showed statistically significant decreases in anxiety. Music also promoted relaxation and decreased stress. Two studies showed faster labor progress.

Reasons posited for why listening to music reduces pain:

• When music enters the ear, it stimulates the hypothalamus to produce dopamine and reduces cortisol. Causes the pituitary gland to release endorphins which decreases pain.
• Gate control theory of pain – non-painful stimuli (music) close the nerve “gates” so less of the painful stimuli reach the brain. (Distraction.)
• Positive memories may be associated with the music.

None of the studies showed any adverse effects or unfavorable outcomes.

Music and Cesarean:

Listening to music before surgery led to increased positive emotions, decreased negative emotions and lower blood pressure (RCT by Kushnir, et al). Listening to music during surgery reduces stress and anxiety (based both on subjective evaluation by the parent and objective parameters like saliva cortisol levels, heart rate and blood pressure). Stress levels continued to be lower two hours after the surgery. (RCT by Handan, et al; RCT by Hepp, et al; systematic review by Weingarten, et al; Cochrane review) When people listened to music after the surgery, they reported less pain and used less morphine. (RCT by Ebneshahidi and Mohseni)

Availability and Caregiver Preferences

In a survey of midwives and OB’s in Germany, 97% had the means to play music during vaginal birth, but just 38% of those did routinely. 47% had the ability to play music during a cesarean, but of those, only 15% typically did. 66% would recommend music during vaginal birth, and 38% during a cesarean. Most professionals felt music was helpful for team communication and patient communication, was relaxing to them and did not report that music distracted the medical team.

It may be worth educating parents that their caregivers might not think to suggest that they use music during labor or might not offer to play music during a cesarean, but that the parents can play music, or ask for it to be played in the OR, and generally that would be supported.

Types of Music

All of the above research is based on simply listening to music. The study protocols ranged a bit on whether the participant listened to music on headphones or in the room, and on the type of music played. Some used instrumental recordings only, some used songs with vocals. In some cases, there was standard music played for all, in some the participants were able to choose amongst a few standardized selections, perhaps in different genres to appeal to different tastes. Some used music associated with cultural traditions or “relaxing” music with no major changes in dynamics. In other cases, the person in labor chose the music.

I have always encouraged parents to think about having two kinds of playlists – one that motivates them to get up and moving which can be helpful when you’re getting tired but know that movement and positioning is helpful and one that relaxes them and make them feel safe and comforted.

Where to Cover

Here are ideas for where to include this info in a prenatal class:

• When talking about stress reduction in pregnancy, touch on the benefits of music for reducing anxiety and improving baby’s heart rate.
• When talking about exercise, talk about creating a get-up-and-get-moving playlist that you can use for exercise during pregnancy and then use in labor if desired.
• When teaching relaxation exercises, talk about creating a soothing playlist to use during pregnancy to calm you and build positive associations, then use it again in labor.
• When talking about what to pack for the hospital, remind them to prepare their playlist.
• When talking about getting settled into the hospital or birth center after triage, remind them to turn on their music to create the environment they will best labor in.
• When I teach the 3R’s of Labor Coping (Relaxation, Rhythm and Ritual) I always say “if you turn on music and the person in labor relaxes, then keep it on! If you turn it on and she tenses, turn it off for that contraction, then between contractions, try to figure out if all music is bad, or just that particular music (or volume or whatever), then correct it.
• When teaching how to have the “best possible cesarean” if it comes to that, include asking for music to be played.

Photo credit: from https://www.beautyandgroomingtips.com/2013/04/6-confidence-tricks-for-pregnancy-blues-days.html, marked in google search as free to share and use

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Breastfeeding Class Curriculum

I created a PowerPoint for a 2 hour long breastfeeding class that reflects all the current research-based lactation advice. I have included recommendations for breastfeeding video clips to use. (And here’s info on how to download them and embed videos in your PowerPoint.)

You can download this and use it in your classes. Hope it’s helpful! (To download it, go to the menu button in the bottom right corner of the slideshow image, click on the down button and choose download. You can then save that copy to your own computer and edit however you choose.)

Here’s a PDF of just the slides, if that is helpful. It doesn’t include the notes with more details on what to say about each slide.

AV Aids for Birth Classes – Videos

Videos are such a powerful tool in a childbirth and parenting preparation series. Seeing someone in labor can help to prepare them for what that might look like and feel like. Seeing a birth in a hospital setting (or at home if you’re teaching a home birth class) can help them start to imagine what their birth will be like and also gives them an opportunity to see maternity care procedures. Seeing a newborn baby squirming around helps them grasp what their baby might be like at birth. And seeing a baby and a breast come together is essential preparation for breastfeeding.

So, where can you find great videos? Here’s a collection of what I know about. PLEASE add comments with more details on these resources or with recommendations for other videos you would use in class.

Other than Injoy, almost all of the videos listed are free of charge. I put a $ sign at the end of the listing if you have to purchase them.

Injoy

If you can afford them, I think that nothing beats Injoy videos. Learn about their videos, and preview clips at https://injoyhealtheducation.com/. Consistently high quality, fairly diverse families featured. They intersperse clips from births with animated graphics of things such as the descent of the fetus during birth, and offer clear, easily understood narration about the birth process, breastfeeding, or newborn care. Childbirth educators who only work with clients planning out-of-hospital births may feel they are too medicalized, but if most of your population is planning a hospital birth, I think they appropriately balance working toward a lower intervention birth while also learning key information about interventions. $$

Other Options I have used:

Mothers’ Advocate. This series was jointly produced by Injoy and Lamaze and covers Lamaze’s 6 Healthy Birth Practices. All the benefits of an Injoy video, but free of charge. https://www.youtube.com/channel/UCaEXrckfk_s3x7i6gZhD5xQ. They are from 2010.

I made a video about newborn cues. You can learn more about it in this post.

Other Recommendations:

All the videos from here down were recommended by other birth educators for use in classes. If the person who recommended the video gave details about what they liked, I included those notes. I have not watched them all myself so please review in detail yourself before using in a class!

Birth Info

Evidence Based Birth by Rebecca Dekker, phD – her blog is great but I have not yet watched these videos, which include a full birth class series called “Birthing in the Time of COVID”. https://www.youtube.com/user/EvidenceBasedBirth/featured

Mandy Irby Birth Nurse – includes a multi-video series called Online Lamaze Class: https://www.youtube.com/channel/UCKzlDuEA1X68s4_Jh-UD82w

Alice Turner, doula and birth educator. Lots of videos with tips on comfort techniques and more. https://www.youtube.com/c/AliceTurner

Gentle Cesarean from Brigham and Women’s Hospital: https://www.youtube.com/watch?v=m5ivEYQQ380

Beaumont Hospital has a full series of videos: https://www.youtube.com/watch?v=5IJp1VSxZno&list=PL_OlobI2SUiqVkMWcLy8yvY3-5jzLAYpR

Hello Baby from the Childbirth Media Center: https://www.youtube.com/playlist?list=PLE6D2082C92555A96. These are good, but they are really OLD – we had them when I started teaching 25 years ago. (To all the old educators out there… these are the Carl and Donna videos.)

For talking about pushing and a way to practice it more concretely when an urge is obviously not present. https://youtu.be/5TRnHcdQE6E

Cesarean video – from Australia, so note any differences between what’s shown and your local practice: https://www.youtube.com/watch?v=5-y4C1G59IA

Playdough Surgery – cesarean. https://www.youtube.com/watch?v=utCS5rzNkfU There’s information here on using it in birth classes. https://www.lamaze.org/Connecting-the-Dots/Post/series-brilliant-activities-for-birth-educators-reducing-anxiety-around-cesarean-births-1

Birth Stories

Examples of what real labor looks like:

Alice Turner, Lamaze educator, recommends 5 birth videos with info on why she likes each video – find her recommendations and links to those videos at: https://www.youtube.com/watch?v=XSAXOgKD1kw

Birth of Easton: https://www.youtube.com/watch?v=eKMZyYJmiG8

Birth of Sloane – the person who recommended this said: “Home birth – Great partner support and example of different positions – no nudity – 6 mins 31 seconds – good sounds – baby born in water – interesting example of cord cutting by burning.” https://www.youtube.com/watch?v=pSyCal8fqig

Blake Andrew Isom. “Shows how the partner was right where the mother wanted him to be. He gave words of affirmation but you don’t hear them in the video. She had a doula at her birth so the husband was able to stay right with the mom holding her hands and comforting her.” https://www.youtube.com/watch?v=u8I1WF60U-Q

Denver Birth Videos. The person who recommended them said “I found this birth videographer from Colorado. She had so many beautiful videos on her website that demonstrated so many coping techniques and different things to try even in early labor like walking up stairs etc. Lots of great partner support and she has a huge range of types of births (home birth, water birth, land birth, hospital birth etc.). I personally messaged her and asked if I could use her videos in my classes and she gave me permission.” https://www.monetnicole.com/birth-videos?fbclid=IwAR1hiUd7gERN3IqP9KjHyr7w-c9vcm4QKURUr7Uc4pTXI2UnnAA7z6LZ3z0

Compilation of scenes from many births: https://vimeo.com/335523310?fbclid=IwAR2ReOU8q6WAsb9P_dxQ23xgwTVxDMxMogTLYimnGwg1qthZKgLLcpsHwMY

Postpartum

Great video with a Black dad talking about ways to support a postpartum parent: https://www.facebook.com/hashtag/postpartumforpartners

For talking about helpers vs visitors. FUNNY! Some may not love it because it pokes fun at some worthwhile breastfeeding advice but I preface it and it lightens the mood as a good transition after talking about some of the hard stuff during postpartum. https://youtu.be/joJb71sv_oE

Viral a couple years ago, but the Frida mom commercial is wonderful to open a discussion of postpartum. https://youtu.be/ZAtV-4_hw-w

Safe Infant Sleep for Grandparents: https://www.youtube.com/watch?v=7cXwlpSJL08

Breastfeeding / Chestfeeding

Please find those video recommendations here: https://transitiontoparenthood.wordpress.com/2023/02/13/av-aids-breastfeeding-videos/

Important Considerations

When choosing videos, here are some things to think about or watch out for:

Preparation:

ALWAYS “set up” the video. Tell them

• what they’re going to see
• why you’re showing this video
• what they should look out for

For example, here’s part of how I set up the Injoy Stages of Labor video: “I always show this video in the first week of class, because it provides a full overview of the labor and birth process from start to finish – sort of a preview of everything we will cover during this class series. You’ll see clips from three or four different families giving birth in a hospital, so you’ll see typical hospital procedures as well. I do want to give you a heads up: you will see a vaginal delivery of a baby – if you are uncomfortable with watching that, you can always close your eyes or turn away – but we find for many people it’s easier to see this for the first time when it’s not you or your partner giving birth… What I really like about this video is you’ll have a great opportunity to see what people in labor may look or sound like, what their partners can do to support them in labor, and how the care providers also support them. I want you all to look for some ideas on what each person does to help work with and manage labor pain.”

De-Brief

ALWAYS allow a few minutes to debrief the video. I kind of putter around a bit when turning off the video, turning the lights back on, sitting back down to give them just a moment to gather themselves. (It’s not unusual for someone to get a little weepy during a video.) Then I say “So, what did you see that surprised you? What do you have questions about?” Usually one of them will respond. If not, I may say something that addresses something that I think may worry someone, like “you may have noticed birthing people who weren’t wearing many clothes during labor… I want you to know that is because they chose to take them off, not because it’s typically required.” Then I’ll ask them to share things about whatever I asked them to look for in the video.

Diverse characters / settings:

Think about the students in your classes – age, race, socioeconomics, visions for ideal births, settings in which they will give birth. Make sure that there are people in the video who look like your students and/or have similar life experiences so they can relate, and they will feel like they belong in your classroom. If the people or settings shown are not like your students, give information about why this video was chosen. If you share a birth story video that focuses on one labor from start to finish, that may not feature a family who looks like theirs, so I introduce it by saying something like “this particular video has a single parent who is supported by her mother and doula – but all the support techniques can be done by any support person” or “this person does not speak English, so they have an interpreter at their birth. I like how the video shows all the stages of her labor from start to finish, so we can see how that process unfolds for one particular person. It shows how families might need to change and adapt their birth plan as things unfold differently than planned.”

Timing

I typically teach a 6 week series. I try to include some video in each session. I sometimes time it for right before a break so we can watch it, debrief it, then I send them off to break, where they might choose to talk it through with a partner or other students. Sometimes I show it right after break to get their brains back into class mode. I personally like videos that are about 8 – 13 minutes long… long enough to be worth settling in for, but not much longer than that because they eat too much into my class time. Some instructors take the flipped classroom approach and have students watch the videos between classes and discuss in class.

Prepping Videos for Use in Class.

I like to download my videos in advance, insert links to them in my PowerPoint and trim them to exactly the part of the clip I want to use. Learn how to incorporate video in PowerPoint.

Be sure to also check out my posts on:

AV Aids for Birth Classes – 3-D Models (dolls, pelvises, breasts, and more…)

AV Aids for Birth Classes – Posters and Images (to put on the wall or into a PowerPoint

Activities for Online Birth Classes

In the past year, so many of us have moved our classes online. We may continue to be online through coronavirus and beyond, as some instructors are considering continuing to offer online classes from now on, in addition to in-person. We’ve discovered that online classes can help make our classes more accessible to people from a broader geographic area, to people with limited transportation, folks who don’t want to deal with commuting to and parking at a class site, folks with disabilities, parents on bed rest, and more.

How do we make our online classes as engaging and memorable as possible? Here are lots of ideas for interactive birth class activities. My examples will go in order from pregnancy topics through the stages of labor and into postpartum and baby care. Most of the techniques can be adapted to many more topics than I address in my example.

Healthy Pregnancy

Due to my state’s Medicaid requirements, we have to cover several specific topics, including substances (alcohol, drugs, tobacco), healthy nutrition and food safety, exercise, sexuality and more. To address these topics, you could create an online Jeopardy game, or create a quiz in Kahoot to use in class, or use Zoom polls to quiz them during class. Or you could use Google Forms to create a quiz to send to the students as “homework.” You could use these wellness cards for ideas for questions and answers to include. You could adapt a grab bag activity by having a slide show with pictures of items and asking them to talk about them.

Anatomy Pictionary

Sharon Muza has a great icebreaker activity where she has students draw anatomy. You can easily adapt this to online classes by splitting students up into breakout rooms, have them use the Zoom whiteboard to create drawings, then screen capture those and return to the main room to share.

Jamboard Signs of Labor

This is an interactive bulletin board type activity, where there are post-its listing symptoms that labor may be starting. Students sort them into possible, probable, and positive signs of labor. Find it here, and make a copy for your use: https://jamboard.google.com/d/1a_zy4wqWA6koO0bfuQ_6aAbZIWjekdMjinHLaO_mjdo/edit?usp=sharing

On a Zoom call, the way you would use this is: paste the link into chat. Everyone goes to the link and they can all manipulate it together, and you can talk them through it. (Learn more about using outside apps with Zoom.) If you’re meeting in-person, I’ve got an old school version of this activity where you print the cards and they sort them.

Comfort Techniques Chat Storm

Tell them “I’m going to ask you all to type some ideas into chat… First, I want you to think about when you’re sick – what helps you to feel better?” They start typing, then you can prompt them more… “It may help you to think – when you were a kid, what did your parent do to help you feel better? Or what did you wish they had done that you think would have helped.” As all the ideas pour in over chat, you can read some out loud, affirm them, comment on how these might be used in labor. Then do another storm for “what helps you to relax?” (more questions)

Comfort Tools Scavenger Hunt

Either during your presentation on comfort techniques for early labor, or in a discussion of “what to pack for the hospital”, send students off to find something in their house that helps when they’re in pain, or sick, or feeling worried. Have them do show and tell, and talk about how you could use those in labor.

Virtual Background for Hospital Routines

When you discuss arriving at the hospital, you can use a photo of triage room as your virtual background. (Learn how to use virtual backgrounds in Zoom.) When you discuss moving to the hospital room, change your background to reflect that.

Word Cloud – what will labor be like?

During in-person classes, I’ve used a worksheet where people can circle words that represent what they think birth will be like (words like: messy, excruciating, beautiful, long…). Then they discuss – if your birth is like that, what support will you need? (Or if you’re providing labor support, and the birth is like that, how will you best support the laboring person?) In a virtual class, you could do this as a word cloud, where all the students add their words, and you’d see common themes arise, as words that multiple people type are shown bigger than those only added by one. I have directions on how to do a word cloud in mentimeter here: https://janelledurham.com/guide…/use-other-apps-with-zoom/

Jigsaw Puzzle Stages of Labor

Take your favorite poster / infographic of the Stages of Labor, and convert it to a jigsaw puzzle, as Mallory Emerson describes here: https://www.lamaze.org/Connecting-the-Dots/Post/series-brilliant-activities-for-birth-educators-solve-the-puzzle-of-virtual-teaching. For copyright purposes, you should only use images that you otherwise have the rights to use in your classroom. You can purchase a variety of images. I like the Road Map of Labor from Childbirth Graphics, but there’s also good stuff available through Plumtree, Better Birth, and Birthing with Guinever. (Find links to those products in my post on Where to Find AV Aids.)

You could either use this as homework – send students a link to do at home after class, or you could do it collaboratively during an online class – maybe as a warm-up before starting class or as a breaktime activity. It’s low key, interactive, and good for the visual and kinesthetic learners to review labor stages by interacting with the images.

Continuum Exercises

In a classroom, I have used a continuum exercise for something like: “If you have TONS of experience taking care of lots of newborn babies, go to that end of the room. If you’ve never held a baby under 6 months old, go to that end. The rest of you array yourself somewhere on that continuum.” It’s helpful to me to see the range of knowledge and helpful to them to see that they’re not the only ones… I have never done this for topics that I feel like people can be judgmental about… “oh, I knew she was one of those people.” But online you can do this anonymously. Have a slide showing a continuum like the pain medication preference scale, and you can have them annotate it to mark where they are. (You could also do this a poll or using another – rate on a scale of 1 – 10 type tool.)

Thumbs Up / Thumbs Down Reactions

They can use Zoom reactions to vote. Could be used for something like: “is this normal or is this a warning sign?” Or “is it time to go to the birthplace?” Or “True or False.”

Show and Tell

Sharon Muza suggests having students bring to class session: something they’ll want nearby when they’re nursing, or something they will use for newborn care. Learn more.

More Ideas / Training

For more general ideas you could adapt to perinatal topics, check out my Zoom Guide for more ideas on Demo Physical Activities on Zoom, Games and Interaction on Zoom, Use Other Apps with Zoom, Using Zoom on Facebook Portal, and more.

If you’d like to learn more about exactly how to use virtual teaching techniques in the birth class setting, I highly recommend the Creative and Confident classes offered by Sharon Muza, FACCE and Mallory Emerson, LCCE.

AV Aids for Birth Classes – 3-D Models

In separate posts, I cover where to find images (posters, PowerPoints, and illustrations) and videos. This post is focused on 3-D models: pelvis, breast, fetal dolls, placentas, and so on.

Note, all prices and links are current as of February 2021, and all may change (especially the Etsy items.)

Childbirth Graphics is the most comprehensive source. They’ve got all the basics: pelvises, fetal dolls, placentas, and breasts. And a whole lot more: cervix models, milk fat comparisons, pregnancy bellies… Durable and high quality. Sample prices: set of pelvis, doll, placenta, perineum is $256; pelvis $74 or $133; newborn doll $69; breast model $87.

Cascade Health Care Products has a number of products… they appear to all be Childbirth Graphics items that they are selling. Some of their prices are higher than Childbirth Graphics and some are lower, so it’s worth comparing. Set $279; doll $64; breast $97.

Birthing, Bonding, and Breastfeeding. Has rubber breast models ($20), crocheted breasts, and a breast model scarf. They say “The rubber silicone-filled breast forms a seal to allow for demonstration of flange fitting and nipple positioning. Breast reacts to pump and simulates what pumping should look like when the nipple placement is correct.”

Anatomy Warehouse. They have multiple pelvis styles and a placenta. They also have lots of anatomical training models that are not items you would use in a class. Pelvises range from $41 – $70.

Brilliant Activities for Birth Educators. This is not a site that sells AV aids… it’s a blog that tells you how to make your own! Lots of fun ideas for interactive activities.

Crochet or Knit Your AV’s: this post has links to patterns.

DIY Pelvis. How to make a pelvis model from 2 file folders!

Amazon

You can buy models on Amazon. They sell the Childbirth Graphics set, but it’s $275, and you can get it for $256 direct from CG. They have multiple inexpensive pelvises that claim to be life-size and flexible, but the reviews often say they are not life-size, not flexible and not that well-made. (But, they do have one that’s just $39, so maybe that’s a fair compromise?) They have this mini doll and pelvis for $39 or the doll, pelvis and placenta for $69, but the quality looks poor. (And they also have identical products that are sold under many brand names for a wide variety of prices, which is typical of low quality imports.) I think you would be better served by saving up money for one of the professional quality models from Childbirth Graphics (which last for decades!) or picking one of the Etsy items below.

(Note: the Amazon links are affiliate links – if you purchase anything on Amazon after clicking on one, I do get a small referral fee.)

Etsy Shops

Edy’s Wonderland. Set of pelvis, uterus, baby, placenta $167 (can buy pieces separately.) Miniature set of baby, placenta, uterus, beanie, diaper $56. Breast $17.

Wicked Stitches. The full set shown of sperm, uterus, placenta, baby, breast, belly balls, and baby poop / diaper is $131. All sold separately. Sample cost – breast $18.

Mother Hen Doula – Felt Pelvis for $6. Knitted breast $8, placenta $9, uterus $17.

Viva Doula. Non-pregnant uterus with detachable vagina and vulva; full-term uterus, placenta and sac; breast $234 for set; pieces sold separately. Sample cost breast $53. Also has miniature sets, dolls, knit penis, weighted doll $197.

Birth Matters NW. Weighted Dolls. $50

Mam Amour Dolls. Breast model and breastfeeding baby doll, $221. VBAC Mama Doll $234.

Namsis Craft. Breast and latch $25; placenta $110; doll $80, pelvis $60, uterus.

Milk Mama Milk. Placenta, baby, uterus $119; breast and latch puppet $34, diaper with poop $13, belly balls $12.

Your Birth. Doll $20. Cesarean birth apron $65.

Bebek liked ishop. Placenta, non-pregnant uterus, 4 breasts for $170. Placenta $48.

Soul Mama Crochet. Breast $22, breast and placenta $44

Hazel Creates Threads. Cloth pelvis, uterus and amniotic sac, crochet placenta and breast $133

Clover Care Doula Services. Uterus, placenta and membranes $108.

More ideas?

If you know of other great sources, add them in the comments!

Free Illustrations for Birth Professionals

Years ago, I created LOTS of simple line drawings for use in birth education materials. I’m putting them here for anyone who wants to use them for any perinatal education or birth support purpose, whether that’s for class handouts, PowerPoints, to show to a client over a video call, or whatever. Everything on this page is free for you to use, no need to credit me as the source. For any of them, just right click on it, and choose copy or save as.

Positions for Labor

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Forward Leaning

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Pushing Positions

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Anatomy

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Maternity Care

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Interventions

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Complications

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Fourth Stage / Skin to Skin

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Breastfeeding

Anatomy

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Positions

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Breastmilk Expression

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Birthplace Options

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Babywearing

Rebozo Techniques

AV Aids for Birth Classes – Posters and Images

I’m gathering links to resources, and will continue to add more, but here’s some to get you started. I cover posters, handouts, and illustrations in this post. I have separate posts on where to find videos and 3-D models.

Childbirth Graphics is sort of the grande-dame of AV Aids. They’ve got pelvises, fetal dolls, placentas, posters, and handouts galore. Primarily physical products you can order and have shipped to you. They have digital versions of posters you could use in an online class. Durable and high quality.

Plumtree Baby. Handouts, posters, and PowerPoints. Like Childbirth Graphics, all good stuff, with a really great look.

Transition to Parenthood. I have around 100 free-to-use illustrations depicting labor and birth positions, maternity care interventions, breastfeeding, and more. All .jpgs you can copy and use wherever you want free of charge.

I also have lots of free printable handouts for birth classes. The Guide to Labor Support is a 2 page cheat sheet that covers the theories of fear-tension-pain and gate control, covers counter-irritants and hormones, and more. I have three wallet cards: questions for informed consent and two versions of a comfort techniques reminder.

Brilliant Activities for Birth Educators. This is not a site that sells AV aids… it’s a blog that tells you how to make your own! Lots of fun ideas for interactive activities.

Better Birth Blog – Lauren McClain, birth educator, has created lots of great visually appealing handouts on a wide variety of perinatal topics. They’re primarily digital files you can print or share with clients.

There are free handouts for childbirth ed students and doula clients at these sites, but I haven’t had a chance to review them in detail: Birth Arts and Childbirth Professionals International. (Best Doulas has created handouts from articles published elsewhere, but I would think about copyright issues for sharing those.)

HolmCreative. Shawna Holm has an Etsy shop with printed cards, a positions poster, printable PDF handouts, and vector illustrations.

Educated Birth. Cheyenne Varner creates fabulously inclusive infographics and illustrations that reproductive health workers can purchase to use as teaching tools. You receive digital files – .pdf, .jpg, .png. The basic use pricing is for people with one income stream (e.g. doula), extra use pricing is for professionals with multiple income streams (e.g. doula, CBE). Can then use with unlimited number of clients.

Queen City Birth Work has another great set of inclusive digital illustrations of birthing positions. All proceeds are donated.

Praeclarus Press has free PDF posters of breastfeeding and also labor support by doulas. Inclusive illustrations.

Royal Midwives – active and upright positions – at https://www.rcm.org.uk/media/2313/rcm-a3-positions-poster-download.pdf

Student Midwife Studygram. Jess is a NHS midwife in England. When she was in midwifery school, she began doing anatomy illustrations to help herself learn, understand and remember what she was studying. Now she makes those illustrations available for others to use. Flashcards or PDF’s.

It Starts with Birth on Etsy has printable handouts, and printable posters

Stanford Medicine Photo Gallery: Images of normal newborn appearance (milia, lanugo, etc.)

Birthing with Guinever. Has two versions of a stages of labor poster.

Cost Comparisons

There are many considerations in choosing AV Aids for your class. First, I encourage you to only choose images that show diverse people – diversity in race, orientation / gender / family structure, ability, etc. I think each of the providers listed on this page does a fair job at that, but some place this as a top priority.

Second, look for the ones which best meet your teaching needs and style.

I know that cost is a consideration for many birth professionals, so low cost is always a nice option, but I also balance that with the fact that the people who create these products are working hard to provide great professional images that support working people and deserve decent pay for that work.

I just wanted to give some sense of the cost of items, so tried my best to compare apples to apples. I looked for a Stages of Labor poster on each of these sites (images above). Childbirth Graphics: 22 x 28 stages poster $25. Plumtree Baby 18×24 stages poster $24; Better Birth stages poster 11×17 (I think) $25. Educated Birth – Labor positions poster with comfort techniques – 24×36 $52. HolmCreative has a 12×36 poster of positions for labor for $50. Student Midwife fetal station and mechanics of labor poster, 11.7×16.5, £8 = $12. Birthing with Guinever – .jpg image, free download.

More ideas?

For more links, check out the Pinterest pages for Foothills Birth Services and Tina Gibbs’ Antenatal Teacher board.

If you know of other great sources, add them in the comments!

Setting Expectations for Parenthood

In a journal article on “Mother’s Expectations of Parenthood“, authors Lazarus and Rossouw address the influence of unreasonable prenatal expectations of parenthood on the development of postpartum mood disorders. They make recommendations for antenatal classes that I think are worth consideration for childbirth educators:

“Current antenatal classes focus mainly on the birthing process; however… it is the transition that occurs once the mother is at home that is pivotal in the development of depression, anxiety, stress, and low-self esteem… An education program focusing on compromised infant, support, and self-expectations during the first year post birth should be created and incorporated into existing antenatal classes… This type of education program should perhaps emphasize the potential realities of having a child (such as a difficult and painful birthing experience or a baby with a more difficult temperament) but, most importantly, it should normalize the ambivalence and doubt that a mother may experience post birth, and stress the importance of reaching out for help and talking to others if she experiences even the smallest difficulty during the transition to becoming a new mother.

“This education program could also highlight how current social norms for new mothers as “super mums” is… not merely unattainable but rather it creates an environment that promotes the development of depression in new mothers, given that women feel strongly obliged to isolate themselves and conceal their true feelings when they are experiencing difficulties and/or depression post birth. These behaviors only succeed in further feeding the symptoms of depression by avoiding the issues at hand… If a healthy shift to new motherhood is to transpire, it is the rule rather than the exception that this transition may be accompanied by some degree of grief and loss and changes in mood.”

As a childbirth educator, or doula, do you encourage your clients to think about their expectations and be certain that they are realistic?

In my post on “Failing to Meet Your Own Expectations“, I offer some questions parents can ask themselves about their expectations for their parenting, and some ways to re-frame them to be sure they are attainable goals.

Wallet Cards for Birth Classes

Long ago, I made small cards of the Key Questions for Informed Choice that I gave to students to keep in their wallets as a reminder. Recently, someone asked me for a copy of the file so they could print their own, and I discovered I had mis-placed it.

So, today, I created some new wallet cards, that you are welcome to use with doula clients, childbirth education students, or whoever would find them helpful.

Key Questions for Informed Choice

This file contains two versions of the key questions. Refer your clients to podcast episode 8 (or its transcript) to learn more about maternity care choices.

To learn more about how I teach clients the questions and how to weigh those against their personal goals and values, read about Teaching Decision Making.

Labor Comfort Techniques Reminder Card

I already had a two-page cheat sheet Guide to Labor Support. I created a comfort techniques wallet card to accompany it. Your clients can find the full Guide on the transcript of podcast episode 1 on Your Toolbox for Coping with Labor Pain.

There is more on the 3R’s in my episode on the Stages of Labor.

Visual Reminder of Comfort Techniques

If you feel like that first card is too wordy, and want something more visual, check out my visual comfort cards. These are not intended to stand alone. They would be best as reminders of concepts and techniques that you taught them, or that they can find in episode 4 – comfort techniques for labor. (The transcript for the episode includes a printable 2 page handout on these techniques.)

Printing the Cards

You could easily print these on paper or cardstock and cut them apart by hand.

I print my own nametags, so I always have “Name Badge Insert Refills” on hand, so I designed them to print on those. (They would also print on any of these products: 74461, 74549 or these Amazon brand cards. Note, those links are affiliate links, and I get a small referral fee from Amazon if you purchase after clicking on those links.)  These can easily be broken apart to create nice professional looking wallet size cards you can share.

Interventions – the Role Playing Game

Years ago, I created a Dice Game for Exploring Variations in Labor which I used when I taught a two hour class on interventions. I divide the class into three groups, and have them create three characters with different motivations, and at various points during the class, I have them roll dice and/or flip coins to see how the labors are playing out, then ask them to role-play how they think their character would respond to those circumstances.

I used the activity a few times, then my teaching schedule shifted to where I was mostly teaching refresher classes, breastfeeding and newborn care, so I shifted out of the habit of using it.

This weekend, I was scheduled for a 5 hour class which covered pain meds, interventions, cesarean, and postpartum. I decided this game would be a fun way to structure the majority of the class. I decided to start it by having them flip one coin and roll one die to determine where their character is on the pain medication preference scale. Then I asked them to create a character, decide WHY that was her pain med preference, and what support team and birth plan she’d have based on that. (Note: you could also include the medical mindset tool here.) Then we went from there, walking through:

• what week in pregnancy labor started (and talking about preterm labor, induction, and decision making about induction)
• how early labor started, how long it was, and how they’d cope and when they’d go to the hospital (to review that info from previous week)
• how long their active labor would be, what they could do to move it along, augmentation, and whether they would choose pain meds based on the combination of their initial preferences and how labor was unfolding for them
• how long pushing would take, what they could do to help, whether interventions would be offered, and what decisions they would make

The class went VERY well, with all the students really engaged, and really getting moments of insight into decision making and the need to be flexible about the details of the birth plan while still honoring the general intent. I also think it felt very non-judgmental, honoring the variety of reasons why people might make the decisions they do.

For example, our character with the -5 PMPS, who was a naturopath and planned a home birth ended up rolling on her first roll that induction was needed. So, we saw how that played out through the rest of the labor. Our character with the +6 requested induction and was counseled out of it, but then went into labor naturally at week 38, and had a fast early labor, and the epidural she chose, but then rolled a slower active labor, so we got to think through what that would be like.

Note: Although there’s lots of randomizing rolls and coin flips, I do sometimes adjust or nudge the results a bit. I want it to turn out that each character faces some challenges, but each ends with a vaginal birth and a positive experience. I cover cesarean after the role play is over.

There are so many ways you can adapt this idea, from a 10 minute review of the stages of labor, to a 30 minute labor rehearsal, or 2 hours on variation, or this ~4 hours class which includes stages review, practice of coping techniques, pain meds, and cesarean. Here’s a lesson plan for this class.