Rethinking Prenatals to Support Physiology & Promote Birth Ownership

Rethinking Prenatals to Support Physiology & Promote Birth Ownership

An Advanced Doula Workshop with Adriana Lozada, AdvCD(DONA), CSP, CBP

Birth is an internally-occurring, non-linear, physiological process, yet the current birth language, model,

and culture -with an emphasis on measuring, delineating and rigorous observation– ignore these facts.

Let’s explore a new educational model for prenatal visits that provides a framework strong enough to

stand up to the existing medical model.

Not only does this new model support birth physiology, but it can help dismantle learned compliance,

promote self-efficacy and birth ownership. We’ll discuss case studies and role play pivotal moments where

circumstances are primed to derail physiology.

Agenda

• 9:00 am – 9:15 am – Registration and Sign-in

• 9:15 am – 9:30 am – Introductions

• 9:30 am – 12:00 pm – Rethinking Prenatals (with 15 min break)

• 12:00 pm – 1:00 pm – Lunch (on your own)

• 1:00 pm – 3:30 pm – Rethinking Prenatals (continued, with 15 min break)

• 3:30 pm – 4:00 pm – Wrap-up, Evaluations, and Certificates

Objectives

1. Describe the 4 entwined aspects of physiological birth presented within this model.

2. Describe ways in which clients can begin to support these 4 aspects during pregnancy, to later improve

labor flow.

3. Describe ways in which clients can support these 4 aspects during labor, and your role as facilitator.

4. Reconsider the need for demarcation of a separate pushing state, learn how to convey evidence and

physiology to help clients internalize this new concept, and discuss how this can be put into practice

within the common hospital approach towards the pushing stage (whether it be directed or not).

5. Name 4 pivotal-moments during the birthing process that may require increased physiologic support,

and ways in which to navigate them.

6. Explore birth scenarios where interventions may be suggested or required (prodromal, PROM,

inductions, epidurals, GBS+), focusing on how to best support physiology, within the boundaries

imposed by the interventions.

7. Discuss ways in which this new birth model promotes birth ownership, and increases birthing

confidence.

Rethinking Prenatals 1 of 2

Outline

1. Consideration of the shortcomings of the commonly used birth model

2. Redefining interventions through a physiological lens

3. Explaining birth as a physiological process

• Building trust in the birthing body

• The iceberg analogy for separation of purviews

• The 4 Aspects of the physiological birth model

• Benefits

4. Ways to support the 4 aspects during pregnancy

5. Ways to support the 4 aspects during labor

6. Rethinking the pushing stage

• The evidence against immediate pushing

• The physiology of the second stage and fetal ejection reflex

• Integrating this information within the current hospital pushing practices

7. Supporting physiology in the face of interventions and/or labor not flowing

• The ROARR acronym

• Quieting the “thinking brain”

• Conveying the non-linear reality of birth through your own birth stories/scenarios

• Inductions

8. Supporting physiology during 5 pivotal moments

• Going past the “due date”

• Early labor

• Vaginal checks

• Crisis of confidence

• Preparation for pushing stage/pushing stage

9. Breakout Review: Partial reenactment of a prenatal meeting to convey this information

10. Birth ownership and the Birthful model

• Filling the void to encourage ownership

• Non-antagonistic, positive shift of power back to parents

• Increased self-efficacy and birthing confidence