Book Review - Hypnobirthing: The Mongan Method (the BEFORE blog)

Since this is the “before” blog you can expect there will be an “after” one as well.  I will be curious to see what that one is like!  I borrowed this book from my friend, who also happens to be my doctor, who used the method successfully for her two births.  She also took the class (which I imagine, after reading the book, is helpful).  But I thought I would review the book now, before labor and then again afterwards to see what I think of it.

Before I start I should throw in the caveat that it may not be completely fair to judge this method on a third labor.  Hopefully (fingers crossed) this is relatively quick compared to the others (although my labor with Asher was only 4 hours, I can’t really complain about that).  But still, I think it’s worth trying.

The reason I’m interested in this method is because I think there is definitely something to it.  I’m not saying it is “the answer” to a pain free birth (as advertised) but having attended hundreds of births I have seen with my own eyes the difference between someone who seems to be relaxed and “in the zone” versus someone who is completely out of control and screaming.  I think “hypnobirthing” or “deep relaxation techniques” or “meditation” or whatever you want to call it is one way of getting in touch with your body and maintaining that control. 

So, the book, I would say it was so-so.  It’s hard for me, as someone who believes in evidence based medicine, to go along with some of the things they say which feel completely fabricated and made up and don’t have any science behind them.  As someone who delivers babies I tried not to feel offended about some of the implications that I might not have the best interest of the patient in mind; I know they aren’t talking about “me” but it’s hard not to feel a little adversarial about that.  But for the sake of participating I pushed aside my scoffing remarks in my head and kept reading.  And like I said, even though there is not a ton of science behind this method, I think there is “something” to it and I’ll go into that a little bit later.

The main premise behind this method is that the reason we feel pain during delivering our babies is that we have “fear” and the fear causes tension which then translates to pain.  The author believes we have all been imprinted upon to believe it is painful and therefore it is.  So a big part of the book is about “releasing fear.”  As someone who has been through labor before (and had an epidural both times) it’s a little hard for me to believe that fear alone made me feel like my body was being ripped in half, like actually torn in two by sharp clawed hands, but, I’ll give them the benefit of the doubt for the moment, because I do agree that pain has a lot to do with how it is being perceived, and we have some science to support that.  There are a lot of analogies and anecdotes in the book about how animals deliver naturally without discomfort, which I don’t think is 100% true (cows bawl when they have calves).  We, as humans, also have the whole “giant head” issue which I would argue is proportionately more painful than it is for other animals.  She also tries to site historical evidence that birth didn’t used to be painful for women back in the day, or else Hippocrates surely would have told us it was.  This is not my favorite type of argument the, “well, they didn’t write down it was painful so it must have been not very painful!”  That just isn’t logical.  The author also clearly experienced her own birth traumas with her own deliveries with the old fashioned ether-forceps method and I really felt bad reading that.  It is embarrassing to me that the medical field did that to women and it makes me angry too, but it is truly not that way any more and so getting people riled up about that now doesn’t seem to be too helpful to me.  Although, I might add, that I “think” the whole thing was well intentioned.  I think doctors thought they were really helping women by putting them to sleep for something that seemed to be really painful, but in retrospect it seems sort of cruel.

After the theoretical and historical discussion, the bulk of the book touches briefly on different types of relaxation/self hypnosis exercises as well as some positioning and labor preparation.  The thing that strikes me as the most funny about the method is that they have renamed pretty much all the aspects of pregnancy and labor with their own terminology.  The author feels that medical terminology puts a negative slant on things and that negative imprinting again can lead to increased fear which leads to increased tension which leads to more pain during labor.  So there are no “contractions” they are called “surges” and your water doesn’t “break” it “releases.”  They actually have a full list of substitute words.  I would argue that it is our perception that makes those words “negative” not the words themselves, but, whatever, call them whatever you want to call them, I don’t care, I’ll stick to my own lingo.  There are some other parts I don’t completely agree with, one being that the birth process can imprint the baby for life and that a hypnobirthing baby is a “better baby” after you take them home.  I’ve seen a lot of different styles of birth and I have trouble believing that a traumatic birth is going to screw up a baby for the rest of their life.  Of course I don’t think anyone has ever studied if temperament is linked to birthing method, but that is what they are suggesting.  What about all of those poor NICU babies, should we just write them off as being future criminals since they were so traumatized as newborns?  I don’t think so!  They often are little fighters and do wonderful as children.  So that part is far fetched to me and setting people up to be potentially disappointed if the method doesn’t work well for them.  The final part that I am wrestling with regarding the book is their description of what we (in medicine) would call “pushing” and they call “breathing down.”  The author emphatically states a woman should “not push” the baby out, that it is counter productive and bad for the baby and that relaxation techniques and breathing techniques be used at this phase.  I’m intrigued by this idea and open to the possibility that maybe pushing can be counter productive at certain times right after transition (which is why we let people “labor down” occasionally).  But personally, even with an epidural, I still felt what I would absolutely describe as “an urge to push” that felt like the natural thing to do.  I also have a lot of patients who describe the pushing phase as a “relief” because it gave them something to do with the pain of the contraction.  I read that section carefully, on how exactly you “breathe down” the baby to delivery, and it sounds an awful lot like panting or quick grunty pushing.  I would be interested to actually see this correctly done and see if it does or doesn’t involve involuntary pushing because I couldn’t completely tell from the book.  Lastly, my final disagreement is that they recommend perineal massage on a daily basis.  This is something we actually have scientific evidence to show that it makes no difference in tearing so I’m completely discounting that advice.  I do have some bigger issues with management of labor stuff they suggest; avoiding intervention, arguing with your doctor and things like that, but I don’t really want to get into that here.  I fully support a natural labor, but I also have the experience and medical knowledge to spot dysfunctional labor and I know what the outcomes are for those labors if we don’t intervene.  My interventions are always an attempt to keep the wheels on the bus to get a good outcome (health mom, healthy baby is the goal!) and sometimes that means things don’t go “as planned.”  Anyway, like I said, discussion for another time.  There are a few other little tidbits here and there that I could argue with but none that seemed like they would actually make any real difference if you did them or not and are probably not harmful, so again, who cares, don’t sweat the small stuff.

The best parts of the book are, in my opinion, the relaxation techniques.  And probably the truly best parts are not the book at all but the relaxation CD that comes with it to listen to and practice relaxing.  While there is some evidence out there about pain perception and meditation there is not a ton of it, but I believe in the mind-body connection (not based on any science at all, just my own experience and belief system) and so I think that there is something to it.  I have had a handful of patients use this method and 2 in particular that I would consider to be very successful with the method and it was amazing to watch them.  It looked like they were sleeping throughout their entire labor and then all of a sudden they woke up and said, “I need to push” and pushed (in what I would describe as the normal way of pushing, not the “breathing down” way) and had completely normal and beautiful deliveries.  After seeing that, who wouldn’t want that for their own labor?  I’ve also seen people use the technique in the beginning but completely lose it during transition.  I’ve also seen people who had no training in relaxation techniques who seemed to find a place, a “zone” where they were definitely not “present” during labor and managed their pain in that way.  My only personal experience with these methods is in athletics (where I had training from a few of my coaches in meditation/relaxation/visualization techniques).  My best races in swimming contained elements of this.  My very fastest race ever was the closest I’ve come to an out of body experience.  It was a mile swim, so it was around 16 minutes of what is usually a pretty painful experience, but in that instance I was swimming faster than I ever had before and I felt no pain, and I also had time distortion where it was like time stood still and skipped forward at the same time.  So I have experienced it before, just not in the instance of labor/birth.  I believe it is possible.

Overall I think this is a good book.  I always have difficulty with these birth advice books because I really feel there is no “right” way to do this and they often suggest there is.  Every woman is unique, every baby is unique, every birth experience is unique.  To try to contain it within any paradigm is a little bit silly in my opinion.  Plus, it is one of the few scenarios in life where no one is actually in control of the outcome or can really predict very well what is going to happen.  So my plan is to try to experience the best of both worlds.  I plan to use the techniques they present to the best of my ability (without buying into the theoretical mumbo-jumbo) and see how it goes.  But being the scientific type I plan to be in a hospital with a doctor where someone can actually help me and intervene if the wheels do start to fall off the bus.  Here’s to hoping for a fast and pain free delivery, but more importantly for a healthy mom and baby in the end!

Product Review: Towels

I don't often endorse a product, but there are some things that I just love and even though they are relatively small moments they have a way of making my day, and these towels are one of those things:

http://www.bedbathandbeyond.com/product.asp?SKU=109354

These are the most amazing towels I have ever owned.  They make me feel like I am in a spa every time they touch my skin.  They seem to be holding up well to washing (I've had them a couple of months) and maintaining their ultra-softness.  These towels actually make me smile and sigh with contentment.  They were sort of a treat to myself for minimizing our towels (because they are expensive) but let me tell you, they are totally worth it!  And for me all of that is part of what minimizing is about, having fewer things but choosing a better quality product that will last longer and bring more enjoyment on a daily basis than something cheaper and larger in quantity. 

Before we moved we had WAY too many towels of a variety of colors and in various states of falling apart.  Most of them had also become sort of "calcified" (I don't know how else to describe it other than stiff and scratchy) from our really hard water in Wisconsin (even with our water softener the water was still very hard!).  So we donated almost all of them to Goodwill (and I'm sure they threw some of them away!).  We did keep a couple to put in the garage for washing the cars and also a couple to use to catch the buckets of sweat my husband produces by spending hours on the spin bike.  I decided to buy 4 of the above bath towels and 3 hand towels and that is it (I skipped washcloths because I don't find they get used at our house).  Just the other day I went back and bought one more bath towel for the baby so that every person in the house would have one towel.  They are plain white and fit into the decor of both bathrooms so I don't have to worry about matching.  I suppose if we are getting technical then the kids each do have an additional "special" bath towel (a butterfly and a dinosaur) that they received as gifts that they use often and we do have 4 "beach" towels for swimming and such (which, if we didn't have room, could definitely be minimized and we could use our bath towels for that purpose, which I might end up doing anyways now that I think about it...).  But even that amount is still much better than the many many towels we used to have stacked in the linen closet.  The only down side I can see to limiting the number of towels in a house to one per person is that if we have more than 2 guests come stay with us I guess Andy and I will have to share a towel, or use one of the swimming towels (which of course would be fine), but otherwise it makes storage much better!

So, if you're looking to replace some old towels with just one amazing towel, try one of these!

Minimalist Nesting

Now that I’m 36 weeks and approaching the time when the milk in the grocery store will have a due date after mine I’m getting that urge to start nesting.  For those that haven’t experienced it before it is difficult to describe other than a little tickle in the back of the brain saying, “prepare! prepare!”  Unfortunately in our society that translates really quickly into “buy! buy!” which is what I’m trying to avoid.  I’m working on channeling that energy in other ways but it is not easy to avoid the marketing directed at parents.

It actually makes me a little angry sometimes, to imagine ad executives coming up with plans to try to catch me at one of my most emotional moments to make me buy things that I don’t need.  Somehow though, despite this hostility, I do occasionally get sucked in and have found myself accidentally shopping for high-end strollers or special bassinets, neither of which I need.  So I’ve done my best to keep myself from shopping and decided that the best strategy would be to make a list of what I felt (for me) the minimalist newborn equipment would be and try to stick to it. 

In making this list, I have the advantage this time around (being my 3^rd child) of experience and so that certainly helps.  I didn’t know about minimalism as a lifestyle concept after my first two kids were born (now 7 and 4 years old) but even with them, as I was buying things or receiving gifts I would often pose the question, “do I really need this thing?” and at the time the answer was, “maybe?” and now I know that often the answer is “no” or at least “maybe I should wait and see if I need it.”  When my son outgrew his baby things I got rid of almost everything, gladly, with the happy thoughts that the people borrowing it or buying it could certainly use it and our closet couldn’t since I didn’t know if we would have a 3^rd child.  So this time around I’m starting mostly from scratch and I love that I get a clean slate. 

The other up side to this being a 3^rd child is that I don’t plan to have a baby shower.  Don’t get me wrong, I love baby showers and parties of all types, but I’ve never been to one where there wasn’t a lot of unnecessary gifting. Looking back at my own shower, it makes me a little sad sometimes to think about the clothing that I was given for my first daughter that never got worn, that I gave away to friends (with the tags still on!) because we got a lot of clothing as gifts, and she didn’t grow at the standard rate (a lot of kids don’t) and so she never got to wear them!  Because of that experience I always encourage people wanting to give a baby gift to give the gift of a housecleaning, meals, babysitting, or a pedicure as those are often the things you really don’t want to do for yourself after your baby is born and you need a break!  Other great gifts are baby or children’s books (because we know reading to your child at an early age is good for them) or a gift card to buy necessary items that pop up along the way.

So the list, it is tailored to me personally, I don’t expect anyone else to use this list as a rule, but I’ll try to spell out why I think it is what it is.  I also welcome feedback and comments as I WISH someone would have told me these things before I had my first child and I imagine there are a lot of different opinions out there.

The list:

Car seat – This is only if you have a car of course!  We do, and we unfortunately have to drive places (we live within walking distance of a lot of local favorites but both my husband and I are working professionals and our jobs require driving a distance that is not walkable).  I am hopefully going to be borrowing a car seat, instead of purchasing one, which is not something that is necessarily recommended by safety experts (to get a used car seat) but it is from a friend I know well and trust and so I feel comfortable with this plan.  But in the end, in the United States, you normally are not allowed to leave the hospital with your baby if you don’t have a car seat, so that is why this is at the top of the list as a necessary item.

Clothing -- Technically they don’t “need” clothing if they have blankets, but I think most of us feel better with our baby in some sort of clothing, I know I do.  This particular baby is going to be a winter baby and so the list is different than it would be if it were a summer baby (which would probably include only onesies, I know that is what my son pretty much lived in as a summer baby).  But, even a winter baby doesn’t need much and in our household of soon to be 5 people, who all have minimized our wardrobes, we do either daily or every other day laundry so it’s not necessary to have a week of clothing on hand.  I believe a reasonable minimum is 6 gowns or footed pajamas and 3 “outfits” for the 0-3 month age range to start with and to have about the same (minus the gowns, because they generally fit for a long time) for the 3-6 month age range.  Will I probably end up with more?  Yes, probably, I am a sucker for adorable baby outfits, but I am trying to limit my own purchases as I expect we will get some of those adorable baby outfits as gifts.  I’m basing these numbers on the experience I had before, that even on a bad day we would usually only go through about 4 clothing changes.  Maybe less with my second child because I just got lazy and tolerated some spit up here and there without feeling the need to change clothes.  Also, I found that both my kids spent most of their time in gowns or pajamas or onesies, they are just so much easier (especially the gowns, no snaps!) than an outfit, although when the opportunity arises to dress them up a little bit it is fun to have a few cute outfits on hand.

Diapers – I don’t plan on stocking up on too many diapers ahead of time because of the size issue; you just don’t know when they are going to need “newborn” size or “size 1” or “size 2” because they all have different size butts and different size poops! I’ll probably buy a pack of newborn disposable diapers to start with because my babies have been on the smaller size in the past and they tend to go through anywhere from 6-12 diapers a day in the first couple of weeks and then go from there. I’ve never done cloth before but have contemplated it for this one.  My husband said he doesn’t want to participate if we do cloth so that sort of takes it off the agenda for me (an agreeable partner is necessary in the newborn phase!).  I would be curious to hear from those out there who use cloth how many diapers and diaper covers they feel they truly “need” versus how many they actually have.  

Crib – we happen to already have a crib, so we will be using it at some point, but I don’t feel a crib is an absolute necessity, especially not in the first few months.  It would be possible to get by with a bassinet and pack and play or some other arrangement for quite some time. I don’t want to really get into a co-sleeping or family bed debate, I’m going to leave that up to everyone’s individual choice, but I think it is likely that most people do end up with a crib at some point.  I encourage people to buy a safe but inexpensive crib, because really, they only sleep there (sometimes) and they are such large pieces of furniture that are difficult to store afterwards and it’s nice to not feel you HAVE to keep it once you are done with it.

Other sleeping equipment  (i.e. Bassinet, co-sleeper, pack-n-play) – Again, depending on what you choose, any of these are not absolutely necessary.  I happen to already have a co-sleeper, and really loved having it for my other kids.  I liked that I could have them near me to breastfeed during the night but not feel like I was causing them potential harm by having them in the bed with my husband and me.  In our other house we had a pack-n-play, which was really convenient for naps on the main level of the house as well as diaper changes and traveling and such.  That being said, this time we are going to do without, we don’t have space in our new house and I figure I could use the exercise of going up and down the stairs more anyway, if this ends up being the wrong decision I could probably borrow or rent one for a few months to get us through.

Entertaining equipment (i.e. Swing, bouncy seat, jumperoo, exersaucer, playmats, etc.) – I don’t think these are truly necessary items in any way.  This time around we may borrow a bouncy seat and then maybe an exersaucer just depending on how things go, because I do think it is nice to have a place where you can set them for 15 minutes while trying to grab a shower or start a meal or things like that where you can see that they are “happy” and safe.  I think it is possible to achieve happy and safe without buying large pieces of plastic equipment, it just takes a little more effort, which, depending on the day, might be more effort than one would want to put forth.  Also, in retrospect, the amount of time they use these items is VERY short.  A couple of months, maybe, before they are beyond them.  So investing a lot of money (and house/storage space) in any of these items is not really a good idea.  We have had all of these in the past and don’t have any of them right now so I’m going to wait to see how it goes before deciding whether or not we need them.

Transporting equipment (i.e. Carriers, packs, wraps, strollers) –With both of my kids I spent a lot of time carrying them in some sort of carrier.  Babies like to be close to warm bodies and mine were the happiest in a sling, wrap, or carrier of some sort.  I don’t have a particular preference as to the type; I did love the Moby wrap with my son and feel it is great even for a newborn and adaptable to older infants as well.  I found I hardly used a stroller for my second child as he was always in his wrap or carrier (our Bjorn wore out and so this time I did buy an Ergo, we’ll see how it goes!).  I did the big stroller/travel system thing with our first child and found it to be a total waste of money and space.  I hardly ever used that bulky stroller and it didn’t even fit in our car very well.  At around 4 months with our first I converted to a lightweight stroller for the purposes of travel and was happy with that decision, we still have that stroller (it’s pretty banged up but it still works!) and will use it if needed, it doesn’t fit an infant seat in it so it will be more useful again after 4-6 months when the kid can sit up.  We do own a double jogging stroller (a Chariot) and we have gotten a lot of use out of it with our two older kids and we love using it for our frequent outdoor activities which are an important part of our lifestyle (running, biking) and we’re contemplating getting the ski attachment to be able to go cross country skiing with it.  That may not be for everyone and it is a big investment based on cost and storage space so think carefully if it will work for you and your current lifestyle before buying any specialty stroller.

Feeding items (bottles, breast pumps, baby food makers) – The breast pump decision is totally dependent on plans for going back to work, etc.  I encourage people to wait to buy one because sometimes (depending on your health insurance) the pump may be partially paid for if you are struggling with milk supply issues.  If you’re going back to work very soon after giving birth then you may want to invest in one.  A lot of people can get through with a hand pump and so don’t discount that as a possibility as it is a cheaper option, but if you have limited time for pumping then a higher grade electric pump is a better choice.  My pump wasn’t working that well after it’s second time through and so I got rid of it, this time I’m going to see how it goes as I won’t be going back to work right away, I may borrow a pump from a friend (not generally recommended to share a pump) but again in this instance it is someone I know well and trust.  I encourage people not to buy too many bottles because I find some infants really have a preference for certain nipple types and you might find yourself going through 3 or 4 different kind of bottles before finding one that works.  Of course, if breastfeeding you may not need a bottle at all so better to just wait until you need one before buying.  Since my kids were mostly breastfed and I tried to feed them myself whenever possible we only ever had a few bottles on hand (approximately 5) since we used them just a couple of times a day and washed them regularly, so I don’t really know how many are “necessary” if you are strictly bottle feeding.  As far as baby food makers, I don’t know a lot about them, we never had one.  The amount of time between starting baby food and converting to “real food” is so short (usually between 6-12 months of age) that again I’m not sure a lot of baby food making accessories are necessary.  I do think it is great to make your own baby food, but if you have a food mill or food processor I’m not sure you need a “babyhood maker” but would be interested to hear someone else’s opinion about this.

Other items – I think all other items are really dependent on your personal preference.  Did we have a special diaper disposal system (like a diaper genie)? No, we didn’t, and we never felt we needed it and we don’t need it now.  We never had a baby wipe warmer and our kids’ butts never seemed to be damaged by a cool baby wipe (in the beginning we used warm wet towels anyway).  We didn’t have a changing table with our kids and we still think it is not a necessary piece of furniture (we had a changing pad which we moved around the house and mostly used on other pieces of furniture or the floor and honestly we felt it was safer that way).  We had a baby bathtub with our first child but after a couple of tries it was clear she hated it and she only enjoyed a bath if we were in the tub holding her so we usually bathed with our kids and got rid of the baby bathtub.  We do have a baby monitor because of the distance between our room and our baby’s room, but if our room was closer I don’t think that would be a necessary accessory and we’re probably not going to need it for the first couple of months anyway.  I had a Boppy pillow with my first child but I found it uncomfortable for me for breastfeeding (personally) and I did better with rolled up blankets and pillows positioned for our mutual comfort.  We do have a glider/rocker chair which is a piece of furniture that I really enjoyed during the first 12 months with both my kids and I am glad we have kept it for this third one.  It is very comfortable for breast feeding and rocking soon after delivery, but I think that is mostly personal preference and again not absolutely necessary.

Toys and books – As a parent I have come to loathe manufactured and advertised toys and this is where I feel the minimalist need the most right now.  This is also where I learned from experience as we overdid it with toys during my daughter’s first couple of years of life.  It became very clear to me rather quickly that they do not need a lot of toys.  Babies are much more interested in interacting with humans (appropriately) and that is what we should be doing with our babies most often!  Putting them in a swing or on a play mat or handing them a toy is not that fun for them (except when they figure out they can create a game by throwing the toy on the floor and observing us pick it up for them repeatedly).  Like most kids our daughter loved playing with tupperware and wooden spoons on the kitchen floor more than she liked any of her plastic toys.  Is it reasonable to have a couple of distracting items (like a rattle or stuffed animal and a couple of toys that they can put in their mouth to chew on) yes, I think that is very reasonable, but most kids end up with an excessive amount of large plastic toys that I think are absolutely unnecessary.  Books, however, are healthy and good for babies and so I think having a small library of baby and children’s books is a good idea.  I think using the local library often is great, and most babies probably don’t care what you are reading to them so even reading a magazine is fine (although expect page ripping to occur).

So that is the list!  Again, I’m interested to hear everyone’s opinion about this, I’m sure there are lots of different thoughts out there and I’m pretty sure there isn’t a “right” or “wrong” answer as to how much and what is needed for a truly “minimalist” nesting and first year of life.  Personally I have been trying to use that little “prepare! prepare!” voice in my head to channel the energy that I might otherwise use shopping for “stuff” and invest it in keeping my body healthy during my pregnancy with a good exercise routine and preparing healthy meals for our family (both time consuming activities that require real effort!).  Also I’ve been taking some time for creative things, like painting a wall mural in the baby’s room and doing some journaling, that are both relatively low in terms of cost but make me feel like I’m giving the baby a gift of something that I made just for her that couldn’t be bought.  Sometimes when I’m walking through large stores and seeing aisle after aisle of cheap toys and baby items it makes my stomach turn a little thinking that we, as a society, have placed such importance on such unimportant things during such an important time in our lives.  Our babies need our time, our full attention, and our love, not our stuff.  They come to us naked and with nothing to give but love, which reminds me that in the end, she is the true gift and blessing, she already has all the “stuff” she needs within her and I never ever want to lose focus on that.

Writing it Down for Posterity

After all of our recent struggles with Avery (and things have slowly been getting better, very very slowly), she totally blew me away with something she said tonight and so I have to write it down, because it may be a very very long time before I ever hear anything like it again!  As she was going to bed she said, "Mommy, I love you so so so much!" and I said, "and I love you too!" and she said, "And thank you for taking such good care of me, and making sure I'm always safe and healthy and alive, because I only have one life."  I have no idea where that came from, but it brought tears to my eyes!