By Tracy Donegan

September's Brilliant Activities for Birth Educators offers a great introductory mindfulness activity that childbirth educators can do with their class families. Mindfulness can be a helpful tool that parents can easily add to their toolbox and Lamaze International has long recognized the concept of mindfulness and relaxation as a great benefit for pregnant and laboring parents. Rachelle Oseran, BA, CD(DONA), LCCE, FACCE, RYT-200 previously blogged 'Mindfulness and Lamaze - Is There a Connection' to discuss this topic. Today, GentleBirth Founder Tracy Donegan shares a simple and easy exercise that educators can introduce to their students. Mindfulness training is a core component of the GentleBirth program. It is a skill that parents can learn quickly, practice almost anywhere and can significantly change how they experience pregnancy, birth, and early parenting. There has been much recent press about it and Science & Sensibility recently covered this topic in a research review. Looking for more creative teaching ideas? You can find all the previous Brilliant Activities for Birth Educators' ideas here. - Sharon Muza, Community Manager, Science & Sensibility.

Why Mindfulness Matters for Childbirth Educators

Mindfulness is not a 'technique' or a birth 'method' and it's so much more than just 'being in the moment' during labor.

As a childbirth educator, think of mindfulness as a way to train the mind to focus. When you consider that it's estimated we check our phones every six minutes this is an important skill to hone. Mind wandering (you probably know it as autopilot) is a normal function of the brain but it's also a great time traveller taking us to places that aren't very positive, parents worrying about how they'll cope with labor...will they be able to breastfeed...or jumping into the past and replaying being cut off in traffic. When you're being mindful, you become aware more quickly that you've just jumped on a train of thought to a destination you'd rather not visit right now (it's stress-inducing) so before you travel too far you can hop off at the next station.

An important aspect for parents is that one of the 'pillars' or attitudes of being mindful also involves acceptance, meaning that we pay attention to our thoughts and feelings without judging them - without believing, for instance, that there's a 'right' or 'wrong' way to think or feel in a given moment (that includes believing that there is a 'right' or 'wrong' way to give birth). Acceptance says 'ok so this is not what I wanted but the fact is this is what it is - so what decisions can I make from here?' Acceptance helps parents see things as they are in this moment rather than how they want things to be. They can pause...direct their focus to their body and then make a decision from a place of intention rather than a place of fear. That's something we all wish for the parents in our classes.

It's estimated that we're on autopilot about half of our waking hours and most of the thoughts are repetitive which means we can get stuck in a loop of negativity quite easily. Mindfulness training helps parents develop an awareness that the mind has left the present moment and has gone AWOL.

The Neuroscience of Mindfulness

In brain science, mind wandering means specific brain circuitry has been activated (Default Network Mode) and when we use any muscle frequently it grows bigger. Why is that important? When we focus on staying present whether that's with our breathing, sensations or an emotion we engage different brain circuitry - (Task Positive Mode) which is associated with more positive emotions, less anxiety, and depression. So learning how to interrupt mind wandering can significantly reduce anxiety. Pregnant people are fortunate to have accelerated plasticity of the brain in pregnancy. They have a nine-month window to do a little DIY brain 'remodeling'. Mindfulness practice literally grows the part of the brain associated with executive functioning (decision-making) and shrinks the fear center. It's like a fitness program for the brain and each moment of mindfulness is like a bicep curl. As a childbirth educator, one of our goals is to provide parents with tools to help them to make informed decisions. With that in mind, can you think of a better muscle to 'grow' in pregnancy?

When to conduct this exercise

This exercise takes about ten minutes with a five-minute intro. It's an excellent exercise to do immediately after a class break or at the beginning of a class to improve learning effectiveness and information retention. I recommend including the exercise in every class of the series you're teaching and encourage parents to practice at home too. Educators can keep to the 15-minute exercise as you move through the different weeks of your class but after the initial introduction of the first week, the extra five minutes can be used as a check in with parents about their at-home practice. Avoid facilitating the mindfulness sessions at the end of an evening class which often results in parents falling asleep instead of remaining wakeful and aware.

How to do the activity in your childbirth class

I have provided a simple script that you can use to conduct the activity. Of course, you can paraphrase and make this your own, by changing the wording to suit your style.

Script: 'As you know focus can be very important in labor. We're going to do a simple exercise you can practice at home that interrupts stressful thoughts quickly'

Invite parents to sit up straight with their feet on the floor and hands in their lap.

Invite parents to close their eyes which helps focus or if they'd prefer they can lower their gaze a little and find a spot on the floor to focus on.

Script: 'Take three deep breaths in through the nose and out through the mouth and then return to your normal pattern of breathing in through the nose and out of the nose.'

Script: 'For the next few moments I'd like you to put your full attention on your breath. For some people, they focus on the feeling of the air entering the nose...can you feel it at the back of your throat? For others, they notice the rib cage as it rises and falls..or maybe you notice it in your belly? Wherever that is for you I'd like you to keep your full attention there.'

Remain silent for about ten seconds as the families focus on the sensation of breathing.

Script: 'And as your mind wanders (and it will) simply bring it back to your breath...you might find your mind wondering how long this is going to take...or you may notice you're getting hungry...simply acknowledge that as 'thinking' or 'sensation' and go back to the breath. Each time you notice that your mind has wandered THAT is a moment of mindfulness - congratulate yourself for paying attention.'

Script: 'Now I'd like you to take your attention to the way your body feels in that chair. Start at the top of your head and do a little scan down over your shoulders...notice the points of contact between the chair and your back...the way your hands feel in your lap...notice if there are areas where your body feels relaxed and areas that feel tense. No need to change anything - just notice it. Just like before, as the mind wanders to what you need to pick up in the grocery store or whether you turned on the house alarm, you'll gently redirect your awareness back to the sensations of your body in the chair. Send your awareness all the way down to your feet. Let's spend a couple of moments keeping your attention on your feet. Wiggle your toes a little. Notice the temperature of your feet...how your shoes feel..how your feet feel on the carpet. They've been on that carpet for x hours and you probably haven't paid any attention to that sensation until now.'

Script: 'Here's a wonderful tip for anytime you're feeling stressed. Ask yourself the question 'where are my feet?. As soon as you redirect your attention out of your head and into your body, you immediately reduce the activity of the emotional center of the brain which allows the decision-making part of your brain to come back online again. It's easy to do so you can practice this skill everywhere...the supermarket...the office...it works in any stressful situation. It's very helpful to do if you have any big decisions to make in labor...or as a new parent. In labor, if you have an epidural and literally can't feel your feet, you can redirect your focused attention to your breathing, your hands, or even the movements of your baby. So let's do that right now - bring your attention to your hands...notice how they feel...light or heavy...warm or cold...do you notice any tingling in your fingers or your pulse? As your mind wanders acknowledge that there has been 'thinking'and simply bring your attention back to your hands.'

Return to noticing the breath for another moment and invite the parents to open their eyes and discuss the experience. Did they find it difficult to stay focused? Can they think of a time recently that this exercise would have been helpful? Are they willing to test it out over the coming week and report on their experiences next week?

Take Away

As mindfulness continues to become more mainstream, we need to to make it accessible for more parents and dispel some of the myths around the practice. Sometimes you'll have parents in your class who have 'tried' mindfulness and found it difficult. This is often because they may have taken a class that starts with a 30-minute meditation session which is like trying to run the marathon with no training. Short training sessions will build their confidence as they develop their practice and build their skills as they begin to notice how much time they are on autopilot.

Class Feedback

'I'm a worrier by nature and it was worse in pregnancy. My husband and I made 'Find your Feet' into a game so whenever I was stressed he'd remind me to 'FF' (I think of it as Fast Forward to Feeling better). Parent Lisa Byrne

Parents will often report feeling relaxed after the short session. Relaxation can be a side effect of mindfulness as we reduce autopilot. Some of the most common responses from parents include the realization of how quickly their mind quickly jumped from pillar to post within a few seconds of starting to focus. Parents can also quickly get into self-judgment mode because their mind didn't 'behave' and wandered. Remind parents that they are exercising a new muscle and just like adopting a new fitness routine they wouldn't expect their physical fitness to improve with just five minutes of cardio. Consistent, repetitive 'training' is required to reap the most benefits and sculpt the brain. Adopting a curious attitude of the activities of the mind will also help parents to be more self-accepting. Encourage parents to be gentle with themselves as they practice and celebrate each time they notice their mind wanders - failure is in fact success. In each moment of every day, they have an opportunity to begin again.

Conclusion

Mindful body awareness is a simple but effective way childbirth educators can help parents change their relationship to stress. I find it even more meaningful for postpartum parents as a way navigate the big emotions of this intense period. Noticing and naming mind wandering as 'thinking', 'sounds' or 'feelings' also reduces limbic activity (known as 'name it to tame it'). This is a simple introduction to everyday mindfulness that parents can practice for short periods of time without needing any special equipment, silence or a darkened room.

Do you think you would be willing to give this exercise a try? Do you already do something similar in your classes? Please share your experiences in the comments section below.

Note: Please establish your own personal practice before teaching mindfulness in your classes. The literature on teaching mindfulness places considerable emphasis on the importance of the teacher embodying the spirit and essence of the practices being taught.

References

Dhillon, A., Sparkes, E., & Duarte, R. V. (2017, April 17). Mindfulness-Based Interventions During Pregnancy: a Systematic Review and Meta-analysis. Retrieved September 22, 2017, from https://link.springer.com/article/10.1007/s12671-017-0726-x

Killingsworth, M. A., & Gilbert, D. T. (2010, November 12). A Wandering Mind Is an Unhappy Mind. Retrieved September 22, 2017, from http://science.sciencemag.org/content/330/6006/932.full

Posner, J., Cha, J., Wang, Z., Talati, A., Warner, V., Gerber, A., . . . Weissman, M. (2015, November 23). Increased Default Mode Network Connectivity in Individuals at High Familial Risk for Depression. Retrieved September 22, 2017, from http://www.nature.com/npp/journal/v41/n7/full/npp2015342a.html?foxtrotcallback=true

About Tracy Donegan

Tracy is a Registered Midwife, author, President, and Founder of the GentleBirth program and App. Tracy is a global advocate for humanized, positive birth experiences. Tracy has a special interest in emotional well-being in pregnancy and the impact of mindfulness training in pregnancy and parenting. Tracy is a DONA International Approved Birth Doula. She lives in California with her two sons and husband Philip.

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