Episode 10 - Active Birthing With Laura Callea Including a FREE ACTIVE BIRTH CLASS link
Physio Laura Callea joins us to explain what active birthing is, and how we can use tools from this toolbox to help us labour with greater ease and confidence. She also shares access to her FREE online active birth class.
[00:00:00] Welcome to the Mama Matters podcast. Whether you're expecting you've recently given birth or you're just starting along your fertility journey, it's time to get down to the nitty gritty and sort fact from fiction. I'm your host, Rosie Dumbrell, Physiotherapist and pregnancy expert. Mama Matter aims to provide an easily digestible up to date and evidence based approach to pregnancy, birth and motherhood, with a side dose of humour along the way. With interviews from the industry's leading experts and experience of my own adventures as a mother to three gorgeous boys under four, I want to share the stuff that helps to grow confidence throughout motherhood. Mama Matters is a podcast by Lenny Rose Active, and this is what you can expect to hear in upcoming episodes.
[00:00:41] The worst thing you can do is to stop exercising completely. I think if we can just find something that works for you in that third trimester. Just to keep me mobile strong leading to birth, it's so important.
[00:00:56] Well, welcome back. Great to be back behind the mic! I think it is quite evident that I do love to chat, but I really hope that you're enjoying the content. And if you are, please let us know by taking a screenshot of the episode that you're listening to and giving us a shout out on Social. You can tag us on @lennyroseactive or use the hashtag #mama matters.
[00:01:21] So today's guest is the amazing Laura Callea, or otherwise known as a Physio Laura. She is a women's health or pelvic floor physiotherapist and is a bit of a pioneer, actually. She took the business from the off-line, bricks and mortar space to the online world a couple of years ago now and has spent the last couple of years building the most amazing online community and a virtual platform in which to provide safe and clinically effective exercises and advice and educate women about their bodies and to really empower them to improve the health and wellbeing through pregnancy and beyond. And so I saw that she was running a free Active Birth class recently, and I just couldn't help but really want to share her wisdom, but also get the information out about her free online active birth class that you can access, especially given the crazy times that we're living in. With perhaps less access to the sort of antenatal classes and that about face to face. So without further ado, here's Laura.
[00:02:29] Hi, Laura. Thanks so much for coming on the program. You're welcome. Thank you so much for having me. We were just chatting away before your first record. Ad nauseum about our children and businesses and having it all kind of flow together in how crazy it is to have a moment of quiet. But yeah - night time can go either way, but we seem to both said we have it under control. But that could change at any moment. So that’s kind of funny.
[00:03:04] So I'd love to chat to you about active birthing and sort of what the background is around it - the philosophy behind that birthing and why you love to promote it, show love to active birthing, as it says, and the whole premises of that movement and being active during labour. So the whole idea behind it is that when you're having labour contractions, you're getting this build-up of adrenaline each time. Now we know with adrenaline it's a fight or flight type of response. Now, with labour, you cannot fly away. So you have to stay and fight. And a really effective way to burn off that adrenaline is to move your muscles and use your muscles and be active, which actually helps that turn into oxytocin, which we know is a really good labour inducing hormone, as well as endorphins, which are our happy hormone. So it's a really effective way to manage labour sensations really well, get more of the feel good hormones happening. And it's a really good mental distraction and focus as well. And I think most people are inclined to want to do those things when they're feeling uncomfortable.
[00:04:06] Anyway, I think it's just really important to have the toolkit and the education and the information behind it. I think we're all naturally swayed to want to be active when we're feeling uncomfortable. And I always give the analogy of when you hit your thumb with a hammer, you don't just sit there and watch it swell up - you rub it or you jump around or you pull your ear, you do something active to try and bombard your brain with pain free stimulus so that the thumb doesn't feel so uncomfortable. And I think it's the same analogy with labour. So while your uterus is contracting and you're getting those uncomfortable sensations, you do other things with your muscles to try and bombard your brain with other pain free stimulus and to burn off that adrenaline, get more oxytocin, get more endorphins flowing.
[00:04:48] So that's kind of the sum up of what active birth is – and it kind of flies in the face of, like everything we see on television. And I know for the first time mums that hopefully that's not kind of what they're imagining is sort of like a hospital bed with the feet up in the stirrups.
[00:05:03] What are the other reasons why its important to be active, if it's possible for you not to be on the bed, obviously, other than when you're in the delivery phase, but in this sort of labour phase? Yeah, there are other sort of reasons why staying off that sort of laying on your back position is a good guess?
[00:05:16] One hundred percent. But look for the very, very small proportion of the population, they may have to be in that position because they're being monitored or if they've got a full epidural and they can't move. There are reasons why you may need to be on your back. But for a majority of healthy women with healthy pregnancies and uncomplicated labour, they should be able to move around. And it's so important because what we're trying to do is help facilitate what our body is already doing and what our body is already doing is trying to descend that baby down, open the cervix and down into the vagina or the birth canal. And so what we want to do is be upright so that we can help gravity do what the body is trying to do so if we're trying to get descent, if we're trying to get baby to move down, it makes sense that we are upright getting gravity to also help with that when we're lying on our back. We're not really getting any of that gravity pressure, helping with that descent,
[00:06:09] pushing the baby's head onto the cervix to help with that dilation to eventually get the baby to move through the birth canal. So that's another way to think about active birth and why it's so important. And even from a pelvic position point of view and a lot of women will report this, is that lying on your back can be very uncomfortable because it can close your pelvis down. So when you're trying to open your pelvis, you want to be upright. You want to be sometimes leaning forward, particularly if you've got a posterior baby position, the baby is putting pressure sensation on your spine. The worst thing you want to do is to lie on your back because you're getting all that extra pressure and it could be very, very uncomfortable. So, again, a small proportion of the population may not have much say in this if there are medical complications.
[00:06:49] But for majority of women, lying on your back in birth is not a good option, if possible, in labour and in birth as well, to be honest. But that's not always possible. But definitely through labour, you want to be moving. You want to be as upright as you can. And that doesn't mean is always good; to preface as well with as some people get really excited, especially first time pregnancy, and they stomp much sway like you, all the active movements, they exhaust themselves. So it's not about harder, faster, stronger, longer, like move as much as possible.
[00:07:19] It's just about being upright, doing some sort of active movement to try and bombard your brain with pain free stimulus, but then also really resting in between contractions and really trying to conserve energy in between contractions because labour can be a marathon and you need to make sure that you don't burn yourself out in the first two hours because you're so active. You need to really be mindful of resting, too.
[00:07:41] Yeah, I mean, I have done Hypnobirthing for all of my sort of labour and delivery, but I've still been very much in an upright position of standing, kneeling. So I feel like there's a bit of an overlap there, like being active. But then the hipnobirthing is all about being very introspective and sort of definitely that sort of energy conservation, but also allowing you to move and to express yourself in a way that feels right at the time. So, yeah, I think that sort of helps in some ways to sum up the active birthing.
[00:08:12] You don't have to be like, yeah, but you can still be active in and positioning yourself in ways that assist the baby to come down the birth canal. But just to come back to as well, you know, if a woman does require or just desire to have an epidural or is there a way that she can be positioned to assist, you know, sort of allowing the baby to still descend?
[00:08:34] Because, you know, I'm not sure if the hospitals will allow you to sort of be a little bit more of an upright position, like semi recumbent on the bed or like is there anything that can sort of still have that sort of gravitational and sort of anatomical assist if you didn't?
[00:08:49] I think it really depends on the hospital, the protocol, your anaesthetist. I think my understanding is there's lots of different variations. So there is something called a walking epidural, and that is like a lower strength version of an epidural. So it allows the woman to still walk around and use her muscles. That still provides pain relief.
[00:09:07] So that's obviously a very different grade of anaesthetic so that you can still use your muscles and move around. However, a majority of women that I see that I deal with, that I treat are confined to the bed (with an epidural). Look, again, I think it really depends on your obstetrician, like most women I know will be on their back for that. But this is why I think it's important to educate yourself beforehand, because anyone who's read Juju Sundin’s book Active Birth Skills, which I highly, highly, highly recommend, she talks about the coffee plunger analogy. And I think this is a really brilliant one to talk about. So using your diaphragm and using your abdominal muscles to help with the pushing phase. We know the uterus as majority of the work that we know that we can help it along by doing effective breathing strategies. And she talks about this coffee plunger analogy. And a lot of women gave her testimonials and feedback after she wrote that book saying how just getting their mind around what that coffee plunger breathing technique for the pushing phase looks like and felt like before they gave birth meant that when they went and gave birth and those who ended up having epidurals, who couldn't feel anything from waist downwards, were still able to use their muscles effectively to birth their babies well.
[00:10:19] And they got lots of feedback from their midwives and their birth team that they were doing such an exceptional job. And it's because they had that visual in their mind at the coffee plunger. So, look, I'm not sure from a positional point of view whether you can get gravity working very much. I think it'll be depend on your hospital, but you can still use tools like that coffee plunger, even if you may be not in the most ideal position. You still got so much within your control to try and help your abs and your diaphragm work effectively to bear that baby down. So I think that's really important to know. So those moments not all lost.
[00:10:49] If you can't feel anything, if you can do the work beforehand and educate yourself and have an idea of what you're trying to achieve. You can still be really effective.
[00:10:57] That's awesome, and I'd just like to add a side note that, you know, sometimes, you know, hospitals have policies that you might not obey there (!) I literally gave birth at St. Vincent's with Leo, and they, like you, have to birth on the bed. And I was like on the knees on the ground and there was no way I was moving. And so my amazing OB got down on his knees and caught the baby like that. And probably that's testament to what a legend he is, actually.
[00:11:24] But I was like, no medical reason. No, I'm not going to do that.
[00:11:30] Well, is that parasympathetic nervous system part of your body, overseeing your body was telling you this is the right position for me right now. This feels most comfortable. And for some women, they've told me that they were on all fours and they then flipped onto their back. And I felt so much better on their back. So, like, I think it's so individual. And I think if you feel really good in a position and you're told to go into another position for no other reason, then you know, there's no medical reason. But you feel better in another position yourself. Sure. Like, I don't see why not, its your birth, and if there's no medical reason, why not give it a crack. There's so many positions you can give birth in and it doesn't have to look like the movies for your pregnancy and birth.
[00:12:09] In my yoga training and pregnancy training, the position of the pelvic outlet being most open is supposed to be on your side, with a flexed hip and kness, You say you're in sort of hip extension, laying on your left side and you've got your right knee sort of up towards your kind of armpit, in a bit of open sort of abduction.
[00:12:27] Is that sort of a position that you've heard of women giving birth in? being on your back because that is common in obstetrics, but also being on all fours or on your knees, leaning over the edge of the bed. That's a really common one. I don't hear a lot of stories about it, but we do know it is associated with lower chance of perineal tearing.
[00:12:51] So it is a great position. I think it's a really good position as well if you are tired come the pushing phase, though, if it takes a lot less energy required, opens the pelvic outlet, less chance of tearing. Well, that's a pretty good position!
[00:13:04] Do you can you sort of recommend you obviously mentioned the book, but are there any other sort of great resources that you can recommend for women who are interested in finding a little bit more about how they can sort of prepare themselves for birth in this way, especially given the sort of crappy situation that we're in at the moment where a lot of antenatal classes are not running face to face?
[00:13:22] Yes, absolutely. So the book was Juju Sundin’s Active birth So it's available everywhere. I think there's audio versions, libraries, not that the libraries are really open right now! But yeah, fantastic book. I highly recommend it. And in terms of other resources, like I feel weird that I feel like I have to give my aunt one a plug because I did just record an active birth class it's free. And I just think it's awesome if people have an hour to sit down and watch it with themselves, preferably with their birth partners as well, because there's lots of partner work in there. But you can download that at activebirthclass.com. And like I said, it's free and you can watch that before you give birth. And I've got a couple of, like, little techniques or tactics in there, which I also think are really good and certainly ties in a little bit with your hypnobirthing and techniques like you did. But I talk about doing the 60 second squad and the cold shower and the premise behind them.
[00:14:26] I'll just give you a very quick summary, is to hold a 60 second squad and practice techniques that you think might be helpful to you, whether that be breathing, chanting, swaying. Just focusing on your breath, meditation, whatever it is, and trying to manage the discomfort of the burn in your legs that you feel when you're holding a 60 second squat so that you can really start to work on training your mindset and honing in on the skills that might help you with uncomfortable sensations in labour. And the same goes for the cold shower is just to blast the shower at the end of your nice warm shower with cold water for twenty or thirty seconds and work on relaxing and focusing and meditating and work on your mindset and not just tensing up at that cold water, but instead trying to relax into it. And I think those two examples are the closest I can think of. Maybe you have another idea of how we can make ourselves uncomfortable and try and mimic those labour sensations without obviously being in labour yet. And there are two tips that I recommend women do to try and really hone this skill set before they heading to the birth suite.
[00:15:28] It sounds great. I mean, I definitely am a huge advocate of staying active, leading right up to labour, obviously, where possible and not contraindicated otherwise, but definitely yes squatting repeatedly bodyweight or holding hands well and breathing through it is a really good way to sort of you know, you've got to help the mind tolerate a higher level of discomfort and then sort of also view it as something that's not threatening. And if you're used to doing that then sort of when the discomfort arises in labour, you're able to do that with a little bit more ease, just as a last sort of little question. Is there anything else in terms of activity that you'd tend to promote? You've obviously got your Pregnancy Posse, which is an online program for women to stay active throughout the whole pregnancy period.
[00:16:19] So they get into the third trimester, what sort of things that you're recommending that they add in or do as part of their sort of activity?
[00:16:25] Before I ever talk about exercise, I always think it's good to preface it with. I think it's important to do what feels good for you as well, because I know I could say to women people felt like doing squats is great. But if you've got pelvic pain or just hates squats or, you know, there's a reason why you really don't want to do it, you do not have to do that. You can still have a great birth if there's another way of exercising that you enjoy. But I do love squats. I think squats are such a fabulous exercise throughout your whole pregnancy. They're super functional. It's a really great way if you're capable of doing full squats to open up the pelvic outlet as well in the lead up to birth and work on pelvic floor relaxation. That's something that you're already seasoned with. I wouldn't recommend it to someone who has not done it before. Things like swimming are fantastic. Nice light ways to move your bodies, especially if you feel achy and heavy and uncomfortable because I think the worst thing you can do is head to the third trimester and you're feeling heavy sore and you stop exercising because then you're heading into labour deconditioned, tired, fatigued. And I think that that's already putting you a little bit behind the eight ball when it comes to managing labour. Well, because you need endurance to manage that really well. And so I think it's important just to keep moving. So whether that be walking, swimming, stationary cycling, I'm a huge fan of that during pregnancy as well. I think that's such a nice way to keep those muscles strong in your legs to get that really safe cardio workout, but without overloading the pelvic floor, a lot of women with pelvic pain can still manage a stationary bike really well as well. So I really like cycling and then the sort of work as I do in the posse in the third trimester, lots of like pelvic movement. So pelvic tilts, pelvic circles, lots of postural exercises, because as your boobs are getting heavier and your tummy is getting heavier, we tend to get a bit more hunchback. So lots of light, nice back and work to keep trying to keep your posture good. And again, lots of squats because I think it's important to keep really strong through the glutes, through the legs, and you need that support for labour. So walking is another if you are able to. I think that's a really lovely way to keep upright, to keep moving things. Saying that, walking can also be super aggravating for women with pelvic pain. And if you are in that category, I do not recommend walking. So even though walking feels like the easiest, lightest exercise in the world, if it aggravates you. It is not for you to even though it should be easy. Certainly, if you have pelvic pain, I wouldn't recommend that. But there's so many other options. Like I said, the worst thing you can do is to stop exercising completely. Like I think if we can just find something that works for you in that third trimester just to keep me mobile strong leading to birth, it's so important.
[00:18:58] Yeah. Very well said. Definitely. Definitely agree.
[00:19:02] Great. Really. Thank you for sharing all of that.
[00:19:18] Thank you so much for sharing your brain, thanks so much, Laura.
[00:19:27] I hope you got as much out of that as I did.
[00:19:29] Laura is just such a wealth of knowledge, and it is really great to have a number of different perspectives and really educate yourself on. There are so many different modes and methods of birthing and different sort of schools of thought. And I really love just immersing myself in sort of all the different types of things that there are. Because the more that we know, the more that we can try, and the more that we can sort of really find that thing that works for us. And so, yeah, you can access Laura's free birth class. As mentioned:
FREE ACTIVE BIRTH CLASS: activebirthclass.com
Physio Laura: physiolaura.com Instagram: @physiolaura
Active Birth Book: Juju Sundin’s Active Birth
What great resources. Jump on and have a look at the active birth class. See what it's all about. And yes, stay home. Stay safe, ladies. And can't wait to continue to bring you more amazing health professionals and support during your pregnancy to motherhood. Journey.
[00:20:36] This episode is brought to you by Lenny Rose Active, Australian owned three times mum and physiotherapist, designed luxe active and technical wear for the pregnancy to motherhood journey. You can find us on Instagram @lennyroseactive