Video Lab [BRBTT23 000 VIDEOS Notes]
[1] [ICE_corrine-flatt] [5 minutes]
[ICE]
A warm welcome! I want to talk about I.C.E. First off, ICE is an acronym that stands for Innerwork, Communication, and Education. These three ideas are the foundation of all birth prep work through the Body Ready Method®, and much of life’s work of just being an intentional person. These ideas “work” best when understood to be woven into each other, like the strands of a braid are stronger for the braiding, strengthening and solidifying our learning, growing, and being.
C.S. Lewis spoke often about the difference between learning to dance and dancing. He says, "[Learning] enables us to do these things best--if you like, it 'works' best--when, through long familiarity, we don't have to think about it. As long as you notice, and have to count, the steps, you are not yet dancing but only learning to dance.”
The Body Ready Method® uses the term "flow" to denote that state of "dancing/birthing", and "ICE" as the intentional, organized, process of "learning to dance/birth".
The “I” of ICE is Innerwork – is the foundation of everything, and is rooted in an understanding of our nervous system. It is the practice of awareness of your beliefs, and their associated feelings, both positive and negative. Innerwork involves learning tools to intentionally rewrite outdated beliefs - to recognize stress, pain, tension, and fear - choosing to replace them with beliefs that lead to feelings of calmness, relaxation, safety, and trust in your body, your support, and the natural process of birth. When we practice awareness, and say aloud, “This is tension, this is bad, this is what we will avoid in labor.” And “this is relaxation, this is good, this is what we will use in labor.” We are talking about “upregulation” and “downregulation” of our nervous system. When we breathe with intention, we are working toward “downregulation”, which is good, and which is what we will use to return to our labor flow state.
Throughout the Body Ready Method®, you are led to opportunities to incorporate and build a partnership or a team to elevate your confidence, support your clear goals, flow with focused attention, protect your personal autonomy, and give and receive calm and timely feedback.
The “C” of ICE – Communication is sending and receiving messages to your inner-self and to others. It is important that everyone in your support team match you in expectations, desires, and beliefs. Being intentional with communication requires awareness, which is a direct result of innerwork. Communication is the GLUE, which allows your entire support team to know what you are about, so that you don’t have to manage the details and interruptions while you are laboring in your flow state.
And finally, the “E” in ICE is Education, which is the process of acquiring knowledge, together with your birth partner or coach, especially that which enhances your trust in your own innate wisdom and abilities, and trust in the cohesiveness of your birth team. [Wheep! Wheep!]
After spending time working on innerwork and communication, Body Ready Method® leads you to learning about the 3 levels of the pelvis, providing an overview and visual of baby’s journey through the pelvis, and an understanding (and thereby confidence) in tools, positions, and techniques to help you intuitively flow into positions that will make more space to aid baby moving through each level of the pelvis. A primary goal of the Body Ready Birth® program is for you to build your body-brain connection – not to memorize every single thing - but to build your innate capacity to trust yourself and your baby to dance – to actually dance the beautiful dance of labor and birth with confidence and joy.
Thank you for Watching!
Cheers! 🌞
[ ] In this video video, we want to see how you explain ICE to your workshop participants. This is a concise explanation that demonstrates your understanding of the BRB foundation - what it is, why it is the foundation of BRB and how ICE impacts the labor flow state. You do not need “participants” for this recording and we do not have suggestions of props to use.
[ ] Able to accurately describe all 3 components of ICE applying a deep understanding of why this is the foundation of BRB and how it impacts the labor flow state
[ ] Describe ICE and what it stands for.
[ ] Explain why it is the foundation of BRB.
[ ] Address how it impacts the labor flow state.
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[2] [SKILL_corrine-flatt] [5 minutes]
[Skill to challenge Ratio]
A warm welcome! I want to talk about Skill to Challenge Ratio.
The Body Ready Method® endeavors for you to approach your time of birthing with confidence and well-founded, or well-grounded confidence needs the proper skill to challenge ratio.
Let’s discuss the Skill to Challenge Ratio, how it impacts the Flow State, and how the two of you can work on this together.
Skill is our perception of our ability to do a thing – in other words, our confidence; and challenge is our perception of the ease or difficulty of the task or activity.
This graphic shows 8 states of being, and how they fall on the Skill to Challenge Ratio.
If you find yourself doing a task or activity that is not much challenge, and you don’t need to try hard, you might find yourself worried, apathetic or bored. If you find that your perception of skill and challenge are out of balance, you might be anxious on the one hand, or possibly too relaxed to enjoy the task.
It is easiest to get into your flow in any task or activity if you perceive that the task or activity is somewhat challenging, but that you have the skills and knowledge to meet that challenge – it is in the times when you are being pushed to try just a little bit harder, that you can find yourself in your flow state.
When a child is learning to cross the monkey bars, it is very difficult, and the child might fall many times, but with practice and determination, possibly support, and an increase in physical strength, coordination, muscle memory, and skill, the child will master the task, flowing through the challenge, possibly losing track of time, and no longer thinking about HOW it is done, and just thrilling in the experience of doing it. We can come up with a big list of examples of this Flow State, when we find the “sweet spot” in our Skill to Challenge Ratio – skills such as riding a bike, writing in cursive, or cooking a perfect egg.
A cool thing about labor and birth is that usually labor starts out with less challenging contractions, and as labor intensifies, your skill increases, and you find yourself in the flow state, where you lose perception of time, and you stop thinking about HOW to labor. As the contractions become longer, stronger, and closer together, you find that you are up for the challenge of each contraction, as it comes.
[ ] In this video, the goal is for us to see your understanding of the skill to challenge ratio and how you would explain this to your workshop participants. This is a concise explanation that addresses what the skill toe challenge ratio is, how it can impact labor flow state, how to work on this and the partner’s role in working on this. You do not need “participants” for this recording and we do not have suggestions of props to use.
How can the two of you work on this prior to birth?
Do your own innerwork – separately and together – first making sure that what you believe about yourself is helpful and true. Communicate with each other about your beliefs, and don’t neglect those things that are a struggle; if you have a lingering concern, discuss the concern, what you can do to minimize the likelihood, and what you will do if it should come to pass, and then set that concern aside – you have made plans, and are prepared for that possibility. And then continue to prepare for the far more likely scenario that this is going to be one of the most amazing and transformative things you are likely to ever do – for both of you. Spend focused time together each week, individually and together, checking in on your beliefs, feelings, and concerns. Do you have affirmations written down as a reminder of where you would like to be mentally and emotionally? Do you have a realistic understanding of the normal progress of labor and birth, common challenges, what you are doing to avoid them, and what you will do if you face them? And finally, are you spending time each week physically preparing, by practicing relaxation techniques to regulate your nervous system, optimizing strength and stamina through regular physical exercise, and building your intuitive knowledge and muscle memory by learning about and practicing tools and positions that make more space for baby as you both move through labor to birth?
Thank you for Watching!
Cheers! 🌞
[ ] Able to accurately explain the skill to challenge ratio with a deep understanding of how it impacts the labor flow state with 2 or more ways both the pregnant person and partner can work on this
[ ] Explain the skill to challenge ratio.
[ ] Explore how it impacts the labor flow state.
[ ] Address how one can work on this.
[ ] Review the partner’s role in this work.
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[3] [JOURNEY_corrine-flatt] [5 minutes]
[Baby’s journey through the pelvis]
A warm welcome! I want to talk about baby’s journey through the pelvis.
Our pelvis is the bony structure at the bottom of our core. It is made up of four bones, and everywhere the bones of the pelvis meet each other or the other bones of our skeleton, they attach with movable connections, or joints. The sacrum is the back piece of our pelvis, above it is our bony spine, and below the sacrum is the coccyx or tail bone. From the sides of the sacrum, and wrapping around our pelvis, are our two illium; which are quite large bones. Our illium features our bony hips, and also our sit bones, the illium connect in the front, which we often call our “pubic bone” but should more rightly be called our pubic symphysis. The Body Ready Method® helps to prepare your body to have strength, flexibility, and balance to support optimal movement of these joints, especially the sacroiliac joints, between your sacrum in the back, and your large illium that wrap around your pelvis.
When we talk about labor and birth, we often hear the question, “What is the dilation of the cervix?” and sometimes, “What is baby’s station?” which might be better as, “Where is baby in the pelvis?” When we ask this question, it is helpful to know a few landmarks of the bony pelvis, though it is not necessary to learn all of the Latin names for all of the landmarks. Also, in spite of any pomposity you might encounter, there is NO agreed upon pronunciation for Latin terms – as Cheryl Lowe famously said, in her thick Kentucky bluegrass twang, “There are no Romans around anymore to correct us.” Just for right now, we are going to assume that baby is coming head first, and baby’s head is oriented in a favorable way. We will discuss variations at another time.
Let’s look at a pelvis model.
The inlet is the top of the opening into pelvis, and is the first level baby has to navigate. The inlet corresponds to stations -3, -2. In early labor, if you find that you are intuitively rocking back and forth, or tucking your pelvis, it might be that baby is in the inlet. Another good indication baby is at or in the inlet is if you feel contractions in your mid back, the side of your hips, at your pubic bone, and/or in your low-mid belly.
The midpelvis is the second level baby has to navigate and is in the middle of the pelvis. The midpelvis corresponds to stations -1, 0 and +1. If, in labor, you find yourself intuitively finding asymmetrical movements or moving side to side, this is a clue baby may be in the midpelvis. Another good indication baby is at or in the midpelvis is if you feel contractions deep within your body, at your pelvic floor, or at your cervix.
The outlet is at the bottom of the pelvis and is the last level baby has to navigate. The outlet corresponds to stations +2, +3. If you are finding front to back movements or untucking your pelvis, such as hanging with an anterior squat, this is a clue baby may be in the outlet. Another good indication baby is at or in the outlet is if you feel contractions rectally, in the low back, and/or tailbone. There may also be an undeniable urge to push.
Thank you for Watching!
Cheers! 🌞
[ ] In this video, the goal is to not only show your understanding of baby’s journey through the pelvis but to also show how you can explain this in a way that is accessible to your workshop participants. In your recording, demonstrate baby’s journey through the pelvis making sure to address each of the levels as baby reaches them. Make sure to review movement + sensation clues used to guess where baby is in the pelvis and use participant friendly terms/words. You do not need “participants” for this recording and we suggest using a pelvis + a baby that will fit through the pelvis to support your teaching.
[ ] Able to accurately explain baby’s journey through the pelvis applying a deep understanding all 3 levels of the pelvis and the movement and sensations that help us guess where baby is in the pelvis
[ ] Demonstrate baby's journey through the pelvis using participant friendly terms.
[ ] Clarify when baby is at each level during the journey.
[ ] Review movement + sensation clues used to guess where baby is in the pelvis.
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[4] [DYNAMIC_corrine-flatt] [10 minutes]
[Dynamic pelvis]
A warm welcome! I want to talk about your Dynamic Pelvis!
Let’s get familiar with the various positions that make more space for baby, as baby moves through your pelvis. We will discuss 8 key movements that affect space inside of the pelvis, 4 base positions that are common in labor and birth, and how these movements and positions change the space in the 3 levels of the pelvis.
Nicole Morales, a midwife in San Diego, a Spinning Babies® Approved Trainer, and author of a growing library of books on Restorative Midwifery – Nicole says that birthworkers are too focused on the hole, and need to, instead, look to the whole – that is the complete picture of you, your baby, and your labor, and she says that birthworkers focus on centimeters, when we should be looking for millimeters. Take your pointer finger and thumb, and ….
Nicole Morales reminds us that when you are in your labor flow state, you and your baby will have “inside information” about what you can do to help baby, each step of the way to birth. If your birth team can support you in your “flow”, you will be able to tune in to that “inside information” – that intuitive knowing – of what you and your baby need, each step of the way to your baby’s birth. [Question – How can the team limit talking to you when you are in your flow state?]
8 key movements – 4 base positions – 3 levels of the pelvis
We already discussed the 3 levels of the pelvis; the inlet, midpelvis, and outlet. The 4 base positions we will discuss today are standing, sitting, side lying, and hands & knees. Please know that you are not limited, in your labor and birth, to these base positions, and there are infinite variations of movement and positions. I believe that you will have access to your “inside information” in your labor, but becoming familiar through the exercises available through the Body Ready Method® Pregnancy and Prenatal programs will make it so much easier to dance this dance.
Let’s look at 8 key movements, and see how they impact the pelvis. Pay attention to how each movement can make more space in one part of the pelvis, which can make less space in another part of the pelvis, and some movements and key positions are especially helpful in making other movements more accessible. [PELVIS] Some movements will rock the sacrum in relation to the illium, so that the top of the sacrum rocks in while the bottom of the sacrum rocks out, which creates more space at the outlet, and less at the inlet (called nutation or nutate). Or the opposite, where the top of the sacrum rocks out, while the bottom of the sacrum moves in, which creates more space at the inlet, and less space at the outlet (called counternutation or counternutate). Some movements bring the outermost part of the hips closer together, while spreading the sit bone part of the illium away from each other, which makes more space at the outlet and less space at the inlet. Or the opposite, where other movements bring the outermost part of the hips wider, while bringing the sit bones closer to each other, which makes more space at the inlet, and less space at the outlet.
The movements available to the pelvis are based on both the mobility and balance of the joints (the sacroiliac joints and pubic symphysis) and of the surrounding tissues - fascia, muscles, ligaments and tendons - that connect to the pelvis. We know that all of these have a role in facilitating and restricting pelvic mobility and balance. Making improvements in your strength, flexibility, mobility, and balance, along with long familiarity through regular practice and review is the goal.
The first set of key movement are those that hinge (haha) at the hips. If you remember anything about triangles or geometry, you can think that our legs can hinge or flex at the hips, creating various angles. It is also interesting to note that these angles are judged not by how it looks from the front of our body, but by the back of our body – in other words, the angle of the line of our back and the line of the back of our legs. An obtuse angle, with hip flexion less than 90°, such as sitting on a tall kitchen stool, a right angle – like sitting on a kitchen chair, or an acute angle, with hip flexion greater than 90°, such as sitting on a low stool. All of these are called “hip flexion”, and the space inside of our pelvis is affected in different ways. We can also create hip extention – which you can imagine as if you were moving into a back bend, or trying to reach back behind you with your leg and foot, or what your back leg does in a lunge.
With hip flexion less than 90°, like sitting on a tall kitchen stool, or the move your front leg makes to go up one stair step. The sacrum is free to rock in or out. It is not being pulled by the soft tissues and is free to rock in either direction.
With hip flexion greater than 90° such as sitting on a low stool, or squatting to pick things up from the floor, the sacrum is rocked in at the top, and out at the bottom, which increases space of the pelvic outlet front to back, decreasing space of the pelvic inlet.
With hip extention, where one or both legs are behind you, as if in a backbend, the sit bones are also pulled back, the space in the pelvic inlet is increased front to back, while the space in the pelvic outlet is decreased.
Another powerful set of movements that change the shape of the inside of our pelvis is internal and external hip rotation.
Internal hip rotation is achieved by moving your knees closer to each other and your heels further from each other. This movement increases space in pelvic outlet from side to side, and decreases space in pelvic inlet from side to side. This movement can be done with both legs or just one leg.
Therefore, external hip rotation is, of course, moving your knees away from each other, and the heels of your feet closer each other. This widens the pelvic inlet from side to side and narrow the pelvic outlet from side to side. This also can be done with one leg or both legs.
Another movement that changes the shape of the inside of your pelvis is reaching up (and looking up), as if reaching for something on a high shelf. There is a strong fascial connection between the upper arms and the sacrum, therefore reaching up (and looking up) increases space in the outlet from front to back, narrows the inlet from front to back slightly. Hanging from a supported “slow dance” position, playing tug-of-war, or even pulling back on your own knees also triggers this fascial connection.
And finally, let’s discuss the key movements of pelvic tucking and pelvic untucking, which I imagine as “bad dog” and “good dog” movements, or the way our hips move in the “cat / cow” of a pelvic rock exercise.
Pelvic tucking, also called posterior pelvic tilt, the “bad dog” or “angry cat” movement, is when the pubic symphysis moves toward your nose, and your lower back flattens. Tucking the pelvis is an orientation change and does not change the available space in the pelvis; however it does orient the pelvis/femur to make it easier to get into hip extension which makes more space available in the inlet.
Pelvic untucking, also called anterior pelvic tilt, the “good dog” or “tired cow” movement, is an orientation change and does not change the available space in the pelvis, however it does orient the pelvis/femur to make it easier to get into hip flexion which makes more space available in the outlet.
Let’s briefly run through a few examples of how you can practice these 8 movements in the 4 positions to make more room at the 3 levels of the pelvis. We will spend time going deeper into this information.
Inlet – The key movements that make more space available at the inlet of the pelvis are hip extension, external rotation, and pelvic tucking.
Inlet standing – Pelvic lift and tuck
Inlet sitting – on an appropriately large physio ball, rocking forward and back allows the pelvis to tuck and untuck.
Inlet side lying – Flying Cowgirl
Inlet hands & knees – in the birth tub, resting against the side of the tub or your partner or coach, with your legs straight or in hip extension, knees bent and feet out of the water. I have also seen this done with mom resting her upper body on a larger physio ball.
Do you need to pee, because we are about to get physical!!!
Midpelvis – The key movements that make more space available at the midpelvis are asymmetrical movements, or moving from side to side. Let’s begin exploring midpelvis openers with the Rock Through Theory.
The Rock Through Theory is that movements and asymmetrical positions help baby navigate through the pelvis. I gave you a toy ball maze puzzle in your goodie bag. The goal of the puzzle is to get the ball through the maze, just like the goal in birth is to get baby through the pelvis. With the maze, you have to move the toy in different directions to get the ball to navigate the available space. The same thing applies to the baby - you move in different ways to help baby navigate the pelvis. Movement encourages progress. Especially through the midpelvis, when alternating movement helps baby rock through the ischial spines. Small movements create an orientation change to help baby navigate the available space. Bigger movement might have bigger changes in the pelvis shape, wherein, the available space in the pelvis is modified. For the midpelvis, it is best to alternate inlet and outlet opening movements to help baby rock through, or choose an inlet opener for one side of your body, and an outlet opener for the other side, and to switch sides often.
Midpelvis standing – curb walking/ yoga block walking, or standing/chair lunge/ Captain Morgan
Midpelvis side lying – exaggerated side lying, or passive leg movements
Midpelvis hands & knees – kneeling on a block, runner’s lunge – these are great in the pool!
Midpelvis sitting – circles on the ball!!! Let’s see how wild and crazy you can get to Jerry Lewis and Guitar Man!
Outlet – The key movements that make more space available at the outlet of the pelvis are deep hip flexion, internal hip rotation, reaching up (and looking up), and pelvic untucking.
Outlet standing – upright squat, arms up around your partner’s neck, or reaching up (and looking up) to your rope or cloth.
Outlet sitting – on a low stool with your knees together and heels apart.
Outlet side lying – put a peanut ball between your feet, and just a thin folded towel between your knees. With pushing, bring your upper knee further up to be able to pull on it.
Outlet hands & knees – Yup! In the running for best position to push your baby out! See if you can do this with your knees closer and heels apart, and reaching up (and looking up), with your upper body on your physio ball or hanging from around your partner/coach’s neck, or rope/cloth.
Thank you for Watching!
Cheers! 🌞
[ ] In this video, the goal is to show that you understand the key movements we discuss in this chapter and their impact on the pelvis. Remember you are talking to your workshop participants - not a fellow BRM® pro! Make sure to include the 8 key movements, the idea that a move that opens the inlet will close the outlet and vice versa, and make sure to incorporate the Rock Through theory in your recording. You do not need “participants” for this recording and we suggest using a moveable pelvis and any other props to demonstrate the key movements (e.g. wall or chair, etc.) to support your teaching.
[ ] Able to accurately explain all 8 key movements are with an accurate impact on the pelvis, the rock through theory is accurately explained and the opposite impact of inlet open/outlet closed
[ ] Explain the 8 key movements and their impact on the pelvis.
[ ] Address what opens the inlet closes the outlet & vice versa.
[ ] Include the rock through theory for midpelvis.
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[5] [MODELS_corrine-flatt] [5 minutes]
[Birth models and ICE]
A warm welcome! I want to talk about two common birth models in practice today.
The two most common birth models in practice today are the medical model and the physiological model.
The medical model sees birth as a process to be managed. The medical provider oversees the process, keeping close tabs on the wellbeing of you and baby, and intervening when the process deviates from the standard. When there is a delay, the medical provider turns to adding more power or force to the contractions, using Pitocin and the Artificial Rupturing of your Membranes. The medical provider sees this close management as the best way to insure positive outcomes, and avoid dangerous situations. [Questions: What even is a positive outcome? What is safe/unsafe? Are the answers going to be the same for everyone? Who is responsible for weighing risks vs. benefits?]
The physiological model sees birth as a natural process to be supported. The provider holds space for the process, keeping tabs on your and baby’s wellbeing, and the steady progress of labor, and turns to body balancing, making space for baby, and your mental and emotional wellbeing that may be inhibiting you from achieving relaxation or your flow state. The provider observes the process, only intervening when there is a clear problem, and then usually beginning with the least interventive option first. Providers believe that well-supported physiological birth is not only safer, but less traumatic and more empowering.
The Body Ready Method® knows that there is a lot that goes into the decisions surrounding where, when, and with whom you chose to birth, and believes that you know what is best for yourself and your baby. There absolutely is a time and place for birthing in a medical setting, and some have medically complicated situations. In those situations, it might be even more important to focus on the foundational work that BRM calls ICE. Innerwork to know what is true about yourself, your beliefs, and your goals, clear communication with yourself, your partner or coach, and your support and medical team, and then making goals for educating yourself and preparing yourself, physically, mentally, emotionally, and spiritually, for what lies ahead – for birth, parenting, and beyond.
Thank you for Watching!
Cheers! 🌞
[ ] In this video, the goal is to show your understanding of the two major birth models discussed in this chapter, how they differ in their approach to a labor stall, and how the BRB ICE foundation relates to/supports informed decision making by understanding these 2 models. You do not need “participants” for this recording and we do not have suggestions of props to use.
[ ] Able to name and accurately explain the 2 models of birth covered in BRB, their approaches to a labor stall, and demonstrate a deep understanding of how the ICE foundation contributes to informed decision making in the context of these 2 models
[ ] Explain the 2 birth models covered in BRB.
[ ] Describe how they differ in their approach to labor stalls.
[ ] Clarify how the BRB ICE foundation relates to informed decision making specifically around these 2 models.
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[6] [COWGIRL_corrine-flatt] [5 minutes]
[Teaching flying cowgirl to participants]
A warm welcome! I want to talk about the inlet opening position called “Flying Cowgirl”.
The inlet is the top of the pelvis and is the first level baby has to navigate. The inlet corresponds to stations -3, -2. Especially in the early part of labor, if you find yourself rocking back and forth or tucking your pelvis, these can be clues baby is in your inlet. Another good indication baby is at or in the inlet is if you feel contractions in your mid back, the side of your hips, your pubic bone, and/or your belly. There are three key movements that help create space in the inlet - hip extension, external rotation, and pelvic tucking. Hip extension is achieved when your knees and feet are behind your hips, making a posterior or backward angle from your back to the back of your thighs, external rotation of your hips happens when your knees are apart, and your feet are together – in a side lying or kneeling position, this might even look like soles-together, and pelvic tucking means pulling your pubic symphysis forward and upward, flattening your lower back.
To get into Flying Cowgirl, you will start in the side-lying position. It is your choice, whether you start on your left or right side, but it will be best if you change sides every so often. If you need a rest, plan to switch sides every 10 contractions, and if you are actively working with your contractions to move labor along, you might switch sides every 3-4 contractions. So, starting in side lying position, with a pillow for your head, you are going to move your knees and feet behind your body as much as you are able, bending your knees at a comfortable bend, and have a peanut ball between your knees, so that your knees are apart, but put your feet/ankles close together, with a folded towel between your feet, if that is more comfortable. Now tuck your pelvis, moving your pubic symphysis up toward your nose as much as you are able, making your lower back and bottom as flat as you can.
Let’s look at the pelvis model. Hip Extension (when your knee is behind you) along with posteriorly tucked pelvis (where your pubic symphysis is moving toward your nose) will create inlet space from front to back and external hip rotation (where the front of your thighs are angling away from each other) will create inlet space from side to side. Let’s look at three images I was able to find. You can see that the models in the photos from BRM and Spinning Babies are not achieving heroic angles in any of those three goals, and the model from The Serenity Doula is achieving a clear hip extension and external hip rotation, it is not clear if she has a good tuck to her pelvis, and … this model is not pregnant. Your partner or coach will need to help watch out for an arch in your lower back, and help you change your pelvis to tuck under to increase hip extension and therefore create more inlet space.
Your partner or coach will need to be actively helping you change sides, helping to adjust your pillow and peanut ball, actively coaching you into relaxation if you find this position to be intense, possibly jiggling for relaxation, as well, keeping track of contractions to help you to switch sides at the interval you have chosen, and keeping track of offering fluids, remembering to help you get up to pee, and all of the other details, so that you are free to find your flow state, if possible. If you have an epidural, your nurse will probably also need to help you switch sides.
[ ] In this video, the goal is to show your understanding of this birthing position, reviewing clues used to guess that baby is in the inlet, incorporate the base position(s), explain the position and how to get into it, talking through the role of the partner, and review what to watch out for. Make sure you are using terminology that is appropriate for your workshop participants. You do not need “participants” for this recording and we suggest using props to support your teaching such as a peanut ball, bolster, blocks, or towels; a moveable pelvis may support your teaching too.
Thank you for Watching!
Cheers! 🌞
[ ] Able to accurately explain the 2 types of clues that help us guess baby is in the inlet and accurately identify the base position for the flying cowgirl plus explaining the position, how to get into it, the partner’s role and what to watch out for that reflects a deep understanding
[ ] Review clues to guess baby is in the inlet.
[ ] Incorporate the base position.
[ ] Explain the position and how to get into it.
[ ] Talk through the partner role.
[ ] Review what to watch out for.
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[7] [LUNGE_corrine-flatt] [5 minutes]
[Teach standing lunge to participants]
A warm welcome! I want to talk about doing a standing lunge to help baby move through the midpelvis.
The midpelvis is the second level baby has to navigate and is in the middle of your pelvis. The midpelvis corresponds to stations -1, 0 and +1. If you are finding asymmetrical movements or moving side to side feels right, this is a clue baby may be in your midpelvis. Another good indication baby is at or in your midpelvis is if you feel contractions deep within your body, at the pelvic floor, or cervix. There are two key movements that help create space in the midpelvis - asymmetrical movements and the Rock Through Theory.
To get into a standing lunge, you will start in the standing position, with a chair or stool to put your foot on, and bring your other leg slightly behind you. This is an unstable position, and it is important for your partner or coach to be in front of you, so you can wrap your arms around, in slow dance position, and sway or lean during contractions. Alternately, you might find that you like holding onto a hanging rope or cloth, for bigger swaying, rocking, and circular movements. It is important, though, that you are not using the back of the chair for support, as (unless you have an exceptionally tall chair-back) it will cause you to hunch over, and unstuck everything above your hips. It is up to you which foot to start with, but with midpelvis work, it is important to remember that changing positions is important, and you will be switching sides every 1 to 3 contractions. (Unless your care provider has found your baby to be in an unfavorable position, and believes that favoring one side would be helpful to add balance.) Because big, asymmetrical movements are what is needed to open the ischial spines to their maximum, and switching sides often will switch these prominences forward and back, which will help to rock baby through.
Chin up bar, rebozo, sling, pelvis, images
Thank you for Watching!
Cheers! 🌞
[ ] In this video, the goal is to show your understanding of this birthing position, reviewing clues used to guess that baby is in the midpelvis, incorporate the base position(s), explain the position and how to get into it, talking through the role of the partner, and review what to watch out for. Make sure you are using terminology that is appropriate for your workshop participants. You do not need “participants” for this recording and we suggest using props to support your teaching such as a chair; a moveable pelvis may support your teaching too.
[ ] Able to accurately explain the 2 types of clues that help us guess baby is in the midpelvis and accurately identify the base position for the standing lunge in addition to explaining the position, how to get into it, the pattern’s role and what to watch out for that reflects a deep understanding
[ ] Review clues to guess baby is in the midpelvis.
[ ] Incorporate the base position.
[ ] Explain the position and how to get into it.
[ ] Talk through the partner role.
[ ] Review what to watch out for.
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[8] [IR_corrine-flatt] [5 minutes]
[Teach internal rotation with reach up (on hands and knees) to participants]
A warm welcome! I want to talk about how to create more space in your outlet while on your hands and knees. This is a GREAT position for pushing, and GREAT for the birth pool!
The outlet is at the bottom of the pelvis and is the last level baby has to navigate. The outlet corresponds to stations +2, +3 and beyond. If you are finding front to back movements or find yourself untucking your pelvis, this is a clue baby may be in the outlet. Another good indication baby is at or in your pelvic outlet is if you feel contractions rectally, in your low back, and/or tailbone, or if you are feeling an undeniable urge to push at the top of your contraction or throughout your contraction. There are four key movements that help create space in the outlet - deep hip flexion, internal hip rotation, reaching up (and looking up), and pelvic untucking. Deep hip flexion (think squatting) and reaching up (and looking up) both help the bottom of your pelvis to open up front to back, while internal hip rotation helps to open the bottom of baby’s passage side-to-side, while untucking your pelvis orients the passage and baby’s head, making the passage a more straight shot, and making the other parts of this position easier, and more available to you.
Let’s put this together, starting in the squatting position. To start, find a comfortable place to squat – somewhere padded, for your knees, then move your knees close to each other, and move your heels as far from each other as is comfortable, and maybe a bit more! Now untuck your pelvis, like a “happy dog”, or like the “cow” in cat/cow. Now find a way to reach up (and look up). Your partner or coach can be in front of you, maybe on a chair or stool, so that you can reach up (and look up) into “slow dance” or standing, so that you can reach up (and look up) to hold onto a 2 or 3 meter cloth that is hanging from your coach or partner’s shoulders (not neck). You might also have found a place to hang a rope or cloth to hang from on your own.
It is very helpful to practice “knees together, heels apart” regularly during pregnancy, as that is a key point in this position as an outlet opener, and also to practice, observe, and become familiar with every level of squatting, from a standing (or hanging) squat with your pelvis in an anterior tilt/untucked, to every step as you move through neutral pelvis and down to a deep squat with your pelvis in a posterior tilt/or tucked. In this position, if you find yourself in a deep squat, know that even if your pelvis is deeply tucked under, you are still in an outlet open position due to the extreme hip flexion, though not quite as open as in the upright squat position.
Thank you for Watching!
Cheers! 🌞
[ ] In this video, the goal is to show your understanding of this birthing position, reviewing clues used to guess that baby is in the outlet, incorporate the base position(s), explain the position and how to get into it, talking through the role of the partner, and review what to watch out for. Make sure you are using terminology that is appropriate for your workshop participants. You do not need “participants” for this recording and we suggest using props to support your teaching such as a scarf, towel or shawl; a moveable pelvis may support your teaching too.
[ ] Able to accurately explain the 2 types of clues that help us guess baby is in the outlet and accurately identify the base position for the IR with reach up in addition to explaining the position, how to get into it, the pattern’s role and what to watch out for that reflects a deep understanding
[ ] Review clues to guess baby is in the outlet.
[ ] Incorporate the base position.
[ ] Explain the position and how to get into it.
[ ] Talk through the partner role.
[ ] Review what to watch out for.
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[9] [SACRAL_corrine-flatt] [5 minutes]
[Teach sacral press to partners]
A warm welcome! I want to talk about how to use a sacral press to help with inlet opening and outlet opening. Both of these presses can easily be done in a hands & knees position, but can also (but not so easily) be done in a standing position. Let’s look at this pelvis model, to locate the ridge on the back of the sacrum. As an inlet opener, we will discuss how to put downward pressure, and as an outlet opener, we will learn to apply upward pressure.
As an Inlet Opener, the Body Ready Method® calls this a Tucking Sacral Press. The inlet is the top of the pelvis and is the first level baby has to navigate. The inlet corresponds to stations -3, -2. Especially in the early part of labor, if you find yourself rocking back and forth or tucking your pelvis, these can be clues baby is in your inlet. Another good indication baby is at or in the inlet is if you feel contractions in your mid back, the side of your hips, your pubic bone, and/or your belly. There are three key movements that help create space in the inlet - hip extension, external rotation, and pelvic tucking. Hip extension is achieved when your knees and feet are behind your hips, making a posterior or backward angle from your back to the back of your thighs, external rotation of your hips happens when your knees are apart, and your feet are together – in a side lying or kneeling position, this might even look like soles-together, and pelvic tucking means pulling your pubic symphysis forward and upward, flattening your lower back.
It is usually easiest to begin in a hands & knees position, maybe leaning on a stool or physio ball, with something under your knees for comfort. Start on your hands & knees, coach or partner, place a palm on the middle portion of the sacrum with your fingers pointing down towards the rectum. Apply pressure downward, moving the pressure from the middle of the sacrum going down towards the tailbone, with gentle but firm pressure. Communication is the key to finding the right angle and amount of pressure. To supercharge this position and movement, you might tuck your pelvis, like “sad dog” or “cat” from cat/cow, flattening your back, move your bottom forward, so that the angle of your back and thigh is an obtuse angle of greater than 90°, and then add knees apart and soles of the feet together. Partner or coach, be sure to focus the pressure in the middle of the sacrum, using that ridge as your guide, not too high or too low on the sacrum, and also use the palm of your hand for this pressure, and keep your fingers very light, almost floating.
Doing this sacral press as an inlet opener in a standing position takes some creativity, but can be an opportunity to “stack” other inlet openers to supercharge your contractions. Doing the sacral press as an inlet opener in a standing position is quite doable with a team of two helpers. Let’s imagine that you and your partner are standing in a slow dance starting position, with you leaning against your partner, in a little bit of a leg extension (where your knees and feet are well behind your hips, and your pelvis tucked, like “sad dog” or “cat” from cat/cow, flattening your back. Now imagine adding the lift and tuck during contractions, by you reaching down under your belly, and lifting your belly up and somewhat in, like a hug. Your partner will need to be supporting you, by gently hugging you, and then an assistant coach can apply pressure downward on your sacral ridge, moving the pressure from the middle of the sacrum going down towards the tailbone, using the palm of the hand, with fingers soft and floating, and with gentle but firm pressure. Communication is the key to finding the right angle and amount of pressure. Have your assistant coach watch for an arch in your lower back, and coach you back into flat back/tucked pelvis/hip extension. Relax from this position between contractions, and try to make it through 10 contractions in this position before moving on to another position, maybe to hands & knees, or maybe flying cowgirl.
As an outlet opener, the Body Ready Method® calls this an untucking sacral press. The outlet is at the bottom of the pelvis and is the last level baby has to navigate. The outlet corresponds to stations +2, +3 and beyond. If you are finding front to back movements or find yourself untucking your pelvis, this is a clue baby may be in the outlet. Another good indication baby is at or in your pelvic outlet is if you feel contractions rectally, in your low back, and/or tailbone, or if you are feeling an undeniable urge to push at the top of your contraction or throughout your contraction. There are four key movements that help create space in the outlet - deep hip flexion, internal hip rotation, reaching up (and looking up), and pelvic untucking. Deep hip flexion (think squatting) and reaching up (and looking up) both help the bottom of your pelvis to open up front to back, while internal hip rotation helps to open the bottom of baby’s passage side-to-side, while untucking your pelvis orients the passage and baby’s head, making the passage a more straight shot, and making the other parts of this position easier, and more available to you.
It is usually easiest to begin in a hands & knees position, maybe leaning on a stool or physio ball, with something under your knees for comfort. Coach or partner, place a palm on the middle portion of the sacrum – the “sacral ridge” – with fingers pointed up toward the head, and apply pressure upward, gentle but firm, with fingers lightly floating. Communication is the key to finding the right angle and amount of pressure. To supercharge this position and movement, you might untuck your pelvis, like “happy dog” or the “cow” from cat/cow, creating a curve in your lower back, move your bottom back, so that the angle of your back and thigh is an acute angle of less than 90°, and then add knees together and heels apart – as far apart as is comfortable – and maybe a little bit more. One last “supercharge” would be to recruit an assistant coach – if this is possible, then lean on your partner, rather than a ball or stool, and have the assistant coach do the sacral press, while you reach up (and look up) and put your arms around your partner’s neck or a 2+ meter cloth that is around your partner’s shoulders or neck. Have the assistant coach do the upward sacral press. Focus the pressure in the middle of the sacrum, using that ridge as your guide, not too high or too low, and also use the palm of your hand for this pressure, and keep your fingers very light, almost floating. Avoid pressure on the lower portion of the sacrum near the tailbone.
Doing this sacral press as an outlet opener in a standing position takes some creativity, but can be an opportunity to “stack” other outlet openers to supercharge the work that your contractions are doing. Sacral press as an outlet opener is a standing position is quite doable with a team of two helpers. Let’s imagine that you and your partner are standing in a slow dance position, with a 2 meter cloth around your partner’s shoulders (not neck). During contractions, you are going to reach up (and look up) and put your arms around your partner’s neck, or anchor yourself using the cloth, and your partner is going to reach around you, under your arms, and linking hands at your mid-back. You can now “hang” or partially hang, untucking your pelvis, making a curve in your lower back, bringing your knees together, and moving your heels apart as far as you can manage. Recruit an assistant coach to do the sacral press. Assistant coach, focus the pressure in the middle of the sacrum, using that ridge as your guide, not too high or too low. Use the palm of your hand for this pressure, and keep your fingers very light, almost floating. Avoid pressure on the lower portion of the sacrum near the tailbone. Communication is the key to finding the right angle and amount of pressure. Do this during contractions, and between contractions, feel free to move and stretch. Alternative: if an assistant coach is not available or not desired, knot a 3 meter cloth where it can securely hang, and loop it under your arms and around your mid-back, reaching up (and looking up), while your partner or coach does the outlet opening sacral press during contractions.
Thank you for Watching!
Cheers! 🌞
[ ] In this video, the goal is to show your understanding of this technique and how it can be used for the inlet and outlet, reviewing clues used to guess that baby is in the inlet and outlet, incorporate the base position(s), explain the position and how to get into it, talking through the role of the partner, and review what to watch out for. Make sure you are using terminology that is appropriate for your workshop participants. You do not need “participants” for this recording and a moveable pelvis may support your teaching too.
[ ] Able to accurately explain how to use the technique, when to use it, the clues that tell you it's appropriate to use it, and what to watch out for…all for BOTH the inlet & outlet with a deep understanding and application of BRM®
[ ] Address how this works for inlet + outlet
[ ] Incorporate how you know it's appropriate to use it for inlet
[ ] Explain when to use this for inlet + outlet
[ ] Review what to watch out for inlet + outlet.
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[10] [LITHOTOMY_corrine-flatt] [5 minutes]
[Lithotomy]
A warm welcome! I want to talk about the lithotomy position.
The lithotomy position is that position you see most often (nearly always) when one is pushing in the hospital, lying on one’s back, flat or at a 45° angle, with knees pulled to armpits.
Let’s take a look at what is going on in this position by breaking down each part. Then, we will bring them all together.
Deep Hip Flexion past 90° – this happens when the knees are pulled up to the armpits. Just like in the deep squat, when the hips move into flexion past 90°, the sacrum open at the outlet of the pelvis, making more space in the outlet, front to back, and less space front to back in the inlet.
External Hip Rotation – also like the deep squat, external hip rotation is created when the knees are brought up to the armpits. This creates more space side to side in the pelvic inlet and therefore less space side to side in the pelvic outlet. This can also push baby forward onto the stiffer anterior pelvic floor, increasing chance of tearing.
Gravity Negative – This position is gravity negative, [pelvis pipe golf ball] meaning it is working against gravity. It is literally pushing uphill. Let’s look at our pelvis model. [ You can show this visually by placing a mobile pelvis model on its back and show how the sacrum cannot nutate and how this works against rather than with gravity. This visual can be very revealing and helpful for participants, especially considering this is the number 1 most common pushing position in the modern medical complex.]
Sacral Restriction – Due to the position of the sacrum against the bed, this position will restrict the pelvis from untucking to further open the pelvic outlet. This restriction can be partially limited by including a sacral roll. Without the sacral roll, this position can actually limit the space in the outlet because of the movement restrictions of the sacrum. A sacral roll is when a towel, yoga matt, or pool noodle is used on either side of the sacrum to create space for it to move. The sacral roll can be used on one or both sides of the sacrum.
Bringing it all together – Lithotomy with knees pulled towards armpits (the standard hospital pushing position most of the time) is the gravity negative version of the deep squat with the addition of sacral restriction! Think about it… Take the deep squat position and flip it onto the back and you have the most common pushing position in the modern birth world. One thing this position gets right is deep hip flexion. Beyond that, this position is not the best at creating space in the pelvic outlet at all. If someone does choose or is coerced to push from a lithotomy position, it would be better to include a sacral roll and find internal hip rotation by bringing knees together, and heels as far apart as possible without rotating into resistance, and then adding tug-of-war, or lift up/look up.
The advantages of the lithotomy position are primarily to the provider. From this position, the provider can sit at the foot of the bed and watch/monitor progress. This is also the position that providers tend to be most comfortable and experienced in as it is the most instructed pushing position. The advantage to you is that you can rest. However, side lying is a restful pushing position that is not gravity negative and has no sacral restriction so, from a BRM® perspective, would be preferable.
Disadvantages – The lithotomy position is simply not a very outlet open position when we take into account the external hip rotation, sacral restriction, and the gravity negative relationship. Plus, with the hips in external rotation, we compress the posterior pelvic floor, forcing baby forward onto the stiffer anterior pelvic floor, which may increase pelvic floor injury.
Thank you for Watching!
Cheers! 🌞
[ ] In this video, the goal is to show your understanding of this position and the limitations of it. Make sure to explain what it is, review why it is not ideal, and incorporate modifications to make it a better position. You do not need “participants” for this recording and we suggest using a moveable pelvis and rolled towels/pool noodles to support your teaching. The video summary table can be found on the following pages. We encourage you to print the table out and use it as you prepare for, record, and review your videos prior to submitting them.
[ ] Able to accurately explain this position, why it is not ideal, and how to modify for improvement in a way that reflects a deep understanding and application of BRM®
[ ] Explain what it is.
[ ] Review clues used to know this position could be appropriate for where baby is in the pelvis
[ ] Review why it is not ideal.
[ ] Incorporate modifications to improve it
