Nursing From Within: How BFW Supports My Work as a Nurse
by Lisa Cryderman
Medical professionals have a way of speaking with authority. We are taught about building therapeutic patient relationships in school, but we have the habit of always speaking as though we are imparting our expert wisdom from on high. I never learned how to build really honest, supportive connections until I encountered Birthing From Within.
As nurses, we often review a birth plan and then automatically move to point out all the misconceptions, as though if we just cleared those things up, the pregnant couple would see the light. Of course, they don’t see the light this way -- instead, they feel unheard and defensive.
With the Birthing From Within concept of mentoring, I’ve learned a style that’s different from the “imparting my expert wisdom” stance. Now, when I read through a birth plan, I start by getting a sense of what the parent is really trying to avoid with all of the rules that they are setting up for their birth. Then I ask them with great curiosity and acceptance, “How did you know to want these things?” When they tell me how they learned to ask for these things I validate them completely.
Now I tell parents, “I want for you what you want for yourself.” By honoring their positive intentions for their birth, I can start building a relationship.
The first time I heard Pam England speak in 2003, I had already been a labor and delivery nurse for eight years. Pam’s lecture began an unexpected journey of personal and professional growth. I remember being struck by her presence: she seemed to pause to listen to some guidance from within before answering each question posed to her by audience members. I had never seen a speaker able to do this. I have always been a blurter myself, and this day was no exception. I blurted out a question that I had been struggling with: “What do you say to a woman who tells you that she will have an epidural if hurts too much?” Pam’s first response was a question: “What do you say now?” I gave some version of “News flash: labor hurts too much.” She responded with another question: “How is that helpful?” I was so embarrassed that I didn’t know how to respond better than that. She suggested that I inquire, “How would you know if it hurt too much? What would you be doing?”
She had my full attention. I hung on her every word.
As a labor and delivery nurse, I had always been passionate about supporting birthing people in what they wanted (“natural childbirth,” or whatever other goal they brought to me). I had thought if I just told them the truth -- “news flash: labor hurts too much” -- they would get it. It was, in a way, an idealistic approach: just give people the correct information, and they will use it correctly. Listening to Pam speak changed my understanding forever. Now, when a pregnant person tells me they will have an epidural if it hurts too much, I always say, “And how will you know if it hurts too much?” To this day, everyone has stopped and stared at me and said, “I don’t know!” Only one person in 15 years had an answer to this question. After giving them a few moments to think, I often prompt them with, “What might you be doing?” If I still get a blank look I might make some suggestions: “Might you be restless? Moaning? Crying?” “Yes! Yes!”
“Would being restless or moaning or crying necessarily mean that you aren’t coping? Have you ever driven a car crying? Many people have driven hundreds of miles crying. Really, they’re coping just fine. They might not be liking it, but they’re coping.” (This is one of the many eye-opening Birthing From Within understandings: you don't have to be enjoying something to be coping with it!)
As we talk, I can often see the light bulb coming on in their eyes as they realize that crying -- or any given behavior with a negative connotation -- doesn’t necessarily mean not-coping. This concept is a revelation to most women. This is the beauty of Birthing From Within: bringing people new understandings in ways that are actually helpful. Two years after hearing Pam speak, I began my Birthing From Within childbirth educator training. My Birthing From Within work has helped me examine my own beliefs and projections, understand how the culture influences what people believe, and build trusting relationships with the people in my care. And honestly, that barely even scratches the surface of what I have learned.
While no Birthing From Within training that I’ve attended has ever directly addressed nursing skills, every single one has deeply enhanced my skill as a nurse.
Even if you are not a childbirth educator or doula, if you work with pregnant or postpartum people in any capacity -- whether as a social worker, therapist, bodyworker, yoga or fitness instructor, lactation professional, doctor, or midwife -- I am absolutely sure that your practice will benefit from the personal growth and professional development that Birthing From Within offers. I encourage you to find a Crossing the Threshold in your area, and dive in!