My first priority is to be emotionally, mentally and physically available for my client. I need to be fully present to observe her body language, breathing and mood from moment to moment as she progresses throughout her labor stages. Also, being aware and mindful of the interaction between the couple is important as I can support each of their needs. Once, I am aware of my surroundings in addition to the client’s, music interventions can be implemented as needed. Knowing various genres of music and its rhythm, timbre, instrumentation, tempo and lyrics (if applied) is beneficial as then I can provide music related to the client’s needs. The key is for me to be flexible as I need to recognize if the music is supporting and matching her mood and rhythm. In addition, to having various genres of music, I also want to be flexible to provide live music. This means, knowing my client’s preference in music, and also how I can incorporate noise within the ambience to create sounds that become part of the improvisation/pre-composed song. The key is to create a supportive environment that can assist the client to relax her muscles and feel safe; along with supporting the client’s partner to feel included and to trust in the birthing process. Last, acknowledging my client’s birth plan and alternative options are important. They trust me to assist them with their birth plan. This may mean that I may advocate for them within a hospital setting, or learn to collaborate with the medical team in order to provide the utmost care for the baby and mother. Unfortunately, there may be instances in a hospital that may create obstacles for the mother to follow through with her birthing plan. Thus, knowing what choices is available and how I can assist the family in adapting is a skill and another priority taken into consideration. My ultimate goal is to be encouraging musically, emotionally, and physically.
I completely agree with you Angel that the ultimate goal is to encourage the birthing mother! I also like how you specifically identified that you want to encourage and support the WHOLE woman emotionally and physically with your musicality. I also agree that flexibility is key. Having never been in labor I only know what I have heard from other close friends and family, but I gather that flexibility is absolutely necessary. My best friend went into it being flexible; however, she didn't have a birth plan and had not really spent time educating herself on the options and relied on trusting her doctor. She did not have the labor she imagined and says looking back that she wished she had been more educated on her options. I think your note about being an advocate for the mother with her birth plan and being knowledgable about it and the alternative plans is a great point! Thank you for your thoughts!
Thanks! I have not experienced labor myself too, but I would imagine that having someone who is flexible, knowledgeable, trusting, and supporting would help with the process of labor. I would want someone who can be supportive rather than impede in my labor.
Great summary Angel... yes presence is no. 1. We need to "be" more and "do" less. Let the music be your co-therapist. We will practice all of this next week. :)
I am going to have to agree with Angel ---> Support! The music is the support for the physical, emotional, and spiritual birthing mother. Music provides physical (entrainment) support with positioning, movement, toning, breathing, and pushing. The music provides emotional support for the mother, support team, and the baby. The music can provide a spiritual support for the mother, partner, and baby. The mother can also provide bonding support between the mother, partner, and the baby. Because of the innate characteristics of music as a non-invasive sensory input, music can provide support in many different ways. In my opinion the top priorities when providing SB-MTACB during labor and delivery would be comfort and support. A variety of comfort measure can be facilitated with these techniques including positioning/movement, environment, bonding, breathing, relaxation, emotional release and awareness, and vocalizations. The music provides a focus and structure for each comfort measure. In my opinion, support means to provide consistent, positive structure for the birthing mother, baby, and support team. Music can do this in many different ways during labor and deliver with the underlying priority to be support for the WHOLE person.
Kristin, I love that you talked about the music providing bonding support between mother, partner, and baby! While our focus will definitely be on the mother it is so important to remember the other people so involved in this life changing process!
My primary goal and responsibility would be to provide constant support to the mother while she is in labor. To be present with and for her for the duration. This would include being fully present and in tune with what her needs and preferences are in relation to the music and other comfort/support measures. It may also mean providing support and encouragement to her birthing partner (father or other) so that they are able to meet the mother's need, preference and desires so that she is able to fully concentrate on working with her body to birth the baby. First and foremost it would be to be a constant source of support and encouragement while providing the musical foundation.
My top priorities would be providing support, comfort and encouragement for a client who is in labor. To be present and available for her physically, mentally and musically when needed and facilitate her needs with music (but be ready to extend, to adapt or even fade out music interventions at any moment when necessary). It is an important factor to provide constant encouragement for the mother throughout the process. That builds up a mother’s confidence of telling her she has the capability to do it, that means she is able overcome the pain and other discomforts; to concentrate and to keep up with the strength for pushing, and most importantly, she is progressing.
I agree with your comment about not just encouraging a mother that she can do it, but that she is progressing. How important after all the work of laboring to know it's not in vain!
Wonderful way to advocate on behalf of the mother (counteracting with positive feedback). Creating a positive culture as mother is overwhelmed with everything at hand!
Yes encouragement and the power of power words is also so important. Yes adapting, extending and fading is a very important part of the experience. We will practice this all next week. See you soon!
When providing support to a birthing mother, my top priority will be to lay aside my own distractions or agenda and be ready to continually assess in a way that allows me to simply be with them in the way that's needed at the time. A lot of planning and preparation goes into labor, but flexibility and improvisatory skills are the most useful tools to bring when it's the real deal. I see my place as an honored guest who has been welcomed in to be a part of welcoming a new person into the world. As such, the birthing family's needs come first and I'm there to advocate for them, regardless of my own ideas or opinions. I must leave my pride at the door and not let it hinder the desires of the birthing mother or her partner. If I have an idea musically that I try, but the mother dislikes it, I humbly keep trying new things, transitioning in and out with ease. I will strive to be an encourager verbally when it seems appropriate, a physical presence to the degree the birthing mother wants, and provide a musical safety net whether that means ensuring sound or silence in the environment. Unsure mothers need to hear they are capable of birthing the baby and reminded of the joy of seeing the baby soon.
When providing Sound Birthing MTACB for a client in labor my top priority would be, as many have already stated, to be present and to bear witness to her experience. I hope to use music to provide a stable and secure environment in which the mother feels safe and comfortable in allowing her labor to progress. Having a working knowledge of my client’s birth plan and the alternatives that may be suggested will also be critical in helping my client feel empowered during her birth experience. I also feel that if the mother’s partner is present it should be part of my role to encourage them to participate and provide support as well. The mother’s partner might be able to provide emotional and physical support I would not be able to, but I could encourage this and support it with music. It will be essential to have a sense of change and flexibility during the labor process and to allow my music to change with the experience.
I remember during my own birth experience I began toning with my contractions. I felt support from my husband and my doula but I believe it could have been an even more powerful experience had they joined me! I feel it will be very important to validate the mother’s instincts and react in a way that shows her I am with her, but she is the one making decisions and allowing her body to guide her.
I also feel it is important to consider that there may be cases when mothers do not want music played at all, or may benefit more from verbal encourage than musical support. This is a scenario in which I need to be prepared for, as I am so much more comfortable existing in music than in verbal communication. In this case I will definitely have to remove my own hesitations about my verbal skills and allow myself to be completely present in the moment to provide the mother with the encouragement she deserves to have.
Yes - a mother may love the music during pregnancy - but labor puts a different perspective on things. We definitely need to be adaptable to any changes just as we are in our other MT sessions. I love that you incorporated toning into your birth experience! How awesome! I do agree that it could have been a more powerful experience if your husband and doula participated along with you. I think that is where practicing the toning together would be beneficial so that it can help decrease feelings of vulnerability.
When we are asked to provide services, I feel it would be an honor at each and every birth. The laboring woman and her birth partner are allowing us to be a part of an important moment in their lives while recognizing that they would like (or need) the additional support. That is my main priority when providing SB-MTACB. To be there for support - for the mom and baby as well as her birth partner. Being present and focused on my client to assist her physically, emotionally and musically through the labor and birth of her baby. To offer encouragement especially at the times when it is needed most. Being aware of her needs and relaying this information in order for her birth partner to feel successful in assisting her throughout the process. Using the music to support the various techniques and comfort measures to best meet her needs at each moment of her labor as well as recognizing when a change in any of these is necessary based on her physical and/or verbal responses. Assisting my clients in achieving their desired plan for birth as well as being reassuring when changes arise that deviate from their plan (whether the change is made by my client or suggested by the medical staff) and making sure my clients understand the procedures.
I see our top priority as giving voice to each mother (though support).
Just as each birthing plan is unique (submitted prior to the hospital) each mother and each mother's desires and difficulties are unique. What an incredible job to put a "voice" to each mother's "birthing plan" and experiences, allowing her presence to be known in the room despite even saying anything. I imagine the music that fills the room puts the environment into a mood that matches the mothers desires and creates a mood for everyone else to match and follow suit. She's in charge, despite her even needing to say anything.
Reminding each mother of her voice, placing value on that voice, and reminding the birthing team of her voice when forgotten.
My top priority is supporting the mother through labor, and this will take on many different forms, such as physical, emotional, communicative, organizational, and environmental. -Physically, my priority is to be a shoulder to lean on or a hand to squeeze if she needs it, or make sure that her partner or family members are doing that. Meaning to just physically be a presence for her that is there for her, because that is not always the case. Some situations may include those with "there own agenda" and it makes a world of difference to have someone physically standing beside you that is on your side. -Emotionally, my priority is to no judge her choices, but make sure she feels that her opinions/wants/needs are being met and understood by her partner, family, and hospital staff. Not bossing others around, but being mindful of her wishes and doing my best to make sure they happen. And if they can't, then helping support her when she deals with it. An example would be if she needed an emergency C-section and has labored so long she can't take it anymore and feels she is "giving in" if she gets an epidural. -Communicative support, in making sure her needs/wants are understood and also the needs of the birth partner who will be running on little sleep and food as well and not able to handle seeing their loved one in pain. This can be in the form of rewording something to see what they are trying to say, or suggesting other positions if they seem like they are getting frustrated. -Organizational support, in the form of keeping notes to help them relive their birth experience and also making sure the music is matching the stage they are in. Keeping the room environment en-trained on the needs of the mother/baby. -Environmental support, which is tied to the last statement of keeping the environment at the same stage as the labor--making sure the music matches the mother's needs at that time. Wow, it is no wonder that after attending a birth, I felt so exhausted myself!!
My main priority is to meet the needs of my client - whatever that may be in the moment. I would predict that support, encouragement, and comfort would be the main needs throughout the journey of labor. I would offer support verbally and musically, encourage her, and even drop out for a while if she needs her partner to be the main focus for a time. As a music therapist in this situation, I would need to be flexible to many different outcome and processes.
Some top priorities for any music therapist supporting a mother in labor include being present for the mother and observant of the environment and providing emotional and sensory support to the mother. A music therapist should be providing a sense of safety and empowerment for the mother through being present in the moment with the mother. Hopefully this would encourage the mother to feel inclined to take steps to fulfill her wishes for her birth plan, knowing that someone is supporting her. The music therapist should also help make sure the environment is specifically tailored to each stage and need of the mother along the way during labor. Being observant of the mother and environment in order to notice and make necessary changes will most set up the mother for a successful and fulfilling birth experience. The music therapist may also be aware of others' actions and attitudes in the room as they may impact the mother and her focus on labor. The music therapist should also be aware of the mother's emotional needs throughout labor. Likewise as the music therapist should react to needs of the mother and demands of the environment and labor process.
Yes by providing the constant quiet presence, monitoring the mother and the environment we can help provide that sense of safety and comfort which will empower the mother to trust her own instincts about birth. The support and music are equally important. It is important to remember the functions of music in labor and how to use them effectively to help the mother to feel safe, calm, and unobserved. It is important to follow the steps of the treatment plan and to utilize client's preferred music within the protocol whenever possible. Most importantly, biological implications of sound must be considered first such as effect of music on heart rate, respiration, etc. during labor.
When assisting a expectant mom in labor, professional caregivers include medical doctors, nurses,midwife, all should take into account of her physical and psychological need, me too. And as a music therapist, I will take more attention to her emotions. Good emotion give her more energy coping with labor pain and the other uncomfortable experiences, and give her more confidence to engaged in and control the process.
Fatigue make delivery woman upset, be sensitive to the expectant mom’s physical energy, have the music matching her pace. Let music help her resting and refueling at the right time. The more body comfortable, the more good emotion, and the good emotion help body dealing with difficulties, this is a virtuous circle.
Yes Ming MIng the music should match her pace. We will have the chance to do some labor assessment and music selection when we meet this week. Music can promote movement when it is needed and rest when rest is needed. You can use the music to support her actions or help her try a different action or position to help her feel more comfortable.
I feel somewhat redundant, but our first and foremost responsibility is to our client. In a birth setting this translates to support. We are there to enhance the experience, to be there for the mother whether her needs are emotional, spiritual, or physical. We can offer support through a combination of live and recorded music, toning, physical contact, and listening to name a few. It is important to be alert and to be able to read the need of the client, because she might not be able to verbally convey her desires. Our top priority is to aid, it is not to be intrusive or take the place of anyone else on the support system. As music therapists we need to make sure all the elements of the music match the women where she is at during the birthing process. We need to be prepared to offer music that is relaxing to aid in relaxing the pelvic floor, or empowering to encourage pushing. No matter where the mother is in the birthing process the therapist has the responsibility to meet her there. The client is always right. We are there to offer comfort and support in an individualized and natural manner.
The top priority of any individual providing Sound Birthing is always the mother and the baby. This encompasses many things, but all interventions must always facilitate supporting the mother and baby through their journey.
Probably the most critical undertaking of the Sound Birthing provider is the promotion of communication. The music needs to communicate relaxation and empowerment among other things to support her through the whole birthing process. The music also has the ability to communicate group cohesion and relaxation of the support team so they can more effectively assist the mother. The most important communication element, however, is the communication between the mother and the baby. They are working together as a team throughout this whole process so each unit needs to stay calm and connected to each other. If either individual becomes stressed or panicked, it will affect the other negatively as well. Because of this, the individual providing Sound Birthing must encourage communication between the mother and baby. This can be achieved in many ways from singing and stroking the belly to encouraging the mother to “go inside” and talk to her baby. When mom and baby are connected and communicating, the whole birthing process goes much smoother.
Another crucial task of the Sound Birthing clinician is providing appropriate comfort measures to the mother. This begins by creating an optimal birth environment, which includes dimming the lights in the room, encouraging people entering and exiting to do so quietly, and providing the mother with warm blankets or cold cloths, depending on which she needs. This also includes playing the appropriate music at the appropriate time. From live to recorded, the music should always match the progress of the labor and should be at a volume that is loud enough to be heard by the mother, but not so loud that it is stressful to the mother or the baby. Positioning is also an important piece of providing comfort measures. There is a wide variety of positions that can be used during labor, and it is the job of the Sound Birthing clinician to be familiar with all of those positions and to be prepared to encourage the mother to try some in different stages of labor.
Finally, the Sound Birthing helper must be willing to advocate. The process of bringing a child into the world can be exhilarating, frightening, exhausting, and many other things. Amidst the confusion, it can be easy for the wishes of the mother to get lost in the melee. Because of this, it is important for the mother to have someone who can advocate on her behalf for immediate skin-to-skin contact or for her spouse to cut the cord or to not have an episiotomy. Obviously, not all of the mother’s wishes may be possible if there are complications, but the Sound Birthing provider must be willing to advocate if and when the occasion arises.
While these are only a few of the responsibilities of an individual providing Sound Birthing, they are some of the most important tasks. Even though the tasks are great and the work can be difficult, being present when a new little one comes into the world is one of the most honorable and respect-filled experiences.
My top priorities when delivering Sound Birthing MTACB are always going to be the health and safety of the mother and child - which involves providing a service which compliments and not impedes, labour. This may involve advocating for and supporting the mother with measures other than music when necessary. For example, a variety of comfort measures such as dimmed lights, privacy, feeling safe and supported - all of which can either help or impede labour if these basic needs are not being met. Therefore my next priority is to ensure that the music is complimenting and supporting her needs as required - whether that be to provide positive focus, relaxation or support through transition and birthing (to name just a few). After these practical needs have been met, I see it as our duty to ensure that music is not only supportive and following a mother's birth plan as much as possible, but providing a soundtrack to the creation of new memories, whose meaning will be greatly enhanced,as well as providing a safe, 'musical container' to hold the birth process.
Haha. But it all seriousness, yes, this is definitely our role in L&D. I thought it was important that none of what you mentioned blurred any lines between MTACB and support a doula might provide! To me this was one of the hardest things to navigate.
Support support support. Allowing yourself to follow her lead and support from you. Understanding her physical, spiritual and emotional needs and providing a musical outlet for that. Knowing when to use music and when to allow quietness that she might desires. . Knowing her birth plan and being flexible to change as she changes. Providing calmness throughout the process and the constant steady stream of positive energy. Allowing the music to match her needs and being ready to change as the situation also changes.
Yes most important phrase- "follow her lead" that is it exactly. It's all about support of her, the environment, her partner, the baby, and we do this with the music and our gentle presence.
My top priority would be respecting the wishes and needs of my client. What is right for me or the past ten clients may not be right for this person in this moment. One of my biggest take aways from this course is there are so many variables in the birthing process. There are variable as far as cultural perspectives, birthing locations, positions, and medications. There is no one right answer and my job is to be there to support the mother and help her have the healthiest birth possible, whatever that means for her. This also means coming prepared with options and being reflexive to meet the mother's and partner's changing needs.
Yes and those needs will change during birth and your client will be in an altered state so things will be different. You are right- you need to respect her wishes at all time and use your intuition and your senses to observe and reflect on what she needs to support her and the baby in this process. :)
The easy answer for this question is: the safety of the client, the laboring woman. This is the top priority of everyone in attendance, which is great. If she has needs that are outside our scope of practice, I can assist by helping her communicate these to the appropriate person. If she is physically safe and her needs are being met by medical caregivers and labor support staff, then I am able to provide comforting, presence, and follow her lead in the music I provide. I will bear witness to her journey and support her.
I was listening to Carolyn Koebel's "Walking Each Other Home" from Honoring the Passage, which is a collection of songs from hospice music therapists, and thinking about how the music therapists' role in a birth setting is similar to the role they may play when with someone who is actively dying. The client will be going on autopilot, will be the focus of everyone in the room, may (will!) be experiencing altered consciousness, and may not be directly aware of your presence. You just get to support from a place of positive presence, bear witness to the transformation taking place, and create the space that they want and need in that moment. We can create that space and help the other attendees feel the preciousness of this experience.
Mary, do you have any experience with Sound Birthing and still birth? Maternal death? I know that the United States is doing poorly when compared to other countries' maternal mortality rates. Just something I find myself thinking about on a beautiful Saturday afternoon...
Yes exactly. Many of the hospice music therapists who take this training say that the role is very similar. It is an honor and a privilege to be there as a soul is coming and and when a soul is leaving. I have had one client who had a still birth. There are music therapists who have taken this training who have decided to specialize in birth loss. There is a doula organization that trains doulas for still birth or death shortly after birth. It is a much needed service for these grieving families.
Our top priority as a MT in the birthing process should be respecting the mother's wishes and keeping her and her baby safe. If she requests something that we feel may be harmful we have an ethical and moral responsibility to consult with the physician.
Apart from that, we are there to help facilitate comfort and support for our clients. We posses a powerful tool that may be helpful for the mother in her birthing process- but she may request us to stop all music and leave the room!
We can use our inherit skills as a therapist to continually assess the nature of affairs during delivery, and adjust as needed. We need to be flexible and willing to go completely off the plan if needed. We need to be present with the mother and all others involved, and present ourselves as fully attentive the their needs.
Right. I have never been asked to stop music and leave a birth so that is probably highly unlikely that it would happen to you. The birth mother develops a rusting therapeutic relationship with you and the need for support is just as critical as the need for music. The two go together and one without the other is not as effective. Yes we often have to go off plan because the baby has its own plan. We are there to help them navigate this experience with as little stress and pain as possible. Regarding harmful behavior in labor.... it did happen once that I was supporting a family at a hospital birth that decided do use herbal medicine while she was receiving standard medical care during labor. I was shocked when it started happening as I had no idea the couple was planning this and it was not part of the birth plan. We talked about how serious the consequences were about keeping secrets from the doctor and that it could be dangerous for mother and baby. I convinced them to tell the doctor what was given to the mother so the medical staff could monitor mother and baby closely. After discussing it with the doctor they decided it was not a wise plan to continue self medicating. I felt pretty uncomfortable in this situation because I was not an employee of the hospital but rather was hired by the couple. I knew that I had an ethical obligation to say something. Sometimes there are surprises at births and sometimes when people are under stress they behave differently than you would expect.
My top priority would be to create a safe and supportive environment for the mother and baby. I have a very whole-person, client-centered approach and with that, another priority will be to follow the lead of my client. I will chose music that corresponds to where she is at in the current moment, making sure that the music is not working against what she is trying to accomplish. I also feel like advocating for the client should be a priority. Theoretically you would be meeting with the mother prior to the birth, and odds would be good that she had shared her birth plan with you. Having another voice on her side (especially if she is not in a place to speak or advocate for herself), could be comforting to her and may help with sticking to her plan. I would think that one of the most important things would be making sure you are attentive to your client and her needs. The goal is to, at the end, have a healthy mother and baby.
Yes creating the birth plan is part of the assessment process so you know the details of it and should have a copy with you. Helping the mother to advocate for herself (if possible) and if not helping the partner to advocate for the mother is best. Reminding everyone of the birth plan and checking in with the couple at opportune moments if things start veering from the plan is a good idea. Yes supporting helathy baby and mother is always the top priority and using music to support each stage of the labor process is critical.
As a professional, my top priority should be to respect and defer to the mother while advocating for her previously stated desires for her birthing experience to any hospital staff, family, and partners. The safety and well-being of the mother and child are always the number one priority, and it is also my responsibility to be intuitive to the needs of the physician.
The very nature of music is an ability to be adaptive, as a professional, I should be prepared for the unexpected and be comfortable in my role to continue to provide excellent care no matter the external situation.
My role should always be supportive, and if it were to at any point be a hindrance, it is also my responsibility to be aware excuse myself. The laboring woman has a right to request me to leave, continue, etc - but within that role it is my professional responsibility to advocate for her best needs -what would biologically and emotionally be most supportive.
I love your adaptive, person-first approach, Hannah. Child birth, as you mentioned, can totally be unpredictable and we as therapists can go into a session as prepared as we want to be and everything can turn around on us. Adaptability is definitely a huge part of our jobs and especially in an arena as constantly changing as child birth.
(Also, hey how are you! Can't wait to catch up on Saturday!)
A few top priorities (hard to put in order!!) 1. Safety of mama 2. Safety of baby 3. Empowering mama while respecting and validating her feelings, goals, and wishes. 4. Creating a sacred birthing space.
I believe many of these can be accomplished by BEING instead of DOING. Of course, with the support of the practitioner. Sound Birthing will go miles toward creating a sacred space and empowering/validating mom. I also suspect that the music therapist has a large role in supporting the birthing woman's partner. Encouraging the partner to remember techniques they practiced, helping them advocate for the mom, and likely allowing them to take a break while knowing mom is still supported.
Laura, your answer seems so short, sweet, and simple, but also encompasses everything in a succinct way. Being instead of doing is a powerful intention for me. Thanks.
Yes a great short list to review every time you support a mother in labor. Another good list to review before a birth is p. 83 of the manual- Summing it Up: MTACB in the Birthing Room. :)
When providing Sound Birthing MTACB for a client in labor my top priorities are to support the mother emotionally, physically, and spiritually while paying close attention to the verbal and non-verbal cues she is giving in order to create a safe, nurturing, and empowering space for birth to happen. It is my role to be a trusted advocate for the mother's birth choices while maintaining respect for the needs of the medical professionals attending to the birth. It is also a priority to stay flexible and attentive to the changes that may be needed in order to support the progression of labor in a non-intrusive way.
I remember my doula asking our childbirth class what a woman needed in order to give birth. There was just one answer.... one thing that a woman needed in order to give birth. People were guessing things like water, shelter, support, etc. But there are plenty of women who give birth all the time without those things. If you pay attention to animals birthing instincts they always go hide somewhere to give birth. This is so the mother can keep her and her babies safe from predators during this vulnerable time, when she is not able to defend or protect them. The one thing that a woman needs in order to give birth is safety. Studies show that women who feel unsafe during labor will stop progressing. They have a physiological response to fear. More than anything, I hope that I am able to create a safe space while providing MTACB.
Yes safety and privacy! You can create a safe space with the music. Dr. Sarah Buckley is a leader in this field of natural childbirthing. In the Birth Music Consultation course we study her work more in depth. Here is a brief 3 min summary of her work on you tube: https://www.youtube.com/watch?v=7446t4WE_Lw
As pretty much everyone has already mentioned, as music therapists, our first priority is always the client, in this case, the woman in labor. Being overwhelmingly supportive and comforting especially as labor progresses is a huge part of our job. One thing I'm learning in my counseling master's program, is that my job is always to empower my client, whatever that means for them. To listen to what they are feeling, thinking or experiencing is of paramount importance. My voice should never be one that is doing anything but advocating for the mother's wishes.
That's our number one, but that's all something that a doula or other birthing partner can do. As trained music therapists, we have far more tools in our tool box to achieve that and can supplement that support musically. In the MTACB handbook, we're instructed to be present with the birthing woman by taking note of several things including body rhythms, labor stages and need for physical support. However, the element that stuck out to me was the sentence written after all that list. "Find music that matches/supports all of these factors and stay with it UNTIL they change, progress or the birthing woman expresses a desire for change."
We all have extensive musical training that allows the ability to give birthing women the gift of exactly what they need. This is both a gift and a responsibility. However, as long as we are always been present with the birthing mother and are creating a space that allows for change and adaptability, we can adjust our music accordingly.
I really like your emphasis on being present. It seems so simple, but being fully present, engaged, and attuned to the mother and the environment is a powerful responsibility. As you say, being truly present allows us to respond and adapt to the mother's changing needs, ensuring that she and the baby remain at the center of the process.
Yes Jessica it is a gift and a responsibility. Well said. We must be constantly aware of where the mother is at, the functions of music and how they can support her best throughout her labor journey in each of the spheres- bio, psycho, social.
I feel, for me, the biggest overall priority when providing MTACB would be the mother and baby -- both their safety, and the mother's needs/wants. This priority would then encompass multiple approaches to fulfill.
I feel the biggest part in keeping the mother and baby first would to make sure one is being present -- their mind is not elsewhere and focused on the room and the birthing mother. Being present allows you to notice what is happening in the room at that moment and adapt the music to meet the mother, father, and baby.
Also, a huge aspect of keeping the birthing mother and baby as a top priority, would be to act as an advocate for the mothers wants and needs as per her birthing plan, or wants/needs that may change in the moment. As labor progresses and a birthing mother is encouraged to go inward, focusing on instinct, and perhaps a partner being overtaken by the moment, it may be difficult for her and/or them to voice wants ands needs. Having developed a relationship and discussed birthing plans prior to labor the Music Therapist can help communicate those to the birthing team.
Of course, when also keeping the health of the mother and baby as a priority, it may be possible that complications arise. If the birth is occurring at a hospital, and perhaps with another doctor that the couple has not met, complications and interventions can be overwhelming. Again, as the Music Therapist has developed a rapport with the couple, it may be helpful for the Music Therapist to help communicate the interventions with them; coming from a developed relationship it may be more comforting.
The role of the music therapist in labor should be that of support, and never intrusive on the experience. I believe it's important to provide positive encouragement and support to the birthing mother and partner, but allow space to the partners to experience the transition in becoming a larger family.
Supporting the mother's natural labor progression and her going inward is so important. Keeping talking and distractions to a minimum is essential. You are so right Kimber and it can make all the difference in the world. :)
When providing Sound Birthing MTACB for a client who is in labor, my top priority it to make sure I am there as a support system for the mother (and partner if that therapeutic relationship has been established), and eventually the baby. The mother needs to know that she has a champion in her corner and that whatever need she has emotionally, physically, and anything else; I am there to help her out. It is is important for mothers to know that they are our priority during this stressful, exciting, and eventually painful time.
To make sure that this priority is accomplished successfully, it is important to always be prepared, but always be flexible at the same time. Make sure we have our MTACB bag always on the ready; as well as our clients portfolio handy. Labor can occur at any moment for an expecting mother.
Most importantly we need to offer a safe, warm, and loving space for the baby to arrive to. If they mother feels safe, loved, and supported, then when the baby arrives, that feeling will spread and blanket the new sweet baby as well.
Providing that support with your presence and the music during labor is so important. Creating that loving, gentle, inviting space to welcome the baby is also equally important. :)
My top priority in providing Sound Birthing MTACB is to do what is best for the health and safety of the mother and baby. I am using health in a holistic way here. Of course, physical health and safety are of the utmost importance, but emotional health and psychological safety are crucial as well. I hope to help the mother feel supported, informed, empowered, and celebrated as she goes through this transformative life experience. This requires flexibility, as each woman and each birth is unique. However, there are some core considerations that I would prioritize when using MTACB:
Safety/holding space - Using music, lighting, etc to create a space that feels protected, comforting and safe. Minimizing distractions and intrusions as much as possible, allowing the mother to stay tuned in to what is happening with her and the baby.
Communication - Verbal and nonverbal. Listening to and observing the mother. Offering information and suggestions when appropriate, or reaching out to the appropriate medical provider. Using music to communicate support and encouragement.
Advocacy - When medically appropriate, helping to protect the mother's plans and wishes.
Honoring mother's choices - Respecting her right to make decisions regarding her labor and birth. Recognizing that the birth plan is not set in stone and being willing to adapt to mom's changing needs and wants.
Celebrating the new life and helping the mother feel a sense of pride and accomplishment.
My first priority is to be emotionally, mentally and physically available for my client. I need to be fully present to observe her body language, breathing and mood from moment to moment as she progresses throughout her labor stages. Also, being aware and mindful of the interaction between the couple is important as I can support each of their needs.
ReplyDeleteOnce, I am aware of my surroundings in addition to the client’s, music interventions can be implemented as needed. Knowing various genres of music and its rhythm, timbre, instrumentation, tempo and lyrics (if applied) is beneficial as then I can provide music related to the client’s needs. The key is for me to be flexible as I need to recognize if the music is supporting and matching her mood and rhythm. In addition, to having various genres of music, I also want to be flexible to provide live music. This means, knowing my client’s preference in music, and also how I can incorporate noise within the ambience to create sounds that become part of the improvisation/pre-composed song. The key is to create a supportive environment that can assist the client to relax her muscles and feel safe; along with supporting the client’s partner to feel included and to trust in the birthing process.
Last, acknowledging my client’s birth plan and alternative options are important. They trust me to assist them with their birth plan. This may mean that I may advocate for them within a hospital setting, or learn to collaborate with the medical team in order to provide the utmost care for the baby and mother. Unfortunately, there may be instances in a hospital that may create obstacles for the mother to follow through with her birthing plan. Thus, knowing what choices is available and how I can assist the family in adapting is a skill and another priority taken into consideration. My ultimate goal is to be encouraging musically, emotionally, and physically.
I completely agree with you Angel that the ultimate goal is to encourage the birthing mother! I also like how you specifically identified that you want to encourage and support the WHOLE woman emotionally and physically with your musicality.
DeleteI also agree that flexibility is key. Having never been in labor I only know what I have heard from other close friends and family, but I gather that flexibility is absolutely necessary. My best friend went into it being flexible; however, she didn't have a birth plan and had not really spent time educating herself on the options and relied on trusting her doctor. She did not have the labor she imagined and says looking back that she wished she had been more educated on her options. I think your note about being an advocate for the mother with her birth plan and being knowledgable about it and the alternative plans is a great point! Thank you for your thoughts!
Thanks! I have not experienced labor myself too, but I would imagine that having someone who is flexible, knowledgeable, trusting, and supporting would help with the process of labor. I would want someone who can be supportive rather than impede in my labor.
DeleteGreat summary Angel... yes presence is no. 1. We need to "be" more and "do" less. Let the music be your co-therapist. We will practice all of this next week. :)
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ReplyDeleteI am going to have to agree with Angel ---> Support! The music is the support for the physical, emotional, and spiritual birthing mother. Music provides physical (entrainment) support with positioning, movement, toning, breathing, and pushing. The music provides emotional support for the mother, support team, and the baby. The music can provide a spiritual support for the mother, partner, and baby. The mother can also provide bonding support between the mother, partner, and the baby. Because of the innate characteristics of music as a non-invasive sensory input, music can provide support in many different ways.
ReplyDeleteIn my opinion the top priorities when providing SB-MTACB during labor and delivery would be comfort and support. A variety of comfort measure can be facilitated with these techniques including positioning/movement, environment, bonding, breathing, relaxation, emotional release and awareness, and vocalizations. The music provides a focus and structure for each comfort measure. In my opinion, support means to provide consistent, positive structure for the birthing mother, baby, and support team. Music can do this in many different ways during labor and deliver with the underlying priority to be support for the WHOLE person.
Yes support + music = Sound Birthing MTACB : )
DeleteKristin, I love that you talked about the music providing bonding support between mother, partner, and baby! While our focus will definitely be on the mother it is so important to remember the other people so involved in this life changing process!
DeleteMy primary goal and responsibility would be to provide constant support to the mother while she is in labor. To be present with and for her for the duration. This would include being fully present and in tune with what her needs and preferences are in relation to the music and other comfort/support measures. It may also mean providing support and encouragement to her birthing partner (father or other) so that they are able to meet the mother's need, preference and desires so that she is able to fully concentrate on working with her body to birth the baby. First and foremost it would be to be a constant source of support and encouragement while providing the musical foundation.
ReplyDeleteThe music and therapist are the constants- we are always there, yet flexible to meet the client's needs. :)
DeleteI love the way you worded that, Mary! I need to remember that one! Yes the music is doing a lot of the work, but so are we.
DeleteMy top priorities would be providing support, comfort and encouragement for a client who is in labor. To be present and available for her physically, mentally and musically when needed and facilitate her needs with music (but be ready to extend, to adapt or even fade out music interventions at any moment when necessary). It is an important factor to provide constant encouragement for the mother throughout the process. That builds up a mother’s confidence of telling her she has the capability to do it, that means she is able overcome the pain and other discomforts; to concentrate and to keep up with the strength for pushing, and most importantly, she is progressing.
ReplyDeleteI agree with your comment about not just encouraging a mother that she can do it, but that she is progressing. How important after all the work of laboring to know it's not in vain!
DeleteI think it could be important especially if the medical team defines the labor progress negatively - we can counteract with positive feedback.
DeleteWonderful way to advocate on behalf of the mother (counteracting with positive feedback). Creating a positive culture as mother is overwhelmed with everything at hand!
DeleteYes encouragement and the power of power words is also so important. Yes adapting, extending and fading is a very important part of the experience. We will practice this all next week. See you soon!
ReplyDeleteWhen providing support to a birthing mother, my top priority will be to lay aside my own distractions or agenda and be ready to continually assess in a way that allows me to simply be with them in the way that's needed at the time. A lot of planning and preparation goes into labor, but flexibility and improvisatory skills are the most useful tools to bring when it's the real deal. I see my place as an honored guest who has been welcomed in to be a part of welcoming a new person into the world. As such, the birthing family's needs come first and I'm there to advocate for them, regardless of my own ideas or opinions. I must leave my pride at the door and not let it hinder the desires of the birthing mother or her partner. If I have an idea musically that I try, but the mother dislikes it, I humbly keep trying new things, transitioning in and out with ease. I will strive to be an encourager verbally when it seems appropriate, a physical presence to the degree the birthing mother wants, and provide a musical safety net whether that means ensuring sound or silence in the environment. Unsure mothers need to hear they are capable of birthing the baby and reminded of the joy of seeing the baby soon.
ReplyDeleteI like the idea of the musical safety net. I also see it as a musical container for a safe birthing space. : )
ReplyDeleteWhen providing Sound Birthing MTACB for a client in labor my top priority would be, as many have already stated, to be present and to bear witness to her experience. I hope to use music to provide a stable and secure environment in which the mother feels safe and comfortable in allowing her labor to progress. Having a working knowledge of my client’s birth plan and the alternatives that may be suggested will also be critical in helping my client feel empowered during her birth experience. I also feel that if the mother’s partner is present it should be part of my role to encourage them to participate and provide support as well. The mother’s partner might be able to provide emotional and physical support I would not be able to, but I could encourage this and support it with music. It will be essential to have a sense of change and flexibility during the labor process and to allow my music to change with the experience.
ReplyDeleteI remember during my own birth experience I began toning with my contractions. I felt support from my husband and my doula but I believe it could have been an even more powerful experience had they joined me! I feel it will be very important to validate the mother’s instincts and react in a way that shows her I am with her, but she is the one making decisions and allowing her body to guide her.
I also feel it is important to consider that there may be cases when mothers do not want music played at all, or may benefit more from verbal encourage than musical support. This is a scenario in which I need to be prepared for, as I am so much more comfortable existing in music than in verbal communication. In this case I will definitely have to remove my own hesitations about my verbal skills and allow myself to be completely present in the moment to provide the mother with the encouragement she deserves to have.
Yes - a mother may love the music during pregnancy - but labor puts a different perspective on things. We definitely need to be adaptable to any changes just as we are in our other MT sessions.
DeleteI love that you incorporated toning into your birth experience! How awesome! I do agree that it could have been a more powerful experience if your husband and doula participated along with you. I think that is where practicing the toning together would be beneficial so that it can help decrease feelings of vulnerability.
When we are asked to provide services, I feel it would be an honor at each and every birth. The laboring woman and her birth partner are allowing us to be a part of an important moment in their lives while recognizing that they would like (or need) the additional support. That is my main priority when providing SB-MTACB. To be there for support - for the mom and baby as well as her birth partner. Being present and focused on my client to assist her physically, emotionally and musically through the labor and birth of her baby. To offer encouragement especially at the times when it is needed most. Being aware of her needs and relaying this information in order for her birth partner to feel successful in assisting her throughout the process. Using the music to support the various techniques and comfort measures to best meet her needs at each moment of her labor as well as recognizing when a change in any of these is necessary based on her physical and/or verbal responses. Assisting my clients in achieving their desired plan for birth as well as being reassuring when changes arise that deviate from their plan (whether the change is made by my client or suggested by the medical staff) and making sure my clients understand the procedures.
ReplyDeleteI see our top priority as giving voice to each mother (though support).
ReplyDeleteJust as each birthing plan is unique (submitted prior to the hospital) each mother and each mother's desires and difficulties are unique. What an incredible job to put a "voice" to each mother's "birthing plan" and experiences, allowing her presence to be known in the room despite even saying anything. I imagine the music that fills the room puts the environment into a mood that matches the mothers desires and creates a mood for everyone else to match and follow suit. She's in charge, despite her even needing to say anything.
Reminding each mother of her voice, placing value on that voice, and reminding the birthing team of her voice when forgotten.
My top priority is supporting the mother through labor, and this will take on many different forms, such as physical, emotional, communicative, organizational, and environmental.
ReplyDelete-Physically, my priority is to be a shoulder to lean on or a hand to squeeze if she needs it, or make sure that her partner or family members are doing that. Meaning to just physically be a presence for her that is there for her, because that is not always the case. Some situations may include those with "there own agenda" and it makes a world of difference to have someone physically standing beside you that is on your side.
-Emotionally, my priority is to no judge her choices, but make sure she feels that her opinions/wants/needs are being met and understood by her partner, family, and hospital staff. Not bossing others around, but being mindful of her wishes and doing my best to make sure they happen. And if they can't, then helping support her when she deals with it. An example would be if she needed an emergency C-section and has labored so long she can't take it anymore and feels she is "giving in" if she gets an epidural.
-Communicative support, in making sure her needs/wants are understood and also the needs of the birth partner who will be running on little sleep and food as well and not able to handle seeing their loved one in pain. This can be in the form of rewording something to see what they are trying to say, or suggesting other positions if they seem like they are getting frustrated.
-Organizational support, in the form of keeping notes to help them relive their birth experience and also making sure the music is matching the stage they are in. Keeping the room environment en-trained on the needs of the mother/baby.
-Environmental support, which is tied to the last statement of keeping the environment at the same stage as the labor--making sure the music matches the mother's needs at that time.
Wow, it is no wonder that after attending a birth, I felt so exhausted myself!!
My main priority is to meet the needs of my client - whatever that may be in the moment. I would predict that support, encouragement, and comfort would be the main needs throughout the journey of labor. I would offer support verbally and musically, encourage her, and even drop out for a while if she needs her partner to be the main focus for a time. As a music therapist in this situation, I would need to be flexible to many different outcome and processes.
ReplyDeleteSome top priorities for any music therapist supporting a mother in labor include being present for the mother and observant of the environment and providing emotional and sensory support to the mother.
ReplyDeleteA music therapist should be providing a sense of safety and empowerment for the mother through being present in the moment with the mother. Hopefully this would encourage the mother to feel inclined to take steps to fulfill her wishes for her birth plan, knowing that someone is supporting her. The music therapist should also help make sure the environment is specifically tailored to each stage and need of the mother along the way during labor. Being observant of the mother and environment in order to notice and make necessary changes will most set up the mother for a successful and fulfilling birth experience. The music therapist may also be aware of others' actions and attitudes in the room as they may impact the mother and her focus on labor.
The music therapist should also be aware of the mother's emotional needs throughout labor. Likewise as the music therapist should react to needs of the mother and demands of the environment and labor process.
Yes by providing the constant quiet presence, monitoring the mother and the environment we can help provide that sense of safety and comfort which will empower the mother to trust her own instincts about birth. The support and music are equally important. It is important to remember the functions of music in labor and how to use them effectively to help the mother to feel safe, calm, and unobserved. It is important to follow the steps of the treatment plan and to utilize client's preferred music within the protocol whenever possible. Most importantly, biological implications of sound must be considered first such as effect of music on heart rate, respiration, etc. during labor.
DeleteWhen assisting a expectant mom in labor, professional caregivers include medical doctors, nurses,midwife, all should take into account of her physical and psychological need, me too. And as a music therapist, I will take more attention to her emotions. Good emotion give her more energy coping with labor pain and the other uncomfortable experiences, and give her more confidence to engaged in and control the process.
ReplyDeleteFatigue make delivery woman upset, be sensitive to the expectant mom’s physical energy, have the music matching her pace. Let music help her resting and refueling at the right time. The more body comfortable, the more good emotion, and the good emotion help body dealing with difficulties, this is a virtuous circle.
Yes Ming MIng the music should match her pace. We will have the chance to do some labor assessment and music selection when we meet this week. Music can promote movement when it is needed and rest when rest is needed. You can use the music to support her actions or help her try a different action or position to help her feel more comfortable.
ReplyDeleteI feel somewhat redundant, but our first and foremost responsibility is to our client. In a birth setting this translates to support. We are there to enhance the experience, to be there for the mother whether her needs are emotional, spiritual, or physical. We can offer support through a combination of live and recorded music, toning, physical contact, and listening to name a few. It is important to be alert and to be able to read the need of the client, because she might not be able to verbally convey her desires. Our top priority is to aid, it is not to be intrusive or take the place of anyone else on the support system.
ReplyDeleteAs music therapists we need to make sure all the elements of the music match the women where she is at during the birthing process. We need to be prepared to offer music that is relaxing to aid in relaxing the pelvic floor, or empowering to encourage pushing. No matter where the mother is in the birthing process the therapist has the responsibility to meet her there. The client is always right. We are there to offer comfort and support in an individualized and natural manner.
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ReplyDeleteThe top priority of any individual providing Sound Birthing is always the mother and the baby. This encompasses many things, but all interventions must always facilitate supporting the mother and baby through their journey.
ReplyDeleteProbably the most critical undertaking of the Sound Birthing provider is the promotion of communication. The music needs to communicate relaxation and empowerment among other things to support her through the whole birthing process. The music also has the ability to communicate group cohesion and relaxation of the support team so they can more effectively assist the mother. The most important communication element, however, is the communication between the mother and the baby. They are working together as a team throughout this whole process so each unit needs to stay calm and connected to each other. If either individual becomes stressed or panicked, it will affect the other negatively as well. Because of this, the individual providing Sound Birthing must encourage communication between the mother and baby. This can be achieved in many ways from singing and stroking the belly to encouraging the mother to “go inside” and talk to her baby. When mom and baby are connected and communicating, the whole birthing process goes much smoother.
Another crucial task of the Sound Birthing clinician is providing appropriate comfort measures to the mother. This begins by creating an optimal birth environment, which includes dimming the lights in the room, encouraging people entering and exiting to do so quietly, and providing the mother with warm blankets or cold cloths, depending on which she needs. This also includes playing the appropriate music at the appropriate time. From live to recorded, the music should always match the progress of the labor and should be at a volume that is loud enough to be heard by the mother, but not so loud that it is stressful to the mother or the baby. Positioning is also an important piece of providing comfort measures. There is a wide variety of positions that can be used during labor, and it is the job of the Sound Birthing clinician to be familiar with all of those positions and to be prepared to encourage the mother to try some in different stages of labor.
Finally, the Sound Birthing helper must be willing to advocate. The process of bringing a child into the world can be exhilarating, frightening, exhausting, and many other things. Amidst the confusion, it can be easy for the wishes of the mother to get lost in the melee. Because of this, it is important for the mother to have someone who can advocate on her behalf for immediate skin-to-skin contact or for her spouse to cut the cord or to not have an episiotomy. Obviously, not all of the mother’s wishes may be possible if there are complications, but the Sound Birthing provider must be willing to advocate if and when the occasion arises.
While these are only a few of the responsibilities of an individual providing Sound Birthing, they are some of the most important tasks. Even though the tasks are great and the work can be difficult, being present when a new little one comes into the world is one of the most honorable and respect-filled experiences.
My top priorities when delivering Sound Birthing MTACB are always going to be the health and safety of the mother and child - which involves providing a service which compliments and not impedes, labour. This may involve advocating for and supporting the mother with measures other than music when necessary. For example, a variety of comfort measures such as dimmed lights, privacy, feeling safe and supported - all of which can either help or impede labour if these basic needs are not being met. Therefore my next priority is to ensure that the music is complimenting and supporting her needs as required - whether that be to provide positive focus, relaxation or support through transition and birthing (to name just a few).
ReplyDeleteAfter these practical needs have been met, I see it as our duty to ensure that music is not only supportive and following a mother's birth plan as much as possible, but providing a soundtrack to the creation of new memories, whose meaning will be greatly enhanced,as well as providing a safe, 'musical container' to hold the birth process.
Yes, yes, yes to all! MD :)
Delete^ what Mary.
DeleteHaha. But it all seriousness, yes, this is definitely our role in L&D. I thought it was important that none of what you mentioned blurred any lines between MTACB and support a doula might provide! To me this was one of the hardest things to navigate.
Support support support. Allowing yourself to follow her lead and support from you. Understanding her physical, spiritual and emotional needs and providing a musical outlet for that. Knowing when to use music and when to allow quietness that she might desires. . Knowing her birth plan and being flexible to change as she changes. Providing calmness throughout the process and the constant steady stream of positive energy. Allowing the music to match her needs and being ready to change as the situation also changes.
ReplyDeleteYes most important phrase- "follow her lead" that is it exactly. It's all about support of her, the environment, her partner, the baby, and we do this with the music and our gentle presence.
DeleteFor sure! To me, MTACB at it's very core is the iso-principle that we all know so well! Meet them where they are at!
DeleteMy top priority would be respecting the wishes and needs of my client. What is right for me or the past ten clients may not be right for this person in this moment. One of my biggest take aways from this course is there are so many variables in the birthing process. There are variable as far as cultural perspectives, birthing locations, positions, and medications. There is no one right answer and my job is to be there to support the mother and help her have the healthiest birth possible, whatever that means for her. This also means coming prepared with options and being reflexive to meet the mother's and partner's changing needs.
ReplyDeleteSounds a lot like a typical day at the office for me ;-)
DeleteYes and those needs will change during birth and your client will be in an altered state so things will be different. You are right- you need to respect her wishes at all time and use your intuition and your senses to observe and reflect on what she needs to support her and the baby in this process. :)
ReplyDeleteThe easy answer for this question is: the safety of the client, the laboring woman. This is the top priority of everyone in attendance, which is great. If she has needs that are outside our scope of practice, I can assist by helping her communicate these to the appropriate person. If she is physically safe and her needs are being met by medical caregivers and labor support staff, then I am able to provide comforting, presence, and follow her lead in the music I provide. I will bear witness to her journey and support her.
ReplyDeleteI was listening to Carolyn Koebel's "Walking Each Other Home" from Honoring the Passage, which is a collection of songs from hospice music therapists, and thinking about how the music therapists' role in a birth setting is similar to the role they may play when with someone who is actively dying. The client will be going on autopilot, will be the focus of everyone in the room, may (will!) be experiencing altered consciousness, and may not be directly aware of your presence. You just get to support from a place of positive presence, bear witness to the transformation taking place, and create the space that they want and need in that moment. We can create that space and help the other attendees feel the preciousness of this experience.
Mary, do you have any experience with Sound Birthing and still birth? Maternal death? I know that the United States is doing poorly when compared to other countries' maternal mortality rates. Just something I find myself thinking about on a beautiful Saturday afternoon...
Yes exactly. Many of the hospice music therapists who take this training say that the role is very similar. It is an honor and a privilege to be there as a soul is coming and and when a soul is leaving. I have had one client who had a still birth. There are music therapists who have taken this training who have decided to specialize in birth loss. There is a doula organization that trains doulas for still birth or death shortly after birth. It is a much needed service for these grieving families.
DeleteShanna DeJoseph
ReplyDeleteOur top priority as a MT in the birthing process should be respecting the mother's wishes and keeping her and her baby safe. If she requests something that we feel may be harmful we have an ethical and moral responsibility to consult with the physician.
Apart from that, we are there to help facilitate comfort and support for our clients. We posses a powerful tool that may be helpful for the mother in her birthing process- but she may request us to stop all music and leave the room!
We can use our inherit skills as a therapist to continually assess the nature of affairs during delivery, and adjust as needed. We need to be flexible and willing to go completely off the plan if needed. We need to be present with the mother and all others involved, and present ourselves as fully attentive the their needs.
Right. I have never been asked to stop music and leave a birth so that is probably highly unlikely that it would happen to you. The birth mother develops a rusting therapeutic relationship with you and the need for support is just as critical as the need for music. The two go together and one without the other is not as effective. Yes we often have to go off plan because the baby has its own plan. We are there to help them navigate this experience with as little stress and pain as possible. Regarding harmful behavior in labor.... it did happen once that I was supporting a family at a hospital birth that decided do use herbal medicine while she was receiving standard medical care during labor. I was shocked when it started happening as I had no idea the couple was planning this and it was not part of the birth plan. We talked about how serious the consequences were about keeping secrets from the doctor and that it could be dangerous for mother and baby. I convinced them to tell the doctor what was given to the mother so the medical staff could monitor mother and baby closely. After discussing it with the doctor they decided it was not a wise plan to continue self medicating. I felt pretty uncomfortable in this situation because I was not an employee of the hospital but rather was hired by the couple. I knew that I had an ethical obligation to say something. Sometimes there are surprises at births and sometimes when people are under stress they behave differently than you would expect.
DeleteMary, do you mind me asking if the client was angry with you for intervening?
DeleteMy top priority would be to create a safe and supportive environment for the mother and baby. I have a very whole-person, client-centered approach and with that, another priority will be to follow the lead of my client. I will chose music that corresponds to where she is at in the current moment, making sure that the music is not working against what she is trying to accomplish. I also feel like advocating for the client should be a priority. Theoretically you would be meeting with the mother prior to the birth, and odds would be good that she had shared her birth plan with you. Having another voice on her side (especially if she is not in a place to speak or advocate for herself), could be comforting to her and may help with sticking to her plan. I would think that one of the most important things would be making sure you are attentive to your client and her needs. The goal is to, at the end, have a healthy mother and baby.
ReplyDeleteYes creating the birth plan is part of the assessment process so you know the details of it and should have a copy with you. Helping the mother to advocate for herself (if possible) and if not helping the partner to advocate for the mother is best. Reminding everyone of the birth plan and checking in with the couple at opportune moments if things start veering from the plan is a good idea. Yes supporting helathy baby and mother is always the top priority and using music to support each stage of the labor process is critical.
DeleteAs a professional, my top priority should be to respect and defer to the mother while advocating for her previously stated desires for her birthing experience to any hospital staff, family, and partners. The safety and well-being of the mother and child are always the number one priority, and it is also my responsibility to be intuitive to the needs of the physician.
ReplyDeleteThe very nature of music is an ability to be adaptive, as a professional, I should be prepared for the unexpected and be comfortable in my role to continue to provide excellent care no matter the external situation.
My role should always be supportive, and if it were to at any point be a hindrance, it is also my responsibility to be aware excuse myself. The laboring woman has a right to request me to leave, continue, etc - but within that role it is my professional responsibility to advocate for her best needs -what would biologically and emotionally be most supportive.
I love your adaptive, person-first approach, Hannah. Child birth, as you mentioned, can totally be unpredictable and we as therapists can go into a session as prepared as we want to be and everything can turn around on us. Adaptability is definitely a huge part of our jobs and especially in an arena as constantly changing as child birth.
Delete(Also, hey how are you! Can't wait to catch up on Saturday!)
Yes Hannah exactly. Well said. And you would establish parameters with your client ahead of time during the prenatal visit.
ReplyDeleteA few top priorities (hard to put in order!!)
ReplyDelete1. Safety of mama
2. Safety of baby
3. Empowering mama while respecting and validating her feelings, goals, and wishes.
4. Creating a sacred birthing space.
I believe many of these can be accomplished by BEING instead of DOING. Of course, with the support of the practitioner. Sound Birthing will go miles toward creating a sacred space and empowering/validating mom. I also suspect that the music therapist has a large role in supporting the birthing woman's partner. Encouraging the partner to remember techniques they practiced, helping them advocate for the mom, and likely allowing them to take a break while knowing mom is still supported.
Laura, your answer seems so short, sweet, and simple, but also encompasses everything in a succinct way. Being instead of doing is a powerful intention for me. Thanks.
DeleteYes a great short list to review every time you support a mother in labor. Another good list to review before a birth is p. 83 of the manual- Summing it Up: MTACB in the Birthing Room. :)
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ReplyDeleteWhen providing Sound Birthing MTACB for a client in labor my top priorities are to support the mother emotionally, physically, and spiritually while paying close attention to the verbal and non-verbal cues she is giving in order to create a safe, nurturing, and empowering space for birth to happen. It is my role to be a trusted advocate for the mother's birth choices while maintaining respect for the needs of the medical professionals attending to the birth. It is also a priority to stay flexible and attentive to the changes that may be needed in order to support the progression of labor in a non-intrusive way.
ReplyDeleteI remember my doula asking our childbirth class what a woman needed in order to give birth. There was just one answer.... one thing that a woman needed in order to give birth. People were guessing things like water, shelter, support, etc. But there are plenty of women who give birth all the time without those things. If you pay attention to animals birthing instincts they always go hide somewhere to give birth. This is so the mother can keep her and her babies safe from predators during this vulnerable time, when she is not able to defend or protect them. The one thing that a woman needs in order to give birth is safety. Studies show that women who feel unsafe during labor will stop progressing. They have a physiological response to fear. More than anything, I hope that I am able to create a safe space while providing MTACB.
Yes safety and privacy! You can create a safe space with the music. Dr. Sarah Buckley is a leader in this field of natural childbirthing. In the Birth Music Consultation course we study her work more in depth. Here is a brief 3 min summary of her work on you tube: https://www.youtube.com/watch?v=7446t4WE_Lw
DeleteAs pretty much everyone has already mentioned, as music therapists, our first priority is always the client, in this case, the woman in labor. Being overwhelmingly supportive and comforting especially as labor progresses is a huge part of our job. One thing I'm learning in my counseling master's program, is that my job is always to empower my client, whatever that means for them. To listen to what they are feeling, thinking or experiencing is of paramount importance. My voice should never be one that is doing anything but advocating for the mother's wishes.
ReplyDeleteThat's our number one, but that's all something that a doula or other birthing partner can do. As trained music therapists, we have far more tools in our tool box to achieve that and can supplement that support musically. In the MTACB handbook, we're instructed to be present with the birthing woman by taking note of several things including body rhythms, labor stages and need for physical support. However, the element that stuck out to me was the sentence written after all that list. "Find music that matches/supports all of these factors and stay with it UNTIL they change, progress or the birthing woman expresses a desire for change."
We all have extensive musical training that allows the ability to give birthing women the gift of exactly what they need. This is both a gift and a responsibility. However, as long as we are always been present with the birthing mother and are creating a space that allows for change and adaptability, we can adjust our music accordingly.
I really like your emphasis on being present. It seems so simple, but being fully present, engaged, and attuned to the mother and the environment is a powerful responsibility. As you say, being truly present allows us to respond and adapt to the mother's changing needs, ensuring that she and the baby remain at the center of the process.
DeleteYes Jessica it is a gift and a responsibility. Well said. We must be constantly aware of where the mother is at, the functions of music and how they can support her best throughout her labor journey in each of the spheres- bio, psycho, social.
DeleteI feel, for me, the biggest overall priority when providing MTACB would be the mother and baby -- both their safety, and the mother's needs/wants. This priority would then encompass multiple approaches to fulfill.
ReplyDeleteI feel the biggest part in keeping the mother and baby first would to make sure one is being present -- their mind is not elsewhere and focused on the room and the birthing mother. Being present allows you to notice what is happening in the room at that moment and adapt the music to meet the mother, father, and baby.
Also, a huge aspect of keeping the birthing mother and baby as a top priority, would be to act as an advocate for the mothers wants and needs as per her birthing plan, or wants/needs that may change in the moment. As labor progresses and a birthing mother is encouraged to go inward, focusing on instinct, and perhaps a partner being overtaken by the moment, it may be difficult for her and/or them to voice wants ands needs. Having developed a relationship and discussed birthing plans prior to labor the Music Therapist can help communicate those to the birthing team.
Of course, when also keeping the health of the mother and baby as a priority, it may be possible that complications arise. If the birth is occurring at a hospital, and perhaps with another doctor that the couple has not met, complications and interventions can be overwhelming. Again, as the Music Therapist has developed a rapport with the couple, it may be helpful for the Music Therapist to help communicate the interventions with them; coming from a developed relationship it may be more comforting.
The role of the music therapist in labor should be that of support, and never intrusive on the experience. I believe it's important to provide positive encouragement and support to the birthing mother and partner, but allow space to the partners to experience the transition in becoming a larger family.
Supporting the mother's natural labor progression and her going inward is so important. Keeping talking and distractions to a minimum is essential. You are so right Kimber and it can make all the difference in the world. :)
DeleteWhen providing Sound Birthing MTACB for a client who is in labor, my top priority it to make sure I am there as a support system for the mother (and partner if that therapeutic relationship has been established), and eventually the baby. The mother needs to know that she has a champion in her corner and that whatever need she has emotionally, physically, and anything else; I am there to help her out. It is is important for mothers to know that they are our priority during this stressful, exciting, and eventually painful time.
ReplyDeleteTo make sure that this priority is accomplished successfully, it is important to always be prepared, but always be flexible at the same time. Make sure we have our MTACB bag always on the ready; as well as our clients portfolio handy. Labor can occur at any moment for an expecting mother.
Most importantly we need to offer a safe, warm, and loving space for the baby to arrive to. If they mother feels safe, loved, and supported, then when the baby arrives, that feeling will spread and blanket the new sweet baby as well.
Providing that support with your presence and the music during labor is so important. Creating that loving, gentle, inviting space to welcome the baby is also equally important. :)
DeleteMy top priority in providing Sound Birthing MTACB is to do what is best for the health and safety of the mother and baby. I am using health in a holistic way here. Of course, physical health and safety are of the utmost importance, but emotional health and psychological safety are crucial as well. I hope to help the mother feel supported, informed, empowered, and celebrated as she goes through this transformative life experience. This requires flexibility, as each woman and each birth is unique. However, there are some core considerations that I would prioritize when using MTACB:
ReplyDeleteSafety/holding space - Using music, lighting, etc to create a space that feels protected, comforting and safe. Minimizing distractions and intrusions as much as possible, allowing the mother to stay tuned in to what is happening with her and the baby.
Communication - Verbal and nonverbal. Listening to and observing the mother. Offering information and suggestions when appropriate, or reaching out to the appropriate medical provider. Using music to communicate support and encouragement.
Advocacy - When medically appropriate, helping to protect the mother's plans and wishes.
Honoring mother's choices - Respecting her right to make decisions regarding her labor and birth. Recognizing that the birth plan is not set in stone and being willing to adapt to mom's changing needs and wants.
Celebrating the new life and helping the mother feel a sense of pride and accomplishment.
Yes Dorothy. Excellent summary of what your priorities should be. : )
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