Realbirth a haven for expectant parents

Students in a childbirth education class at Realbirth practice a massage technique to be used as a pain-coping strategy during labor.

By Lawrence Lerner

On a lazy Sunday afternoon recently, nine young couples sat calmly around the perimeter of a square red-carpeted room on padded vinyl mats, leaning back against the wall with bed pillows squeezed between them or situated beneath the women’s swollen legs. As the instructor gesticulated from the middle of the intimate space, amid photos of newborns along one of the walls, many of the female students strewn about the floor periodically repositioned themselves for comfort, shifting their fluffy pillows in unison with their bulbous bodies, their gaze fixed on Erica Lyon, the woman holding forth.

“Usually, pain is a warning sign for us, a sign that we’ve injured or broken something. But labor is one of those rare circumstances when you experience pain as a cue to where your body is taking you next, rather than as a warning sign,” Lyon said. “It actually signals progress in labor, and seeing it this way helps us embrace it and take the mythology out of it.”

Those encouraging words, coming off Lyon’s tongue with as much empathy as ease, were part of her childbirth education class at Realbirth, a well-trodden space that has become a Chelsea institution since opening a few years ago, carving out a niche as a reliable, nondoctrinarian source of information, inspiration and support among couples—gay and straight—considering either a natural childbirth or hospital delivery.

Founded in June 2004 by Lyon, a former childbirth educator at Chelsea’s Elizabeth Seton Childbearing Center, Realbirth is certainly not the only place where expectant parents can turn in New York City to prepare for the arrival of their long-awaited offspring, though it seems to have set the standard in Manhattan for this type of education, packing classes with students from New York City and as far away as New Jersey, Pennsylvania and Connecticut, as well as Upstate New York.

As Sunday’s class progressed, Lyon continued by inviting the couples to share their biggest fears as their due dates approached. The class obliged, starting with an expectant mother with long brown hair and tired brown eyes, who shot up her hand. “I’m afraid it’ll be more than I can handle,” she said as several women around the room nodded their heads knowingly.

“I fear that if I do need meds, I’ll end up having much less control over my labor than I want,” another chimed as Lyon worked her way around the room. Finally, a woman raised her hand tentatively and said, “To tell you the truth, I’ve never been down this road before. I think the unknown is the scariest part.”

Lyon, who had been bulleting the comments on a white board with a marker, turned to the students, clasping her hands and wearing a look of recognition. “Fear of the unknown is a big obstacle for many women about to give birth. But think about it: How many unknowns have you navigated in life since you were a kid? And how have you usually handled these situations?” she asked rhetorically. “You’ve had a road map and a support system, hopefully, and then you’ve put one foot in front of the other til it’s over. And best of all, you lived to tell about all of them. It’s the same thing with this experience.

“In fact, birth is powerful for women precisely because you go through this monumental moment where no one can hurt us, and we come out the other side intact. Forever after, you get to carry around a feeling of, ‘All right, you gonna mess with me now?’ precisely because you go from being vulnerable, to not dying, to strong.”

The talk of women-centered empowerment is one of the hallmarks of Realbirth, which is heir to a venerable midwifery–natural birth tradition here in New York City. Lyon started it out the ashes of the Elizabeth Seton Childbearing Center in 2004, a year after that space was shuttered because of the skyrocketing cost of malpractice insurance. Elizabeth Seton, which had opened in 1996, was itself the successor of The Childbearing Center, which opened in 1975 as a pilot project of the 89-year-old Maternity Center Association and was the country’s first freestanding birth center, located on East 92nd Street in Manhattan until its closure the same year Seton opened.

Realbirth continues in the tradition of Seton by offering childbirth preparation, breastfeeding and newborn-care classes for expectant mothers and their partners. Since Realbirth prides itself on being nondoctrinarian, the childbirth preparation class comes in two varieties: one for women who want to do natural childbirth or are considering pain medication but want to know all of their choices, the other for women who have decided to use the epidural as their main pain-coping tool.

“Our instructors don’t teach you hospital procedure. We arm you with information and teach you the questions to ask so you’ll know all of your options as you go down the path to childbirth—which means choosing and talking with your medical provider, approaching birth and then advocating for yourself once you’re in labor,” said Lyon. “What makes a birth a positive experience is not whether or not a women gets the epidural, but that she makes the choices and is treated respectfully when she’s vulnerable.”

Regardless of which option they choose, Lyon suggests expectant parents take the childbirth prep class at the beginning of their third trimester, leaving time at the end to take the newborn care and breastfeeding classes if they choose.

“We don’t want folks to take it in their second trimester because there’s a physical and psychological change that happens in the third trimester, which signals the body preparing for labor,” said Lyon, whose book, “The Big Book of Birth” (Penguin Group USA), was released last month. “At that point, we start to feel big and unwieldy, the baby’s kicks get stronger, we toss and turn at night, and we’re hungry to hear how we’re going to get through it. In the second trimester, we’re still enjoying the pregnancy and we’re not yet focused on getting the baby out.”

Lest parents think they’re on their own after the child has arrived, Realbirth also offers post-partum workshops, support groups, and creative play and educational activities for parents and their babies during the transition to parenthood. These include lactation and post-partum depression support groups; a dad workshop; a seminar on vaccinations and their efficacy; baby music classes; and courses on CPR and safety, baby sign language and infant massage.

But it is the childbirth education classes that lie at the core of Realbirth’s curriculum, taught as they are by a variety of childbirth educators, all of whom are certified through the Childbirth Education Association of Metro New York, a comprehensive two-year education certification program—available only in New York City—that focuses not on one methodology such as Lamaze or the Bradley method but draws from multiple tools that are useful to mothers as they move through labor. These include pain-coping strategies like physiological positioning, breathing, hydrotherapy, massage, acupressure, medications, vocalization and the active role a spouse or support person can play.

After Sunday’s class, Seema Shah-Nelson, a 31-year-old interior designer who recently moved from Manhattan to the Catskills, recalled that her biggest concern coming into the session was whether she could handle the pain.

“What I learned is that there are so many different ways to handle it, and that so many people do, whether through drugs or other non-drug techniques. That in itself helped calm me to the point where I’m not really dreading it anymore—it kind of seems like it’ll actually be nice,” she said. “I mean, obviously, it’ll still be painful and difficult, but it’s something to be excited about instead of something to be in terror of. For me, that’s huge.”

With their family-centered focus, Realbirth’s childbirth education classes also emphasize the value of the father’s, or partner’s, contribution throughout pregnancy and the birthing process. In fact, several of the men interviewed for this article spoke with surprise about how active a role they could play during labor and delivery. One of them was Oliver Ulich, 35, who works for the United Nations and lives in the East Village with his wife, Dolly Mirchandani, a 31-year-old lawyer.

“I realized it’s going to be a lot more work for me than I expected, in terms of massages and other tasks I can contribute when it comes to pain-coping strategies. I may have to get to the gym and get a little bit fitter before doing all that,” he said wryly. “But in all seriousness, I think that’s a good thing, since it gives me a greater sense of responsibility besides just making sure Dolly gets to the hospital.”

Lyon and the other Realbirth educators also stress that as she moves through labor, the mother and her partner will reach junctures where decisions must be made in concert with her healthcare provider (in the best of circumstances) about when and how to proceed. Becoming aware of and owning those choices is central to the approach proffered by the Realbirth course.

That sat well with Mirchandani.

“I came into the class quite open-minded about the spectrum of options once I go into labor, and I’m leaving quite open-minded as well. But mainly, I feel more empowered because I’m more educated about the decision points themselves, and the pros and cons at each juncture,” she said. “I actually feel more equipped to make those decisions now, with the knowledge I picked up, and the emphasis Erica placed on informed consent and advocating for yourself when dealing with doctors.”

Much of this advocacy takes place around the issue of caesarean sections, not surprisingly, given that the U.S. caesarean rate hovers near 30 percent, almost twice the rate recommended by the World Health Organization.

“You hear about caesarean rates going up in the city. And you think you’re in the hands of a doctor and you’re supposed to be on the same side, but you feel that 30 percent of the time, they might be on the other side,” said 30-year-old Jersey City, N.J., resident Sameer Maru, who took Lyon’s class with his wife, Urvashi Maru, who is 28. “So, you need to protect yourself. This class makes you aware of possible pitfalls and how to deal with them.”

The Marus also responded strongly to the communal aspect of the Realbirth course, saying it added positively to their experience. “We read a lot before coming in, but you hear so many more questions with eight other couples in the room,” said Urvashi Maru. “The discussion goes to places you wouldn’t have taken it, so in the end, you gain a lot more knowledge from this class than a book.”

Sameer Maru put it slightly differently.

“You know, there’s always this thought in the back of your mind, that many people have gone through this before you, that kids are born every day and everything’s going to be fine,” he said. “But there’s still this anxiety, because now it’s your turn. So, seeing others in the same setting as you makes a big difference. You feel everybody’s in the same boat and you’re not the only ones facing this anxiety. It really helped calm me.”

After the exhausting all-day class on Sunday, that kind of talk was music to Lyon’s ears.

“Look, not only do we have to get you reams of information, we have to keep you awake through it all!” said a self-effacing Lyon, who notes that just being able to do that—all daylong or late at night with a roomful of pregnant women and overworked partners—is a feat in itself. “So, to hear that is just great. There’s definitely something to be said for coming together. Community is a powerful thing.”

Realbirth also offers classes in Brooklyn and is opening a second location in April at 49th St. and Ninth Avenue in Manhattan. Call 212-367-9006 or visit realbirth.com for further details.