I recently had the opportunity to try out my brand spankin’ new Kaya Birth Stool while supporting a client throughout her labour and birth. I have been really psyched about the stool ever since I first saw the design on Toronto designer Kara Springer’s website, and I was itching to give it a whirl.
I’ve already written about the stool, in terms of how, theoretically, it could be useful during labour and I am excited to report that it really, really was!
When I arrived at my client’s home around 4am, she was resting comfortably, having contractions less than ten minutes apart. They were getting more intense bit by bit, but she was finding them pretty easy to manage at this point. She did complain of some back pain though, which led us to try counterpressure with my hands on her lower back, while she sat in an upright kneel, leaning her forearms and forehead against the back of the couch. This worked very well, so we stuck with it for a number of contractions. While her contractions were increasing in intensity, they weren’t getting much closer together, so we went for a long walk together. As I had hoped, by the time we returned, they were coming more regularly and closer together. They were also getting stronger and my client’s back was still bothering her during the contractions. I didn’t think it was back labour, since there was no pain between contractions, but I suggested we try some lunges during the next few contractions anyway, to see if that might ease things a bit. [I’ll explain: if the baby is head down but facing the front of the pelvis instead of the back, this can cause continuous back pain for mama, also known as back labour, because the back of the baby’s head is pressing against mom’s lower spine/tailbone. Lunges can encourage a baby to turn from facing the front to facing the back, because they open up the pelvis and give the baby a little more wiggle room. Usually you try a few lunges on one side – maybe three contractions worth, and then switch. If one side feels markedly better than the other, you stick with that one.]
Anyway…lunges – finally a chance to try out the stool!
When the next contraction came I stood next to my client with my arm around her and she lifted her right leg up on to the stool. As the contraction moved through her she swayed her hips from side to side, leaning gently into the lunge. While she didn’t find it uncomfortable, my client did find it tiring to be standing through the contraction and she didn’t find the lunging to be better than the upright kneeling with counterpressure in terms of alleviating her discomfort, so we didn’t stick with it. There were two issues with this first use of the stool. First, I didn’t think to put a yoga mat down and we found it a bit slide-y, so we got the yoga mat out to provide some traction after the first attempt. Second, and this has more to do with lunging in general than with the stool specifically, I think that this position was very tiring because we had a large height discrepancy between us. I’m nearly 5’9″ and my client was probably 5’1″ – as a result, it was hard on my back to support her side-by-side and she probably felt that she couldn’t “let go” and lean into me completely because of the awkwardness caused by the height imbalance. [As an aside: I’d be curious to hear if any other doulas out there have had experience working with someone who is much taller or shorter than you – any tips for overcoming that height difference when using standing poses? Comments welcome!]
We went back to upright kneeling on the couch for a while, but as things became more intense I felt that she could do with a position change again, and so we tried sitting on the stool, with me in back and her sitting between my legs leaning back (like in the picture above). Wowee! Oh my goodness, as a support person, I have to say that the stool made it so comfortable for me to sit and support her weight completely without feeling any strain on my own body. In addition to the fact that she was able to completely relax her muscles, let go and give in to the contractions, the fact that she had her head back on my shoulder and her back against my chest meant that she could feel and follow my breathing as I carefully inhaled deeply and exhaled slowly. I was able to speak quietly and soothingly to her, repeating positive affirmations and words of encouragement. We had the yoga mat under the stool by this point and there were no more issues with traction, even when she leaned right back. I have to admit, I was very impressed that there was enough room for both of us on the stool! This posture worked really well for quite a while.
Things continued to intensify, but contractions were still fairly far apart (we were both napping lightly in between them and moving to the stool as each contraction began). When she started to become more inwardly focused during her surges, I could tell that the sensations were getting pretty strong and she was really needing to focus. I suggested a shower to ease her discomfort (also hoping that it might bring her contractions a little closer together). She hopped into the shower and was feeling mighty good about that decision right away. I sat in the bathroom, keeping her company while I timed a few contractions. After a few contractions had gone by (I noticed that they were increasing in frequency now) she said that she was enjoying the shower but that she was feeling tired from standing (I didn’t want her to have a bath at this early stage, for fear it might slow things down). Lucky for us, we happened to have a shower-friendly birth stool right in the next room! It was a bit wide for her tub, but we managed to turn it onto its side so that she was able to sit on it comfortably under the stream of water. Aahhh….
Things really started moving after that. Contractions picked up over the next little while until they were about 3-4 minutes apart and they didn’t space out again once she got out of the shower. She was still coping very well but she indicated that she was feeling some ‘push-y’ pressure here and there, so I thought we should head to the hospital.
We woke up her boyfriend, grabbed her bags and the mat and stool and hopped into a cab. After a long delay getting into triage and then a very long time in triage (where we learned that she was already 4cm dilated) we were able to move into the labour room. I set up the yoga mat with the stool right away (the pink yoga mat and the blue stool really added a ‘pretty’ element to the room, which, in addition to dimming the lights, made it feel a little more home-y). I chatted with a nurse about where to put the mat and stool, so that they wouldn’t be in the way of medical staff but would still be accessible if my client wanted to use them.
My client was really into active labour by this point and the monitoring that she had to have done for admission was really uncomfortable for her, but luckily she only had to endure the straps for 15 minutes before we were able to get back to doing what was best for her and her labour progress.
Since active labour was upon us and there was a jacuzzi tub in the room, I asked my client if she’d like to take a bath. She liked the idea so a nurse got the water running and showed us how to use the jets. Most of the remainder of active labour was spent in that tub. My client was very good at letting go of each contraction as it passed and entered a deeply relaxed state in between each surge. It never ceases to amaze me how effective hydrotherapy is for pain management – they don’t call baths the ‘midwife’s epidural’ for nothing!
Throughout her time in the tub, nurses came to periodically assess the baby’s heart rate. They were able to use a ‘waterproof’ hand-held doppler, which meant that my client didn’t have to get out of the tub each time. As the baby descended though, it was getting harder and harder for the nurses to get the doppler into a position to pick up the tones (you can’t submerge the doppler – it’s really only water-resistant, not waterproof). As one nurse tried to get my client to lift her belly out of the water and as my client struggled to do so, I had a flash of inspiration – the stool! I ran and grabbed it from the next room and slid it into the tub behind my client. She was able to slide her bum up onto the stool and grip the edge of it while the nurse quickly found the heart beat and confirmed that the baby was doing great. I then slid the stool back out and my client eased back down into the water. I was really glad that my client was able to stay in the tub where she felt most comfortable. The hospital’s tub was wider than my client’s at home, but it was not at all a “birthing pool” designed for movement or for sharing with a partner or for actually giving birth in water (though many women have given birth in even smaller tubs of course). I felt that the stool was super useful in this one instance in the tub and I was glad we had it, but to really make a lot of use out of it in water, you would need to be using a pool or tub designed for water birth.
I could really see the Kaya stool coming in handy if baths were off-limits (either because of hospital policy or if it was still too early in labour or for any other reason) and there was access to a wider-than-average tub (like the one we had in this case at the hospital). Being able to sit and lean forward in the tub with hot water from a shower raining down on one’s back would be very soothing and one would be able to stay in this position comfortably for quite a long time even if they were tired. It could also be great for back labour, as that leaning forward pose would take some of the pressure off of the woman’s spine while the water poured over her back. Hands and knees can be great for that too, but I personally find that my knees start to hurt after a while in that pose. Having the stool would allow for more variety in terms of postures that take the weight of the baby off of the spine and that can be used in or out of a shower.
That was it as far as my client’s use of the stool was concerned, but it did play a major role in my comfort for the latter half of transition. Once my client entered transition, she wanted out of the tub. She was coping well but things were obviously very intense for her. I spent the first half of transition up near her head, helping her to breathe through her contractions and avoid pushing (she was having very strong urges all through transition and really wanted to push). At a certain point she rolled onto her side and wanted to hold her boyfriend close. I noticed at that point that she was moving her feet up and down almost constantly, in a sort of stepping motion on the bed. While her boyfriend soothed her and continued to encourage her to breathe and relax, I pulled the stool up to the foot of the bed. I put my forearms on the bed, with my wrists bent at almost 90 degrees and my fingertips pointing upward, so that she could push the soles of her feet against the palms of my hands. I don’t know why, but a lot of women seem to like to exert pressure with their feet or their foreheads when labour is really intense. It can be challenging as a doula to provide the support they need for this, while protecting one’s own body from injury. The stool was the perfect height for me to do this and was super comfortable. I was able to provide a surface (my hands) for my client to press against for the remainder of transition and my own body was not strained or injured by it. Standing or sitting in a different chair would have required me to bend or hunch down, which would have been uncomfortable for my back and might have prevented me from being able to continue doing this for my client for as long as I did. By supporting my body, the stool allowed me to better support my client.
I have had two more clients request the stool for their births this summer and I am excited to see how we’ll use it! Every birth really is different – having a tool that allows for a wide variety of uses and poses both in and out of water makes so much sense. If you are expecting a baby and want to try using movement and varying postures for your labour, or if you are a doula whose clients might want another option for their births, I highly recommend the Kaya stool. It’s cute looking and brightly coloured too, which means that after your birth (or between clients if you’re a doula) you could use it in a child’s room as an every day seat (it’s low enough that a toddler could sit on it with feet on the floor). It’s made of a food-grade polyethylene and does not contain any phthalates or other unsafe additives, so you can feel good about keeping it in your home. As for clean-up, it wipes down easily with spray cleaner and a cloth. If you’re a transit doula like me, it fits easily in the back seat or trunk of a cab and I even carried it home on the subway without an issue (tired and during rush hour no less!).
I’ve invited the designer to set up a vendor table at the doulaC.A.R.E. annual general meeting in the fall, so if you’re a member you’ll hopefully be able to see and play with the stool for yourself then. Otherwise, you can order directly off of the website. If you have any questions about my experience with the stool, feel free to get in touch!
Do you have a favourite ‘tool’ for labour?
Update: I asked my client for her thoughts on the stool – this is what she said:
I really liked the birth stool because it relaxed me from the waist down when sitting on it, so I wasn’t feeling tense while standing or laying. Also, it was big enough to fit us both sitting and that made me feel comfort. Its great because there’s so many positions you could use it for so you never get tired of the same one and it never loses its touch 🙂
I loved the article. I am a labor nurse and I like to keep up on what different people use for comfort during labor. It really helps me help the patient through the labor process. Many patients do not have doulas and we are the ones there providing the reassurance and teach different techniques for comfort. Plus if someone was to bring in something like this stool I would like to be educated on its uses to assist the patient. Thank you for the article!
Thanks Rhiannon! It’s true, most women are still not hiring doulas yet, which puts a lot more pressure on you already overworked L&D nurses! Sounds like you really care about your patients and are going above and beyond to learn new ‘tricks of the trade’ when it comes to comfort measures. Thank you for the amazing work that you do for birthing women 🙂
Hi, I’m pregnant with my 5th child now. How does a birthing chair/stool go with the idea of “natural” childbirth… I have used one of these contraptions(not my idea) and I have also birthed in a natural squatting position on my knees. If you have the instinct/urge to squat or kneel it will come naturally and you do not need special equipment. I had bruises on the back of my legs from the one I used. If you have a posterior baby you will be much more comfortable in your own natural squatting position as a birthing chair cannot accommodate the many different body types and sizes of different women. We don’t need tools or classes… Women have natural instincts that will guide them into the best position they need to be in. Leave the birthing contraptions to the doctors please and allow women who trusted you for support to birth naturally!
These are really great comments and I agree with your general theme for sure! Thank you for sharing your thoughts. The stool can definitely be a benefit to a natural birth (the mom quoted in my review had a completely natural and very instinctual birth wherein she achieved a trance-like state throughout active labour – without any hypnosis training or prep – and spontaneously pushed her baby out in a few minutes without a single directive or instruction, only words of encouragement). Allow me to elaborate a little.
The nice thing about the Kaya stool, as opposed to most birth stools/chairs is that it can support a variety of positions and body types/sizes. For instance, if a woman wishes to be on her knees, resting her head, she can lean against the stool, flipped on its side and the curved edge will allow her to rock if she wishes. A birth ball can support a similar position, but not in water (the Kaya stool is designed to be submersible). Another example is if a woman wishes to be in a low squat/sit position with her partner or doula behind her so that she can lean back while she sits/squats. The Kaya stool is wide enough that most women can sit this way comfortably and still have room for another person behind them. This is especially helpful if labour is very long or if she has knee trouble that prevents her from squatting without something supporting her weight. The idea behind the Kaya stool is that it can be used to support any number of positions that a woman might choose for herself. It won’t work for everyone, but that’s ok. Water doesn’t work for everyone, rebozos don’t work for everyone, birth balls don’t work for everyone, but these options sure are nice to have around! I bring my Kaya stool to most births, some moms choose to use it a lot, some a little and some not at all, but I have never regretted having it with me. I have used it in home birth settings, as well as hospitals for both natural and medicated births. It often comes in handy just by providing an extra spot for me or the woman’s partner or midwife to sit! Many triage rooms and even birth suites that I have been in only have one chair for support people. I have also used it as a seat for myself next to a tub, allowing me to be at my client’s side for longer without bodily discomfort. Partner and doula physical comfort are important for allowing us to give maximum support to mom.
I’m sorry to hear that you were bruised by a stool – I don’t get the impression that it was a Kaya stool though, but perhaps I’m wrong? The typical birth stool is definitely not very comfortable and only really supports one position (and usually only small bums!). You should definitely not have been pushed into using any tool or intervention that you didn’t want to use. I’m sorry that you had that experience.
As for babies in an OP position, there are a lot of great ways to use the Kaya stool to help baby turn during 1st stage – it can be used as a prop under one foot while mom lunges (allowing the pelvis to open on one side, encouraging rotation of baby’s head) or it can be used to support mom’s head and arms in a knee-chest position (which puts mom’s bum in the air, allowing baby to slide up and out of the pelvis, before hopefully re-engaging in OA). While pushing in a squat without the stool (perhaps with a rebozo or rope dangling from above to hang onto, or with a partner’s knees under one’s armpits for support if needed) would probably be better if baby is still OP during second stage, that doesn’t mean there can’t be uses for the stool at earlier points in labour, even if baby is ‘sunny-side up’…IF mom wants to try it. I wholeheartedly support your wish to give birth without the aid of any tools, just as I support moms who want to have some options. What I might choose for myself is not what others might choose, and that’s ok. It is not for me to decide what is ‘right’.
Best wishes for a smooth and joyous birth experience!
Hallo there, I am a practicing midwife in New Zealand and am interested in finding out the cost of your birthing stool plus postage etc.
Hi Louise! The Kaya birth stool is not my product, though I do own and use one and am quite happy with it as I’m sure you could tell from my review! It is a Canadian product, though many midwives, doulas and hospitals throughout the world use it. There are two kinds – one for ‘personal’ use and one for professionals. The latter is made of a heavier duty material, suitable for going through the high-powered hospital cleaners. Even though I use mine professionally, I have the personal use model because I clean it by hand so I don’t need the sturdier plastic. You can find out more about costs and shipping from the Kaya website here: http://www.kayabirth.com/purchase.html