Childbirth And Pregnancy Blog

Childbirth professionals, birthing networks, birth professionals, natural childbirth advocates…are all names used to describe the growing community actively advocating for childbirth as a normal healthy part of a woman’s life cycle. Through the use of childbirth education, this community’s life goal is to empower women to make informed choices around their pregnancy and delivery options using evidence-based research as the foundation.

As a member of this growing community, I am often caught between what I view as two worlds. My reality, in which I am childbirth professional certified in childbirth education, perinatal fitness, and a breastfeeding peer counselor trainer. Then there is the other real world, where my work in a community-based agency allows me to witness the politics of being pregnant and giving birth in the “inner city.”

I listen to my professional daytime colleagues express opinions indicating that what we birth advocates do is ‘cute’, but distracting to the bigger picture, their picture. They ask if our services are free, as if we shouldn’t dare dream of earning a living this way. They even sometimes dismiss our credentials with statements such as, Yes, what you do is nice, but clients prefer to have someone qualified with them.”, when they talk about providing quality education.

To be fair let’s examine the flip side of the coin. The same people who I treasure for their insightfulness and dedication to mothers and their families can sometimes be overwhelming with their crusade. Exaggerations are made about obstetricians and the quality of hospital births and bashing sometimes becomes part of the circle of sharing.

What is childbirth education and why is it important?

The definition of childbirth education can be as varied as there are education modalities. Although definitions can vary among educators and or certification institutions… it can be simply defined as follows:

Childbirth Education Classes prepare a woman for the experience of pregnancy, labor, and delivery. Through the use of a series of classes a woman is educated on the anatomy, physiological changes, nutrition, risks and benefits of medical interventions, pain coping strategies, cesarean risk reduction, and breastfeeding. Some educators are also taught to encourage women to recognize and use their innate abilities and intuition to birth.

Did you know the Healthy People 2010 update section 16:7 directly addresses childbirth education? The Healthy People 2010, a set of health objectives designed to guide health professionals in achieving improved health results for Americans over the first decade of the new century, speaks to the importance of improving maternal, infant and child health in this quote:

Section 16:7

As part of comprehensive prenatal care, a formal series of prepared childbirth classes conducted by a certified childbirth educator is recommended for all women by the Expert Panel on the Content of Prenatal Care.[49] These classes can help reduce women’s pain [50] and anxiety [51] as they approach childbirth, making delivery a more pleasant experience and preparing women for what they will face as they give birth. A full series of sessions is recommended for women who have never attended. A refresher series of one or two classes is recommended for women who attended during a previous pregnancy. At a minimum, the childbirth classes should include information regarding the physiology of labor and birth, exercises and self-help techniques for labor, the role of support persons, family roles and adjustments, and preferences for care during labor and birth. The classes also should include an opportunity for the mother and her partner to have questions answered about providers, prenatal care, and other relevant issues, as well as to receive information regarding birth settings and cesarean childbirth. Attendance is recommended during the third trimester of pregnancy so that information learned will be used relatively soon after presentation. Classes should begin at the 31st or 32nd week and be completed no later than 38 weeks. The refresher class should be completed at any time between 36 and 38 weeks.

This recommendation is important and should be highlighted by all advocates and prenatal care providers. It validates the need for childbirth education as a routine part of comprehensive women’s prenatal healthcare. Independent childbirth educators are an excellent choice for women who want to receive unbiased information not driven by hospital policy and procedures. For those educators whose work does come under the parameters of organizations’ policy and procedures, they must remember their main function is to work for the betterment of their client “the expectant mother”. In evaluating the quality of childbirth education classes, the curriculum should be consumer focused and the materials and information presented should be honest and forthcoming in presenting the risks vs. benefits based on evidence-based research.

What is the bottom line?

We live in a fast paced society, particularly here in the New York metropolitan region. As a result, many consumers are requesting shorter classes and fewer sessions. It is our responsibility as birthing advocates to give them quality services, and if this means an increase in the quantity of time we devote to instruction then that’s a responsibility we need to meet. Many online classes and weekend intensives are now replacing traditional 6 week plus classes. This new trend is essentially depriving women of the support that is traditionally found in longer face-to-face settings. Although the Healthy People 2010 statement does not specifically spell out what a full series of classes consists of, one can intelligently conclude that based on the amount of recommended information to be covered a realistic time allotment is needed for the human mind to receive, accept and digest.

As childbirth professionals we need to continually refer back to the evidence-based literature around childbirth which includes research findings which can be found online (at sites such as Childbirth Connection (formerly the Maternity Center), the Coalition to

Improve Maternity Services and the World Health Organization (WHO) to name a few).

The Expert Panel on the Content of Prenatal Care has officially validated the value of childbirth education classes essentially confirming what we know anecdotally. It is now our responsibility to know what that truth is and speak it boldly to our clients. The truth about pregnancy is that childbirth education classes should be a routine part of every woman’s comprehensive prenatal care. Recognizing that every pregnancy and birth is unique, for the woman who has delivered before a refresher course would update her on her options and also allow her and her support person to ask related questions. These two scenarios are examples of knowledge as power because they create an opportunity for the mother to be educated and as a result make decisions that are best for her and her baby.

This article is a product of Just Us Women Productions.

http://www.Justuswomen.org

When weighing your options for childbirth, it helps if you have accurate information about the options available to you. Unfortunately childbirth is an area where myth often pervades fact. What you hear may have started as truth, but has become such a distorted version, there isn’t much truth left. Here are ten of the most common misunderstandings about natural childbirth and the truth behind them.

1. You have to have a super-high pain tolerance.

Almost nobody likes pain, and it is easy to assume giving birth causes large amounts of pain so only the most pain tolerant women can do it. What is less well known is how a woman’s body increases endorphin levels during labor. This means as the intensity of the contractions build, so does her ability to handle them. Also, contractions peak at about 30 seconds. This means once your contractions become about a minute long they may increase in duration (get longer), but they do not tend to continue building in intensity.

2. You have to do HEE HEE HOO HOO panting the whole time.

While Dr. Lamaze did include patterned breathing for distraction in his natural childbirth training, it was one of several tools and his was the only program that recommended it. Dr. Dick Read, Dr. Bradley and others recommended natural deep breathing relying instead on positioning and relaxation. Patterned breathing remains one of many tools a woman can use in labor if she finds it helps her manage contractions, but most women use normal breathing.

3. It feels like pulling your lower lip over your head.

I enjoy a good comedy routine, but we shouldn’t base our understanding of childbirth on stand up comedy. After having given birth without medication twice, I can most assuredly promise you it feels nothing like pulling on your lips. The parts of the body needed for childbirth are designed to stretch and make room for baby – your lower lip is not designed to be pulled over your head.

4. You have to be at home to do it.

Homebirth is an option, but it is only one option. Women interested in natural childbirth can also give birth in birth centers or hospitals. It is not the location that matters, but the support you have to help you through contractions. While hospitals have access to medications and emergency equipment, many also have birth tubs, balls and flexible staff who will work with a family to achieve the birth they desire. Hiring a doula gives you even more support and increases your chances of giving birth naturally.

5. Women become screaming lunatics, yelling at their husbands.

Childbirth is not a psychosis where a woman suddenly takes on a new personality. Although in the earlier half of the 20th century women were given labor drugs that made them act very strange indeed, becoming crazy isn’t a part of the natural childbirth process. What does happen is a woman uses all her energy to focus on the work she is doing and distraction makes this harder. Women in hard labor will use the least amount of energy to communicate – this may mean body language, grunts or one word commands. Without the understanding this behavior is normal, a support person can feel as if they have somehow upset the laboring mother.

6. Childbirth is the worst pain you will ever feel.

A childbirth educator’s husband figured out from her normal 12 hour labor that the time she spent in pain in contractions totaled to about 3 and a half hours. You can be in pain longer than that for a migraine. And unlike other types of pain, contractions build to a peak, release from the peak and then give you a break. Even in a longer than average labor, there are breaks between contractions. In a 12 hour labor, you might not even need to work through contractions until the last 2 or 3 hours before pushing because most of the time you spend in labor is early labor.

7. If they know you want a natural childbirth, the nurses won’t give you anything for the pain.

Wanting a natural childbirth and achieving a natural childbirth are two different things. While most doulas, nurses and midwives will work with you to achieve your goal of a natural childbirth, they never force you to give birth without medication. Whether or not to use medical pain relief remains your choice regardless of what type of labor you prepared for.

8. There is no reason to go through labor pain anymore.

There have been ointments and herbs to treat labor pain as far back as the Roman Empire, and probably further back than that. There are also positions and non-medical techniques that work extremely well for keeping mothers comfortable and helping labor progress. It isn’t so much the use of a treatment to manage pain that bothers modern women as much as it is the possible side effects and risks of using the treatments. There is a big difference between the risks of having a massage in labor and having an epidural. Although the massage may not eliminate all the pain, if it allows the woman to labor without having to add the risks of an epidural then why not use it? Studies show just the change of using a doula for additional support decreases requests for pain medication while also decreasing needs for additional medical interventions. It should more rightly be said that with all we know today, there is no reason to add the risks of medical pain relief to manage labor pain anymore.

9. Women used to die giving birth.

Yes, and women still die giving birth. It has nothing to do with the natural childbirth process. Instead factors such as poor nutrition, infection and inadequate sanitation are the causes of high mortality rates. In fact, the highest childbirth mortality rate happened because birth was moved to the hospital and infection spread quickly among laboring women when doctors didn’t wash their hands. Pain medications increase the risks of having a problem in labor, not reduce them. Cesarean birth adds the increased risks of surgery to childbirth, which means for a normal, healthy pregnancy your risk of dying from childbirth goes up.

10. I don’t need to prepare to give birth, it’s a natural process.

While your body is doing the work with or without you, how you respond to labor will have a large impact on how well labor progresses and the amount of pain or discomfort you feel. Knowing positions, tricks and techniques for labor greatly improves your chances of being successful at giving birth naturally, and greatly improves your chances of staying comfortable during labor. It takes physical and mental energy to labor; if you haven’t practiced natural childbirth techniques enough to use them without thinking you won’t be able to use them during labor. Preparing for a natural childbirth doesn’t necessarily guarantee you will give birth without medications, but not preparing almost always guarantees you will use medications.

Jennifer Vanderlaan is a childbirth educator and doula who helps families learn tools, tips and techniques for natural childbirth at http://www.birthingnaturally.net