The Journey of Becoming a Mother

Nature intends that the physical and hormonal changes of pregnancy insure the growth and development not just of the baby but of the mother. The physical and emotional changes of pregnancy and, then, labor, birth, and breastfeeding play vital roles in guiding women on the journey of becoming a mother. Standard prenatal care and medicalized labor and birth interfere in powerful ways with nature''s plan and, consequently, women''s ability to negotiate this journey. In this column, these issues are explored, and implications for childbirth education are discussed.     

Really teaching lamaze: evidence-based practice

In this column, a reader identifies the importance of accurate, up-to-date information in making informed decisions. She is shocked to find that the Lamaze classes she observes are not evidence-based. Evidence-based practice is described, and examples of the use of best evidence in childbirth classes are discussed. The implications for childbirth education are explored.     

The Lamaze Certified Childbirth Educator’s Role in Teaching Survivors of Childhood Sexual Abuse

There is a strong likelihood that at least one participant in any Lamaze childbirth education class has had personal experience with childhood sexual abuse. Using the wisdom of Lamaze Certified Childbirth Educators and respected authors in the field of childhood sexual abuse, this column enlightens the childbirth educator in three ways: understanding the incidence of female and male childhood sexual abuse; understanding the effects of sexual, emotional, physical, and verbal abuse on the pregnant and parenting family; and facilitating classes that are sensitive to the needs of survivors of childhood sexual abuse as well to all expectant parents.     

Childbirth education for multiple pregnancy: part 1: prenatal considerations

Women with a multiple pregnancy have unique learning needs in preparing for birth. This paper explores the issues relevant to women with a multiple pregnancy to support a positive birth experience. One of the foundations of childbirth education and nursing care is to provide the individual woman and her family with knowledge regarding the birth process, what to expect, and how to cope with labor and birth. Education also focuses on caring for the newborns after birth and how to manage in the early days at home. However, traditional childbirth education classes, which meet in a series of evenings or Saturdays, may not meet the needs of women with a multiple pregnancy. In addition, because of the differences in care that exist for women with a multiple pregnancy, new paradigms for childbirth education are needed to meet the learning needs of these families. The purpose of this paper is to provide information to the childbirth educator on the differences in care women with a multiple pregnancy can expect and to suggest strategies to meet the childbirth education needs of these families.     

New Resources for Childbirth Educators and Parents

In this column, reviewers offer perspectives and comments on a variety of new media resources for childbirth educators and for expectant and new parents. The books and DVDs reviewed in this issue''s column address the following topics: new directions for childbirth education classes; pregnancy tips for expectant mothers; empowering women to give birth naturally; midwifery care; breastfeeding; labyrinths and “laborinths” (an alternative approach to preparing for birth); preterm labor; understanding newborns'' language cues; and exercise programs during pregnancy and the postnatal period, as well as exercises that strengthen the pelvic floor and help new mothers deal with incontinence.     

"The birthing from within holistic sphere": a conceptual model for childbirth education

An expanded conceptual model of childbirth education is offered, proposing the benefits of balancing informative teaching processes with creative, experiential, introspective learning processes for parents. The application of these two teaching dimensions to exploring four different perspectives of birth (the mother's, the father's, the baby's, and the culture's) is discussed, along with examples from "Birthing From Within" classes. Implications for current practice and the evolving role of childbirth educator are noted.     

How Do Women Who Plan Home Birth Prepare for Childbirth?

In this column, the findings of a secondary analysis of data from a larger qualitative study of the experience of home birth are discussed. The aim was to describe the ways in which women who plan home birth prepare for their births. The findings provide support for the idea of birth preparation and education occurring throughout pregnancy and describe the ways in which women planning to give birth at home develop confidence, plan for support, and make decisions related to the particulars of the labor and birth. Implications of these findings for childbirth education are explored.     

Integrating Preparation for Parenting Into Childbirth Education: Part II-A Study

This study was designed to test the effectiveness of using a broad conceptualization of childbirth education that includes parenting preparation in pregnancy. The goal is to assist in breaking cycles of dysfunction in families. At the core of this expanded model of childbirth education is the concept of prevention. The intervention described in Part I in the Journal of Perinatal Education 7(4), 26-33 provided parents with information and coping mechanisms by drawing parallels to traditionally learned coping skills for childbirth with techniques needed to cope in post-partum. This approach also encouraged prenatal parents to learn techniques for promoting attachment to their children before birth. The curriculum was tested by randomizing 48 couples to the expanded or traditional model of childbirth education. A pre- and post-Prenatal Parenting Scale was administered to both groups. Only the experimental group demonstrated improvement at the post-class administration.     

Revisiting the classics in childbirth education

In celebration of Lamaze International's 50th anniversary, reviewers share their thoughts on some classic Lamaze resource materials and how their content relates to today's viewpoints on birth and childbirth education. Although some of the material may be outdated, all of the resources offer timeless insights as well as a unique view on the history of childbirth education. The following topics are addressed: past cultural views of birth; advocacy for change in birth practices; Lamaze method; pioneers in childbirth; importance of childbirth education; and birth advocacy.     

Childbirth education in the 21st century: an immodest proposal

Childbirth education was an important social movement in the 20th century but has lost its way in recent years. We describe the reasons for the dwindling importance of childbirth education and offer a proposal for reform that will align childbirth education with the needs of today's birthing mothers. Our plan will create "Centers for the Childbearing Year" (CCBYs) and a new model of childbirth educator, which we call the "birth coach." The CCBY is the place for women to go to for information and support related to fertility, pregnancy, childbirth, and newborn care; the birth coach combines the role of childbirth educator, doula, and postpartum caregiver. In creating a fresh model of childbirth education, we not only honor our pioneers but also rediscover the wisdom in community and relationship that childbirth offers us, and we learn in new ways to journey alongside each other to create new possibilities for birthing families.     

Childbirth Education and Obstetric Interventions Among Low-Risk Canadian Women: Is There a Connection?

The objective of this study was to examine the associations between attendance at childbirth education classes and maternal characteristics (age, income, educational level, single parent status), maternal psychological states (fear of birth, anxiety), rates of obstetric interventions, and breastfeeding initiation. Between women’s 35th and 39th weeks of gestation, we collected survey data about their childbirth fear, anxiety, attendance at childbirth education classes, choice of health-care provider, and expectations for interventions; we then linked women’s responses (n = 624) to their intrapartum records obtained through Perinatal Services British Columbia. Older, more educated, and nulliparous women were more likely to attend childbirth education classes than younger, less educated, and multiparous women. Attending prenatal education classes was associated with higher rates of vaginal births among women in the study sample. Rates of labor induction and augmentation and use of epidural anesthesia were not significantly associated with attendance at childbirth education classes. Future studies might explore the effect of specialized education programs on rates of interventions during labor and mode of birth.     

Listening to Mothers II: Knowledge, Decision-Making, and Attendance at Childbirth Education Classes

In this column, a woman describes her concern that her childbirth classes did not provide the information she needed to make informed decisions during labor and birth. The results of the Listening to Mothers II survey suggest that this experience is not unusual. Although most women (97%) who participated in the survey wanted to know all or most of the potential risks of epidural, induction, and cesarean before consenting to have the intervention, the majority-including mothers who had experienced the intervention, women who were experienced mothers, and women who had attended childbirth classes-did not know the complications of induction or cesarean. These findings raise important questions about the outcomes of childbirth education. The factors that may contribute to these findings are discussed, and suggestions are made for insuring that women have the knowledge they need to make informed decisions about their maternity care.     

Public display of affection in couples attending childbirth education classes: implications for practice in Thailand

The purpose of this article is to describe couples' touch behaviors and positions during their interactions in childbirth education class exercises in the United States-practices that might be construed differently among couples in Thailand. Using observations collected at childbirth education classes conducted in the United States during the fall of 2002, the author found four positions that would be considered culturally sensitive with her Thai experiences. Perhaps with some modifications in the technique, mothers and their partners in Thailand will more readily accept childbirth education classes.     

Birth stories: a way of knowing in childbirth education

Birth stories have a lasting impact on expectant mothers. The purpose of this paper is to recognize the influence of birth stories as a key component of informal communication of knowledge about childbirth for expectant mothers. The review of literature and research is related to childbirth education, anthropological thinking, and applied learning theory with foundational concepts from Vygotsky, Bruner, and Bandura. Implications for childbirth educators are included.     

Listening to mothers: take two

LISTENING TO MOTHERS II: Report of the Second National U.S. Survey of Women's Childbearing Experiences (Declercq, Sakala, Corry, & Applebaum, 2006) is essential reading for the childbirth educator. Birth continues to be "intervention intensive" in the United States, and less than 2% of women have births characterized by the six care practices that promote, protect, and support normal birth. Only a little more than half of the women surveyed attended childbirth education classes, and only 4% reported that childbirth classes were their most important source of information. Seventy-eight percent used the Internet as an information resource. As a result of childbirth classes, women report, they are more confident in their ability to give birth but also less fearful of medical intervention. The results of these and other findings have important implications for childbirth education.     

Grant writing for childbirth educators: lessons learned from the resource center for young parents-to-be

Obtaining funding to support community-based childbirth education programs can be a challenge for childbirth educators who may have little grant-writing experience. This article was written by two nurse educators/nurse-midwives who have been involved for over 10 years with a grant-funded parenting and childbirth education program for pregnant teens. It reviews the background of the Resource Center for Young Parents-To-Be, suggests grant-funding sources, and explains the building of partnerships in the community. The basic steps involved in the grant-writing process are presented as well as the importance of follow-up evaluations and reports. Grant-writing skills and the ability to forge partnerships with other community organizations can be important tools for childbirth educators and health-care professionals.     

依法加强大学生婚育教育与管理的研究

回顾高校对大学生婚育管理方式的变革,针对变革中婚育“解禁”的问题,重点分析大学生可能面临的四种主要选择,在此基础上,提出高校应该对大学生婚育行为依法加强教育和管理的建议。     

Steps toward innovative childbirth education: selected strategies from the blueprint for action

To mark the 50th anniversary of Lamaze International, Childbirth Connection celebrates landmark accomplishments in education for childbearing women and families, and takes stock of the changing educational needs and preferences of current childbearing families in looking toward the future. Childbirth Connection's multi-year, multi-stakeholder Transforming Maternity Care initiative resulted in two landmark reports: 2020 Vision for a High-Quality, High-Value Maternity Care System and Blueprint for Action: Steps Toward a High-Quality, High-Value Maternity Care System. Selected recommendations of greatest relevance to the field of childbirth education are discussed, and the new Transforming Maternity Care Partnership is introduced.     

Transition of maternal competency of married and single mothers in early parenthood

Women who perceive maternal competency in early parenthood feel comfortable with infant care. A convenience sample of 58 married, first-time mothers and 22 single, first-time mothers was surveyed at six to eight weeks after childbirth to determine the differences in maternal competence perception between married and single mothers. Findings in this pilot study reveal that single mothers significantly reported less comfort in the maternal role as compared to married mothers. Implications for practice, research, and education are discussed.     

Perinatal Nurses Respond to Shared Decision-Making Education: A Quasi-Experimental Study

Women describe a loss of autonomy during childbirth as a contributing factor to labor dissatisfaction. Shared decision-making with choice, option, and decision talk may improve satisfaction. Nurses (n = 29) received education on supporting women''s autonomy with a standardized communication tool (SUPPORT) to facilitate shared decision-making and create an evolving birth plan. This quasi-experimental pre-/post-test design evaluated participant responses to the education module. Participants supported the use of the SUPPORT tool for shared decision-making and developing evolving birth plans. Most recommended initiation between 13- and 26-weeks'' gestation. Nurses'' willingness to advocate for women''s autonomy increased significantly after education (p = .022). Shared decision-making with standardized perinatal communication may support a woman''s perinatal education and her satisfaction with labor.