Patients' perspectives on the role of prepared childbirth education in decision making regarding elective labor induction

The purpose of our study was to explore reasons why nulliparous women chose to have an elective labor induction and to identify the influence of prepared childbirth classes on their decision. The study included 1,349 nulliparous women at term who participated in a survey regarding their choices for childbirth, their attendance at prepared childbirth classes, and their experience with labor and birth. Sixty-three percent of women who attended childbirth classes and did not have elective induction reported that classes provided helpful information to assist in their decision-making process. Study results suggest attendance at prepared childbirth classes can be an effective source of information regarding elective labor induction and influential in women's decisions regarding whether or not to have elective labor induction. Women perceive prepared childbirth classes positively and find the information provided valuable.     

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.     

Childbirth Education at the Crossroads

In this column, a reader expresses concern that attendance at childbirth classes is declining at the same time the cesarean rate is rising. The history of childbirth education is discussed in the context of both access to information and changes in maternity care since the introduction of formal childbirth education. Changing goals and contemporary challenges facing childbirth education are discussed. The need for a new model of educating and empowering women is identified, and ideas for changes are explored.     

Contemporary dilemmas in american childbirth education: findings from a comparative ethnographic study

In this article, we examine key dilemmas childbirth educators experienced as they made crucial decisions about the content and format of their classes in the current U.S. maternity-care context. This ethnographic study demonstrates that childbirth education is a cultural phenomenon with deeply embedded values regarding the nature and importance of information, scientific evidence, and consumer choice. Articulating how culture shapes the presentation, content, and format of childbirth classes is an important step in understanding and increasing the relevance of this experience for birthing women.     

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.     

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.     

The story of ferris urbanowski: california, here we come!

Although childbirth educators may not all have known her by name, the lovely redhead who was the star childbirth educator in the 1970s film The Story of Eric was a familiar face. After viewing the film numerous times in our classes, early childbirth educators all felt that we knew her. Ferris Urbanowski was an early crusader for the Lamaze method of childbirth preparation in California in the 1960s. She worked to convince physicians in the Los Angeles area of the merits of the method, to establish classes for expectant parents, and to start a chapter of ASPO (now, Lamaze International, Inc.) in Los Angeles. Her book about yoga illustrated how additional methods of relaxation could benefit pregnant women. Today, Urbanowski attributes her past involvement in childbirth education to her current professional role as a teacher and counselor in the field of stress reduction at the Stress Reduction Clinic at the University of Massachusetts Medical Center.     

Are women really asking for it?

Childbirth educators and doulas express frustration that the vast majority of women choose standard obstetric care for labor and birth, even though the evidence shows that this care increases the likelihood that they will experience unnecessary intervention and morbidity. Women are preparing for childbirth by reading and taking classes, but they are unprepared for this reality. What responsibility do doulas and childbirth educators have in alerting women of the risk?     

Advocating for normal birth with normal clothes

Childbirth educators need to be aware that the clothes they wear when teaching classes send a nonverbal message to class participants. Regardless of who wears the clothing or what is worn, clothes send a message; thus, both the advantages and disadvantages related to clothing choice should be considered. Ultimately, the message should reflect the values of supporting normal birth. For childbirth educators who are allowed to choose their own apparel to wear in their classes, street clothes may be the benchmark for which to strive. This article discusses the many nonverbal messages that clothes convey and provides support for the choice of street clothes as the dress for the professional childbirth educator; thus, "normal clothes to promote normal birth."     

"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.     

Continuing Education Module Top 10: Tips on Teaching Lamaze Classes

Lamaze classes should help women think differently about birth, dispel myths, and ultimately make informed decisions that are right for them. In the current maternity care environment, this is a monumental task. In this column, the authors discuss 10 teaching tips that serve as a guide for teaching childbirth classes and ultimately facilitate learning.     

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 fathers' postbirth views of antenatal classes: satisfaction, benefits, and knowledge of family services

New fathers (men whose partners had recently given birth) were asked to indicate to what degree antenatal classes had prepared them for childbirth, for their role as support persons, and for lifestyle and relationship changes after the birth. These postbirth findings were compared with a previous exit survey of male attendants at antenatal classes in which fathers-to-be predicted that the antenatal classes had prepared them well on all fronts. The new fathers in this study, however, reported that the antenatal classes had prepared them for childbirth but not for lifestyle and relationship changes after the birth. Additionally, couples who attended antenatal classes were asked to what extent they were familiar with family-related services in the region and how often they had used these services since the birth of their baby. Fathers were less familiar than mothers with the family-related services.     

Parents’ Expectations About Participating in Antenatal Parenthood Education Classes

Our objective was to assess parents’ expectations about participating in antenatal parenthood education classes and to determine whether their expectations might be related to gender, age, and educational level. Data from 1,117 women and 1,019 partners residing in three cities in Sweden were collected with a questionnaire in a cross-sectional study. Participants believed that antenatal education classes would help them to feel more secure as parents and to be better oriented toward childbirth. Men had more positive expectations about the childbirth than the women. The participants mostly wanted help in preparing for parenthood and in learning infant care skills, followed by help in preparing for childbirth. The participants’ expectations were affected by gender, age, and educational level. The expectant parents appeared to want more focus on preparation for parenthood than on childbirth.     

The history of lamaze continues: an interview with elisabeth bing

Elisabeth Bing-physiotherapist, childbirth educator, and cofounder of the American Society for Psychoprophylaxis in Obstetrics (now Lamaze International)-is well known to most childbirth educators in the United States. She has been a true pioneer in the education of parents for pregnancy and birth. Her book, Six Practical Lessons for an Easier Childbirth, served to guide many parents and childbirth educators in the use of the Lamaze Method for labor and birth. She has prepared a countless number of parents for their birth experience in both her hospital classes in the 1950s and 1960s and in her private classes in the "studio" of her New York City apartment building, where she began teaching in the 1960s and continues to teach today. Elisabeth is beloved by all those who have had the opportunity to meet her or work with her. She has created a legacy that will continue for decades to come.     

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.     

The Impact of SARS on Childbirth Education

The SARS (Severe Acute Respiratory Syndrome) crisis in Toronto in the spring of 2003 had major consequences for prenatal learners. Classes in hospitals were cancelled; many couples were left without any prenatal education. This paper outlines the decision-making process of one programme that was determined to keep classes open. The impact of SARS on hospital procedures is also described. Childbirth educators are encouraged to prepare for future public health emergencies. Strategies to prepare for conducting childbirth education classes during times of crisis are outlined.     

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.     

A Changing Landscape: Implications of Pregnant Women's Internet Use for Childbirth Educators

Internet use among pregnant women is common and frequent, while attendance at childbirth education classes appears to be on the decline. This article explores why women turn to the Internet in pregnancy and how Internet use may affect their knowledge, attitudes, and behaviors. It suggests strategies for engaging women's interest in the Internet and describes how doing so may help increase the effectiveness of "traditional" childbirth education while mitigating the potentially overwhelming and confusing aspects of Internet use.