Giving Birth: “We Just Don’t Talk About It”

In this column, Alyson Grauer, a young woman recently embarking on her postuniversity career, shares her experiences with friends who do not talk about childbirth. She contrasts their fear and their unwillingness to talk and learn about birth with her own experience being the daughter of a Lamaze Certified Childbirth Educator and doula. Grauer’s experiences provide a backdrop for a deeper understanding of young adults’ beliefs about childbirth. Judith Lothian provides insight related to when and why women and men stopped talking about birth and the implications for childbirth education.     

Midwife Learns Lessons as a Hospital Patient

After her first-time experience as a patient in a hospital, a midwife and childbirth educator reflects on the vulnerability and dependence of women who undergo operative birth. Continuous support for these women during the early postpartum period is imperative. Childbirth educators are encouraged to advocate for these women's needs and to teach them how to advocate for themselves.     

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.     

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.     

Current studies on two populations: childbearing teens and women with cesarean births

Young women in their teen years and women who have had previous cesarean births are two special groups taught by Lamaze Certified Childbirth Educators. This review includes research related to both groups. Information collected from these studies can help childbirth educators assess their programs and plan appropriate classes that address the particular needs of each group.     

Lamaze certified childbirth educators: drawing strength from our past to build the future

This year's 50th anniversary of Lamaze International is a time to reflect upon our past and present as we work together to build the future of childbirth. In the 1950s and 1960s, thoughtful men and women such as Elisabeth Bing began to look carefully at the birthing practices in the United States. Lamaze Certified Childbirth Educators became leaders in improving birthing practices by teaching women and their partners the truth about how women were cared for during childbirth. Currently, the rise in maternal mortality and morbidity in the United States illustrates the pressing need for more changes. Lamaze Certified Childbirth Educators are leading change by pushing for the wide adoption of Lamaze International's Six Healthy Birth Practices to promote natural, safe, and healthy birth.     

Confidentiality in childbirth education

Protecting the confidentiality of the personal information that childbirth educators receive from their clients is crucial. Without this respect for privacy, educators will not be able to get the information essential to meeting their objectives. Childbirth educators who work in schools may come under federal law that protects individual student records (Family Educational Rights and Privacy Act, or FERPA). Childbirth educators who are employed in a health-care facility may come under federal law that protects individual health information (Health Insurance Portability and Accountability Act, or HIPAA). All childbirth educators must be thoughtful advocates of the rights to privacy and self-determination of expectant parents.     

Birth and a vision: lamaze childbirth education in kenya, East Africa

Lamaze Certified Childbirth Education was an unknown entity in Kenya, East Africa, just a few years ago. Today, programs are firmly established in two leading private hospitals in Nairobi and gaining credibility in the region's medical community. Prepared childbirth is finding its place in the lives of the rapidly urbanizing African society. Implementation of Lamaze techniques in antenatal programs serving women outside the private sector is taking place as Kenyan midwives work toward their certification as Lamaze Certified Childbirth Educators.     

The lived experience of knowing in childbirth

Research on knowing in childbirth has largely been a quantitative process. The purpose of this study was to understand the ways first-time mothers learn about birth. A phenomenological approach, using a feminist view, was used to analyze two in-depth interviews and journals to understand nine first-time expectant mothers' experiences of knowing in childbirth. The findings demonstrated a range of knowledge that contributed to issues of control and conflict. The participants also described an increased dependency on their mothers and a lack of their own intuition contiguous to the birth process. These findings contribute understanding to how expectant mothers know birth, suggesting that their knowing does not diminish conflict surrounding the event and may even exacerbate it when not combined with learning skills to manage conflict. Childbirth educators may want to include instruction on negotiating power differential in relationships encountered during childbirth in order to strengthen a first-time mother's ability to receive the care she wants. Educators may also want to assess the expectant mother's view of birth and her expectations for birth. Schools of nursing should consider the inclusion of women-centered care curricula at both the undergraduate and graduate levels. The mothers' responses in this study clearly reveal that the politics surrounding birthing remain in place and must be removed in order to provide a supportive environment for normal birth.     

Continuing education module: finding the path

In this guest editorial, the challenges and pain of childbirth are presented as essential components of important life transitions. The role of pain in childbirth is explored. Childbirth is discussed as a "flow experience," and recommendations for assisting women to meet the challenges of labor and birth are presented.     

Helping hospitals change: part 1: what childbirth educators can do

Childbirth educators need to take the lead in helping hospitals change by teaching women what the evidence says. When women, one by one and collectively, start insisting on their right to have normal birth options, more bonding time, and better support of breastfeeding, hospitals and care providers will respond and change will happen. This article suggests strategies childbirth educators can use to advocate for women and help hospitals improve their maternity-care practices.     

Promoting and implementing evidence-based, best practices in childbirth education

Childbirth educators have a duty to promote and implement best practices. Best practices are individualized and evidence-based, using quality research to optimize outcomes. This requires addressing change. The childbirth educator must model evidence-based practices by systematically engaging in activities to improve his or her own changing curriculum. The childbirth educator is also a professional in a core position to play an active role as a change agent in the system through evaluation and dissemination of information to parents, fellow childbirth educators, and other professionals on the health-care team. This information provides the basis for important health-care decisions for self and others.     

Construct validity of the childbirth trauma index for adolescents

The potentially traumatic nature of childbirth for adult mothers has been confirmed in research; however, adolescent childbirth trauma is unexplored. This article presents research on the construct validity of the Childbirth Trauma Index by providing a conceptual analysis of psychological childbirth trauma, factor validity of the Childbirth Trauma Index, and discussion of testing the Childbirth Trauma Index via contrasted-groups approach. Childbirth trauma can result in an acute stress reaction or actual posttraumatic stress disorder. Using subjective reports, the Impact of Event Scale, and the Childbirth Trauma Index, an appraisal of birth trauma, trauma impact, and indicators associated with childbirth trauma were revealed among 112 adolescents. Clinical implications and research recommendations are offered.     

The power of numbers: transforming birth through collaborations

Collaborative efforts and coalitions have replaced exclusivity as birth organizations and individuals unite to humanize birth and provide women with transparency of information about maternity care providers and facilities and about access to the midwifery model of care. The Coalition for Improving Maternity Services and the upcoming 2010 "Mega Conference" to jointly celebrate the 50th anniversaries of Lamaze International and the International Childbirth Education Association serve as excellent examples of collaborative efforts to support natural, safe, and healthy birth practices as well as women's choices in childbirth. Childbirth educators are encouraged to learn from and support national coalitions devoted to improving maternity care and to use local resources to develop their own collaborative efforts on behalf of childbearing families.     

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?     

Applying the Listening to Mothers II Results in Lamaze Classes

Childbirth educators can use Childbirth Connection's Listening to Mothers II survey as a resource for updating their curriculum and teaching methods. The survey reveals that issues surrounding a woman's choice of care providers, her nutrition and fitness habits, and her possible experiences with depression and abuse may not be addressed sufficiently in a traditional, third-trimester, Lamaze class and may need greater emphasis in early pregnancy. The survey's results also show that women turn primarily to books, friends and family, health-care providers, and the Internet for information on pregnancy and birth. Suggestions for incorporating new sources of information and Internet technologies into Lamaze classes are discussed.     

Really teaching lamaze: the power of pain

In response to a reader's question, this column discusses the benefits and uses of pain to facilitate childbirth. Childbirth educators are urged to help women understand pain, so that they may work with pain and appreciate the role it plays in providing them with the inner wisdom to give birth.     

Postpartum Depression: How Childbirth Educators Can Help Break the Silence

The voices of women suffering from postpartum depression are often silent. Women are reluctant to reveal to others that they are unhappy after the birth of their babies. Much has been written on possible causes, risk factors, and treatments for postpartum depression, but little has been done to investigate why women take so long to seek help. Early detection and treatment are key to a full recovery. Childbirth educators are in the position to offer anticipatory guidance on possible complications of the postpartum period, including postpartum depression. This article explores why women with postpartum depression choose to suffer in silence and suggests how childbirth educators can help new mothers find their voices.     

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."     

Listen Up: What We Can Learn From Women’s Birth and Postpartum Experiences

In 2013, Childbirth Connection published findings from a U.S. study of women’s pregnancy, childbirth, and postpartum experiences, Listening to Mothers III. In this issue of The Journal of Perinatal Education, we publish the major survey findings of both the pregnancy and birth survey and the postpartum survey. This editorial discusses some of the major findings of the childbirth survey. Listening to what mothers have to say about their experiences suggests a mandate to “listen up” to what mothers are telling us and continue to advocate for evidence-based maternity care. Articles in this issue of the journal are presented.