Helpful Resources for Childbirth Educators and Parents

In this column, reviewers offer perspectives and comments on a variety of books and CDs that address topics related to the politics of midwifery in the United States, preparing expectant parents for childbirth, babywearing techniques, breastfeeding guides, and a child''s perspective of home birth.     

Promoting Optimal Care in Childbirth

In 1996, the World Health Organization set out guidelines for normal birth. Because that time birth in the United States has continued to be intervention intensive, the cesarean rate has skyrocketed and maternal mortality, although low, is rising. At the same time, research continues to provide evidence for the benefits of supporting the normal physiologic process of labor and birth and the risks of interfering with this natural process. This article reviews the current state of U.S. maternity care and discusses research and advocacy efforts that address this issue. This article describes optimal care in childbirth and introduces the Lamaze International Six Healthy Birth Practices.     

Jonah’s Birth

Rachel Goldstein shares her experience of exploring options related to care provider and place of birth early in her pregnancy. Goldstein and her husband, Marc, after reading and research, chose midwifery care and a home birth. She shares the story of a long labor at home supported by her husband, her doula, and her midwife. Her positive attitude, her ability to use various comfort strategies, and the support she received throughout labor contributed to being able to give birth naturally and ecstatically to her son Jonah.     

They Said So on the News: Parsing Media Reports About Birth

In this column, the authors reprise recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses shortcomings in the news media coverage of childbirth issues. The authors demonstrate how to identify misleading claims in the media and highlight how childbirth educators can apply a common-sense approach and careful fact checking to help women understand the whole story.     

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 expectant and new parents. The books, CDs, DVDs, and kits reviewed in this issue''s column include the following topics: the birth experiences of mothers who survived childhood sexual abuse; lively teaching techniques and ideas to help energize and enhance childbirth education classes; breastfeeding in the workplace; expectant fathers; perspectives on motherhood; unique, helpful tools for childbirth educators to use in designing their class content, addressing the stages of labor, and discussing planned cesarean birth; exercises for pregnant women on bedrest; and a compilation of presentations featured at Birthing the Future''s international symposiums.     

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.     

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.     

Waiting to inhale: how to unhurry the moment of birth

A doula and expectant mother's view of birth is forever changed when she sees a midwife simply place a newly born child below her mother at the moment of birth. The pause that the mother experiences in this moment as she studies, touches, and claims her child prompts the author to reflect in this guest editorial on ways we might be disturbing the natural sequence of birth as we deliver babies directly to their mothers' chests.     

Safe Prevention of the Primary Cesarean Delivery: ACOG and SMFM Change the Game

Safe Prevention of the Primary Cesarean Delivery, a joint statement of the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, changes the rules of maternity care management. The statement reviews the research and uses the findings to make practice recommendations. This article discusses the major recommendations and their importance in decreasing risk and increasing safety for mothers and babies. The articles in the current issue of the journal are also reviewed.     

Preparing for the First Birth: Mothers' Experiences at Home and in Hospital in Australia

The aim of this research was to explore the experiences of a group of first-time mothers who had given birth at home or in hospital in Australia. Data were generated from in-depth interviews with 19 women and analyzed using a grounded theory approach. One of the categories to emerge from the analysis, “Preparing for Birth,” is discussed in this article. Preparing for Birth consisted of two subcategories, “Finding a Childbirth Setting” and “Setting Up Birth Expectations,” which were mediated by beliefs, convenience, finances, reputation, imagination, education and knowledge, birth stories, and previous life experiences. Overall, the women who had planned home births felt more prepared for birth and were better supported by their midwives compared with women who had planned hospital births.     

In Search of a Common Agenda for Planned Home Birth in America

Leading maternity provider organizations in North America have been in conflict about birth at home and birth centers, debating issues related to safety, access, the value of obstetric intervention, and patient autonomy. In today’s environment, childbirth educators and doulas are often required to explain to parents why physiological birth and evidence-based, low-technology methods of labor and birth care are not available in every setting, and why maternity providers disagree about birth place. There are very few regions in the United States where home birth providers are integrated into interprofessional provider networks that allow for seamless care across birth settings. In October 2011, multidisciplinary leaders met at a Home Birth Consensus Summit in Warrenton, Virginia, to discuss the status of home birth within the greater context of maternity care in the United States. This article describes the intent and outcomes of the summit. Four of the nine consensus statements developed at the summit are of particular interest and importance to mothers and families and, hence, to childbirth educators and advocates. Consumers, educators, and birth advocates are encouraged to widen the circle, identify communications experts, lead individual projects, or serve as advisors.     

Safe,Healthy Birth: What Every Pregnant Woman Needs to Know

In spite of technology and medical science''s ability to manage complex health problems, the current maternity care environment has increased risks for healthy women and their babies. It comes as a surprise to most women that standard maternity care does not reflect best scientific evidence. In this column, evidence-based maternity care practices are discussed with an emphasis on the practices that increase safety for mother and baby, and what pregnant women need to know in order to have safe, healthy births is described.     

Listening to Mothers II: Report of the Second National U.S. Survey of Women's Childbearing Experiences: Conducted January–February 2006 for Childbirth Connection by Harris Interactive? in partnership with Lamaze International*

With permission from Childbirth Connection, the “Executive Summary” for the Listening to Mothers II survey is reprinted, here. The landmark Listening to Mothers I report, published in 2002, described the first national U.S. survey of women''s maternity experiences. It offered an unprecedented opportunity to understand attitudes, feelings, knowledge, use of obstetric practices, outcomes, and other dimensions of the maternity experience. Listening to Mothers II, a national survey of U.S. women who gave birth in 2005 that was published in 2006, continues to break new ground. Although continuing to document many core items measured in the first survey, the second survey includes much new content, exploring earlier topics in greater depth, as well as some new and timely topics.     

Being a resource for both mother and child: fathers' experiences following a complicated birth

The aim of this study was to describe fathers' experiences of being present on a postnatal ward and during the first days at home following a complicated birth. Fifteen fathers were interviewed, and content analysis was used for the analysis. The theme illustrated that fathers were a resource for both mother and child through practical and emotional engagement. The categories describe how the father empowers the mother and illustrates adapting to new family roles. Following complicated birth, fathers should be invited to stay around-the-clock on postnatal wards because it gives them the opportunity to place their resources at the disposal of mother and child. In antenatal courses, fathers should be prepared for their empowering role after a complicated birth.     

Research Summaries for Normal Birth

In this column, the author summarizes four research studies relevant to normal birth. The studies summarized include a systematic review of trials evaluating the benefits versus harms of routine artificial rupture of the membranes; a study of the effect of continuous female labor support by a minimally trained family member or friend on attachment and early parenting; a systematic review examining the relationship between cesarean surgery and postpartum urinary incontinence; and a randomized controlled trial of warm perineal compresses during the second stage of labor.     

First,Do No Harm: How Routine Interventions,Common Restrictions,and the Organization of Our Health-Care System Affect the Health of Mothers and Newborns

In this column, the author reprises recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses a new study that demonstrates the “First, do no harm” principle in a different way. New research on the potentially harmful effects of intravenous lines demonstrates that refraining from routine interventions in labor protects the safety of women and babies. A new systematic review of movement and position changes in labor shows that eliminating unfounded restrictions also protects maternal and infant health and well-being. Finally, a study of patterns of use of neonatal intensive care units reveals how the organization of the maternity care system itself can affect the health outcomes of its beneficiaries.     

Listening to Mothers II: Report of the Second National U.S. Survey of Women's Childbearing Experiences: Conducted January-February 2006 for Childbirth Connection by Harris Interactive(R) in partnership with Lamaze International

With permission from Childbirth Connection, the concise version of the Listening to Mothers II "Survey Methodology" is reprinted here. Harris Interactive(R) conducted Listening to Mothers II: Report of the Second National U.S. Survey of Women's Childbearing Experiences on behalf of Childbirth Connection. The survey consisted of 1,373 online interviews and 200 telephone interviews with women who had given birth in U.S. hospitals in 2005, with weighting of data to reflect the target population. Interviews were conducted from January 20 through February 21, 2006. The methods used to conduct the survey and analyze the data collected are described.     

Healthy Birth Practice #4: Avoid Interventions Unless They Are Medically Necessary

Maternity care in the United States is intervention intensive. The routine use of intravenous fluids, restrictions on eating and drinking, continuous electronic fetal monitoring, epidural analgesia, and augmentation of labor characterize most U.S. births. The use of episiotomy is far from restrictive. These interventions disturb the normal physiology of labor and birth and restrict women’s ability to cope with labor. The result is a cascade of interventions that increase risk, including the risk of cesarean surgery, for women and babies. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #4: No Routine Interventions,” published in The Journal of Perinatal Education, 16(3), 2007.