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 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 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.     

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.     

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.     

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 II: A Lamaze Educator's Response

A Lamaze Certified Childbirth Educator and labor-support doula who provides services in two major, metropolitan areas shares her reactions and education experiences in dealing with the findings of Listening to Mothers II. She found that her first response to the survey findings involved assisting a community-wide effort to raise the awareness of women about their childbirth options, with a special emphasis on providers who practice in adherence to The Coalition for Improving Maternity Service's Mother-Friendly Childbirth Initiative. In addition, she added a component to her classes to help her students proactively explore why so few women feel they can assert their rights to refuse unnecessary interventions during childbirth.     

Breastfeeding Attitudes of WIC Staff: A Descriptive Study

A sample of staff members from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC program) were interviewed about breastfeeding and their perceptions of WIC recipients' views on breastfeeding. WIC staff members universally supported breastfeeding and expressed desires for more linkages between WIC agencies and perinatal education specialists in childbirth education classes, as well as with mothers during their postpartum hospital stay. The WIC staff members in this study reported on a variety of beliefs about breastfeeding held by their WIC clients, including cultural beliefs, the importance of family support, and experiences of pain during breastfeeding.     

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.     

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.     

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.     

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 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.     

Promoting wellness in lamaze classes

Lamaze childbirth educators are responsible for teaching wellness-based classes that do not add to the anxiety of the current, fear-based culture of maternity health care. Expectant parents' vulnerable months of pregnancy offer "teachable moments" for the childbirth educator, during which parents can be encouraged to alter their lifestyles and adopt the concept of wellness to their principles of living. In this article, concepts of wellness are examined, drawing from the writings of wellness advocates, midwifery researchers, and an anthropologist. Nutrition, physical exercise, breathing, and awareness of the five senses are components of potential class content explored in this article.     

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.     

Healthy Birth Practice #2: Walk,Move Around,and Change Positions Throughout Labor

In the United States, obstetric care is intervention intensive, resulting in 1 in 3 women undergoing cesarean surgery wherein mobility is treated as an intervention rather than supporting the natural physiologic process for optimal birth. Women who use upright positions and are mobile during labor have shorter labors, receive less intervention, report less severe pain, and describe more satisfaction with their childbirth experience than women in recumbent positions. This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #2: Freedom of Movement Throughout Labor,” published in The Journal of Perinatal Education, 16(3), 2007.     

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.     

Old childbirth educators never die ... They just labor away

Teaching childbirth education classes year after year can become monotonous or stale for some educators. Consequently, their students may also become bored. Rejuvinating one's professional self takes effort; however, the results are a renewed sense of purpose and a more exhilarating atmosphere in class.     

Differing gender preferences for educational media among Thai students studying English at university

There have been many reports indicating that there are differences between male and female students in various issues in education. This research examined the preferences for various forms of educational media by freshmen students studying English in Thailand. Approximately 3000 students at seven university campuses in central Thailand were surveyed on their preferences for the media used in and out of English classes. The results indicate many similarities between the male and female choices. Overall, students believed that traditional media were effective for in-class learning, but the media used in alternative classroom activities are more enjoyable. The students thought that entertaining media and the internet are popular ways to learn English and can be better utilized in classes. There was a stronger interest in the internet among male students. Overall, this study shows that there is a great interest from all students to have more technologically focused media available to help them learn.