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.     

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 as a Catalyst

The Listening to Mothers II report is not only a document; it is a tool that is accessible to childbirth educators. By becoming familiar with its contents, educators can use the information to help expectant parents think about options available to them and inspire them to use evidence-based information as they make choices for the birth of their child.     

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."     

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.     

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: 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.     

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.     

What once was old is new again

Through seminars and continuing educational opportunities, recently certified Lamaze childbirth educators beginning their teaching careers have learned of the changes in birth practices over the past 50 years. However, they may not have heard the personal stories about the locations and conditions in which Lamaze educators first taught. In this column, five childbirth educators share their memories of the birthing climate, teaching strategies, class populations, and other aspects of Lamaze childbirth education 50 years ago and how the "old ways" compare with today's classes. Their stories not only provide an important, historical perspective to build on the past and improve future educational opportunities for expectant women and their families but also illustrate Lamaze's ongoing efforts to promote natural, safe, and healthy birth practices.     

Interpartner conflict and child abuse risk among African American and Latino adolescent parenting couples

OBJECTIVE: The goal of this study was to identify links between observed conflict interactions and risk for child abuse and harsh parenting among a multiethnic sample of adolescent mothers (14-19 years) and young fathers (14-24 years). METHODS: Prior to childbirth (T1), observation-based relationship data were collected from 154 expectant adolescent couples as well as information about physical aggression between partners. Two years after childbirth (T2), data relevant to harsh disciplinary practices and child abuse-prone attitudes were collected from both young mothers and fathers. Multiple regression analyses were run to examine the correspondence between (a) couples' relationship quality prior to childbirth and (b) subsequent risk for harsh and potentially abusive parenting practices. RESULTS: Findings indicated that interpartner violence prior to childbirth predicted physically punitive parenting behavior for fathers, but not for mothers. Young mothers and fathers observed to be more warmly engaged with each other during their pre-birth couple interactions (T1) reported lower rates of physically punitive parenting behavior with their children at T2. Couples' hostility at T1 predicted fathers' level of observed hostility toward his child during a structured play activity at T2. CONCLUSIONS: Results underscore the importance of addressing the quality of couples' relations as means of preventing dysfunctional parenting practices among adolescent mothers and their partners. Adolescent mothers and their partners are at heightened risk for engaging in dysfunctional parenting, including child abuse. Focusing on pregnant adolescents and their partners, this study sought to identify interpersonal predictors of child abuse risk. Although this study did not involve administering prevention or intervention services, the goal was to test hypotheses that would inform the development of programs for young at-risk couples. PRACTICE IMPLICATIONS: The decision to recruit young couples prior to childbirth was based on the presumption that this period of time could provide a window of opportunity to administer couple-based child abuse prevention programs. Consistent with previous research on marital relations and parenting, results of this study support the idea that efforts to develop and administer preventive-intervention programs targeting at-risk couples could help reduce the occurrence of harsh parenting behavior and abuse.     

Preparing expectant couples for new-parent experiences: a comparison of two models of antenatal education

This paper describes a pilot antenatal education program intended to better prepare couples for the early weeks of lifestyle changes and parenting. Eight weeks after birth, data were collected by questionnaire from 19 couples who participated in a pilot program and from 14 couples who were enrolled in a routine hospital program. Women in the pilot program were significantly more satisfied with their experience of parenthood. Facilitated gender-specific discussion groups formed a key strategy in the pilot program.     

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.     

Fathers online: learning about fatherhood through the internet

In the transition to fatherhood, men face numerous challenges. Opportunities to learn new practices and gain support are limited, although the provisions of father-specific spaces such as fathers' antenatal classes or "responsible fathering" programs are important advances. This article explores how men use the social space of a father-specific Internet chat room to learn about fathering. Messages to an Australian-hosted, father-specific chat room (for fathers of infants or young children) were examined, and three overlapping themes illustrated men's perceptions of their transition to fatherhood. The themes concerned recognition of and response to a lack of social space, services, and support for new fathers. The implications for fathers' perinatal education are discussed.     

近视眼准分子激光原位角膜磨镶术知情告知的探索

调查了解准分子激光原位角膜磨镶术患者的知情状况,探索医方告知和告知方法对患者术后康复满意度的影响。对接受近视眼准分子激光原位角膜磨镶（LASIK）手术的566例（1115眼）近视眼患者进行自设知情问卷调查,根据问卷中存在的问题开展知情告知。本组患者完全知情者12例,完全不知情者8例,其余均为部分知情。在问卷过程感觉到接受LASIK的患者对该手术存在强烈的了解欲望,希望通过医患沟通消除疑虑,这主要表现为三方面：第一,对LASIK矫正近视的原理存在较为严重的认识误区;第二,大多数患者对术前准备虽较为重视,但知情较少;第三,对术后可能发生的问题知之甚少。调查结果显示医方恰当告知能让患者基本了解手术原理,消除存在的误区和疑虑。知情同意原则是临床上处理医患关系的基本伦理准则,患者有知情权,医方有告知义务,做好诊疗过程各环节恰当的知情告知,是提高医患双方满意度和构建良好医患关系的重要手段。     

The murder of children by fathers in the context of child abuse

OBJECTIVE: This study examined the backgrounds of fathers who fatally abuse their children and the contexts within which these homicides occur. The type of relationship between victim, perpetrator, and the victim's mother was a particular interest. METHODS: Data were gathered from 26 cases of fatal child abuse perpetrated by fathers derived from the wider Murder in Britain study. Quantitative and qualitative data were collected from extensive prison case files of men serving life sentences for child murder. RESULTS: This was a group of undereducated, underemployed men with significant criminal histories. All except one victim had been subjected to previous violence by the offender, almost three-quarter of whom had also perpetrated violence against their intimate partners (the child's birth mother). Many men had unreasonable expectations and low tolerance levels of normal childhood behaviors, and many appeared jealous and resentful of these young children. All 26 victims were under 4 years of age. Sixty-two percent of the offenders were stepfathers and in only four cases was the perpetrator a birth father married to the birth mother. Stepfathers had more disrupted and disadvantaged backgrounds and experiences than birth fathers. CONCLUSIONS: Findings suggest that fathers who perpetrate fatal child abuse have a propensity to use violence against children in their care and intimate partners, raising questions about the gender dynamics and generational boundaries operating in these families. The nature and type of intimate relationship (whether married or cohabiting) and fathering relationship (whether birth or de facto) were important differentiating factors in these homicides as well as characteristics of the offender. PRACTICE IMPLICATIONS: Professionals working in child protection strive to provide effective services to children and families, ever vigilant to the possibility of the death of a child as a consequence of an assault. By and large, fathers (either biological or de facto) as the perpetrators of such assaults have received minimal attention in both policy and practice. Findings from this study suggest that practitioners need to be cognizant of men's attitudes towards and expectations of fathering (particularly stepfathering) which may present increased levels of risk to both children and intimate partners.     

Listening to the boys again: an exploration of what boys want to learn in sex education classes and how they want to be taught

This article describes the preferences expressed by 16‐year‐old and 17‐year‐old boys when they were asked what they want to learn from sex and relationship education classes and how they want to be taught. Research was carried out in eight secondary schools with boys in year 12. Qualitative responses from questionnaires issued to 307 boys were analysed together with the results from three focus groups carried out in three of the schools. The research found that in most areas boys are not being taught what they want to know. The areas of feelings and emotions, sexuality, sexual techniques, sexually transmitted infections, pornography and the effects of the ‘boy culture’ are not being addressed sufficiently, or in some cases at all. Boys also called for smaller class groups, and for more active methods of teaching and some of them asked for time away from girls to express themselves without censure. They called for more education at an earlier age and that their desire for a safe, non‐critical environment should be met.     

Using the official lamaze guide in childbirth education classes

Normal birth has long been promoted by Lamaze International in its mission and vision statements and by the Lamaze Institute for Normal Birth. The Official Lamaze Guide: Giving Birth with Confidence, a book by Judith Lothian and Charlotte DeVries, can be used by birth educators to alter the focus from learning what to expect when one fears the worst to empowering women to understand that birth is usually a healthy, normal process. In this column, the author suggests ways in which childbirth educators can use The Official Lamaze Guide in their classes.