Toward more evidence-based practice

Childbirth educators are responsible for providing expectant parents with evidence-based information. In this column, the author suggests resources where educators can find evidence-based research for best practices. Additionally, the author describes techniques for childbirth educators to use in presenting research-based information in their classes. A sample of Web sites and books that offer evidence-based resources for expectant parents is provided.     

Creating Change and Staying Connected through Collaboration

In this column, a childbirth educator describes feeling overwhelmed and alone in her work. Collaboration is presented as a key agent to creating change, staying connected, and “keeping going.” The Cochrane Library, the Coalition for Improving Maternity Services, the ongoing collaboration of Lamaze International with the Maternity Center Association and DONA International, and birth networks are presented as examples of valuable collaborations. Childbirth educators benefit from these collaborative efforts by being able to access and use evidence-based information and to feel connected with like-minded colleagues.     

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.     

Continuing Education Module Styles Vary When Teaching Expectant Parents About Medications

In this column, the author presents information from prominent Lamaze childbirth educators and from the literature to describe various options that educators can share with expectant parents regarding the use of pain relief medications during labor and birth. Ann Tumblin teaches about epidurals in a hospital class without losing sight of evidence-based practices that support normal birth. Jessica English focuses her classes on the natural processes of giving birth and spends only a little time presenting information about pain medications. Judith Lothian encourages educators to consider a new framework for Lamaze classes that involves letting go of the details and incorporating Lamaze’s six Healthy Birth Practices and storytelling.     

Position paper: promoting, supporting, and protecting normal birth

This updated position paper contrasts medical management of labor and birth with the normal physiology of birth and describes the care practices that support and facilitate the normal process. Lamaze International urges care providers to adopt these care practices as the standard of care, unless evidence-based medical reasons dictate otherwise. The roles of Lamaze-certified childbirth educators and the Lamaze Institute for Normal Birth in protecting, preserving, and promoting normal birth are described.     

Continuing education module-lamaze parents magazine: more than a giveaway

The Lamaze Parents magazine is an annual publication produced by Lamaze International to inform parents and childbirth educators on issues related to healthy birth preparation, normal birth, and parenting. The author of this column introduces teaching strategies for childbirth educators and doulas to use in tandem with the magazine's content in order to enhance their efforts in sharing current, evidence-based information with expectant parents.     

Grant writing for childbirth educators: lessons learned from the resource center for young parents-to-be

Obtaining funding to support community-based childbirth education programs can be a challenge for childbirth educators who may have little grant-writing experience. This article was written by two nurse educators/nurse-midwives who have been involved for over 10 years with a grant-funded parenting and childbirth education program for pregnant teens. It reviews the background of the Resource Center for Young Parents-To-Be, suggests grant-funding sources, and explains the building of partnerships in the community. The basic steps involved in the grant-writing process are presented as well as the importance of follow-up evaluations and reports. Grant-writing skills and the ability to forge partnerships with other community organizations can be important tools for childbirth educators and health-care professionals.     

How I teach evidence-based epidural information in a hospital and keep my job

A childbirth educator reveals her dilemma in teaching evidence-based practice in today's high-tech birth climate. She focuses on strategies to use when sharing epidural information with expectant parents.     

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.     

The dance of advocacy

A childbirth educator asks how she can continue to use best evidence and prepare women adequately for birth within the constraints of a hospital practice that pressures educators not to "rock the boat." This column discusses the challenge of advocating for normal birth and the dangers inherent in the advocacy role. Advocacy requires the childbirth educator to "dance" with many partners, including physicians and hospitals. Strategies for inviting colleagues and class participants onto the dance floor and teaching them the steps of the dance are explored. Guidelines for reducing risk and engaging women are discussed.     

The journey of an early lamaze childbirth educator

The author, who accomplished the majority of her work as a childbirth educator while based in Tampa, Florida, journals the experience of being an early pioneer in promoting Lamaze childbirth in the United States, beginning in the 1960s. Many aspects of her story are common to the stories of other childbirth educators who also pioneered the childbirth movement in the United States during the same time frame. This history is presented for its potential usefulness to those who continue to work to advance the Lamaze International goal of promoting normal birth.     

Teaching in a patient-centered medical home

Teaching Lamaze International classes in a patient-centered medical home allows the childbirth educator the best environment for giving evidence-based information and empowering parents to give birth their way. Patient-centered medical home facilities and providers practice evidence-based care and adhere to the principles of family-centered maternity care. In patient-centered medical homes, women can expect to give birth using the Lamaze Healthy Birth Practices and to fully participate in their care with appropriate interventions and the right to informed consent and informed refusal.     

Health-Care Reform for Childbirth

In this column, the editor of The Journal of Perinatal Education discusses the current health-care crisis and the need for health-care reform to promote, support, and protect natural, safe, and healthy childbirth. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote normal birth.     

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.     

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."     

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.     

Facilitating Professional Development during International Practicum: Understanding our Work as Teacher Educators through Critical Incidents

This collaborative self-study details the experiences of an Australian teacher educator and a Canadian teacher educator, who led teacher candidates on international practicum placements to the Cook Islands and Kenya respectively. Focusing on critical incidents, they collaboratively analyzed dilemmas that occurred when providing professional development sessions for local teachers during these placements. These dilemmas required the teacher educators to think deeply about their beliefs and practices in these contexts. Findings from the study included the teacher educator’s tendency to make assumptions about good teaching and learning practices that were reflective of their personal pedagogical values and beliefs; their discomfort with their perceptions of some neo‐colonial practices within these international practicum sites and uncertainty about how to navigate the resultant tensions; and, the need to view the work of teacher educators though a new cultural lens when working in transnational contexts. Implications for teacher educators working with local hosting teachers during international placements include the need to understand and acknowledge the complexity of this dimension of teacher educators’ work, and for teacher educators to engage in parallel learning journeys with the teacher candidates they accompany. This involves critically reflecting on the experiences, assumptions, and beliefs that they bring to their new contexts, as well as adopting a global perspective and a deep consciousness of how one is perceived by others who are culturally, racially, or linguistically different.     

Home birth: the wave of the future?

A childbirth educator expresses frustration with a medical system that does not work for women or for many maternity care providers. She suggests out-of-hospital birth as an alternative. This column explores the safety of home birth, women's experiences of home birth, and the issues related to home birth once again being the standard. Childbirth educators are encouraged to present home birth as a viable choice.     

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.     

Ethics of product endorsement: taking a look at freebies

Childbirth educators are potentially a large vehicle for marketing promotions to young and purchasing parents. Many free materials-educational matter and product samples-are available for the educator's own use and for distribution to the parents who attend class for evidence-based information. In this column, the author encourages childbirth educators to use good judgment in selecting materials that will protect normal birth, encourage positive parenting, and promote breastfeeding. Educators must consider the effect a brand name will have on the purchasing power of parents and whether or not the materials or samples will undermine breastfeeding efforts.