Childbirth education in the 21st century: an immodest proposal

Childbirth education was an important social movement in the 20th century but has lost its way in recent years. We describe the reasons for the dwindling importance of childbirth education and offer a proposal for reform that will align childbirth education with the needs of today's birthing mothers. Our plan will create "Centers for the Childbearing Year" (CCBYs) and a new model of childbirth educator, which we call the "birth coach." The CCBY is the place for women to go to for information and support related to fertility, pregnancy, childbirth, and newborn care; the birth coach combines the role of childbirth educator, doula, and postpartum caregiver. In creating a fresh model of childbirth education, we not only honor our pioneers but also rediscover the wisdom in community and relationship that childbirth offers us, and we learn in new ways to journey alongside each other to create new possibilities for birthing families.     

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.     

Can visions of natural births dance in our heads?

Through the observations of a childbirth educator of women who are planning epidurals, these women's vision of birth can be contrasted with a vision of the inner-strength-promoting experience that birth can be.     

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.     

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.     

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.     

Presenting relaxation techniques to pregnant adolescents

Teens present a unique challenge for the childbirth educator. A committed educator must find creative teaching strategies that will ease an adolescent's tension and provide a safe environment where a teen can "own" the message of her body's ability to give birth. The author of this column presents one of her own strategies for teaching relaxation techniques to adolescents.     

The history of lamaze continues: an interview with sunnye strickland

Although the most publicized beginnings of the Lamaze method in this country took place in the New York City area in the 1950s and 1960s, change was taking place even earlier in other parts of the United States as well, for women everywhere were eager to be educated and awake for their birth experiences. One of the early leaders of the "natural childbirth movement" in Colorado, Wyoming, and Oklahoma from the late 1940s through the early 1960s was Sunnye Strickland. Strickland began her career as a labor and delivery nurse, became a devoted advocate of prepared childbirth as a result of her own birth experiences, and embraced the philosophy of the psychoprophylactic method after visiting Dr. Pierre Vellay in Paris. She then became a faculty member with the American Society of Psychoprophylaxis in Obstetrics (ASPO/Lamaze, now Lamaze International, Inc.) and eventually a certified nurse-midwife. Her professional story spans five states, several countries, and 46 years, with a rich variety of experiences in which she was a change agent, educator, and active leader in the childbirth education movement.     

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.     

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.     

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."     

Web Sites that Address Epidural Anesthesia for Childbirth

Epidural analgesia has become a popular way to reduce pain during labor. Because epidural use is not limited to women who plan its use, but extends to some who originally planned a nonmedicated birth, it is important for the childbirth educator to provide information on this topic to all women. In this column, the authors provide examples of Web sites that address epidural anesthesia. Web sites for professionals and consumers are included. Encouraging the use of such resources by expectant parents can provide them with good information and allow the class time on this topic to be that of clarification.     

Julian’s Birth

A grandmother of seven and childbirth educator shares her daughter’s successful vaginal birth after cesarean (VBAC) birth story in Switzerland.     

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.     

Continuing Education Module The Courage to Birth

Childbirth educator Kathryn McGrath reflects on fear and courage and comes to see some levels of fear as a normal part of the process of pregnancy and birth and not something to be brushed aside. In this article, originally presented as a keynote address in 2005 at the Lamaze International Annual Conference, McGrath discusses fear during pregnancy and birth and presents ways in which the childbirth educator can acknowledge and accept women’s fears, and help find the courage they need to give 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.     

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.     

A Paradigm of Normal Birth: Teaching Through the Healthy Birth Practices

Debra McAllister, a childbirth educator with 9 years of experience as a labor and delivery nurse, provides commentary on how she teaches through the Six Healthy Birth Practices as a paradigm for normal birth.     

A childbirth educator speaks out for increased advocacy for normal birth

Upon noting that, over the years, normal birth has become less and less a cultural norm in the United States (where cesarean births now approach 30%), a childbirth educator speaks out to say it is time for normal-birth advocates to organize in order to increase efforts at social marketing of normal birth as a cultural norm.