Childbirth educators, doulas, nurses, and women respond to the six care practices for normal birth

This collection of commentaries by childbirth educators, doulas, a labor and delivery nurse, and a woman preparing for the birth of her second baby provide an overall response to all six of Lamaze International's care practice papers that promote normal birth: Labor Begins on Its Own; Freedom of Movement throughout Labor; Continuous Labor Support; No Routine Interventions; Non-Supine (e.g., Upright or Side-Lying) Positions for Birth; and No Separation of Mother and Baby with Unlimited Opportunity for Breastfeeding. Strategies for using the position papers to facilitate learning in childbirth classes and for helping expectant parents access and understand research are presented. The commentaries describe the value of the position papers as a catalyst for professional growth, a foundation for creating change, a way to encourage reflection among professionals and women planning for the births of their babies, and an inspiration for everyone who advocates 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.     

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.     

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.     

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.     

Home birth: safely protecting and supporting normal birth

In this column, the author examines the safety and advantages of home birth. She urges childbirth educators to promote normal birth by encouraging pregnant women to consider the option of home birth.     

Promoting, protecting, and supporting normal birth

This column discusses ways in which childbirth educators can promote, protect, and support normal birth to help make it the standard.     

Selling normal birth: six ways to make birth easier

In this column, a reader expresses concern at the declining number of women attending childbirth classes and her inability to influence a woman's decision to choose normal birth. It may be more effective to market Lamaze as a way to have an easier birth rather than a normal birth. The six care practices that promote, support, and protect normal birth are suggested as a framework for teaching Lamaze classes with the goal of having an easier labor and birth.     

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.     

Creating Community

In this column, the editor of The Journal of Perinatal Education describes ways that Lamaze International is helping to create a community for those who share a common interest in promoting, supporting, and protecting 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.     

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.     

A Family-Centered Cesarean Birth Story

This is the family-centered cesarean birth story of my twin grandchildren. Because of good prenatal education; a well-chosen, dedicated care provider; and parents with focus, I am able to share a beautiful birth story. I hope relating this story encourages other childbirth educators to present various options for cesarean in their classes, thereby educating the public about this beautiful opportunity if a cesarean birth is necessary.     

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.     

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.     

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.     

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.     

Are women really asking for it?

Childbirth educators and doulas express frustration that the vast majority of women choose standard obstetric care for labor and birth, even though the evidence shows that this care increases the likelihood that they will experience unnecessary intervention and morbidity. Women are preparing for childbirth by reading and taking classes, but they are unprepared for this reality. What responsibility do doulas and childbirth educators have in alerting women of the risk?     

Addressing sexuality and pregnancy in childbirth education classes

A positive, nonjudgmental, and informed approach to sexual health during pregnancy promotes acceptance of the normal functioning of women's bodies. It also encourages the development of close and supportive relationships that are so essential during pregnancy and birth. Common concerns do not need to become problems. Concerns include issues of libido, positioning, and preterm labor or fetal health, as well as myths and cultural attitudes. Childbirth educators can use tools such as the PLISSIT model to approach the topic of sexuality during pregnancy. In addition, opportunities are available in every childbirth class to acknowledge or ignore sexual issues. Perinatal educators who take responsibility for addressing this often-taboo topic can enhance women's feelings of safety and their confidence in normal birth.