Legacies,Transitions, and Advancing Normal Birth

In this column, the new editor of The Journal of Perinatal Education discusses the significance of legacies, transitions, and advancing normal birth. The editor pays tribute to the legacies left behind by former editors Francine Nichols and Sharron Humenick and shares her vision for The Journal of Perinatal Education as it transitions into the next phase of advancing normal birth. 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.     

Activist for change: an interview with suzanne arms

Suzanne Arms's name is readily recognized by many in the field of perinatal education. For 30 years she has been a tireless advocate for childbearing women, a fighter for change in the traditional maternity care system, and a feminist with strong beliefs about the physical, emotional, and spiritual impact of birth. Arms's well-known books and frequent speaking engagements have allowed her to spread her message and her plea to humanize the childbirth experience. Talking with Arms is an energizing encounter. Her life path is a powerful and compelling story that is an inspiration to all who continue to work to make birth a positive event in the lives of women and their families.     

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.     

#3: continuous labor support

In this position paper-one of six care practice papers published by Lamaze International and reprinted here with permission-the benefit of continuous labor support is discussed and presented as an evidence-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. Women with continuous support are less likely to have a cesarean, an instrument delivery, and regional anesthesia. They are also less likely to report dissatisfaction with or negatively rate their childbirth experience. The value of the doula for both the laboring woman and her labor partner is discussed. The accompanying commentary-written by a leading proponent of maternity care practices-supports evidence that promotes continuous labor support. Lamaze International encourages women to plan for a supportive birth environment that includes continuous support.     

Witnessing a Natural,Safe, and Healthy Birth

In this column, the editor of The Journal of Perinatal Education discusses her experience witnessing a natural, safe, and healthy home birth. 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.     

Giving Birth: “We Just Don’t Talk About It”

In this column, Alyson Grauer, a young woman recently embarking on her postuniversity career, shares her experiences with friends who do not talk about childbirth. She contrasts their fear and their unwillingness to talk and learn about birth with her own experience being the daughter of a Lamaze Certified Childbirth Educator and doula. Grauer’s experiences provide a backdrop for a deeper understanding of young adults’ beliefs about childbirth. Judith Lothian provides insight related to when and why women and men stopped talking about birth and the 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.     

Commentary: Childbirth Education in Iran

With regard to childbirth, the role of every health-care system is to improve maternity care as well as the birth experience of women and their family members. Despite many efforts to improve maternity care in the Islamic Republic of Iran, the nation's childbirth care still faces a tremendous amount of unnecessary intervention and, consequently, a high rate of cesarean births. This article describes the strengths and weaknesses of Iran's maternity-care system and childbirth education in light of evidence-based practice.     

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.     

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.     

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.     

Birth and death: opportunities for self-transcendence

One thing that is often absent in childbirth education classes is a discussion of the spiritual aspect of giving birth. Birth offers women a wonderful opportunity to awaken their spirituality. Natural childbirth, in particular, has the potential for self-transcendence, offering an even greater appreciation for the miracle of life. The normal, natural pain in labor can challenge the core of one's being-it is a healthy sensation that provides direction for women moving through the maze of labor. The challenge of giving birth today is to develop confidence and trust in one's inner wisdom and allow nature to do its thing. When this is accomplished, a woman's body is often permeated and nourished by spiritual energy and guidance. She emerges from her labor bed with a renewed sense of her body's strength and power and with an enhanced spirituality.     

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.     

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.     

伦理学批评视角下的《紫颜色》

《紫颜色》是美国当代黑人女作家艾丽斯.沃克的代表作。文章从伦理身份缺失,伦理意识觉醒和伦理环境压迫这三方面讨论了美国南方黑人女性被剥夺了最基本的为人子女、母亲以及妻子的伦理身份;失去了正常伦理属性家庭关系里本应享受的父母之爱与两性之爱。文章认为:《紫颜色》充分体现了黑人女作家沃克一贯主张的伦理诉求:即广大黑人女性只有通过自己的奋发自为,解除父权社会下"男尊女卑"观念的精神枷锁,才能获得真正意义上的解放。     

Where Have All the Midwives Gone?

In past centuries, only women attended women in childbirth. Birthing women were in control, choosing who should attend them and where and how to give birth. Men were usually excluded unless they were needed for their strength and their tools if labor was obstructed. Eventually, with the medicalization of childbirth, male physicians became involved, introducing new techniques that interfered with the normal birth process and competed with midwives. By the 19th century, midwives struggled to hold onto their profession and advance through education. Midwives survived in Europe, but in America, they were eventually usurped in the early 20th century when birth began taking place in hospitals and as medical science and technology advanced. Midwives eventually rose again as educated nurse-midwives. Technology and obstetric interventions in normal childbirth continue, in spite of lack of evidence of their efficacy. Midwives are again in jeopardy because of rising malpractice insurance costs, women''s trust in technology, and, most recently, renewed efforts by physicians to once again prevent midwives from practicing autonomously and outside the hospital environment in the United States.     

The power of numbers: transforming birth through collaborations

Collaborative efforts and coalitions have replaced exclusivity as birth organizations and individuals unite to humanize birth and provide women with transparency of information about maternity care providers and facilities and about access to the midwifery model of care. The Coalition for Improving Maternity Services and the upcoming 2010 "Mega Conference" to jointly celebrate the 50th anniversaries of Lamaze International and the International Childbirth Education Association serve as excellent examples of collaborative efforts to support natural, safe, and healthy birth practices as well as women's choices in childbirth. Childbirth educators are encouraged to learn from and support national coalitions devoted to improving maternity care and to use local resources to develop their own collaborative efforts on behalf of childbearing families.     

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.     

Childbirth experience in women at high risk: is it improved by use of a birth plan?

Women at obstetric high risk more often experience negative feelings related to childbirth than women with normal outcomes. For these high-risk women, an individual birth plan does not appear to improve the overall experience of childbirth; rather, it seems to intensify the negative feelings in several aspects. The increased vulnerability in women at high risk warrants special attention to the possibility that types of care routinely offered to all women may negatively influence the experiences of high-risk women.