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.     

产妇社区健康指导与效果评价

目的探讨社区产妇健康指导的效果。方法将在我院正常分娩的106例产妇作为实验组,以家庭访视的形式进入社区,采用讲授、示范、视听等方式进行健康指导,及时收集反馈信息,进行效果评价。将另一段时间正常分娩的101例产妇作为对照组,按照常规方法给予保健指导。结果实验组相关知识掌握率达95.3%,母乳喂养率达98%,对护理服务满意率达99%,与对照组比较差异具有统计学意义(p<0.05)。结论采用以家庭访视为主要形式的社区产后健康指导,既能满足产妇及家属各方面的需求,又能提升产妇的自我保健能力及家属对我们的信赖度。     

African American Women's Preparation for Childbirth From the Perspective of African American Health-Care Providers

Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women's birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. Focus group participants answered seven semistructured questions. Four themes emerged: connecting with nurturers, traversing an unresponsive system, the need to be strong, and childbirth classes not a priority. Recommendations for nurses and childbirth educators include: (a) self-awareness of attitudes toward African Americans, (b) empowering of clients for birthing, (c) recognition of the role that pregnant women's mothers play, (d) tailoring of childbirth classes for African American women, and (e) research on how racism influences pregnant African American women's preparation for birthing.     

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 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.     

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.     

Lamaze certified childbirth educators: drawing strength from our past to build the future

This year's 50th anniversary of Lamaze International is a time to reflect upon our past and present as we work together to build the future of childbirth. In the 1950s and 1960s, thoughtful men and women such as Elisabeth Bing began to look carefully at the birthing practices in the United States. Lamaze Certified Childbirth Educators became leaders in improving birthing practices by teaching women and their partners the truth about how women were cared for during childbirth. Currently, the rise in maternal mortality and morbidity in the United States illustrates the pressing need for more changes. Lamaze Certified Childbirth Educators are leading change by pushing for the wide adoption of Lamaze International's Six Healthy Birth Practices to promote natural, safe, and healthy birth.     

They Said So on the News: Parsing Media Reports About Birth

In this column, the authors reprise recent selections from the Lamaze International research blog, Science & Sensibility. Each selection discusses shortcomings in the news media coverage of childbirth issues. The authors demonstrate how to identify misleading claims in the media and highlight how childbirth educators can apply a common-sense approach and careful fact checking to help women understand the whole story.     

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.     

Continuing Education Module Top 10: Tips on Teaching Lamaze Classes

Lamaze classes should help women think differently about birth, dispel myths, and ultimately make informed decisions that are right for them. In the current maternity care environment, this is a monumental task. In this column, the authors discuss 10 teaching tips that serve as a guide for teaching childbirth classes and ultimately facilitate learning.     

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.     

More Than Clinical Waste? Placenta Rituals Among Australian Home-Birthing Women

The discursive construction of the human placenta varies greatly between hospital and home-birthing contexts. The former, driven by medicolegal discourse, defines the placenta as clinical waste. Within this framework, the placenta is as much of an afterthought as it is considered the “afterbirth.” In home-birth practices, the placenta is constructed as a “special” and meaningful element of the childbirth experience. I demonstrate this using 51 in-depth interviews with women who were pregnant and planning home births in Australia or had recently had home births in Australia. Analysis of these interviews indicates that the discursive shift taking place in home-birth practices from the medicalized model translates into a richer understanding and appreciation of the placenta as a spiritual component of the childbirth experience. The practices discussed in this article include the burial of the placenta beneath a specifically chosen plant, consuming the placenta, and having a lotus birth, which refers to not cutting the umbilical cord after the birth of the child but allowing it to dry naturally and break of its own accord. By shifting focus away from the medicalized frames of reference in relation to the third stage of labor, the home-birthing women in this study have used the placenta in various rituals and ceremonies to spiritualize an aspect of birth that is usually overlooked.     

Construct validity of the childbirth trauma index for adolescents

The potentially traumatic nature of childbirth for adult mothers has been confirmed in research; however, adolescent childbirth trauma is unexplored. This article presents research on the construct validity of the Childbirth Trauma Index by providing a conceptual analysis of psychological childbirth trauma, factor validity of the Childbirth Trauma Index, and discussion of testing the Childbirth Trauma Index via contrasted-groups approach. Childbirth trauma can result in an acute stress reaction or actual posttraumatic stress disorder. Using subjective reports, the Impact of Event Scale, and the Childbirth Trauma Index, an appraisal of birth trauma, trauma impact, and indicators associated with childbirth trauma were revealed among 112 adolescents. Clinical implications and research recommendations are offered.     

A tribute to sharron smith humenick: 1937-2006

The purpose of this article is to honor Dr. Sharron S. Humenick, a long-time advocate of normal childbirth and Lamaze International, for her many accomplishments, her vigorous commitment to promoting the benefits of normal birth, and her passionate and diligent efforts in encouraging ongoing, evidence-based research that underscores the importance of a satisfying, normal-birth experience for women and their families. Dr. Humenick was a trailblazer in life and also became an exceptional guide in demonstrating how to cope with a terminal illness and dying. Through her numerous colleagues and friends in the United States and other countries, Dr. Humenick's legacy will live on in worldwide efforts to improve the childbirth experience for women and their families.     

Making the most of your revista lamaze: culturally responsive teaching for Hispanic clients

The traditional classroom in many Latin American countries does not overtly support an environment of discussion, reflection, and analysis-the foundation of a Lamaze education. Even when working with couples from cultures that reflect learning styles different from our own, it is possible for the childbirth educator to be faithful to the goals of Lamaze education by changing the way in which information is presented and by encouraging learner participation. By using Revista Lamaze, combined with culturally appropriate teaching techniques, a childbirth educator can successfully educate Hispanic couples without offending their culture.     

Evoking the power of learners

Our mandate, as Lamaze International childbirth educators, is to assist women in making healthy pregnancy, birth, and parenting choices. Being mindful of health promotion theory and using learning tasks and dialogue education to provide information creates a collaborative Lamaze class where the teacher is the facilitator and the learners are accountable for their learning. This column offers Lamaze educators a deeper understanding of adult learners and our roles in their birth education.     

Postpartum Depression: How Childbirth Educators Can Help Break the Silence

The voices of women suffering from postpartum depression are often silent. Women are reluctant to reveal to others that they are unhappy after the birth of their babies. Much has been written on possible causes, risk factors, and treatments for postpartum depression, but little has been done to investigate why women take so long to seek help. Early detection and treatment are key to a full recovery. Childbirth educators are in the position to offer anticipatory guidance on possible complications of the postpartum period, including postpartum depression. This article explores why women with postpartum depression choose to suffer in silence and suggests how childbirth educators can help new mothers find their voices.     

头位阴道分娩致宫颈裂伤62例分析

[目的]分析头位产宫颈裂伤的原因.[方法]对头位产宫颈裂伤62例临床资料进行回顾性分析.[结果]宫颈裂伤与产程的干预有关,是产后出血的原因之一.[结论]正确的处理产程,减少人为干预,是预防宫颈裂伤的有效措施.     

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.     

Childbirth Education at the Crossroads

In this column, a reader expresses concern that attendance at childbirth classes is declining at the same time the cesarean rate is rising. The history of childbirth education is discussed in the context of both access to information and changes in maternity care since the introduction of formal childbirth education. Changing goals and contemporary challenges facing childbirth education are discussed. The need for a new model of educating and empowering women is identified, and ideas for changes are explored.