Ursula Miguel. CNM, MS

Childbirth education has been around for almost 50 years. It began in Europe and North America as an alternative movement to what was perceived as over-medicalized obstetrics with its liberal use of pain-relieving drugs and operative delivery. Childbirth became a medical event when it moved from the home to the hospital setting in the late 1930’s.

When we think of childbirth classes, connotations, such as Lamaze, “artificial breathing patterns, sense of failure if you end up taking medication, anti-epidural,” and many others come to mind.  Is there a benefit to childbirth classes?

Childbirth education is at a crossroads. Attendance at classes is down at a time when we are experiencing a crisis in maternity care: increasing rates of Cesarean births, elective inductions, epidural rates of over 90% in many hospitals, less access to vaginal birth after Cesarean. The above trends have not led to improved maternal and neonatal outcomes.

Do we still need childbirth classes? Are childbirth educators keeping up with the changing needs of childbearing women??? If the laboring woman chooses an epidural anyway, what is the purpose of classes? What about the plethora of information available online? Can’t you just get all the information there and save money?

As an experienced childbirth teacher and practicing midwife, I will attest to you that there is more than ever a place for childbirth preparation, especially for the first time pregnant mom, who is exposed to much conflicting and inaccurate information on the internet and in the media. Even if you are planning an epidural from the get-go, you need to understand what is going on in your body as you labor, and how to cope with the early labor contractions. It is always best to know common side effects of interventions and medications in labor, so that you can make an informed choice. You should also keep in mind that you might have to wait for your epidural for a while if the anesthesiologist is not immediately available or an IV has not infused yet.

Childbirth education does not lead to an easier birth, less pain or promise you less complications. In fact, the research on the effects of childbirth education on labor variables has been inconclusive and needs more rigorous investigation. The bottom line is: You do not have any options about your childbirth experience unless you know them. Knowledge is power and learning to trust birth will increase the self-confidence of the laboring woman.

A good childbirth educator must teach evidence-based information, remain up-to-date with newest research and integrate the individualized goals of each childbearing family into her classes, even if they are in conflict with her own philosophy of birth. Good teachers also need to be open to new teaching modalities, such as shorter classes and online learning for today’s fast-paced consumer.

At a minimum the following topics should be covered in classes:

• Process of labor and birth, anatomy of late pregnancy
• How to recognize labor
• Danger signs in pregnancy and during labor
• Comfort measures for labor and birth, benefits of support
• Pain relief options, both medical and non-medical
• Informed consent, communication skills and birth plans
• Cascade of interventions
• Newborn care and Breastfeeding
• Postpartum Care

Additional goals and psychological benefits would be: good health habits, stress management, anxiety reduction, improved family relationships, feelings of empowerment, enhanced self-esteem, successful infant feeding, smooth postpartum adjustment and advice on family planning. Another nice benefit that I often observe during my classes is the development of peer support and friendships among class participants, which often continues after the class ends.

The following is a listing of the most common childbirth education models:

• Lamaze: introduced in 1951, based on French obstetrician Fernand Lamaze,  not just the “old breathing any more” – more a philosophy now than a method, promotes six fabulous care practices for laboring women;  www.lamaze.org
• The Bradley Method: husband-coached natural childbirth model, promotes avoidance of medical intervention and medications; www.bradleybirth.com
• International Childbirth Educators Association (ICEA): Promotes freedom of choice based on knowledge of alternatives; www.icea.org.  Some newer models include: HypnoBirthing (The Mongan Method): www.hypnobirthing.com and Birthing from Within, based on Pam England’s book.

Women need to take back birth once again!!!!! But childbirth education must meet women on their own terms and help them understand the power of normal birth in ways that are relevant to them. Childbirth educators need to help the childbearing family sort out the wealth of both accurate and inaccurate information that is available to them via the internet and the media.

At Princeton Midwifery Care we provide information on all childbirth classes, both hospital-based and private sessions. In addition, we offer childbirth and breast feeding classes in the convenience of our offices.

To get a convenient appointment with one of our four midwives or information on childbirth classes, please call (609) 896-0777 Lawrenceville or our new East Windsor office at (609) 336-3266.