Childbirth Education in Real Life
Nancy Halseide is our new editor for Midwifery Today. We are very excited about having her expertise, which includes having taught high school English for a decade. She brings a kind and loving heart, as well as a gift for words. The other exciting part is she has been a childbirth educator and sometimes doula for the past five years. It is enjoyable to have another childbirth professional to plan with! She has written the guest editorial for this issue of E-News. Feel free to e-mail her at: email@example.com. —Jan
The Internet has become a place where we can learn skills and acquire vast amounts of knowledge. I learned how to make homemade Christmas ornaments, my daughter learned how to finger crochet and one of my former high school students learned how to do a back flip all from watching YouTube videos. Many couples these days are even learning about how to give birth from articles on the Internet, instead of attending childbirth classes.
So what is the big deal? If you can learn it all from the comfort of your own home, why not learn about the different stages of labor from online articles, or better yet, why not take an online pregnancy class? Well, speaking as a mom and a childbirth educator, I have some strong feelings on this topic.
First of all, let me tell you what students have said after taking a series of childbirth classes. A mom-to-be said, “This class helped us through so much not only by teaching us what to expect with our pregnancy and labor but by also providing us with resources for after the baby was born! When we were expecting our second baby, we took the class again for the wonderful experience and because we loved the idea of having time each week dedicated to our baby on the way.” And a dad-to-be shared this, “I learned so much! I came into this clueless. Now I can help because of what I learned.”
When my husband and I were pregnant with our first baby, we were fairly uneasy and somewhat frightened by thoughts of labor and delivery. We chose to take natural childbirth classes that were recommended to us by a friend. Boy, are we ever glad we signed up! The childbirth classes were packed with information that was enormously helpful. The class focused on the stages of labor, skills to handle the sensations of labor, and how to avoid interventions and unnecessary pain. Once the 12 weeks were over (yes, our childbirth class was three months long!) we were empowered, confident and ready for the amazing experience of birth. Because of that class, I decided to become a childbirth educator myself.
I have come to love the information I share with couples, but when I look back on our childbirth education days (nearly seven years ago, now), my most treasured aspect of the class was the friendships I formed. Tracy, Tori, Jamie and Nancy became a magic foursome that later included Jenna, our “adopted” friend who didn’t take birthing classes with us, but shared many of the same parenting ideas we did; we were “The Mommas and Babies.” Because of those three months—the special months of preparing to be mothers—a special bond was formed between us. The focus in pregnancy can be so geared to the day/s of birth, that once you have that little baby in your arms, you think “Now what?” That group of women helped me with the “Now what?” questions that came with parenting our little bundle of pink.
Yes, childbirth education is a necessary step in preparing yourself for the birth of your baby, but forming a community with other parents in the same stage of life is important, too. The Mommas and Babies have dispersed due to job changes that resulted in moves, but we still keep in touch and look back on those first years of motherhood together with so much joy and thankfulness. My birthing experience and the first years of my daughter’s life were so much richer because of the dialogue, friendships, information, and person-to-person experiences that came as a result of our childbirth class.
Nancy Halseide is the managing editor for Midwifery Today and mother of two beautiful little pearls. Nancy is also a childbirth educator and co-owner of Eugene Birth Education.
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Jan Tritten is the founder, editor-in-chief and mother of Midwifery Today magazine. She became a midwife in 1977 after the amazing homebirth of her second daughter. Her mission is to make loving midwifery care the norm for birthing women and their babies throughout the world. Meet Jan at our conferences around the world, or join her online, as she works to transform birth practices around the world.
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The 2011 CNN Hero of the Year award was recently presented to Robin Lim, an American woman who has helped thousands of poor Indonesian women during pregnancy and birth.
Lim, often called “Mother Robin,” or “Ibu Robin” by the Indonesian locals, offers free prenatal care, birthing services and medical aid in Indonesia where many families cannot afford care.
‘"Every baby’s first breath on Earth could be one of peace and love. Every mother should be healthy and strong. Every birth could be safe and loving. But our world is not there yet,” Lim said during the CNN tribute.
Lim believes the high maternal and infant mortality rates in Indonesia are caused by the high cost of maternity care. The average family’s income in Indonesia is equivalent to $8 a day, according to the International Monetary Fund. A delivery costs about $70 at a hospital, and a cesarean can cost as much as $700. Most Indonesian women simply cannot afford these high prices and instead go through pregnancy and birth without proper care.
After an 11-week vote on CNN.com, Lim was chosen by the public as one of ten heroes. For being named Hero of the Year, she will receive $250,000 for her cause, which is in addition to the $50,000 that Lim and the rest of the heroes each received for making the top 10.
— Almond, Kyle. “‘Mother Robin’ wins CNN Hero of the Year.” CNN. December 27, 2011. http://www.cnn.com/2011/12/11/living/cnn-heroes/index.html?hpt=hp_c2
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When Childbirth Education Causes Anxiety
As childbirth educators, we continually face this question: How should we deal with important information that raises anxiety in our students? Should we avoid such topics and risk later criticism? “I was not prepared for complications, or transfer to the hospital, or a cesarean, or stillbirth…. If I had only known about fetal movement counting or about prolapsed cord….” Or should we discuss such topics, even though our students may worry and fret about things that are unlikely to happen to them? “I’m more scared now than I was before I took the class!” Do we want to protect or prepare our students in childbirth classes?
I believe it is okay—even desirable—to raise anxieties in the course of teaching relevant information if: 1) the woman’s or couple’s knowledge can make a positive difference in their experience; 2) we provide constructive ways to deal with the problems discussed; and 3) the problems arise fairly often. Therefore I have no doubt that topics such as labor pain, labor complications, hospital transfer, various interventions and cesarean section should be discussed.
But my dilemma comes when the problem is rare as is late fetal death or stillbirth and prolapsed cord. I would appreciate readers’ opinions on how to handle these topics.
I advocate formal daily fetal movement (FM) counting not only to those who are postdates or who have some high-risk condition, but to all my class members during late pregnancy. I even provide a form to help them keep track of their baby’s activity. I do this because FM counting has been shown to result in lower infant mortality (1,2) [although one scientific trial showed no benefit (3)]. It costs nothing, can be done daily and is convenient and easily performed. The main disadvantage is that it asks women to focus daily on the slim possibility (1 in 100) that their baby may be doing poorly. It may make them anxious. Of course, in teaching about FM counting, I emphasize that by setting aside some time each day to focus on their babies, they learn a lot about their baby’s sleep-wake patterns, various types of movements, position within the uterus, and more. These side benefits, however, do not hide the fact that I am raising the possibility that their babies might die.
- Neldham, S. 1983. “Fetal Movements As an Indicator of Fetal Well-being.” Dan Med Bull 30 (4): 274–78.
- Moore, TR, and K Piacquadio. 1990. “A Prospective Evaluation of Fetal Movement Screening to Reduce the Incidence of Antepartum Fetal Death.” Am J Obstet Gynecol 160 (5): 1075–80.
- Grant, A, L Valentin et al. 1989. “Routine Formal Fetal Movement Counting and Risk of Antepartum Late Death in Normally Formed Singletons.” Lancet 8659:345–49.
— Penny Simkin, PT
Excerpted from “When Childbirth Education Causes Anxiety,” Midwifery Today, Issue 18
Midwifery Today Issue 18 is out of print. Look here for a complete list of available back issues.
Expanding your personal library?
How about expanding your local library with books that encourage natural and instinctual birth? How much information about natural and instinctive birth is at your library? As a patron of a library, you have a say about what books they carry. Let your library know you want natural birth and midwifery materials to be available.
Your library is your resource. Use it.
Let Miss Margaret inspire you!
|Margaret Charles Smith caught her first baby when she was five years old, then went on to become one of the last great “Granny” midwives in the United States. Watch this DVD to learn about the woman Ina May Gaskin called a “national treasure.” You’ll be inspired by her courage, perseverance and motherwit. To Order|
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Midwifery Today Back Issues have the information you need!
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Read these articles from Midwifery Today magazine recently posted to our Web site:
- Fetal Demise: Helping a Mother Cope with Her Pain—by Jude Stensland
Excerpt: When I arrived, I immediately scanned the quiet tummy. Lydia watched the screen with a worried expression. I could find no cardiac movement. Finally I put away the probe and moaned, “Lydia, I am so sorry, the baby is gone.”
- Midwives and Cytotec: A True Story—by Marsden Wagner MD, MSPH
Excerpt: Midwives must find the strength and courage not to be sucked into practicing a more interventionist type of care—resist the temptation to become a “medwife.”
- How Aphrodite, Buddha and Jesus Developed Their Capacity to Love—by Michel Odent
Excerpt: Until recently, love was the realm of poets, philosophers and holy scriptures. But at the end of the twentieth century, love also has been studied from multiple scientific perspectives.
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Q: Can you give us some good tips or tricks of the trade for teaching childbirth education?
— Jan Tritten, on Facebook
A: I think women often feel restricted or awkward making noises during childbirth. It may be the most helpful of classes where a woman and her partner practice moaning (not just breathing)...loud, deep, quiet, long, etc. The childbirth education leader should guide the mother through what I would call “the sounds of labor”…not only does it break the ice of the classroom, but it can open new doors for labor pain management—helping the mother become more open and comfortable to the sounds and movements that can really help move labor along.
— Jill Coleman
A: I teach childbirth education primarily to teen moms and I find that it helps to be approachable to parents. I try to explain things in terms that are easy to understand and I encourage questions to be asked and for my students to participate during the classes. I also think that props are extremely helpful. My favorite props are small cans of Play-Doh which I give to each student in order to demonstrate cervical dilation and effacement.
— Abby Lindsey
A: You have to live what you teach. Information is cheap—authenticity is what changes people.
— Denie Heppner
A: Props! I have found that teaching hands on with birth balls instead of chairs keeps them comfortable and in optimal positions which translates to labor. Games to help remind them of the goals they have like changing positions (pregnant Twister!) and blowing on a candle steadily and lightly to wave the flame but not blow it out teaches control of breathing to help breathe baby down and out. These are things that can be brought to the labor to help them focus and remember what they learned. I have dozens of these things!
— Kaye Squad
A: Lots of hands-on manipulates—get Dad/partner involved—few lectures and more interactive activities.
— Leah Racicot Kohlstrom
A: We discuss vegan or vegetarian diets and how to make sure everyone is getting enough iron, calcium and B vitamins (we discuss animal, dairy and veggie sources) and supplements (I highly recommend dandelion to enhance blood flow and keep healthy blood pressure) and a send them home with recipe for mother’s milk cookies and talk about herbs to help with lactation. Being an LLL leader I will separate the women from the men, show breasts and talk about proper latch.
— Ann Noviello
A: Using rubber bands with varying thickness to explain why early labor takes a while. The thickest rubber band takes quite a bit of effort to stretch and open…that’s what your body is doing over many, many mild contractions. As the rubber band gets thinner and thinner, it takes less and less effort to open out. And, you get that “A-ha” moment. Couple this with the 5 Ps of labor; it is perfect to get them to understand why labors vary, and why they should be patient with themselves in labor!
— Vijaya Krishnan
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During pregnancy, a lot of women do not feel it necessary to take a childbirth class, or even pick up a book to read about childbirth in general, and I wholeheartedly believe that this accounts for a large portion of negative or less than ideal birth outcomes. Many think today that you can just waltz into a hospital and have an amazing experience because the birth of any child is such a joy-filled occasion. Unfortunately because of the state of maternity care and hospital births in our country, the one-size-fits-all style of experiences because of “hospital protocol” leads to something which I personally like to compare to a factory conveyor belt.
— Danielle Elwood, birth advocate, aspiring midwife, mother and wife
Childbirth education has been shown to reduce women’s pain and anxiety as they approach childbirth, and is associated with a more satisfactory birth experience. A landmark national survey found that most mothers reported a better understanding of their maternity care options, and communicated better with their caregivers following participation in childbirth classes. An expert panel on the content of prenatal care convened by the US Public Health Service recommends a formal series of prepared childbirth classes conducted by a certified childbirth educator for all women.
— Indiana Perinatal Network, an organization seeking to improve the health of all mothers and babies
Although many women have had multiple babies, as first time parents, or maybe even second time parents, we are extremely nervous. There is nothing like education to alleviate fear. Fear is typically the absence of knowledge and once one understands something, fear will go away. Prenatal care and childbirth preparation should be on the top of your list to help you alleviate that fear. As preparation for this experience, education is first needed…. Being emotionally prepared may not be something that you can learn except through experience. Support and knowledge is empowering.
— Meagan Hughes, doula, childbirth educator and mother or two
If you’d like to share a bit of wisdom from the Web, please send a 4–5 sentence excerpt, accompanied by a link, to firstname.lastname@example.org.
Harrisburg, Pennsylvania, April 11–15, 2012
Our wonderful midwives from Ghana are planning to come to the Harrisburg, Pennsylvania, conference. They are a delightful group of midwives, many of whom have joined us at past conferences in both Eugene and Germany last year. One of our very important goals with the conference is to nurture you in your journey. We want you to be able to take the inspiration and knowledge you received from the conference and go back to your community and put it into action. We have amazing teachers who join us to teach, nurture and share with you, though the registrants you meet and make friends with are the other high point of conference. Bring your address book or cell phone to keep track of your new friends.
We are also getting really excited about this conference because we feel we have a really rich program which should be enlightening to all who attend. We get to enjoy Ina May and Stephen Gaskin again. Both of their teachings are inspiring. There is a nice cultural component to the conference with speakers from many countries as well as Amish and Mennonite Midwives. The world is truly becoming more connected in birth and midwifery ways as we are all making discoveries of “people treasures” in our travels. We will bring you many of these jewels in both the people who will be there and the information taught. Don’t miss this inspiring opportunity to come to one place where we will bring the world’s amazing birth practitioners to you. See you there! midwiferytoday.com/conferences/Harrisburg2012/
Toward Better Birth,
From a simple holding of hands to an elaborate full-body massage, touch is the foundation and heart of midwifery care. “Midwife” is Old English for “with woman”; to be with means to be in contact through touch, not simply close or nearby.
— Kara Maia Spencer, LMP
Excerpted from “The Primal Touch of Birth; Midwives, Mothers and Massage,” Midwifery Today, Issue 70
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