Friday, May 29, 2009

Natural Childbirth Classes Offer No Special Benefit Part 2

If you teach childbirth education classes OR are a doula, be prepared for a flood of questions about the new Swedish study discussing childbirth education. The British Journal of OB/GYN has published the full text version of the study and the study makes some sweeping statements.

However, I will try to dissect it all down for you - first and foremost, READ the entire study. And be prepared to work with the facts about the study and the value of childbirth education. Be sure also to listen to the 5 minute interview between the co-author of the study and Belinda Phipps of the UK National Childbirth Trust.

1) The sampling is small, only 1087 women over 1.5 years and in one geographical location. This calls into question the statistical significance where broad statements are made.

2) The educators were all midwives. However, there is no mention of these midwives being childbirth educators, having taught childbirth education before, or being trained or certified by any childbirth education organization. Those who have been trained and certified as childbirth educators are well versed in the methods of adult learning/education, can provide memory hooks to aid in informational retention AND the passion to present objectively all of the information an expectant mother and her partner would need to make sound decisions based on the information.

2a) What was the belief system of the educators? Do they believe what they are teaching? Did anyone monitor voice inflections and body language?

3) Flow Chart #2 provides some significant questions about the model of education given to the "natural childbirth" classes. Omitted from the "natural classes" was the Risk/Benefit model of teaching where interventions, complications or birth plans with exploration of expectations could be discussed.

4) Also missing from the "natural classes" were the films. What films were shown? What was the tone of the films?

To me, if a study is to make broad statements that could impact a woman's birth experience, the EXACT same classes should have been taught to the expectant participants sans only the psychoprophylactic information. As a Lamaze certified childbirth educator for over 30 years, I would energetically challenge the validity of this study based on the 4 comments above.

It is important to note that this study should not be embraced immediately without further study and much tighter/more accurate models of education.

As an aside, Doulas have enjoyed nearly 25 years and over a dozen studies are still are not fully embraced.

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