As a veteran childbirth educator, I am always being asked by newer childbirth educators what are the most important topics in a childbirth education class! That can be an easy yet difficult topic. It can be easy because there are so many topics that should be covered to adequately inform expectant parents. Yet, this question can also be difficult because of time constraints imposed on the educator.
Below are the first 5 top topics of 10 frequently requested by the expectant parents:
Should I really go to childbirth education class? If so, how do I choose which one?
|Jamilla Walker RN|
The Labor LadyGets Pregnant
Childbirth classes are designed to provide factual answers to questions. The classes should the parents a complete understanding of the process of birth and techniques that will help them through that process. Childbirth education is far more than learning to relax and breathe through contractions. When we understand the birthing process then we are better able to work with our bodies and not against them.
Choosing an Educator It is important to take the time to inquire about the qualifications of a childbirth educator prior to attending their classes. Certified childbirth educators should go through an intensive training course and demonstrate competency in teaching and in childbirth. Parents should not be afraid to ask for references or to see past course evaluations. Note: they don’t teach how to be a teacher in nursing school. So because a childbirth educator is a nurse, doesn’t always mean she is a good educator.
When choosing a class, determine whether the class is consumer oriented or provider oriented. Consumer oriented classes tend to encourage expectant parents, the consumer, to take an active role in choosing the options desired for the birth. Provider oriented classes tend to inform parents as to the care and procedures they can expect from the hospital and your doctor during childbirth, sometimes with little emphasis on alternatives.
Private or Group Class Once they have choosen the childbirth educator, then they should determine whether to have private instruction or be part of a group class. Private instruction allows for more flexibility and individualization. Classes are arranged around their schedule and greatly benefit those who are not able to attend the weekly group classes. Moreover, private classes can benefit those who may have apprehensions about being involved in group activities. Also, private classes allow personal questions to be asked that otherwise may not ask in a group setting. Some private classes are taught in the comfort of their home. This especially benefits those women on bed rest. Private classes will cost a little more, but it may be worth the difference.
Group classes greatly benefit those who prefer to meet other women or couples who are also pregnant. Group discussions on issues related to childbirth are common and oftentimes invigorating. Many hospitals offer group classes so parents can become familiar with the policies and procedures of the hospital in which they plan to give birth. This affords them opportunity to know what options are available and what they can expect during their hospital stay. Since the class members have similar due dates, they may even see them in the hospital during or after the birth. These friendships can last long after the birth of the baby.
Types of Classes There are a variety of childbirth classes available to you. The most common is the basic childbirth preparation course consisting of at least 12 hours of instruction. There are also weekend courses that can help those on a busy schedule. The refresher course benefits those who've previously given birth and the teen course is especially designed to address the needs of pregnant teenagers. Some childbirth educators also offer hourly consultation for those who have questions to ask but don't necessarily want a structured course. This, however, is not advised for first-time moms or teenagers. Take the time to review the contents of each course to determine which course is best suited for you.
Bottom line: Know who all of the childbirth educators are in your community and what method they teach. Be able to give referrals freely to Lamaze childbirth educators, independent educators, hypnobirthing educators, Bradley teaching couples, hospital classes, etc.
Pregnancy wellness and the impact on labor/birth
Length of childbirth education classes often dictate what topics and to what extent topics are covered. Unfortunately today, expectant parents feel like they cannot afford the time to take childbirth education classes – they are just too busy. In answer to this feeling, hospitals have shortened and shortened childbirth classes to where some classes are only 4 – 8 hours long: one day. Some educators call these brief experiences “drive through” classes, because the exposure to information is so incredibly brief.
Topics usually on the chopping block first are those of pregnancy wellness, nutrition, exercise and stress reduction – and their impact on labor and birth. Wait….if all of these topics impact labor and birth and are left out of a curriculum …..are educators short changing parents? This is a bold statement, but the answer is YES.
How to teach this topic? Explore the new My Plate information on nutrition (http://www.choosemyplate.gov/foodgroups/downloads/MyPlate/SelectedMessages.pdf) , exercise (http://www.mayoclinic.com/health/pregnancy-and-exercise/PR00096), and stress relief during pregnancy http://womenshealth.about.com/cs/pregnancy/a/mispregstress.htm. Evaluate what you can actually teaching within the time boundaries of your class and what you can afford to put into handout format. Be a good resource for community based referrals also such as pregnancy exercise or pregnancy yoga classes!
What will labor really be like?
This topic can include the Stages and Phases of labor, cervical dilation and effacement, pelvic station, cardinal movements, intensity of labor contractions, time variations within the stages and phases, emotional and spiritual changes in the laboring mother, physical changes in the laboring mother….this can be a really inclusive topic! Be certain to include the topics of fear and pain. These are two elephants in the room that are fed healthy diets by many cable TV shows about pregnancy and birth. The pain of labor must be differentiated from, for example, the pain of a headache or muscle strain.
How to teach this topic? You can use a variety of teaching strategies including lecture, interactive discussion, handouts and visuals such as charts, models and videos.
What are my options?
For many women, childbirth is their first experience in a hospital. It might also be their first healthy experience with a hospital – if family or friends have been previously admitted into a hospital when sick or injured. It is vital to address the fact, prior to exploring options, that pregnancy is an experience of health. It is not like other events of hospitalization where one is ill. Therefore, a laboring mother and her partners’ options are greater. Options include choice in physical comfort (such as positions, labor apparel worn, massage/touch etc), support (including partner support, doula support, family support and genuine emotional support from hospital staff), coping strategies (including breathing, relaxing, guided imagery, focusing, touch/effleurage, aromatherapy, water therapy, music, spiritual support), educational support (proactive reading and attendance at childbirth education classes).
How to teach this topic? A firm foundation of comfort measures meshed with an equally firm foundation in anatomy and physiology of labor/birth leads to a conversation of informed consent. This powerful topic, informed consent, lays the ground work for patient satisfaction in the entire birth experience. Research shows that the degree to which a laboring woman feels that she is a vital role in the decision making process of labor/birth, increases her satisfaction with the process and positively impacts her parenting. Lecture, guest speakers (other parents), videos, group discussion/brainstorming, and handouts may all be utilized.
What can I expect when laboring/birthing in the hospital?
The reality of nurses carrying multiple patient loads is a topic that needs to be covered in any childbirth education class. This is a reality that may not be on every expectant parents’ radar. Likewise, typical/routine interventions such as electronic external or internal fetal monitoring, medication for induction/pain management, mechanical induction methods, and the latest evidence-based information regarding routine birth/newborn procedures. It is quite possible for a rousing discussion of “why do they still do that if it is not evidence-based” might follow any lecture situation on routine birth/newborn procedures. Keep your objective teacher hat ready and avoid letting your personal/professional biases show. Let the evidence speak for itself.
How to teach this topic? Not only do you need a great objective teacher hat but also a great poker face for this group of topics. Here, more than anywhere else, your biases will show. The separation between a childbirth educator and a great childbirth educator is the great childbirth educator presents the topics with the current, up-to-date evidence-based research and the class members have no idea of any bias. Borrowing from the Fox News Channel motto “we report, you decide”, would be a good way of keeping professionally focused on this topic. If you have a strong bias and poker faces are not your strong suit, use videos (such as Healthy Birth Your Way – free download at http://injoyvideos.com/mothersadvocate/videos.html), handouts (see same website for excellent handouts) plus group discussions….as long as you feel comfortable coping with hot topics and charged personalities.