Friday, September 11, 2015

Is this what happens when there is no childbirth education?

For many of us, childbirth education has always been available.  From 1960, when the International Childbirth Education Association first began, parents have had the opportunity to have a guide through the maternity jungle.  Educators have provided the latest information to parents without the parent having to sift through mountains of research and medical speak.  

When parents, who are also consumers of medical care, are equipped this information, change happens.  The parents ask for information and they ask for changes in the traditional way of care.   Educators do not just reach parents.  Educators also reach out to health care professionals in hospital settings, helping them become informed of the latest in research. Then, as professionals become informed, permanent change occurs.

When change based on research occurs, care truly improves.  But it is not just about the care provided......the outcomes also change, for the better!  Specifically in the US, is it any wonder why the cesarean section rate is stable at 32%, and maternal/infant morbidity/mortality rates are not improving?  Is the answer that only 33% of all expectant women attend childbirth education class?

If we assume that the 33% statistic for childbirth education class attendance is accurate, what is happening with the other 67% of expectant parents?  Some may be readers, yet may also obtain information that is biased in the reading material (whether in a book, magazine or online).  Others may rely on television as their source of information, not understanding the sensationalism with which television shows include.  Still others may rely on their care providers to give them information.  It is well established that in the US, physician office visits last an estimated 6-12 minutes, there is little time for teaching or questions/answers in such a short period of time. 

Therefore, it could be assumed that some of the 67% of parents will not receive any education. If there is no education, there may be no questions asked, no information sharing and no plans for an individualized birth.  Birth procedure stays at a status quo, the way that it has always been done, and thus care may not be aligned with the latest information.  Without childbirth education, especially in the hospital setting, preparation classes become more of hospital orientation classes with much less emphasis on birth empowerment.  If there is no knowledge, there is no understanding.  Cesareans rates rise, breastfeeding rates drop.  While this is not evidence-based, it is certainly anecdotal.

A study done in 1995 indicated that women who had attended childbirth education classes scored significantly higher than women who had not attended classes in the areas of self-actualization, health responsibility, exercise, nutrition and interpersonal support.  Over 75% of women in this study felt their confidence for labor and birth had increased and over 91% would recommend classes to their friends.  In another study, 52% reported that information on pain medication influenced their decisions about pain relief.

While research outcomes contain variations that prevent definitive declaration that childbirth education is vital, studies do demonstrate the overall value of childbirth education.  As stated in the closing implications by Kloen, "if the goal of childbirth education is health, then this is an important area of research for promoting not only the value of childbirth education but also that of childbirth educators as health professionals."


Handfield B, Bell R. Do childbirth classes influence decision-making about labor and postpartum issues? Birth1995;22:153–160. 

Jackson C. P. The association between childbirth education, infant birth weight, and health promotion behaviors. The Journal of Perinatal Education. 1995;4(1):27–33.

Koehn, M. (2008). Contemporary Women’s Perceptions of Childbirth Education.The Journal of Perinatal Education17(1), 11–18.

Koehn, M. L. (2002). Childbirth Education Outcomes: An Integrative Review of the Literature. The Journal of Perinatal Education11(3), 10–19.

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