Why Childbirth Education Teaching Strategies Need to Change

Who is the person in childbirth education classes now?  

Gen X and Gen Y - the two most tech savvy generations, who also use social media and online learning to expand their knowledge base.

Unless guided to evidence based websites and blogs, even the most knowledgeable expectant Gen X or Y will still have a solid element of fear.  Hard to believe, studies are showing that women are not exposed to normal, uncomplicated vaginal births in the media (Morris & McInerney, 2010).  These same women may be unaware of childbirth education philosophies and practices that support low/no intervention births or physiologic births. This along with the rising cesarean rate, elective induction rate and high epidural rate, this makes for an evidence-based information dissemination nightmare.

According to Dr. Julia Kish-Doto, women of childbearing age rely heavily on social networks for health

information including childbirth knowledge.  By using social media to expose Gen X/Y to physiologic birth concepts, we may increase awareness of physiologic birth and decrease the fear factor.

It is also important to point out that women and especially mothers are the major influencers on their family units in regards to medical care.  If they do, in fact, rely on social media for information about pregnancy, birth, infant feeding and other medical issues, as childbirth professionals, this has become a mandate for us to assimilate social media into our education/teaching strategies.

Childbirth education using social media has a major advantage to the typical childbirth education classes: information can be accessed at ANY time day or night.  Information regarding newborns, breastfeeding and postpartum issues are available at 2 a.m. as well as 2 p.m.

We have a unique opportunity to wage a dynamic and comprehensive information campaign that can change the way our society looks at childbirth.  May is coming up and contains Mother's Day (May 12) and International Week for Respecting Childbirth (May 20-27).

What if, for one week, we all joined together in one gigantic media campaign to set right the information about childbirth, physiologic birth, evidence based information?

Imagine...........

References:

Kish-Doto, J. RUprego? The Role of Social Media to Educate Young Women about Low Intervention Childbirth.  Cases In Public Health, Communication & Marketing. Vol IV, Summer 2010.

Morris, T. and Mclnerney, K. Media representations of pregnancy and childbirth: an analysis of reality television programs in the US.  Birth 2010; 37(2): 134-40.

They All Want You To Ask The Hard Questions But They Don't Want To Hear The Answers

It isn't easy being an advocate for evidence-based maternity care.  

Why? Because it an advocate speaks the truth...the evidence-based truth.

On the surface, the "they" we all encounter want to have best practice.  They want to jump through all of the hoops to be a Local Leader or Credentialed, Certified or Approved.  Being an advocate involves asking
"them" the hard questions.  Hard questions such as why is that a practice guideline or what evidence is used to substantiate it.  But rarely do "they" want to hear that "their" best practice is not evidence-based, in the best interest of mothers and babies.

"They" also really don't want their decisions or practices questioned even though they want transparency and want everyone's opinion to be heard and respected.  Of course, that is the statement that they repeat over and over but do not embrace and do not own.

Being an advocate is a lot like being a mirror.  "They" don't want to see their reflection.

Perhaps it is because their reflection is not one that actually solves any problems.  As mentioned before in countless entries of this blog, the statistical data on childbearing in the United States is not one that we can be proud of.  Our breastfeeding statistics are slow to improve but not at the rate that logic would have it.  When you examine the research, as was recently done in the outstanding book, Optimal Care in Childbirth: The Case for a Physiologic Approach, the research does not hold up both types of care models currently being used, the medical model and the physiologic care model.  To quote authors Romano and Goer, "The two models also diverge in whose needs and concerns take precedence.  The medical model centers around the doctor and institutional staff."..."In marked contrast, the physiologic care model puts the woman at the center.  Mother and baby form a single, inextricable unit; what is good for the mother becomes, by definition, good for the baby."

Seems simple enough right?  We need to put the health and well-being of mothers and babies first. Ignore the law suits and the economic incentives of long labors, the use of medication/anesthesia or admissions to the NICU.  Wasn't the fact that now with the Internet and easy access to the Cochrane Database and National Institute of Health, the era of evidence-based practice was to be the panacea of all of the problems with maternity care? Well, it hasn't been.

In searching for encouragement, I stumbled upon a rather lengthy excerpt from Optimal Care in Childbirth: The Case for a Physiologic Approach.  They write: "We, along with other advocates for maternity care reform, expected that evidence-based medicine would be the antidote to opinion-based practice.  Science, not what a Lancet editorial scathingly called "GOBSAT" - Good Old Boys Sat At Table - would dictate care practice." Yet contrary to our hopes, even the evidence has been used to substantiate medical management model.  But all is not lost, as I was beginning to feel and have seen others feel.  Romano and Goer continue, "Despite the deck being stack against physiologic care, we must not give up.  The stakes are too high.  The financial costs of medical management to society are enormous - just reducing the cesarean surgery rate to the World Health Organization recommended 15% would save $3.4 billion dollars annually.  The human cost is also enormous.  As a result of overzealous use of technology in labor and birth, millions of women and babies have suffered, and all to many have died.  Without a doubt, being a change-maker is likely to be frustrating and difficult, but when the health and wellbeing of childbearing women, babies, and society is at stake, no effort is too great, no accomplishment that forwards that goal too small."

I encourage you to read or reread Optimal Care in Childbirth: The Case for a Physiologic Approach as I did.  Shove the apathy out the door.  Grasp the mirror firmly in both hands.  Let's go.