Extrapolating: A "SMH" Moment for Childbirth Education!

I recently came across this photo on my Facebook newsfeed.

www.theperfectbirth.com 

I sat there a few minutes and, in a mindset that my high school Algebra teacher would have loved, tried to reverse the statistics.  If 2/3 of the guidelines for medical practice that OB/Gyns use is not based on evidence- based science, that means that only 1/3 of the guidelines for medical practice that OB/Gyns use IS based on evidence- based science.

Then I went on to apply this to a human relationship:  if your partner in a relationship was only honest with you 1/3 of the time, would you stay in that relationship?

Wow, I thought, that really changes the perspective!  And if a person WOULD stay in a relationship like that, WHY?

Extrapolating, why would you want to stay in a relationship where someone lied 66% of the time?  And why would they lie 66% of the time anyway?  To make themselves look better?  To lure you? To protect themselves from....? To hide what they are doing?  Are they too afraid to admit they don't know the truth?

Now, return from that tangent and refocus on maternity care.  Here are the facts:

1. 23% of discharges from US hospitals are childbearing women/newborns.
2. The preterm birth rate has only enjoyed modest decline - .1% over the last year.
3. Low birthweight births continue to rise.
4. The US maternity morbidity/mortality stats are not improving.
5. The US infant morbidity/mortality stats are not improving.
6. The US cesarean rate is still climbing.
7. The state of non-nurse midwifery is out of control (I am not implying legislative control, here).
8. The number of "drive through" childbirth education classes are increasing.

Since "we" are not practicing evidence-based maternity care and since "our" statistics are worse than 40+ other nations in the world...

WHAT IS KEEPING "US" FROM PRACTICING EVIDENCE-BASED CARE?

WHY DON'T "WE" CARE MORE ABOUT OUR FELLOW MAN AND FUTURE SOCIETIES?

AND WHEN WILL "WE" STOP BICKERING AMONGST OURSELVES AND DO SOMETHING?

Extrapolating again, why would you want to stay in a practice where someone lied 66% of the time?  And why would they lie 66% of the time anyway?  To make themselves look better?  To lure you? To protect themselves from....? To hide what they are doing?  Are they too afraid to admit they don't know the truth?

References:
*http://transform.childbirthconnection.org/resources/datacenter/factsandfigures/ 

What Parents Need and What They Want in Childbirth Classes: Is there a disconnect?

My experience as a Lamaze Certified Childbirth Educator has given me the opportunity to teach in a variety of venues.  I began teaching at an adult school affiliated with a high school in a rural California, to a community college on the Atlantic coast of Florida, to private classes in Los Angeles, to volunteer teaching on an Air Force Base, to teaching for three hospitals, and finally back to private teaching now in Ohio.  From my Lamaze Seminar Trainer, Harriet Palmer, I learned that being able to empower women and families through research based information (or the truth) was the most valuable teaching tool.  And even though I had to leave one of the hospitals because I wanted to teach the truth and resisted censorship, I can still look myself in the mirror and be proud of the educator that I am.  I personally and professionally have fought against co-optation.

Birth professionals who have been active since the 60s and 70s will no doubt remember the writings of Eugene Declercq in the Birth & Family Journal (now the BIRTH journal) and Polly Perez and myself in Lamaze's Genesis, pointing out the side effects of co-optation....when former community based childbirth education classes become part of the hospital revenue stream.  The fear then was that childbirth education classes would be censored, restricted, condensed and basically not resemble anything close to childbirth education.  They would be, in a sense, what to expect from THE HOSPITAL while you are in labor.

The time arrived and co-optation did occur as predicted and in most (yes, I say most because there are still a few hospitals who value evidence-based uncensored childbirth education classes) cases, there have been censorship, restrictions, and condensed versions.  In most situations, labor and delivery nurses are asked to teach childbirth education classes and I must tell you that nursing school does not prepare you to teach childbirth classes.  While it does prepare you to do snippets of education at the bedside, childbirth education is another animal altogether.  And in many cases, these labor and delivery nurses are not required to become certified childbirth educators in order to teach classes.

Why does this all of this matter?  It matters for several reasons:

• Co-opted childbirth classes are not in the best interest of the expectant parents.
• Certification DOES matter.
• Teaching informed decision-making and evidence-based information impacts everyone.
• Birth matters to the baby.
• Birth matters to the mother/parents.

Midwives are particularly suited to add childbirth education to their repertoire of services as they have had the emergent and normal/physiologic side of childbirth in their education....nurses typically do not receive the normal/physiologic information in their classroom studies.  Midwives can take the time to teach and explain thus empowering their clients to achieve and enjoy this once in a lifetime birthing opportunity; to not be rushed through a process which can leave a lasting imprint on a woman's heart and soul.

Educating expectant parents of today takes more skill and cleverness, resourcefulness and constant marketing.  Today's parent needs to be exposed to something nearly 10 times before acting on it, as opposed to the 3-4 exposures for parents in the 1980s.  Educators must make their classes timely, evidence-based and truly innovative to meet the ever changing learning needs of parents.  Parents still need the information, the evidence and the facts, but they need all of this in a concise package with minimal fluff and tricks ~ otherwise they get very bored very fast.

Get certified.

Become well-versed in social media marketing to reach the parents of today.

Write your own curriculum - tedious, yes but more valuable than you can ever imagine!

Evaluate your curriculum including the dates of the evidence for topics as well as the teaching strategies.  

Remember we aren't in Kansas anymore Dorothy and the bottom line is we can't teach like we are!