In my previous post in this series on childbirth education, we explored reasons why it’s important to take childbirth education classes during pregnancy, but what does a high-quality class include?
There are a number of different approaches to childbirth education and different organizations that teach and certify childbirth educators, but there are a few important elements that every high-quality comprehensive childbirth education program contains. The goal of childbirth education is to prepare you for the experience of childbirth, which is physically and mentally demanding, and emotionally charged. A good program will address all those aspects of the birth experience. It will also provide the time and support you’ll need to integrate what you learn in class into practices that will actually stick with you when you go into labor. Here’s what to look for:
The health of the mother and the health of the baby are top priorities for expecting parents, so the information in the classes should be based on the latest available evidence about practices that achieve that end.
Focus on Physiologic Birth
Pregnancy and childbirth are normal biological functions of the female body which, when allowed to unfold undisturbed, are most likely to lead to healthy outcomes for mother and baby. Classes should teach how the normal process occurs. This information should include discussions about:
- The physical and hormonal processes involved from initiation of labor, through the various stages of labor, the initiation and continuation of breastfeeding, and through postpartum recovery.
- Normal labor patterns, both physical and emotional
- How to identify when something is no longer normal
Labor Management Techniques, or Comfort Measures, Including Deep Relaxation
There are a number of techniques that can be employed throughout labor to help it progress effectively and in ways that are manageable. Classes should teach a variety of techniques, as the more “tools in the toolbox” a laboring woman can draw from, the more prepared she will be for the variations that may occur during labor. Deep relaxation is an important skill that should be included and takes time to develop.
Typical Interventions and Their Benefits and Risks
Not all labors stay within the range of what is considered “normal,” and there are typical interventions that care providers might suggest or might be necessary during labor or delivery to reach a healthy outcome for mother, baby, or both.
Expectant parents should learn about these interventions, including induction, electronic fetal monitoring, IV fluids and restriction of food and drink during labor, use of antibiotics for women who test GBS-positive, augmentation of labor, pharmaceutical pain relief options including narcotics, epidurals and nitrous oxide, episiotomy, use of vacuum extractor and forceps, manual removal of the placenta, and cesarean surgery.
Newborn interventions discussions should include early cord clamping, skin-to-skin contact, suctioning, use of oxygen, vitamin K, newborn blood testing, Hepatitis B vaccine, antibiotic eye ointment, bathing the newborn, introduction of infant formula or glucose water, and NICU admission.
Patient’s Rights and Working with Care Providers
A high-quality class will teach clients about their rights as patients, and teach skills for working effectively with care providers within the medical setting. These skills are important for getting individualized care within a sometimes-overwhelming setting.
A Supportive Learning Environment
5 to 6 couples is an ideal size for a childbirth education class, with 12 couples being the maximum. Parents should feel comfortable sharing their thoughts and concerns, learn from each other, and begin to develop relationships with others going through similar experiences. Private classes are another option. Although they lack the peer-to-peer learning, they create a deeper connection with the instructor as a resource.
Extended Contact With the Material and the Teacher
It takes time to digest information and to learn skills and techniques. The minimum investment of time for effective childbirth education is 12 hours, with most high-quality classes taking between 18 and 24 hours, spread out over a number of weeks. This extended contact gives you time to do research outside of class, process what you learn, practice and develop the skills, like relaxation, that will help you manage labor.
These are the core elements that are contained in high-quality comprehensive childbirth education classes. Other topics might include pregnancy and breastfeeding nutrition, newborn care, communication skills for couples, community resources, managing the emotional demands of becoming a parent, and cesarean prevention. There are also classes that deal with specific concerns, such as multiples, VBAC, and chronic health conditions or disabilities.
Some courses might offer high-quality instruction on one aspect of childbirth preparation, such as relaxation or handling the emotional aspects of the experience, but not provide comprehensive education as described above. If you are drawn to take such a course, make sure you get the other education components from another high-quality source.
The point of taking childbirth education classes is to prepare you for the momentous experience of bringing your baby out to the world from inside your body. It’s fashionable now to take a one-day or weekend class at the hospital. This may mean you can check that preparation requirement off your list as done, but quick classes tend to cram in lots of information that you’ll quickly forget, and don’t allow the time and connection with the information for deep learning. The high cesarean rate, rising rates of birth trauma and PTSD, and rising maternal and infant mortality rates suggest these short classes aren’t providing all the necessary information and skills to come away from birth with a healthy baby and a healthy mother. A greater investment of time and effort is required to see those kinds of outcomes for more families.
Taking a high-quality childbirth education course can’t guarantee a healthy birth for mother and baby. It can provide the information and skills to manage a normal, healthy labor and make informed healthcare decisions if things become more complicated.
Read the next post in this series on childbirth education.
Michal Klau-Stevens is The Birth Lady. She is the creator of the Mastering Maternity™ system, a program that helps expectant parents confidently approach pregnancy, birth, breastfeeding, early parenting, and navigating the maternity healthcare system. She is a maternity consultant, pregnancy coach, consumer advocate on maternity care issues, Past President of BirthNetwork National, Lamaze Certified Childbirth Educator, and mother. Her website is TheBirthLady.INFO. Find her on Facebook at The Birth Lady page!
Click here to receive a FREE mini-guide by email and to receive more tools and information on mastering maternity.