June 3, 2011

Childbirth Education Classes Why? When? Where?

I am probably a bit biased about the importance of taking a childbirth education class given I am a certified Lamaze teacher. Given that, I am always surprised when a student asks me if this is something she and her partner really need to invest time and money in to. I try to be diplomatic with my answer and explain that it is a choice if one wants this information. My belief is that you cannot make informed and empowered choices if you don’t know what your choices are.

Most childbirth education classes are going to cover the essentials: the stages of labor, what to expect within those stages, the emotional signposts of labor, pain management techniques, how to involve your partner, interventions and complications, and a video showing of at least one vaginal birth. For many people, this could be their first introduction to interventions and complications, and they may be presented with choices they had never thought about. Once they have this information, the couple can start to determine what is important to them and then discus these points with their care provider before the birth process begins. (See 5 questions….)

If a woman has an idea of what to expect, it takes some of the fear out of this unknown experience (even if she and her partner simply learn the basics). For many women, their only encounter with birth is what they see on TV or in the movies, and these scenarios are often depicted as a scary emergency situation or a comical event. When fear is lessened, a woman may feel more confident in herself and her body’s ability to birth. A less stressed state will allow the natural hormonal system to work better, which may lead to less chance for intervention.

A few students have told me that their care providers said such classes are unnecessary since they – the doctor or midwife- will tell them what they need to know during the labor. From my experience as a labor support doula, I haven’t seen a doctor show up at the woman’s home and offer her pain management techniques or take the time to explain the pros and cons of labor induction, or show her comfortable laboring positions. My opinion- if given this advice from your provider, you may want to think of switching providers UNLESS you are 100% comfortable with your care provider taking the drivers seat.

When to take these classes?

I recommend taking the childbirth education class sometime during the 3rd trimester. Most care providers like to have “the big talk” about your birth choices around week 36. If you have taken your class and have had time to discuss and further investigate your options, you will be able to go into the meeting with your provider with a clear idea of your birth choices. (I try to stay away from the term birth plan, because most of life does not go as planned, but “choices” allows for more flexibility.) Also- keep in mind that full term is considered anytime after 37 weeks, so you may not want to wait that long.

If you are shooting to take your CBE class between 32 to 34 weeks, you need to sign up well in advance. I am speaking from my experience at the Prenatal Yoga Center, and from knowledge of many NYC birthing classes. Most of our CBE classes fill up about 2 months in advance, and we receive many panicked calls from people needing a class right away. Plan ahead of time!

Where to go for your class?
This really depends on the teacher. I have run into some situations where hospitals have had the same teacher teaching the CBE classes for many, many years and have not changed their approach or information. One student told me her teacher is still teaching the Lamaze rhythmic breathing. The Lamaze Organization stopped teaching that style of breath work quite a while ago.

Another concern I have with taking a hospital course is that the course may just cover their protocols, and not introduce you to the many options that are available. For example, if that hospital has a standing rule that everyone on the Labor and Delivery floor is required to have full time external fetal monitoring, the class may not discuss the option of intermittent monitoring, or the data and studies that suggest that it is better for low risk women. If the hospital holds strictly to “no eating or drinking once admitted to Labor and Delivery” the teacher may not share that ACOG (American College of Obstetricians and Gynecologists) has relaxed their stance on fluid intake other then ice chips. However, some teachers of hospital courses may not feel obligated to stay within the parameters of the hospital’s protocols and may offer more general information.

Overall I think that you get more diversity in taking an out of hospital class, and perhaps hear more options of birthing styles and ideas that could inform your birth choices. My husband and I recently took a class with 8 other couples. Out of those 8, many different hospitals were represented, a few couples planned to birth at the Birth Center, and one couple was planning for a home birth. Some of the couples that are birthing in a more traditional hospital seemed to enjoy hearing the options of a Birth Center. One mother even said it inspired her to talk to her doctor about trying to make the hospital experience more like a birth center approach.

Aside from thinking about our birth choices, it seems that there are a million other things to think and learn about! For example, my husband and I spent days talking about, researching and reading reviews for the kind of stroller and crib we want to get. It made us wonder if people are spending more time researching strollers than researching birth choices. Be even more diligent about educating yourself on the birthing process and deciding what is right for you. Your birth experience will stay with you a lot longer than any of the items off your registry.

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