How do you find the right childbirth class?

This is a guest post from Doogie.  She’s newly pregnant with her first and has agreed to give us some insights on what’s she’s thinking and how she’s finding info in her pregnancy.

Just so we get this out of the way quickly, I’m a complete novice at the childbirth thing. I’m the ultimate blank slate waiting to be filled with good information.
Last week, I had my first consult with my doctor’s nurse. Among the things she gave me was a list of available classes for new parents.  She circled the one about emergency childcare and pulmonary resuscitation. They do offer Hypnobirthing, but not Lamaze.  My sister in law I know did Hynobirthing and she spoke well of it, but I’ve never really had much luck with self-hypnosis, so I’ll put that on the back burner to think about while I investigate other options.

They have a prenatal childbirth class that from the description could be a crashing waste of time, or the most useful information ever.  “This five week class helps pregnant women and their partners make informed decisions about childbirth. Topics include information about relaxation breathing, realistic labor options, understanding the process of labor, and infant care.”  It’s recommended for the last trimester, so I have a ways before I have to worry about that.

In my mind, the definitive childbirth method is Lamaze.  I have a friend (sadly, not local) who is Lamaze certified, so I decide to go to their website. I went to http://www.lamaze.org to see what the lamaze class options in my area are.  I click on the provider information and get a search page where I can enter information.  I enter my zip code and come up with nothing.  I enter my area code (figuring that will give me a broader range) also nothing.  I try another entry point which tells me there are only Lamaze classes in 9 states, and mine isn’t one of them.  Well, I find that very hard to believe and eventually it turns out that those are hospital certified programs.  I go back to the original page and search again, on state only this time, and I come up with three pages of names and email address.

Names and email address.  I’m looking for class schedules, times, costs, something that will help me make an informed decision about where I should be going and what I should be doing.  Am I supposed to cold email every Lamaze provide in the towns with names I recognize as being within easy driving distance?  Do I send a mass mail to all of them at once or am I expected to personalize it?  No one has a website?  No one has a calendar?

I do a Google search on Lamaze classes in my state and get everything from yoga to cooking.  I do eventually find a link to another set of childbirth classes as another hospital near me, which doesn’t offer Lamaze, but does offer Hypnobirthing so I read the description:

This popular new course is designed for couples seeking a calm, peaceful and pain-free delivery of their baby. Hypnobirthing is a method and philosophy of gentle birthing that uses deep relaxation to reduce the fear and tension that can cause long labor and pain, replacing it with confidence, calm and comfort. In Hypnobirthing classes you will learn to work with your body as you become focused with preparing for an easier, safe and more comfortable birth through proper nutrition, good posture, fitness and an attitude of trust in the birthing process. With the Hypnobirthing techniques of self hypnosis and deep relaxation, you empower yourself with confidence that will allow you to experience the birth of your baby with relaxed expectation and joy. The course is taught by Certified Hypnobirthing instructors.

It also has times, dates, and cost.
I don’t know what a certified Hypnobirthing instructor is or who certifies the instructors, but it looks like a better class than the one offered by my hospital:

This class will teach expecting parents deep relaxation techniques that help in having a more calm and peaceful-and less stressful-birthing experience. These techniques have been shown to shorten labor and reduce fatigue.

No time, no dates, but the cost is listed and it’s 105$ more than the one at the other hospital.

They’re both roughly equidistant from me, about a 15 minute drive and they both include a number to call for more information, but none of these has answered my basic question.

What class should I be taking to help me prepare to have a baby?  And how do I find it?

Doogie is a 38 year old professional who has been struggling with infertility for 7 years.  During that time, she’s had many drugs, shots, transvaginal ultrasounds,  two miscarriages, and is now 9 weeks into what seems like a viable pregnancy.

Avoid Interventions That Are Not Medically Necessary

This is the health birth practice that gets me strange looks – why would anyone want to avoid medical interventions?? I truly think that people 1) aren’t stopping to hear the medically unnecessary part and 2) simply don’t trust birth to be uncomplicated and go off without a hitch.? Seriously, machines are not designed to give birth but women are!

The use of medical technology in the rare instance of a complicated birth is a blessing, but the flip side is that overuse of the exact same technology is a curse.? The use of fetal monitoring has done nothing but increase the cesarean rate.? Don’t believe me?? Ask ACOG.? We routinely give women IVs, fetal monitoring and the cesarean surgery rate has gone up 46% in 10 years.? Something is wrong.? That is the misuse of medical technology in a typically uncomplicated process.? When cooking, do you skip the blender because you know how to chew your food?? Or do you process all your food into liquid in case you might choke on a piece of it?

Here are some ways to avoid unnecessary interventions in birth:

• Consider where you are giving birth. Giving birth at home or in a birth center will help ensure that you are well supported in an uncomplicated pregnancy.? Unnecessary technology is not available because it is not needed.? Emergency equipment is saved for emergencies.

• Consider with whom you are giving birth. Giving birth with a midwife at home, a birth center or even a hospital could have beneficial effects on your labor by the lack of unneeded technology.? There are certainly OBs and family practitioners who provide quality, low risk care without overusing medical technology, but they are not trained in the specialty of low risk women.

• Frequent conversations about your needs. Talk to your practitioner about what you need both in terms of support and (in)action from them.? Ask them when they would resort to medical technology and open up that conversation.? Remember, the point is not that intervention is bad but that unnecessary intervention is harmful to labor, baby and mom.

• Don’t hesitate to change. So many women get into their pregnancies and realize that either they’ve changed their goals or that their practitioner is not supportive.? Some choose to have home births, some choose to go to a different facility or different provider.? That is an acceptable thing, do not be concerned about hurting your practitioner’s feelings.? If your plumber provided services that were not what you needed would you hesitate to find a new one? Or live with a broken faucet?

Trying to tell if a medical intervention is necessary?? Talk to your practitioner.? Over the course of your prenatal care, your relationship has grown and you need to trust this person in practice and philosophy.? Get informed consent.? Do you have time to think about it and discuss it or is this an emergency? Do you know why a test or procedure is being proposed? What is it supposed to so?? When will you know if it worked?? Are there other procedures, tests or possibilities?? What are the benefits?? What are the trade offs? What happens if you decide to do nothing or not go forward with what they are proposing?? If you determine, with the help of your medical team, that an intervention is necessary and not “just because we do it to everyone,” then you are still keeping with the spirit of this healthy birth practice.

Lamaze Healthy Birth Practice | Mothers Advocate Video | Mothers Advocate Handout

Move, Walk Around & Change Positions Throughout Labor

Moving in labor is something that we don’t often think about these days.? After all, if you give birth in a US hospital, you walk in and see a bed.? If you were following the live birth on the Internet the other night, we were all amazed at the size of the room (it was small) and it was the VIP room!? What did you see prominently featured in the center?? he bed, of course.? Unfortunately freedom of movement in labor has come to mean, you can lay on your right or your left side.

I’m here to tell you that moving around in labor helps a lot.? When my leg hurts, I shake it out, I stand up and move, changing how I put pressure on it.? When my back hurts, I stretch, bend and fold until the pain subsides.? Labor pain is no different.? And yet by restricting movement we take away a woman’s freedom to alleviate that pain without medications.

Now, some hospitals will claim that they are not actively restricting movement of their laboring patients.? And while we do not hand cuff women to their beds very often anymore, we do tether them with physical items like IV poles and fetal monitoring equipment.? Then add the psychological aspects of the bed and being a good patient and throw in a poorly designed hospital gown that shows your buns at every turn and you’ve got a woman who is more likely to stay in bed.

So here are my tips for freedom of movement:

• Begin this discussion early and often with your practitioner. Ask lots of questions that can only be answered with open responses.? “Can I move?”? elicits the answer: “Sure!”? But you’re thinking hands and knees, squatting and roaming the halls and? your practitioner is thinking, on your back and sitting up. Try something like, “What positions have you seen women give birth or labor in?”? You might also try, “What positions do you recommend for pain relief in labor?”

• Tour the hospital or birth center. Other than a bed, what can they provide you to help you move?? Do they have birth balls?? Do they offer an early labor garden or path? These hospital tours are given in groups or in private.? Try both if you can.

• Exercise and practice. Just as with anything, if your body isn’t ready to use muscles that are required to squat, you’re not going to be very successful at doing so. It will also help you and your partner feel more comfortable as the movements become familiar to you and your body.

• What tips would you add?

For more information on this healthy birth practice, you can see:

Lamaze’s Handout | Mothers Advocate Handout | Mothers Advocate Video

Healthy Birth Practices

Healthy birth practices sound like something everyone can get behind.? They are six things that have been determined by multiple medical and scientific centers and research to promote births that are safe for mom and baby.? What’s not to love?

These practices have been identified and released by Lamaze International.? They are:

• Let Labor Begin on Its Own
• Walk, Move Around, and Change Positions Throughout Labor
• Bring a Loved One, Friend, or Doula for Continuous Support
• Avoid Interventions That Are Not Medically Necessary
• Avoid Giving Birth on the Back and Follow the Body?s Urges to Push
• Keep Mother and Baby Together ? It?s Best for Mother, Baby, and Breastfeeding

Each day this week, we will be looking at one of these practices and how it can influence your birth.

Lamaze Birth Network Grants

The Lamaze Institute for Normal Birth offers small grants to birth networks every year for projects that they are doing. ?The awards are between $500-1000. ?While the word grant might scare you off, these are very straight forward to do, though require some thought and planning. ?Don’t let the October 16th deadline come up before you start writing!

Some birth networks have funded projects like maternity information fairs. ?Others have used the money to train leaders, work on a local transparency project or support education locally. ?The whole point is that a birth network has the pulse of what’s going on in their neighborhood and can best decide what projects they need.?What would you do with that money? ?Feel free to talk it out in the comments, we have some mentors reading and willing to help you!

Lamaze Discusses Cesareans with Medscape

Lamaze International’s President, Dr. Pam Spry, discussed cesarean section with Medscape recently. Here is a small excerpt:

Medscape: Are rates of surgical delivery being driven up by women or clinicians? Is this the age of Blackberry birth — scheduling everything ahead of time?[16]

Dr. Spry: Actually, there are 2 parts to this question. One is, what has driven up the rate of repeat cesareans, and that answer is easy: there has been a big decrease in the availability of choosing to labor and deliver vaginally (VBAC) after having 1 or 2 previous cesarean births, causing a huge increase in the rate of surgical delivery [for repeat cesareans]. Compared with the early 1990s when VBACs were encouraged and acceptable, many hospitals, insurance companies, and clinicians now refuse to allow women to try laboring after a previous c-section because of perceived medical and legal risks.

The second part of the question is whether women or clinicians are responsible for the increase in the primary c-section rate, and I think that’s more difficult to answer. In a study of more than 1500 women, we tried to determine just that. The research results indicated that only 1 woman in the study actually reported that she requested a cesarean, which leaves the decision for the vast majority of cesarean deliveries up to clinicians. So understanding when cesareans are medically necessary, as well as the risks involved, is important in achieving a safe and healthy birth.

There are definitely some interesting discussions. If you’ve been around the block, they aren’t new, but it’s nice to see them laid out so nicely for the average person. Read it and let us know if you agree with Dr. Spry’s conclusions about how and when change will occur.

Birth Videos from Mothers Advocate

These great videos are based on the Healthy Birth Practices from Lamaze and InJoy Video.

Lamaze Offers Birth Network Grants

Application Deadline: 5:00 p.m. (EST), Friday, October 17, 2008

The Lamaze Institute for Normal Birth was launched to support
initiatives that provide credible, relevant and useful information about normal birth to birth professionals and the public. A key initiative of the Lamaze Institute for Normal Birth is to support the development of grassroots, community-based Birth Networks. Since 2003,
the Lamaze Institute for Normal Birth has given numerous mini-grants to birth networks throughout the United States.

The Goals of the Birth Network Mini-Grant Initiative
The Birth Network Mini-Grant Initiative is designed to support the development or expansion of community-based networks that bring the public and birth professionals together to:

• promote the Six Care Practices that Support Normal Birth and the Mother-Friendly Childbirth Initiative (MFCI)
• improve the quality of maternity care locally
• provide information and resources to expectant women and their families so that they can make informed choices about maternity care.

The Lamaze Institute for Normal Birth offers up to ten $500 to $1,000 grants annually to support established or emerging community-based Birth Networks in North America

http://www.lamaze.org/Default.aspx?tabid=529

Lamaze- Building Confidence Weekly

Three weeks ago I signed up for Lamaze’s new Building Confidence Week by Week e-mails. So far, I have found them to be fantastic! Each e-mail has a little something written on preparation for labor and birth, a specific stage of birth, etc. The best part is the tone that they are written in. A lot of what is available on the internet is written to scare pregnant women. Lamaze’s e-mails are written the way you would expect – that pregnancy and birth are normal, natural parts of life. The other thing I have found is that when reading the e-mails I feel so much more positive. I get EXCITED about my baby’s arrival instead of dreading it as some literature has made me feel. So, overall, I give them four stars. What about you? Have you enjoyed them? If you haven’t signed up – you can do so here Lamaze Building Confidence Week by Week

I’m home!

I know you missed me. I went to the ICEA conference after I left Phoenix. It was really nice to see even more women dedicated to helping families. I heard some really great speakers on really great topics and truly enjoyed rooming with Teri from Passion for Birth and CBE Blog. I also managed to score some new bloggers! Look for more exciting posts to come…

And a shout out to the The Lactivist for her support of Lamaze International!

And, if you’re in NYC, Mama Knows Breast is doing a book signing, her site has the details.