Childbirth Education Classes Face New Challenges In Adapting To Today's Culture Of Expectant Parents

Main Category: Public Health
Article Date: 10 Dec 2007 - 2:00 PDT

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Parents' view of childbirth education classes has changed dramatically from 50 years ago. This fact has presented unique and sometimes detrimental challenges that affect both the format and outcomes of childbirth education, according to a new study entitled "Contemporary Dilemmas in American Childbirth Education: Findings from a Comparative Ethnographic Study" published in The Journal of Perinatal Education.

Christine H. Morton, Ph.D. and Clarissa Hsu, Ph.D. collected and reviewed data from 11 childbirth education class series and 17 childbirth educators to examine how and if cultural factors influence childbirth education class attendance and participant satisfaction. The researchers observed participants in childbirth classes, conducted in-depth interviews of childbirth educators birthing women and key informants, administered a survey and reviewed class materials. Eight of the classes took place in larger institutions (including hospitals) and three were offered by independent educators. A variety of childbirth education classes were represented.

Results from the authors' data analysis revealed that childbirth educators encounter five key dilemmas that affect their class structure, format, and content. These dilemmas, in turn, affect how class participants experience childbirth education in the United States today.

The first dilemma was labeled, "Essential Rite of Passage Versus Extra Burden." While childbirth educators viewed childbirth classes as a valuable source of information and essential during pregnancy, pregnant women often viewed the classes as an extra task or burden. The Listening to Mothers II survey, conducted in 2006 by Childbirth Connection (in conjunction with Lamaze International) to better understand and improve women's childbirth experiences, found that only 11 percent of women viewed childbirth education as a routine part of pregnancy. For childbirth educators, this poses the challenge of how to convince women that attending a childbirth class is more valuable than reviewing information online, in books and on television.

Further exacerbating this challenge is parents' desire to attend shorter, more concise classes, which has forced educators to change their class format. Childbirth educators must sometimes condense up to eight weeks' worth of information into these shorter classes. This dilemma, "Information Overload Versus the 'Necessary' Information," made childbirth educators feel that they must compromise the information they provide to reach expectant couples.

Shorter classes also affect the amount of time for socializing and bonding between class participants. Today, class participants do not view childbirth classes as place to build relationships, but as a place to gather as much information about birth as possible in the shortest amount of time. Earlier childbirth education classes split their focus between providing information and building a support group for expectant parents, whereas today, childbirth educators are torn between "Building Community Versus Just the Facts."

Another dilemma deals with the type of information provided in classes and how it is presented. Childbirth educators struggle with, what the authors call, "Negotiating Evidence, Beliefs and Experience Within the Framework of 'Unbiased Information' and 'Choice.'" In most classes in the study, educators presented scientific evidence and research findings, while incorporating cultural beliefs and individual experience. The overall goal was to provide class participants with unbiased information in order to allow them to choose what was best for them.For fear of appearing judgmental or biased, educators placed a higher value on supporting a woman's decision, regardless of the choices made.

Childbirth educators today are more likely to empower women to have a satisfying birth experience rather than to advocate for a specific type of birth. Most educators in the study emphasized that a satisfying birth meant different things to different people; what was important was that the birth experience was based on decisions made by the woman. This dilemma, "Empowerment Versus Birth Advocacy," has caused a shift in the childbirth educators' role, from natural birth advocate to someone that provides information to enable women to make informed choices.

"Today's childbirth educators are caught between what to teach and what students want from their classes," says Judith Lothian, RN, PhD, LCCE, FACCE, co-author of The Official Lamaze Guide: Giving Birth with Confidence. "If we are to keep childbirth education alive and thriving, we have to listen to what today's mothers want, without losing the core values and importance of childbirth education.

In a related article in The Journal of Perinatal Education, authors Charlotte A. DeVries and Raymond De Vries, Ph.D., propose a new model of childbirth education that fits the needs of a modern society while at the same, preserves the role of improving the health of moms, babies and families. This new model of education, termed "Centers for the Childbearing Year," would be independent of medical practices and hospitals, and would serve as a the complete source for women to go to for information and support related to fertility, pregnancy, childbirth and newborn care. For the complete information presented in the Listening to Mothers surveys, visit http://www.childbirthconnection.org. Information about Lamaze childbirth education can be found at http://www.lamaze.org.

About The Journal of Perinatal Education

The Journal of Perinatal Education is the leading peer-reviewed journal for childbirth educators. The Journal is published quarterly by Lamaze International for readers who provide parent education in the areas of childbirth, pregnancy, breastfeeding, neonatal care, postpartum, early parenting and young family development. For more information about The Journal of Perinatal Education and Lamaze International, visit http://www.lamaze.org.

About Lamaze International

Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area networks, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers. For more information about Lamaze International and the Lamaze Institute for Normal Birth, visit http://www.lamaze.org.

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