Here is a post from Life & Times that started some talk about hospital based childbirth education. I teach hospital based childbirth ed, and therefore feel the authority to criticize it. This is one of the reasons why I started my blog childbirth ed series and be able to do it my way. For those who plan to take a childbirth education class, I highly encourage you to keep this post in mind.
Childbirth Education is a Fraud
If you attend hospital based programs, that is. This is why:
Most hospital based Childbirth Education programs have curriculum that is reviewed and approved by the medical staff. The obstetricians want to make sure that what their patients are being told is congruent with their medical management of labor and delivery. What most people don't understand is that "medical management" of labor is usually unnecessary for healthy, normal pregnancies. They want their patients to know that it is "normal" to be continuously hooked up to the fetal monitor, that an "adequate" labor pattern means contractions every two to three minutes apart even if less frequent contractions have been causing cervical change, and that epidurals are the way to go. And, oh yeah, a few minutes of breathing techniques is helpful for when you are waiting for that epidural.
I am a labor and delivery nurse in a hospital, and I teach in a hospital based childbirth education program. I am continuously frustrated by the incongruent messages that pregnant women are given in regards to "normal" birth. For most, and particularly those who attend my classes, a normal birth consists of going to a hospital, being monitored by machines, getting an epidural, and pushing on your back while your support person and the nurse hold your legs. And this may be the positive experience that most want. Which is fine if that is what makes you feel safe and what you envision as a positive birth experience. I have attended many births that follow in this path and those women and their families are very happy and grateful for the experience and outcome. So, I can't say that just one way is the right way. I have also attended births where the woman wants to grab her baby as it's being born and place their baby directly onto their chests and didn't want an epidural. But none of those things happen, and she later voices to me that she wished that she was "never talked into that epidural" and that it took 20 minutes before she even got to hold her baby after the birth.
However, what I can say is that what the public is being told is not the only way. It is also not necessarily the safest way, either. What many people don't know is the the United States does not have the lowest neonatal and maternal death rates among industrialized countries. The US has the second worst newborn death rate among all industrialized nations, according to the Save the Children foundation. Which makes me wonder how good is all of the advances in fetal monitoring really? If one was to look at this statistic: in the US, there has been a 99% decline in maternal deaths, it would be encouraging. But I still wonder what is it we are missing that other countries, such as Finland and Sweden, have figured out?
Anyhow, back to childbirth education. So as I was saying, what is taught in hospital based childbirth education programs is not what a lot of people would think of as a "normal" birth. Again, the focus on childbirth education in my class is intervention and medical management. I also cover comfort measures, but with all the other information that I have to cover in regards to what these mothers are going have happen to them when they get to the hospital cuts that material to about an hour. The total class time is 12 hours. I also try to squeeze in information about "normal" birth according to Lamaze International, and inform women of the recommendations for inductions and c-sections according to the American College of Obstetrics and Gynecology. Many are surprised to learn that what their doctors are telling them ("You're baby is probably going to be too big, so we need to do a c-section" or "You've had a lot of aches and pains this pregnancy, and I am going to be on-call the day of your due date, so why don't we schedule an induction?") are not medically or even ethically indicated. I can't tell you the number of times these things come up in my classes, and I am continuously stunned. And frustrated, because in the end, the patients almost always go with what the doctors are telling them what should be done, and I (as well as my fellow Childbirth Educators) look like liars.
One other factor is that many doctors approach their practice negatively. In other words, in our litigious society, these doctors feel they must rely on technology and conservative medical approach to birth in order to cover their butts (aka CYA). They feel it's safer to have a woman hooked up to a monitor, an automatic blood pressure cuff, and an epidural (for a quicker c-section if needed) than to allow her to walk around to facilitate labor with intermittent fetal heart rate auscultation. And so these classes must cover what the "normal" birth is like for their patients, which by my standards is not normal for healthy women.
So, the bottom line: if you are looking to learn about how to experience a "normal" birth, attend a childbirth education class that is independent of your hospital. If you can afford one, hire a doula. Or talk with a trusted female family member or friend and see if they would be willing to be your labor doula. Statistics also show that women who have continuous labor support have less complications, shorter active labor phases, and fewer medical management of pain than women who do not have a doula. Also, many women are under the false impression that their labor nurse will be at their side breathing through every contraction with them, dabbing their brows with cold cloths. As much as labor nurses want to be right at the bedside with a laboring woman, we can't. It's impossible when we are trying to manage all that equipment, interpreting fetal heart rate patterns, and also managing the care for one or two other laboring women. Which is why I wholeheartedly welcome doulas.
Anyhow, I encourage pregnant women to learn about and seek a normal birth. Because pregnancy and birth is not an illness.