Positive Pregnancy Test! Now What?

The flood of emotions that comes with a positive pregnancy test is quickly followed by pressing questions.  How do I manage the symptoms I’m feeling?  Should I change my diet and exercise, or the medications I take?  When should I tell my family, friends and co-workers?

But sometimes it’s easy to overlook other issues that can impact your pregnancy and “The Big Day.” Lamaze’s latest webinar will address one of the most important questions any newly pregnant woman can consider.

“What can I do now to increase the chances I’ll have a safe and healthy birth for my baby and me?”

The following webinar discussion (embedded below) will provide resources and perspectives on what newly pregnant women can be thinking about and doing in early pregnancy, and how they can take charge in pushing for the best possible care. The “Positive Pregnancy Test? The Top 5 Things You Should Do Next” webinar will help you to:

  • Consider options for care you might be overlooking
  • Avoid “due date” mistakes
  • Get savvy on real-world childbirth challenges
  • Equip your childbirth partner to be rock-solid support
  • Think about healthy choices in a new light

The presenter of this webinar is Jessica Deeb, MS, WHNP, CLC, LCCE.  Two years ago, she shared her first childbirth experience with fellow moms in Lamaze’s Push for Your Baby video.  Since then, she has applied her professional training in labor and delivery and her passion for better birth to become a Lamaze Certified Childbirth Educator.  She is expecting Baby #2 in December!

Red Light, Green Light – A Quiz on Getting the Best Care

Are you getting the best prenatal care from your provider (midwife, OB, or family doctor)? Take this “red light, green light” quiz to find out. Red light indicates care that is not evidence based or respectful of your choices. Yellow light indicates care that should make you question your provider further to see if she is the best fit. Green light indicates great care!

More than Birth Prep in a Childbirth Class

“An eight hour class to learn about birth?! All that for just one day?!”

There are so many decisions and choices surrounding the birth of a child — your child. So yes, a childbirth class requires time to cover all of the relevant information on childbirth. BUT, a comprehensive childbirth class also covers much more than birth! If you attend a comprehensive childbirth course (at least 8 hours in total length) taught by a certified childbirth educator, you can generally expect to receive education on some or all of the following topics, outside of information on birth:

  • Caring for your postpartum body for vaginal and cesarean births
  • Basics of and resources for breastfeeding
  • Signs of and resources for postpartum depression and related disorders
  • Basic newborn care
  • Prenatal and postpartum nutrition information
  • Your post-baby relationship

Birth is a big deal. Life after birth is a huge deal. Preparing for both in advance of your birth can help you and your baby get the best start in life. Most parents will say they wish they had known more about what to expect in the first few days, weeks, and months after bringing baby home. If you’re considering taking a childbirth class, but don’t know if it’s worth your time and effort, know that with the right class, you’ll receive information to take you beyond your birth. Also know that not all classes are created equal. Research classes in your area — if the course content is not detailed online, email the instructor to find out what is covered.

You can find a Lamaze class in your area with the Lamaze class locator. Many Lamaze instructors offer different types of courses that range from a “quickie” class to the more traditional, comprehensive classes that cover several topics.

 

Did your childbirth class cover information outside of birth? How did it help you?

 

Five Tips for Expectant Dads to Prepare for Labor and Birth

Around Lamaze, it’s Father’s Day every day! That’s because we understand and celebrate the value of the role that fathers play in contributing to a safe and healthy birth for their partners. The following article is one of many resources found on the Lamaze.org website for expectant parents, where you can also find a tool to locate a Lamaze class near you

When it comes to childbirth, popular media often love to portray fathers as helpless and incompetent during labor and birth. When labor starts, the mother-to-be calmly manages her contractions as the dad sets into a panic, leaving behind the pre-packed bag, taking a wrong turn to the hospital, or running the halls searching for a nurse.

In reality, dads often play a critical role in supporting mothers during pregnancy and birth and advocating for safe care. As Father’s Day approaches, Lamaze International wants expectant dads to know that childbirth education goes a long way when it comes to learning how to be the most helpful, from the moment they find out they’re expecting through the first contraction and beyond.

Cherington Shucker and Darin Gehrke of New York welcomed their first child earlier this year and talked about their experience in Lamaze’s Push for Your Baby video, “Parents Push”: www.Lamaze.org/pushforyourbaby-video. Both agreed that Darin’s participation in childbirth education classes enabled him to take an active, positive role in the delivery of their child.

“To help ease the pain of childbirth, I was able to support Cherington in using various types of pain-relief techniques,” said Gehrke. “We knew in advance that there were many natural options to find greater comfort, and it was especially important for us to avoid any unneeded medical interventions that could lead us down the road to a cesarean birth.”

The importance of fathers advocating for the best care is underscored by persistent and growing gaps in the quality of care women and babies often receive. A recent report by Consumer Reports says, too often, unnecessary medical interventions are used in birth, increasing risks to mothers and babies.i For example, unnecessary cesarean births can come with unintended health consequences for mom and baby, including breathing problems for baby or complications in future pregnancies for mom. One recent study published in the Archives of Disease in Childhood even suggests that babies born by cesarean may have about twice the risk of becoming obese as infants delivered vaginally.ii

Other interventions pose challenges to the health of moms and babies too, including early induction (performed before 39 weeks of pregnancy), epidurals and electronic fetal monitoring.

“Dads can play a key role early on in pregnancy to help mom and baby get the care that’s safest and healthiest,” said Lamaze President-elect Tara Owens Shuler, MEd, CD(DONA), LCCE, FACCE, Director of Continuing Education, Special Projects, and Lamaze Childbirth Educator Program for the Duke AHEC Program. “He’s a very important advocate, and can provide emotional support for mom throughout labor and birth.”

Here are five tips to help dads prepare for and provide support through pregnancy, labor and birth:

I.  Take a childbirth education class with your partner.

The benefits of a good childbirth education class can often be overlooked. A class can help dads, and other support people, learn about the different options and interventions, and get the tools and knowledge to push for the best care during pregnancy, labor and birth. It can also spark the conversation between and among couples, so you can learn from one another and interact with other expectant parents in your shoes.

II.  Work with mom to plan.

Talk things through with one another and with your care provider. Chances are greater for a positive birth outcome if support begins early on in pregnancy. Discuss the different options for a safe and healthy birth, and map a pathway to get there. Labor and birth can be a dynamic process so it’s vital to work with mom to create Plan A, Plan B and Plan C.

III.  Learn how to be an advocate for mom.

Birth is an intense process, emotionally and physically. It’s important for dads to be informed and know how to advocate for her wishes. She may come under pressure from family members or healthcare providers and the father’s voice is important in pushing for the safest, healthiest care.

IV.  Find out about techniques to help minimize the pain.

There are many natural ways, such as relaxation, to find greater comfort in childbirth and help labor progress. Every woman is unique and has her own ways of feeling safe, comfortable and relaxed. Whether she uses a hot shower or bath, hip squeezes and pressure points, or birth ball exercises, dads can help mom identify the pain-relief tools that are best suited for her individual needs.

V.  Be prepared to welcome baby into the world.

Help mom recover. Birth can be exhausting for both mom and baby, and dad can help to support both after birth. He can help mom by managing visitor times, rocking baby to sleep after feeding, and making sure mom is fed and gets enough rest.

Expectant dads can find out even more at www.PushForYourBaby.com.

 

References

i “What to reject when you’re expecting.” Consumer Reports. May 2012. Available online: http://www.consumerreports.org/cro/2012/05/what-to-reject-when-you-re-expecting/index.htm. Accessed 6/12/12.

ii Huh, S., et. al. Archives of Diseases in Childhood. March 2012. Available online:http://adc.bmj.com/content/early/2012/05/09/archdischild-2011-301141.abstract?sid=4f920274-7dd6-40cc-b98b-fe9f4f5d9076. Accessed 6/12/12.

Thoughts on Birth the Second Time Around

By Caitlin Tucker

I knew right away this time around — I started to feel those familiar signs of pregnancy, cramps, tiredness and nausea. I took a test the first day of my missed period this time and those two little lines came up. My husband and I were very excited! Of course, I have the usually worries throughout the first trimester and the excitement to hear that little heart beat for the first time. For my daughter, who is now 15 months old, we took the typical route of care. We went to my family doctor to confirm that the home test was right, I stayed in their care until I was 28 weeks along and then I transferred care to an obstetrician for the remainder of my pregnancy. I felt confident with both my family doctor and obstetrician, and in spite of the quick visits  and long waits in the waiting room, I was satisfied overall.

We also took the typical labour and delivery classes through our local hospital. I remember only learning what to do once we got to the hospital and how to be admitted,  but not much about how to cope during labour. I figured, since I wanted a natural birth, it would just happen that way. I read a lot of books and spoke to a few of my friends that had already had babies. I wanted a non-medicated, natural and healthy birth. At 38 ½ weeks pregnant I felt my first contraction. After a few that were about 15 minutes apart, I let my husband know I thought early labour was starting. We arrived at the hospital when they were 1-3 minutes apart after about 5 hours of early labour. After about 7 hours more at the hospital, our little girl arrived at 5:43 a.m., weighing 6 pounds 15 ounces. We were relieved and so excited she had finally arrived! I think we were both just so happy she was healthy that it took a few months to come to the realization that my labour  did not go  the way I had hoped and planned. After I arrived at the hospital, I was set up on the fetal monitor and was continually monitored throughout my labour and wasn’t allowed off the hospital bed. In hindsight, I came to understand that being on one’s back during labour is one of the least comfortable positions in order to achieve a successful natural birth. I  laboured for 3 hours on the bed without medication, but as labour  got more intense and I wasn’t able to move around, the contractions became very difficult to cope with. My nurse was very nice, but didn’t offer any labour support and just kept her eyes on the baby monitor. My OB was also very nice, but as usual, she was on-call and was in and out of the room and also offered no support during labour other then medication options. Throughout my labour I was asked several times if I wanted an epidural and I kept saying “no” but after 3 hours and not knowing when it was going to end, I gave in and signed the form for the epidural. After taking the medication, I was relieved the pain was finally over. Two hours later, I was fully dilated.  After 2 more hours of directed pushing, our little one arrived.

Initially, we were satisfied with how things went and didn’t think too much about the disappointment that our natural birth plan didn’t happen. When I started to think about having more children, I realized how important it was to me to have a natural, healthy and safe birth. I started to read more books on natural births, watch documentaries, and educate myself. I spoke to my friends who had natural births and talked about what they did differently than myself. One major point that differed from my experience was that they prepared themselves by taking classes on how to cope with labour and had professional support with them during labour who encouraged and supported natural birth under safe situations. I continued my education on natural birth and it lead me to look into other care professionals that promote natural birth as a healthy part of life, instead of viewing the pain and experiences of natural childbirth as a burden.  When we found out that baby number two was on his/her way, I knew this was my opportunity to be as prepared as I could for labour this time around. I am now seeing a supportive midwife, enjoying their peaceful office with minimal wait times, and receiving encouragement to have a natural birth and continual support throughout labour and postpartum home visits. I believe that our bodies were designed to give birth that is inherently safe, and under most circumstances, women have the ability to give birth without medication, to move freely throughout labour. I believe that women need support from their friends, family, care givers and society as a whole to give birth naturally. It should be celebrated by women. Even though I’ve given birth once, I truly want to experience birth and have the support of my husband and midwife as they help me labour through the discomfort and bring another life into this world. I’m choosing not to be simply satisfied with my birth story – I want to be in awe of it.

 

Caitlin lives in Toronto, Canada, and is a wife and stay-at-home mother to one little girl and baby number two on the way. She and her husband are involved in their church and Caitlin helps run a mothers group on a bi-weekly basis. She recently enrolled in the Douglas College Lamaze Childbirth Educator Program and hopes to bring knowledge, empowerment, and encouragement to other women throughout their pregnancy and birth.

Making Time for Childbirth Classes: A How-to Guide

One of the biggest arguments made for moms or couples who don’t attend childbirth classes is “I/we don’t have time.” And in today’s over-scheduled, over-committed and over-worked life, it’s true that many (often too many) things compete for your time. On our blog, we’ve already presented reasons why attending childbirth classes are worth your time; now we’re going to talk about how to make that time.

When are classes offered? Before you do anything, find out when the classes you want to take are offered. Typically, childbirth classes are offered on one weekday evening for 4-6 weeks or during the day over the span of a weekend.

What’s on your calendar? One of the best ways to get a complete picture of your day-to-day is to see it, visually represented, in front of you. You can do this simply with pen and paper or you can craft an Excel spreadsheet of your schedule (here’s a cool template).

Establish your non-negotiables. For many of us, this is work. But for pregnant mamas, it’s also things like 8 hours of sleep, yoga, or naps. Star these items on your schedule.

Determine what can be rearranged, delegated, or rescheduled. Would your boss allow you to trade shifts with a coworker for a few weeks so you can have the time to go to class? Would a neighbor come by to let your dog out so you can go straight from work to class?  Can you push back a dinner date to the following weekend? Will a friend watch your other child(ren)?

If all else fails. If your schedule truly does not allow you to attend the childbirth class of your choice during the time it’s offered, call the instructor of the class and find out if she offers any alternative times or teaches private/in-home courses. Good childbirth educators are passionate about what they do and may be willing to do what it takes to help you prepare for birth!

 

How do you plan to make time to attend childbirth classes? For moms who have given birth, how did you fit it into your schedule?

Five Factors to Consider when Choosing a Childbirth Class

By Allison J. Walsh, IBCLC, LCCE, FACCE

Just as every pregnancy and birth is unique, so too is every childbirth class. While the options available to you may seem overwhelming, it is important to do your homework. A good childbirth class can not only prepare you for labor, it can expand your personal view of birth, lessen your fears and, most importantly, build your confidence in yourself and your body. To find one that works for you, take into account the following five factors.

1. Instructor

The instructor can make or break a class. Before you choose one, call a few and ask questions about their curriculum, philosophy and teaching methods (there should be a variety). You want an instructor who can offer a wide array of coping strategies for labor and can address ways to communicate effectively with your health-care team. It is crucial for your instructor to provide current, well-researched information. Be wary if the chilbirth instructor simply presents hospital rules.

All aspects of a childbirth class should serve to build your trust in your body and baby: It should be taught in a manner that is empowering, respectful and hopefully even fun. A good instructor is an advocate who shares all of the information you need to make truly informed decisions.

There are many organizations that train childbirth educators but Lamaze International offers the only certification program for childbirth educators that is accredited by the NCCA (National Commission for Certifying Agencies).  If your childbirth educator is Lamaze Certified she has demonstrated her knowledge and skills by passing a rigorous international examination that meets the highest standards for assuring professional competence.

2. Location

Classes are held in hospitals, birth centers, health-care providers’ offices, homes or other community locations. In-home classes can be set up for one couple or for groups. Many women simply sign up at the place where they plan to give birth; before you do so, first check that the topics being covered will meet your needs. Again, if you attend hospital-based classes, be careful that they do not simply present the hospital’s rules.

3. Size

You’ll likely get the most out of a small childbirth class: It will be more personalized and will allow for more questions and answers. Private classes are also available for couples with complicated schedules.

4. Duration

It may be tempting to sign up for an intensive day-long or weekend session, but there are many benefits to a course that meets five or six times over the span of a few weeks. At each session, there is time to review content from the prior one; this repetition will help you retain information. In between, you can reflect both personally and with your partner on what was discussed, and if questions arise, you’ll have the opportunity to pose them next time. It’s also helpful to be part of a group of people approaching parenthood at the same time. You might make new friends, and you will surely find others who share your thoughts, concerns and challenges.

5. Content

A childbirth class should cover the following:

  • the normal, natural process of labor and birth, and health-care practices that support it
  • changes during late pregnancy and the stages of labor
  • the important role that pain plays in labor and a wide variety of coping strategies for managing it
  • the importance of labor support
  • movement and positioning during labor and birth
  • medical interventions and their indications, risks and alternatives
  • how to communicate with your health-care provider
  • developing a birth plan
  • breastfeeding and newborn needs
Class Participation

Some partners are reluctant to attend a childbirth class because they don’t think it has much to do with them. Let yours know that you need his or her presence in class just as you will need it in labor. Together, make every effort to find a program that works with your schedules and with which you will both be comfortable.

Come to class prepared to focus: Turn off your cell phone and leave the rest of your life behind. Look at posters or visual aids around the room, and do any assigned reading. Ask questions and participate as much as you like, but remember that it’s fine to speak with your childbirth class instructor privately if there’s something you don’t wish to discuss in front of the group. Be open to learning and allow yourself to be amazed by the natural process of birth and the part you are playing.

Push for Your Baby

Have you ever felt scared or insecure when asking your doctor a question? Personally, there have been times when I felt like, “what if I ask a stupid question,” or “will she think I’m one of those know-it-all internet research junkies,” or “I don’t want to come across as too pushy.” As it turns out, women who feel this way aren’t alone. A recent study in Health Affairs highlights how patients, worried about being labeled “difficult,” can be reluctant to discuss or question a health care provider’s recommendation.[i] For pregnant women, the pressure to agree to certain practices from family and friends, as well as care providers, can be significant. In fact, a Childbirth Connection study showed that many mothers have felt pressured by a health care provider to have an induction (17 percent with induction) and C-section (24 percent with cesarean).[ii]

In recognition of this issue, Lamaze International has initiated the “Push for Your Baby” campaign, which  encourages women to advocate for better care for their babies and themselves. “With the right information and education, women have the opportunity to be active partners in their care during pregnancy and birth, not just recipients of that care,” said Lamaze President-elect Tara Owens Shuler, MEd, CD(DONA), LCCE, FACCE, Director of Continuing Education, Special Projects, and Lamaze Childbirth Educator Program for the Duke AHEC Program. “This campaign is designed to help women be ‘savvy shoppers’ and prepared to seek out the best care for their babies and themselves.”

Through the Push for Your Baby campaign, Lamaze is working to provide expecting parents with the tools and resources they need to partner with their care providers to get that care, including:

    • PushforYourBaby.com – A website dedicated to expecting moms and dads that houses up-to-date information about childbirth challenges, ways to identify the best care, tips for pushing for better care, details about Lamaze education, and questions to ask their care provider.
    • Parents Push – With this shareable video, moms – and dads – share their personal childbirth experience, both the highs and lows, and underscore the importance of childbirth education to having the safest, healthiest birth possible. The video offers those expecting a little one a chance to hear directly from someone who has been in their shoes.
    • Push Story Sharing – Lamaze knows that some of the best learning happens through story telling. The Push for Your Baby campaign gives parents the opportunity to share both written and video birth stories highlighting the things they were glad they knew – or wish they had known – before labor and delivery, as well as the role that childbirth education played in their experience. Submissions will be shared on the campaign website and the top three entries in each category (written and video) will receive prizes from Lamaze, Tomy and GC Brands Childrenswear, and their photos and blogs posted to the home pages of Lamaze.org and PushForYourBaby.com.

“Its all about women getting the care that matches their unique needs, and not just having things happen to them. Sometimes that may mean saying, ‘I’d like to consider another option,’” said Shuler. “Women should know it’s OK to push for better. And knowing how to spot good maternity care is the key to getting it.”

“With clear challenges to getting high-quality maternity care, the value in being prepared and educated is more important than ever,” said Shuler. “Childbirth education may seem like a hassle to busy parents and Google might feel like a decent way to answer questions, but a good childbirth education class can help pregnant women sort through conflicting or inaccurate information, and give them the tools they need to get the care they want. Lamaze certified childbirth educators (LCCE) have a stake in the expecting parents we teach, and it’s our priority to help them achieve the safest, healthiest outcomes.”

In addition to Push for Your Baby, Lamaze recently launched a newly revamped website (www.lamaze.org) with a focus on expecting parents, and a separate site dedicated to supporting Lamaze educators (www.lamazeinternational.org). The new parents’ site features the Push for Your Baby campaign resources, a social media updates, a video library, tips for expecting parents and evidence-backed information about maternity care from pregnancy through birth.

 


[i] Frosch, D., et. al. Authoritarian Physicians And Patients’ Fear Of Being Labeled ‘Difficult’ Among Key Obstacles To Shared Decision Making. Health Affairs. May 2012. Available online: http://content.healthaffairs.org/content/31/5/1030.abstract.

[ii] “Listening to Mothers II Report.” Childbirth Connection. 2006. Available online: http://www.childbirthconnection.org/article.asp?ck=10396. Accessed 4/16/2012.

Jessica Simpson Is Right About Birth but Wrong About Lamaze

A very pregnant Jessica Simpson appeared on Monday night’s The Tonight Show with Jay Leno. During her interview, Jessica covered the basic details of her pregnancy, including the surprise of Braxton Hicks contractions, and her relationship with dad-to-be. She also answered questions on her preparation for birth. When asked whether she would be attending a Lamaze class, Simpson replied no — that women in Lamaze classes “get so out of breath.”

While Simpson was likely playing up her signature ditsy humor, she touched on a commonly misunderstood element of Lamaze: breathing. Simpson remarked that women need energy to push and that being “breathless” or “seeing stars” would not be helpful. She’s right — hyperventilating and breathing without focus can be counterproductive to labor and pushing. It depletes a woman’s energy and can raise her adrenaline level, causing exhaustion and anxiety.

Today’s Lamaze classes focus on all elements that make up a healthy, safe birth. Breathing is just one the many suggestions offered to provide focus and increase comfort during labor and birth. The following, excerpted from The Official Lamaze Guide: Giving Birth with Confidence by Judith A. Lothian and Charlotte DeVries, provides an overview of breathing during labor and birth:

Conscious Breathing
Conscious breathing (especially slow breathing) reduces heart rate, anxiety, and pain perception. It works in part because when breathing becomes a focus, other sensations (such as labor pain) move to the edge of your awareness.

Conscious breathing is an especially useful labor tool because it not only keeps you and your baby well oxygenated, it’s also easy to learn and use. It’s naturally rhythmic and easy to incorporate into a ritual. And best of all, breathing is the one coping strategy that can’t be taken away from you—even if you’re stuck in bed attached to an electronic fetal monitor and intravenous fluids.

Conscious (or patterned) breathing used to be the hallmark of Lamaze childbirth education. For many women, it’s still an important way to stay relaxed and stay on top of their contractions. It’s true that conscious breathing can help you relax and feel less pain during contractions.  There’s no “right” way to breathe in labor, despite what others may tell you. Slow, deep breathing helps most women manage the pain of contractions. But the right way for you to breathe is whatever feels right to you. Issues like your number of breaths per minute, breathing through your nose or your mouth, or making sounds (like hee-hee) with your breaths are only important if they make a difference for you.

That last part — “….are only important if they make a difference for you” — is so key. Quality birth preparation, like Lamaze classes, should provide you with several tools in your tool box to be able to choose the best one for the job when the time comes. Labor and birth is such an “in the moment” experience  – you simply cannot predict exactly how you will react until you’re there.

It may help you to have a visual focus to accompany your conscious breathing. You can recall an image with your eyes closed, focus on a picture or special object from home, keep your eyes on your partner, or simply stare at a spot on the wall. You may also find that as labor progresses, faster, shallower breathing—like a dog gently panting—feels better. You’ll figure out what works best for you. And what works best will probably change as you move through labor.

Many women “practice” breathing during pregnancy by using conscious breathing when everyday life presents stressful situations, like being caught in traffic, running late for an important meeting, or worrying about any number of things.

Find Your Rhythm
At some point in labor, you’ll “find your rhythm” or “get in a groove,” much like a marathon runner does. You’ll be living in the moment, doing without thinking.  To others you’ll appear to be in another world. Your movements will be rhythmic; you’ll relax between contractions; you’ll respond to contractions in the same way over and over again, perhaps shaking your arms, rolling your head, breathing slowly, chanting, or praying.

You’ll be totally focused, but you won’t necessarily look comfortable. You’ll look like you’re working very, very hard—which you are. When this happens, you’ll know endorphins are working their magic—dulling your pain and helping you ride your contractions intuitively. You’ll be doing exactly what you need to do. You won’t need to be rescued; in fact, the worst thing that could happen to you at this point is to be disturbed or interrupted. A healthy dose of encouragement, support, and respect are all you’ll need from your support team.

Simpson commented to Leno, “it’s all about being calm [in labor]” — and in a sense, she’s right. Being “calm,” in the way that one feels confident in her ability to birth and in the support from those around her, is key to a positive birth experience. Whether a woman finds her calm through breathing, labor support, meditation techniques, back massage, or laboring in water is inconsequential; that she has access to such tools when she needs them is indispensable.

 

Birth Choices: Are You Informed?

In a recent Canadian study that was reviewed in The Journal of Perinatal Education, researcher Michael Klein, MD, reports that women are inadequately informed and care providers are not delivering evidence-based information when it comes to birth practices. (1) This dangerous combination makes it hard, if not impossible, for women to make informed decisions. A truly informed decision comes when a person has been given complete and unbiased information on which to base her action.  Among the study’s findings:

The women’s lack of evidence-based knowledge about epidural analgesia included failure to appreciate that it interfered with labor and was associated with an increase in the use of forceps and vacuum. Many were unaware of the benefits and risks of cesarean surgery, including whether it was associated with urinary incontinence or sexual issues. The women’s knowledge was also insufficient about the benefits and risks of episiotomy, the role of doulas in improving outcomes for mother and baby, and the place and mode of birth, including a birth center or home birth.

Further compounding the search for evidence-based information in birth is the diverse and conflicting information that is published in mainstream media. Earlier this month, articles from two different large media outlets questioned the true dangers of epidurals and whether they were overstated. (2,3) The articles provide both anecdotal information about each authors’ birth experiences and point to scientific studies. After presenting and debating the science, author Melinda Wenner Moyer says, “Women shouldn’t cave to pressure from either side. They should make informed decisions based on their goals and priorities.” The problem is — once again — how can a woman develop her goals and priorities if she is not truly informed?

At the end of her piece, Moyer sums it up by saying, “My unnatural childbirth left me with a memory that does not involve intolerable pain, and that’s exactly what I wanted.” It’s great that she achieved the birth she wanted! Unfortunately, however, her description negatively influences other mothers’ perception of birth. My unmedicated (aka, “natural”) third birth was painful, yes, but it was not “intolerable.” When mothers believe that the pain of birth is intolerable (as many moms do in the United States), they are driven to choose an epidural without considering alternatives that can make birth just as enjoyable, not to mention healthy!

So with all the obstacles to becoming truly informed, how do you navigate the jungle of mass-misinformation-overload? Lamaze childbirth educator (and Giving Birth with Confidence contributor) Ami Burns responded aptly on the Lamaze Facebook page, “Yet another reason why comprehensive childbirth education is needed. Moms need the information — even when research may be inconclusive — so they can decide for themselves.” Childbirth education, when chosen wisely, helps women look at all of the options by providing pros and cons, risks and rewards to the many decisions a woman can make during labor and birth. Contrary to what some may believe, a good childbirth class doesn’t deliver the “natural birth or bust!” philosophy. A good childbirth class provides evidence-based information to help women be as prepared as possible to make the best decision for her and her baby.


How did you seek information on birth? What helped in your decision-making process? What hindered it?

 

References:

(1) Klein, Michael C. Many Women and Providers Are Unprepared for an Evidence-Based, Educated Conversation About Birth. The Journal of Perinatal Education, Volume 20, Number 4, 2011 , pp. 185-187(3).

(2) Moyer, Melinda W. The Truth About Epidurals. Slate. January 11, 2012.

(3) Dell’Antonia, KJ. Are the Dangers of Epidurals Overstated? The New York Times. January 23, 2012.