Childbirth: Preparation is Key

As soon as I settled down on my bed in the hospital where I would deliver my baby, I looked around my room. I spied a beautiful white flower in a painting hanging on the wall across from me, and decided the flower would be my “focal point.” I would focus on that flower whenever I felt a contraction coming on, a technique I learned at my childbirth class.

When I was first pregnant with my son, I thought I knew how I wanted my childbirth experience to be. I briefly considered childbirth classes and decided they were not for me. None of the women in my family had ever sought formal instruction on how to handle labor, and I decided that I did not want to go to a class and be lectured on how to deliver a baby.

But when my obstetrician suggested that we may want to register in the childbirth classes offered at her practice, my husband said he wanted to go – for his sake. He wanted to know what to expect in the delivery room so he would not panic over something that was entirely normal. So we went, for an hour and a half every Monday starting in my seventh month of pregnancy, for six weeks.

Attending the childbirth classes was one of the best things I did during my pregnancy. Although I had read anything I could get my hands on about pregnancy and labor, the classes focused our attention on those few hours before, during and after childbirth. They gave us just enough information to decide if I wanted the epidural or wanted to try doing without.

If I wanted to do the latter, the classes gave us the tools – breathing exercises and focusing techniques – to manage the pain. The focusing techniques worked so well that, as labor progressed, I did not hesitate to ask anyone (including my doctor, at one point) who blocked my view of my focal point to get out of the way.

Best of all, my husband was an integral part of the childbirth. He could talk intelligently about contractions and the stages of labor, and he knew when to call the nurse or the doctor and when we could go through the process by ourselves. Although, prior to attending the classes, he was in favor of my taking epidural during labor, the information provided at the classes gave him the courage to support me through a natural childbirth.

Preparation was the key to our positive childbirth experience. We were able to anticipate the events that occurred in the labor room, and were equipped to handle them.

In the Washington, DC area, there are a variety of resources for childbirth preparation classes. Most OB/GYN practices offer classes at their offices, as do the hospitals with maternity services. In addition to these, Lamaze® International (http://www.lamaze.org/) and The Bradley Method® (http://www.bradleybirth.com/) both offer classes through certified instructors.

[Note: Hospitals in India now offer childbirth classes. Your OB/GYN should be able to direct you to one.]

While the goal of each of these classes is to prepare parents for labor and childbirth, they vary in terms of their approach to childbirth, content and length. As with any decision these days, from choosing the right color for the walls to buying a car, picking the right class warrants some research.

If you are looking for basic information regarding labor and childbirth, then the classes provided at your hospital or OB/GYN practice is a smart way to go. Classes are typically around six hours long and are tailored to fit various schedules. For example, there are weekend intensive courses, or courses that are spread over a few weeknights in one to three hour sessions.

These classes focus on the childbirth process and are taught by labor and delivery nurses who are familiar with your doctors’ or hospital’s approach to childbirth. Content varies slightly from practice to practice or from hospital to hospital, and includes topics such as the stages of labor, birth, medications, anesthesia, breathing and relaxation techniques, pain management techniques, and the role of the spouse or partner during labor. A tour of the hospital where the baby will be born is also typically included as part of the class.

Once you have attended the basic course, you have the option of registering for follow-up classes that provide more detailed information on childbirth topics such as relaxation breathing or cesarean births.

In addition to childbirth classes, most hospitals with maternity services and OB/GYN practices also offer classes in other aspects of parenting requiring separate registration. These include classes in breastfeeding, baby care, preparing siblings for the arrival of a new baby, CPR and infant massage.

For comprehensive courses providing detailed information on not only childbirth issues, but also pre-natal (nutrition and exercise) and post-natal (breastfeeding and newborn care) issues, The Bradley Method and the Lamaze method are good choices. Both methods have the common goal of producing healthy mothers and healthy newborns at the end of childbirth, but there is one important difference in terms of the way they approach that goal.

Susan Gunn, a Bradley Method instructor based in Washington, DC, describes the method as “a method of childbirth that teaches moms and dads about relaxation techniques in order to avoid unnecessary pain and medical intervention during childbirth.” Gunn uses the term “medical intervention” to describe any drug or procedure intended to augment the birth.

While the Bradley Method “is founded on the principle that with proper education and preparation, many women neither need nor want medical interference while giving birth,” the Lamaze method does not advocate non-medicated births.

“It advocates being informed about what is available and making informed choices based on your needs at the time,” says Gayle Miller, a Lamaze certified childbirth educator and Program Manager for Birth and Parenting Education at Inova Health Source. “A great deal of our women today want to use epidural anesthesia, which is a very positive thing to do.” says Miller.

The course content of both of these methods reflects their philosophies.

The Bradley course is 12 weeks long, and the individual instructor decides the duration of the classes each week. It covers a different relaxation technique each week, along with the coach’s role during each stage of pregnancy and labor. A discussion of each issue is accompanied by a discussion of non-medical ways of dealing with that issue.

Classes on the stages of labor, for example, emphasize “the natural process and [examine] the built-in safeguards for [the mother] and the baby.” The class on variations and complications (such as cesarean births) also discusses “how to avoid these problems if possible, how to evaluate whether it is necessary to intervene and how to handle interventions that become necessary.”

While stressing the natural method of childbirth, the Bradley Method recognizes that there is a time and a place for medical intervention. “Thank goodness we have medical intervention. But the Bradley Method is for women who are having healthy, low-risk pregnancies and anticipate a healthy, low-risk childbirth,” says Gunn.

Lamaze classes are at least 12 hours long, and are divided into a number of weeks. Classes are a combination of lecture, group activities, and demonstrations, and cover topics such as anatomy and physiology, pregnancy exercises, the different stages of labor, medication for labor and birth, cesarean births and newborn nutrition. A discussion of the different stages of labor includes coping strategies for both the mother and the support person.

Medical management and interventions form an integral part of these discussions. “The goal [of the Lamaze method] always has been for women to be able to make choices for themselves and to have the kind of childbirth experience they would like…. One of the keys is to have them be able to work with their physician or midwife so that they can have a positive childbirth experience,” says Miller.

Before registering for any childbirth preparation class, it is important to consider a few questions. What are you looking for in a class? Do you want a non-medicated, natural childbirth? Have you decided you want epidural? Or are you just looking for all the information you can get about the childbirth process so you can make the decisions later?

Your answers to these questions will determine which resource will be the most useful to you as you prepare for childbirth. For example, if you have decided you want to take epidural, then it would serve no purpose to go to classes that emphasize non-medicated, natural childbirths. But if you have not yet made a decision on that point, you would want to take classes that give you information to decide and the tools to cope with whatever kind of childbirth you decide on.

When you make the right choice, not only will you find that all the information you receive is useful to you and your partner, but you will also enjoy attending the classes with other expecting parents with similar goals and dreams for a positive childbirth experience.

A version of this article originally appeared in Washington Woman magazine.