What to expect when you're expecting (108 page)

A chance to have a relatively more enjoyable labor—and a relatively less stressful one—thanks to all of the above. Couples who’ve had childbirth preparation generally rate their childbirth experiences as more satisfying overall than those who haven’t.

A chance to become empowered. Knowledge is always power, but it can be especially powerful when you’re in labor. By eliminating the fear of the unknown (what you don’t know, in this case, can definitely hurt your confidence), a childbirth education class can leave you feeling more in control, more empowered—ready to handle just about any labor scenario that nature throws your way.

So you’ve decided to take a childbirth class. But where do you begin looking for one? And how do you choose?

In some communities, where childbirth class options are limited, the choice of which class to take is a relatively simple one. In others, the variety of offerings can be overwhelming and confusing. Courses are run by hospitals, by private instructors, by practitioners through their offices. There are “early bird” prenatal classes, taken in the first or second trimester, which cover such pregnancy topics as nutrition, exercise, fetal development, and sex; and there are down-to-the-wire 6- to 10-week childbirth preparation classes, usually begun in the seventh or eighth month, which concentrate on labor, delivery, and postpartum mother and baby care. There are even weekend getaway classes.

If the pickings are slim, any childbirth class is probably better than none at all. If there is a selection of courses where you live, it may help to con
sider the following when making your decision:

Back To School

Besides studying up on childbirth techniques these days, there’s another class you should consider signing up for now: infant CPR and first aid. Even though you don’t actually have the baby yet, there’s no better time to learn how to keep that little bundle you’re about to deliver safe and sound. First, because you won’t have to line up a babysitter to attend class now. And second—and more important—because you’ll be able to bring baby home, secure in the knowledge that you have all the necessary know-how at your fingertips in case of an emergency. You can find a course by contacting the American Red Cross (
redcross.org
. or the American Heart Association (
americanheart.org/cpr
), or check with your local hospital.

Who sponsors the class?
A class that is run by, under the auspices of, or recommended by your practitioner often works out best. Also useful could be a class provided by the hospital or birthing center where you’ll be delivering. If the laboring and delivering philosophy of your childbirth education teacher varies a lot from that of the person or staff who will be assisting you during labor and delivery, you’re bound to run into contradictions and conflicts. If differences of opinion do arise, make sure you address them with your practitioner well before your delivery date.

What’s the size of the class?
Small is best. Five or six couples to a class is ideal; more than 10 or 12 may be too large. Not only can a teacher give more time and individual attention to couples in an intimate group—particularly important during the breathing and relaxation technique practice sessions—but the camaraderie in a small group tends to be stronger.

What’s the curriculum like? To find out, ask for a cours outline.
A good course includes a discussion of cesarean delivery (recognizing that more than a quarter of the students may end up having one) and of medication (recognizing, too, that many will need or want it). It deals with the psychological and emotional as well as the technical aspects of childbirth.

How is the class taught?
Are films of actual childbirths shown? Will you hear from mothers and fathers who’ve recently delivered? Will there be ample opportunity for parents-to-be to ask questions? Is enough time allowed during class for practicing the various techniques that are taught?

For Information on Pregnancy/Childbirth Classes

Ask your practitioner about classes in your area, or call the hospital where you plan to deliver. The following organizations can also give you referrals to local classes:

Lamaze International:
(800) 368-4404;
lamaze.org

Bradley:
The Bradley Method:
(800) 4-A-BIRTH (422-4784);
bradleybirth.com

International Childbirth Education Association:
(952) 854-8660;
icea.org

Association of Labor Assistants and Childbirth Educators:
(617) 441-2500;
alace.org

New Way Childbirth:
(864) 268-1402;
newwaychildbirth.com

The American Society of Clinical Hypnosis:
(630) 980-4740;
asch.net

Society for Clinical and Experimental Hypnosis:
617) 469-1981;
sceh.us

Childbirth education classes in your area may be taught by nurses, nurse-midwives, or other certified professionals. Approaches may vary from class to class, even among those trained in the same programs. The most common classes include:

Lamaze.
The Lamaze approach to childbirth education, pioneered by Dr. Fernand Lamaze in the 1950s, is probably the most widely used in the United States. Its foundation is the use of relaxation and breathing techniques by the laboring woman, along with continuous support from a spouse (or other coach) and trained nurse to allow the laboring woman to experience a more “natural” childbirth (remember, back in the 1950s, most delivering moms were put to sleep). According to the Lamaze philosophy, birth is normal, natural, and healthy, and a woman’s confidence and ability to give birth naturally can be either enhanced or diminished by the level of support she receives from her care provider, as well as by the comfort of the birthing environment (which could be a birthing center or home as well as a hospital).

The goal of Lamaze training is active concentration based on relaxation and rhythmic breathing patterns. To help with concentration, women are encouraged to direct their attention to a focal point. Courses also cover comfortable labor and birthing positions. breathing, distraction, and massage techniques; communication skills; and other comfort measures, as well as information on the early postpartum period and breastfeeding. Though the Lamaze philosophy states that women have a right to give birth free from routine medical interventions, classes generally cover most common interventions (including pain relief) to prepare couples for any birthing scenario. A traditional Lamaze course consists of six 2- to 2½-hour sessions.

Bradley.
This approach emphasizes deep abdominal breathing rather than panting. Bradley recommends that the laboring woman concentrate within herself and tune in to her own body to control the pain of the contractions, rather than relying on distractions. In Bradley classes, women learn to mimic their nighttime sleeping positions and breathing (which is deep and slow) for use during labor and to use relaxation techniques to make labor more comfortable.

According to the Bradley technique, during labor a woman needs darkness, quiet, physical comfort aided by pillows, and closed eyes. Bradley teachers acknowledge that labor hurts, and they stress acceptance of pain. Medication is reserved for complications and C-sections (which are discussed so parents can be prepared for any eventuality), and about 87 percent of Bradley graduates who have vaginal births go without it. The typical Bradley course runs 12 weeks, beginning in the fifth month, and most are taught by married couples. “Early bird” Bradley classes, which focus on matters prenatal, are available.

International Childbirth Education Association (ICEA) classes.
These classes tend to be broader in scope, covering more of the many options available today to expectant parents in family-centered maternity care and newborn care. They also recognize the importance of freedom of choice, and so classes focus on a wide range of possibilities rather than on a single approach to childbirth. Teachers are certified through ICEA.

Hypnobirthing.
Classes for individuals or groups that teach how to use hypnosis to reduce discomfort and pain (and in some highly suggestible women, to eliminate it entirely), achieve a deep state of relaxation, as well as improve mood and attitude during labor and childbirth, are becoming more available. Check with your practitioner or a national clinical hypnosis organization for names of licensed health professionals who teach hypnobirthing. (For more on hypnobirthing, see
page 306
.)

Other childbirth classes.
The range is wide. Association of Labor Assistants and Childbirth Educators (ALACE) champions a woman’s right to a natural or unmedicated birth when at all possible. Rather than try to teach expectant parents how to avoid labor and childbirth pain, classes provide coping tools to work with the discomfort. Childbirth Education Preparation (CEP) certifies nurses and practical nurses as childbirth educators who are trained to run classes that explain and teach the many options, including Lamaze and Bradley, available to expectant parents during labor. In addition, there are childbirth education classes designed to prepare parents to deliver in a particular hospital, and classes sponsored by medical groups, health maintenance organizations (HMOs), or other health care provider groups. In some areas, prenatal classes, which cover all aspects of pregnancy as well as childbirth, are also offered, usually beginning in the first trimester.

Home study.
If you are on bed rest, live in a remote area, or for some other reason can’t or don’t want to attend a group class, you can look into the Lamaze program on video or DVD available from Lamaze International.

Weekend classes at resorts.
These offer the same curriculum as typical classes, packed into a single weekend instead of spaced out over a series of weeks, and they are a nice choice for those who can—and would like to—get away. In addition to promoting camaraderie among expectant parents (especially rewarding if you don’t have other pregnant friends to talk to at home), these weekends can promote romance, too—a nice plus for twosomes who are about to become threesomes. Plus, they’re a great opportunity for some pre-baby pampering.

Classes for Second Timers

Been there, done that? Pregnant with your second baby? Even seasoned pros stand to benefit from taking a childbirth education class. First of all, every labor and delivery is different, so what you experienced last time may not be what you can expect this time. Second, things change quickly in the delivery business, and they may have changed quite a bit, even if it’s only been a couple of years since you were last on a birthing bed. There may be different childbirth options available than there were last time: Certain procedures that were routine may now be uncommon; certain procedures that were uncommon may now be routine. Taking another course may be especially useful if you’ll be using a different hospital or birthing center. Chances are, however, that you won’t have to sit in with the rookies. “Refresher” courses are available in most areas.

W
ELCOME TO YOUR THIRD
—and final!—trimester. Believe it or not, you’re two thirds of the way to the finish line, and just three months away from holding (and kissing, and cuddling) your prize. In this last stretch of pregnancy (definitely the biggest stretch, at least as far as your belly is concerned), you’ll probably find the excitement and anticipation mounting—along with your pregnancy aches and pains, which tend to multiply as the load you’re lugging gets heavier and heavier. Drawing near to the end of pregnancy also means you’re closing in on labor and delivery, an event you’ll begin planning for, preparing for, and getting educated about. Time to think about signing up for those classes, if you haven’t already.