Wednesday, January 14, 2009

Are Childbirth classes necessary?

Babble has an intelligent discusssion on the reasons for the classes. I have often wondered if I really needed the classes, since the birth that I experienced was so different, but I do think the classes empower you with the knowledge to make a choice. So when I felt the pain of natural childbirth was unbearable. I asked for an epidural. I gained that knowledege from the childbirth classes.

Childbirth education exists to fill a gap in the modern birthing system. Your caregiver will definitely talk to you about your pregnancy, and should be able to answer questions you have about childbirth. But most doctors and many midwives don't educate their patients about all the various ins and outs of pain coping strategies and hospital procedures. They just don't have time. Call it a conspiracy or just a byproduct of our medical system, but it's usually not part of the package. Childbirth education fills in where the doctor's office appointment leaves off.

Ideally, in childbirth ed, you learn what happens to your body in labor; how to cope with the pain (with equal attention given to medical and non-medical approaches); what hospital or birthing centers' policies are and how they might affect you; what choices you may have along the way.

Birth classes may also include some info on postpartum health, newborn care and breastfeeding, although most often these topics are covered in separate, designated classes. You can learn most of what is taught in a birth class from a good book or even online, but there are a few aspects of the classes that can't be picked up from a little Googling.

Some benefits of in-person preparation:

· You can ask questions and see positions in person.

· You have contact with an educator who can put you in touch with other experts or resources if you need them now or later.

· A series of classes will allow you to ramp up gradually as you get closer to your actual birth.

· In a group class, you will meet and hear from women/couples at your same stage of pregnancy. Even if you don't become lifelong friends, you might benefit from hearing their questions or stories.

· Classes can help partners — who don't have the constant physical reminder of pregnancy — focus on the upcoming birth and life changes. This is especially helpful for partners who don't attend prenatal visits. And a good class will teach specifics about how partners can help.

That said, not all birth classes are ideal. For one thing, teachers are people and they have opinions. When these opinions don't connect with your own, it can be uncomfortable, or add anxiety. And if you do end up having some reactions or procedures that were presented negatively, you might feel more stressed out by them, or feel bad afterwards. This may be what people are thinking when they warn you away from childbirth education.

Another reason lessons from childbirth ed get tossed aside at the first contraction is that the skills taught in the class weren't applicable to the birth that ended up happening. Birth is unpredictable. The usefulness of a class depends on the teacher's ability to show the huge range of possibilities and different options for dealing with them.

Generally, a class in the hospital will present the birth experience as it's managed medically (including medical pain relief options). A class in a yoga center will be more likely to encourage managing pain naturally through position, breath and sound. Lamaze teaches breathing techniques for natural labor, Bradley emphasizes a "husband-coached birth." Birthing From Within is a more spiritual approach using visualization and imagery, among other things. "Hypnobirthing" is a technique for reducing stress and trying to reframe the idea of pain. Each of these techniques has lots of fans, but they're not all for everyone.

Luckily, there are classes out there that teach more than one approach to coping with pain in labor. To find a class that will work well for you, ask friends for recommendations, or take a look at any local centers or groups that sound appealing. You can always ask the teacher questions before signing up for the class to try to gauge the philosophy and techniques that will be taught.

There is a deeper, perhaps more existential, aspect to your question: Is birth actually something you can "prepare" for? A really good class will help give you the knowledge you need to make informed decisions, help you keep an open mind, prepare for the unpredictable, and give you a number of tools to pull out depending on how you feel at the time. Because what you need more than anything, going into your birth, is permission to react to the situation in the way you, personally, see fit at the time — not what Dr. Lamaze, Dr. Bradley, your yoga teacher, the Church of Scientology, the lady down the street or any other childbirth instructor believes is best.

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