Saturday, March 28, 2009
Why take a childbirth class?
Call me a hypocrite. I’m a childbirth educator who has given birth six times and never taken a childbirth class. At least not as a pregnant person. I did have to observe some classes for my childbirth education diploma. If the truth be known, I wanted to take the hospital childbirth prep course when I was pregnant with my first baby. I hadn’t registered, and my husband wasn’t acting like he was going to have anything to do with it, but I certainly wanted to take them and probably would have. (Even if that meant going alone). If I remember correctly, the hospital wanted us to be 27-28 weeks when we started the class. I went into preterm labor at 22 weeks, and was in and out of the hospital and on strict bedrest for the duration of my pregnancy. Needless to say, I *couldn’t* take the classes. I read books on pregnancy and birth, but every time I thought or read about labor, I would start contracting! I was terrified. I was afraid that I wouldn’t even carry my baby to term (after all I couldn’t see myself as a mother, and I couldn’t picture it all in my head, so I thought it wouldn’t happen). I was afraid that if I DID get to term my baby would be deformed from all the medications I had taken to stop the labor.
In my Epidural post, I mentioned that they did not have Epidurals (at my local hospital) for laboring women when I was pregnant with my first. I was facing the unknown and I was living in fear. It would have been so nice to have a doula and a childbirth educator to help ease my fears and concerns. Not just with childbirth, but with the preterm labor stuff. I remember sometime around 32-33 weeks I was in the hospital, and it was looking like the labor wasn’t going to stop. I didn’t know what to expect of a baby at that gestational age... if it could cry, or if it would even “look” like a baby. The nurse did show take me to the nursery to see a 33 weeker. (My mother worked with the grandmother of the child, and they told us to go see the baby so I could see what my own baby would look like). The baby was perfect in every way. It LOOKED like a real baby. I don’t know what was going through my head, because I couldn’t accept that my baby would look anything close to that perfect baby. At times, I wasn’t sure my child was human at all! (Case in point, I was completely in shock seconds after I gave birth to her, because she was not only human, but beautiful and absolutely perfect).
My family was great. I did have lots of love and support from my husband and my family. I don’t think my daughter would be here today without them. But as wonderful as they were (and still are), they couldn’t help me understand what to expect in the delivery room. My mother had some of her babies under twilight sleep, gas, or spinals, so she couldn’t tell me what to expect. She did tell me (more than once) that women have been giving birth for thousands of years without drugs, and women give birth every day, and I could do it too. I don’t think I believed her. I was different. Heck, I was giving birth to an alien baby, so why should I believe anybody about the normalcy of birth? My niece sent me a wonderful letter. She told me not to worry and that she has just recently gotten a tattoo, and that hurt her much worse than when she gave birth to her daughter. I did find comfort in that. If I thought about a tattoo before that, I was certainly marking that off my list! My sister spent countless hours in long distance phone calls to me. She was a huge support person, but she was 2000 miles away. She gave birth twice without drugs, and had no doubt I could do it, but she was stronger than me. I was smaller, I was sure I couldn’t birth a baby bigger than 5 or 6 pounds. You get the picture. I was scared and I had no faith in my ability to give birth - especially vaginally.
Funny thing is that during this whole time of me fearing labor -I was contracting, and dilating and effacing! I remember a few weeks before my daughter was born, I was 4 cm and 90% effaced. My labor was half over before I even delivered. (I was 5 cm and 100% effaced the week prior to labor day).
Anyway, after her birth, I was overjoyed that I gave birth, and lived to tell about it. Not only that, I had a beautiful daughter with a thick head of dark hair rooming with me. I was so excited I could barely sleep that night!
So WHY do I feel childbirth classes are important? It’s certainly not my belief that women do not know how to birth their babies. They do! That is built into us. Our bodies know how, and they do it very well. Our brains, well, they can get in the way sometimes. But, even then, we are still very capable of having a wonderful birth. So, why do I still feel they are important?
During pregnancy we are faced with choices. Some may not even realize they *have* a choice. In either case, there are still choices every women makes. It might be her care provider, or the place of birth. It might be a procedure like pap smear or something more invasive like amniocentesis. We decide what we eat, and what we drink, and usually how we plan on parenting. (Things like breastfeeding, cloth or disposable diapers, to circumcise or not..etc) Some things we know are choices we are *free* to make, and sometimes we don’t realize we have any say in the matter. Especially if that decision has to do with something going on in the delivery room.
Do women have a choice in the way they give birth? Some things are obvious to most women, but not for everyone. For example, with my first, and even my second child, it did not occur to me that I could walk around during labor. I thought women went to the bed, and laid there for their labor. It did not occur to me that standing could make contractions feel ‘better’. I didn’t know I could walk around. After all I was attached to a machine and didn’t I have to have that on the whole time? It was not obvious to me!
You’d think I would understand something simple like getting out of bed - but nobody brought it up, and no one in my family knew anything about things like that - and the books I read obviously didn’t tell me these things either. (The one book said to relax, so I thought that meant lay down in bed). No, I would have to wait until child number 4 to understand many of ‘my choices’.
Now for someone like me (back then), it would have been extremely helpful to have taken a childbirth course.
So I’m sure you are asking: “Well, I’m pretty certain (or I KNOW) I’m going to have an epidural. Why should I take classes? “
If you take well rounded class, you will cover more than just basic childbirth. You’ll get some ideas on how to deal with pregnancy discomforts. You’ll learn about the various tests and procedures for pregnancy as well as during delivery. You’ll learn about what to expect where you are delivering, and get an idea of what will happen. How will you know if it’s real labor or false labor? Do you allow your doctor or midwife to break your water? If so, should it be done in early or late labor? Does it even matter? Would you rather tear or have an episiotomy? Do you have to have an IV? What is your option if you don’t want one? What constitutes an emergency, and how do you know if cesarean is really necessary? All of these things are nice to know before going into labor, and have nothing to do with pain control.
You’ll also learn a bit on what to expect after the birth. Women have lots of questions about this, but they still do not find it necessary to take a class that might explain it. Do you know what to look out for? What is serious enough that you need to call your doctor? What about the newborn baby? If this is your first baby, a newborn basic class is good too. Many childbirth classes talk about the newborn in one of their classes. You might learn about the tests and procedures they do on the baby, and what the results mean. You will learn what is normal, and when to call the doctor. You might know this stuff already - and if you do, skip that class if you want. I bet if you do go, you’ll still learn something you didn’t know! I know I did - even after baby number SIX!
Now what about unexpected things? If you read my blog on Epidurals, you will have read that there is a chance that your epidural will not work! Perhaps it will only work half way. Perhaps your anesthesiologist is not on call at your hospital, and you have to deal with labor for an extra hour longer than you think. Sometimes, labor just doesn’t go as planned. You might want to look into that back up plan: How to deal with labor naturally.
What if you have been in prodromal labor for a few weeks, and you have been slowly dilating and effacing (and if you don’t know these words, I suggest you take a childbirth class ;-), and you end up with a very fast and furious birth? What *IF* you end up giving birth before you get to the hospital? Yes, it is rare - but it does happen. I teach emergency childbirth in my classes, and I highly suggest that everyone look for a class that teaches some basic “how to’s”. Even if you have not been dilating, and effacing - you can still have that very rare - “I -gave- birth- in -two- hours -from- start- to- finish” births.
What about your partner? Wouldn’t it be nice if that person could learn what to expect? What is normal? What sounds you might make - (even if they are made before the epidural). How can that person help you cope? What can they do to make the contractions ‘better’? What about the very sights, sounds and smells of birth? Even if the mother has pain medication, your partner might want to see what birth looks like before your special day.
So is a childbirth class ‘worth it’?
Ask a bunch of your friends if they took childbirth classes, and if it ‘was worth it’. If they took a hospital childbirth course, you might find mixed reviews. Many will say “don’t bother”, and some will say “it was GREAT”. Ask another group about classes taken in a place OTHER than a hospital, and you will almost always get a positive review. Why? They most often have less couples per class, which means you can ask more questions. The instructor is up to date on all of the new research. Hospitals tend to use a nurse to teach classes, and they are not always up on the current research. They also tend to teach you how to be a “good patient” instead of letting you know you have certain options. Hospital childbirth classes tend to be more hit and miss. They don’t always talk about all of the things mentioned above. There are LOTS of really good hospital based childbirth classes out there. But you might have to ask around. With an out of hospital birth class, you are more likely to walk away a satisfied customer. Just do some ‘googling’ on childbirth classes. You’ll see what I mean. Hospitals: hit or miss. Private classes: almost always a really good review.
The types of classes I am referring to are “The Bradley Method”, “Birthing From Within”,” Lamaze” (and for some reason a hospital based lamaze class can be hit and miss too, so you still might be better off with an off hospital site class). There are more types of classes, and I’ll let you can find them. There are instructors, like myself, who are ‘independent’, who teach a little bit of everything - combining the best of all of the methods. Out of hospital childbirth classes are usually a bit more expensive. However, at least you know that your chances of wasting your money are a bit more slim. Like I said, most don’t regret taking this type of class. So the next time somebody says “don’t waste your money”, ask them where they took their class. If it was out of the hospital, just look for a different one :-)
More than likely, you will walk away feeling better about birth. I venture to say that most of the women out there who are saying “I’m getting an epidural”, are also afraid. They are afraid of the pain, to the point of - making sure that is what they get. Wouldn’t it be nice to at least walk in to the delivery room without as much fear? Even if you plan on an epidural, at least you know what you are asking for. You’ll understand it’s pros and cons, there won’t be any surprises should you have a side effect from it - and MOST OF ALL: You will walk in the birthing room with confidence. Give it a try, and if you want, comment on what your experience was like! I look forward to ‘hearing’ from you all :-)